H1N1 Flu Primer: when to call the doctor

November 7, 7:40 PMSF Fiftysomething Lifestyle ExaminerAmy Wachspress

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Flu shot
Lance McCord at Flickr

The flu season is here and H1N1 is for real. Fortunately for older folks, it appears that people over 25 have a stronger immunity to H1N1 than do young people. But that doesn’t reassure older folks about the health and safety of children and grandchildren. So when should you call the doctor if you or someone you love comes down with the flu?

Symptoms of H1N1 are much the same as symptoms of the regular flu. They include fever, body aches, dizziness, cough, sore throat, runny nose, and in some cases stomach upset (vomiting, diarrhea, and/or nausea). Most people who get sick will weather H1N1 with no more discomfort than the regular flu and will likely never know whether or not they had H1N1. However, others may become extremely ill. Typically, those who develop a more severe bout of H1N1 and/or serious complications have the usual symptoms described above, then begin to feel better, then swiftly relapse and become very sick. Sometimes people have gone to the doctor, they seem like they are managing the flu OK, they even get better for a few hours, and then they get very sick. Because they have already been to the doctor, they don’t go back. That’s dangerous.

So when should you call the doctor? Health professionals are advising that you always call before going into the office or emergency room. If you have any concerns or are worried or wondering, call your doctor’s office and speak to the doctor, nurse practitioner, or physician’s assistant to determine if a visit is in order.

For adults, symptoms that indicate that you should see the doctor include chest pain or tightness in the chest, shortness of breath, spitting up bloody phlegm, dehydration, infrequent urination or bright yellow urine, severe dizziness, confusion. For children, alarming symptoms that indicate that a trip to the doctor is in order include fast or troubled breathing, bluish or gray skin color, persistent or severe vomiting, dehydration (e.g., if you are unable to get the child to drink enough fluids), child is hard to wake up or is not interacting as usual, or if the child runs a fever for more than three days. For both adults and children beware of instances where the person seems to get better for a day or so but then relapses with a high fever. This might mean that the fever goes away for a day (without taking any fever medication) and then returns. If there is a relapse, get to the doctor immediately. For infants, call your doctor if the baby has a fever greater than 100.4 degrees.

Note that doctors in the U.S. as well as worldwide are not generally testing for H1N1. It’s not usually necessary to test for it and most people who get it will not fare any worse than they would with the seasonal flu. However, doctors are frequently prescribing Tamiflu to be on the safe side and to make flu sufferers more comfortable. Tamiflu is most effective if taken within the first 48 hours of onset of symptoms. Oscillococcinum is an over-the-counter homeopathic flu medicine, widely used in Europe, that relieves flu symptoms (just google it for more information).

If you have not already gotten the regular flu shot this season, what’s keeping you from doing so? And if you are due for the pneumonia vaccine then it would be a good idea to get one this year since pneumonia is one of the primary complications of H1N1 that has caused life-threatening illness and death. H1N1 vaccines are now available and are recommended. Call your doctor or the San Francisco Department of Public Health for more information.

Remember that around 40,000 Americans die of the regular seasonal flu every year. Many health professionals are of the opinion that H1N1 is not as deadly as was at first anticipated while others believe that the high level of awareness and the steps people are taking to prevent the spread of H1N1 may be working to contain it. Here is the link to the San Francisco Department of Public Health information page about the flu.