My 10-day ordeal with H1N1

2009 年11月17 日

Like most people, I've been following the news about the H1N1 swine flu with some concern. Unlike most people, however, I've spent years interviewing doctors.

And from the many hours talking with infectious-disease specialists, I knew that it was never a matter of if there might be another flu pandemic, but when.

The question was, would H1N1 turn out to be that dangerous pandemic flu, or not?

Since most reports of H1N1 swine flu have described a mild illness for the majority of those infected, I wasn't especially worried for my family or for myself.

Perhaps I should have been, because, despite repeated reports from health experts around the world that the swine flu isn't all that bad as far as flu goes, it can pose serious problems for those with chronic medical conditions such as asthma, diabetes and heart disease.

And I have asthma.

Still, I took the few precautions that all of those doctors have always told me -- thorough hand washing, not sharing hand towels, wiping down common surfaces like doorknobs and phones with antimicrobial products -- and we planned on getting the H1N1 vaccine as soon as it became available.

But, at the start of school this year, flu quickly spread through my daughter's high school. It turned out those disinfectant gel stations scattered throughout the school were no match for a quickly replicating virus. My daughter ended up missing her second full week of school because she had a fever, muscle aches, a sore throat and a persistent cough. Her doctor ruled out strep, and when I asked if she had H1N1 swine flu, he said, "Could be."

By Thursday of that week, I started feeling very tired and achy, but not terrible. By Friday night, I'd developed a slight fever and was coughing a bit, but still didn't feel awful.

But the next morning, my chest started to feel a bit heavy, and the cough was worsening. By the end of the day, I could barely breathe.

My mild asthma is well-controlled most of the time, but now I was wheezing a lot, short of breath and my lungs felt as if they were weighted down. At one point it felt as if they were burning. I couldn't believe how quickly I found myself in serious respiratory trouble. I'd never had symptoms like that before, and I'd had pneumonia a number of times in the past.

I have plenty of asthma medications on hand to help control symptoms, but even at the maximum dosage, I was having trouble getting enough air.

I'd also developed full-blown flu symptoms -- a fever, muscle aches, coughing, inflamed throat, headache, but no sneezing or sniffling. The fever and muscle aches -- the real flu part -- weren't too severe. In fact, as flu goes, it was mild. But, my chest symptoms -- exacerbated by my asthma -- were another story.

By Sunday evening, I was having so much trouble breathing that I considered going to the emergency room. I decided to wait, but headed to the doctor on Monday. The waiting room was chock-full of flu misery. Almost everyone there had a nearly non-stop cough, and those who weren't coughing shot accusatory glances at those of us who were.

My doctor said I likely had the flu, but she didn't hear pneumonia in my lungs yet. I left with a handful of prescriptions, including one for oral corticosteroid medications to help open up my airways. She also recommended that I head to the hospital for a chest X-ray. Because I'm a health reporter, I'm somewhat leery of unnecessary radiation exposure, so I asked if she thought it was absolutely necessary. She said I could wait until the morning, but if the steroid medications didn't help, I shouldn't wait longer than that.

After I'd left, I realized I'd forgotten to ask the all-important question -- was this the H1N1 swine flu? I certainly suspected it, because the serious lung symptoms came on faster than any illness I'd ever had before.

When I got home, I checked the U.S. Centers for Disease Control and Prevention's surveillance Web site, and discovered that the only flu strain really active in my area of New York state was type A. Of those that were type A, half were sub-typed and tested positively as H1N1. The other half weren't sub-typed, but I suspect most were probably H1N1.

And federal health officials have reported that virtually all flu activity so far has been caused by the H1N1 virus.

It took several days for the corticosteroids to work their lung-clearing magic, which is longer than usual, but I was finally able to breathe again, and to speak full sentences without coughing mid-way through. During the time I was sick, my non-asthmatic husband got all the same flu symptoms I'd had, except none was nearly as severe.

About 10 days after I first felt ill, I woke up and suddenly felt fine. My illness, which I believe was H1N1, had left as quickly as it had come. All that's left is a lingering cough.

I recently spoke with Dr. Kenneth Bromberg, chairman of pediatrics and director of the Vaccine Research Center at The Brooklyn Hospital Center. After hearing my symptoms, he said without hesitation, "It's H1N1."

When I asked him why I'd had so much trouble breathing, he said that infectious-disease doctors suspect that this flu replicates in receptors in the lungs, as opposed to seasonal flus, which tend to replicate in the sinuses or upper throat. That means the illness is concentrated in the lungs, and, he said, if you're starting out with lungs that aren't "as happy," like people with asthma, "that makes you more susceptible."

Bromberg said I shouldn't have waited over the weekend to get medical help, and I was lucky I hadn't ended up in the hospital on a respirator due to the delay.

What still strikes me is how ill-prepared I was for the severity of this illness. Despite everything I've read, and even though I talk to doctors and other health experts all the time, H1N1 blindsided me. I now understand how people -- particularly people with chronic health problems like my asthma -- can succumb so quickly to the virus. There's simply no warning that it's going to get as bad as it does, leaving you little time to act.

My advice from the flu trenches? If you have any type of lung disease, get to the doctor sooner rather than later -- as soon as you suspect you might have H1N1. Use the U.S. government's flu.gov Web site, and if it advises you to get medical help, don't wait. If you have the chance to get the H1N1 vaccine, get it. And, of course, get your annual seasonal flu shot as soon as possible.

By Serena Gordon, HealthDay Reporter  Reprinted by permission of HealthDay News,
http://www.healthday.com/Article.asp?AID=632824