Flu Season Strategies for the PH Patient

By PHC Medical Editor, Helen Puckett

As we approach the flu season in the United States, many of us are worried.  As a group, PH patients fall within the high risk category, those with an underlying condition who are more at risk for serious and sometimes fatal complications from the flu.  To make things even more difficult this year, there are two different flu strains to avoid.

The flu, whether it be the annual flu or the H1N1 “swine” flu, is not a disease to be taken lightly. For those with heart and respiratory disorders, it’s an even greater danger. The flu can be a killer.

If you've been listening to the news or tracking the cases online, you're already aware that with the opening of school, there's also been a sharp increase in the number of H1N1 “swine” flu cases here in the US and for now, there is no vaccine available. It is expected that the H1N1 vaccines may be available in early October, but there is some uncertainty about the timing and quantity that will offered as this strain is a slow grower. There is no shortage of the regular yearly flu vaccine and shipments are on their normal schedules. The CDC is recommending that everyone receive the regular yearly flu vaccine. The current recommendations regarding the H1N1 vaccine state that persons, such as those with PH, be among the first to receive the vaccine as soon as it becomes available. However, if there appears to be a shortage of vaccine, the CDC is recommending that those adults with underlying conditions be relegated to the second shipment wave. There is no telling though when and how many of the shots will be available until the vaccines actually ship. These are only recommendations and it will be the doctors who will have the final say as to when or whether a person should receive the vaccine.

So where does that leave us? If you are planning on receiving the flu vaccines, it would be wise to talk to your doctor now. Let them know that you wish to have the H1N1 vaccine as well as your yearly flu shot so you are not forgotten when the orders go in and the shipments arrive. You could also discuss the pros and cons of the antiviral therapies such as Tamaflu that are available should you actually contract the flu. This year, the CDC is recommending that doctors provide a written prescription for the antivirals to their high-risk patients, discuss how and when to use it, and when to fill it should the need arise. The antivirals are by no means a cure, nor do they work for everyone, but they can greatly reduce the symptoms of the flu, shorten it's course and help prevent complications. They also must be given at the very start of symptoms to be most effective. If you have not already done so, it's also time to discuss the pneumonia vaccine with your doctor. Pneumonia is the leading cause of death from the flu. The vaccine will confer some immunity to several strains of pneumonia and reduce your risk for this dreaded complication.

There are other strategies to consider as well. Many people have been purchasing masks to wear in public. Most disposable facemasks will provide some protection against transmission of droplets in the air from a sneeze or a cough.  They are not created to protect the wearer from breathing in very small particles.  In Mexico when we first learned of the existence of the H1N1 virus, many people wore disposable masks, but it did not protect them from getting the flu. 

Respirators, on the other hand, are made to provide more protection. They are similar in appearance to the relatively inexpensive facemasks but are designed specifically to protect the wearer from breathing in such particles. These masks, known as N95 for its filtering ability (estimated at 95 percent), fit more snugly on the face than face masks so that most air is breathed through the dense filter material. They work best if they are fitted specifically to the person wearing the mask.

Before you run out to purchase your N95 masks, there are several points to consider.  These masks do fit more snuggly and they are made of denser material which also means they are harder to breathe through.  For someone with a medical problem that already affects breathing, these masks may not be a good idea at all.  Even if you use supplemental oxygen where you could argue that the airflow, because of the supplemental, could be managed well, the mask won't fit as snuggly on your face to provide maximum protection. 

If you are a PH patient considering purchasing and using the N95 respirator masks, you probably need to have a discussion with your doctor.  He/she can help you make this decision. 

While the respirators may become part of your flu fighting strategy, do not forget that avoidance of crowds or anyone who looks ill, the careful, frequent washing of hands and being mindful to keep your hands away from your face are the best protection you have. The flu virus is a lurker. It is not only transmitted through the air from person to person but it can remain alive on surfaces long enough for a person to pick it up on their hands and transmit it to the mucus membranes of the face. It would be very wise to carry a small bottle of hand sanitizer or hand sanitizing wipes with you wherever you go this flu season and use them frequently. So after you’ve pushed the shopping cart around for awhile, consider your hands as toxic. Don’t touch your food or rub your eye until you’ve thoroughly washed those hands. 

Family members and friends should also be recruited in your efforts to stay well since they are potential sources for contact with the flu. It’s something you should discuss with them. They too can help you stay well if they are willing to observe the simple precautions of frequent hand washing, avoiding situations, wherever possible, where they are likely to get exposed to the flu and keeping their distance from you if they are feeling ill. 

No one action you take will provide complete protection so it is important to keep your guard up as flu season approaches. Even the flu vaccine is not always 100% effective for everyone so it’s just as important to remain mindful even if you’ve had your vaccination.  If you have not been called a germ-a-phobe, it might be a good  time to earn that label.  It might just mean the difference between sickness and health through the cold season ahead. 

Note:  In researching this piece, we found many posts online about the cost of the respirator masks going up and up recently as sellers try to cash in on flu season fears.  You will want to shop around as prices vary widely. 

Written expressly for PHCentral - September 2009

More Information:

General Information from the CDC re: H1N1
What You Should Know About Using Facemasks and Respirators During a Flu Pandemic

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