Plague cups and the Pirates of the Caribbean

We started on this whole family thing rather late in life. We’d already been married almost a decade-and-a-half before Rio, and Debbie turned forty the week after he was born.

When you are forty, you need more than 2 hours of sleep per night.

Babies, however, do not.

One of the emergency survival measures we imposed on ourselves was paper plates and plastic cups. That reduced the dishes to pots and pans and silverware. My tree-hugging sisters were appalled, but hey, this was survival. Wiping out a small forest was buying us a handful of desperately needed minutes each and every day.

Seven years later, we are still razing forests in the interest of a few extra minutes of sleep. And speaking of sleep, I just spent the better part of the last eleven days in bed. Yep, over a week ago we got our first confirmed flu case at the clinic, and two days later it had bypassed my defective Type-1 immune system and took over my body.

Which flu? Seasonal, or the media-hyped Novel H1N1, a.k.a. “swine flu?” Well, right now all flu is H1N1. According to the CDC, 99% of tested and reported flu this last week was H1N1.

If you got flu, you got the new stuff. Garden variety seasonal flu hasn’t made its appearance yet this year.

(By the way, the best place for real info on the H1N1 is here ). But if you don’t want to wade through the CDC statistics, here is everything you need to know about the flu virus, H1N1 or any other kind: the flu is like the Pirates of the Caribbean.

Yep. Flu viruses are a bunch of miss-fit DNA strands that need to hijack a ship before they can accomplish anything else.

Viruses reproduce by taking over cells. Then they launch protein boarding parties to take over other cells. Once the pirates have an armada of ships, they attack towns, harbors, forts, and the like; raping and pillaging.

Enter Tamiflu (Roche Social Media Summit attendee disclaimer: Tamiflu is a Roche Product). As a chronically ill healthcare professional, I have a Tamiflu stash at home. Break glass in case of emergency. Deciding when to break the glass is where the devil is in the details.

Tamiflu works by trapping the pirates on the boats they’ve already hijacked. Picture a ring of fire keeping the boarding parties from leaving the hijacked cells to take over more cells. If the pirates already have an armada, there is no point in taking Tamiflu. It is already too late when villages are being burned. You need to start taking the Tamiflu within 48 hours of the onset of symptoms, and 24 hours is even better. By doing so you are stopping the spread while the pirates only have a few ships.

This requires you, if you have a stash, to decide if you really have the flu or just a common cold in the first 24 hours; and that is easier said than done. I broke the glass, and it turned out to be a good call. Even with the Tamiflu, it was a long ride.

Tamiflu doesn’t “cure” the flu, but it does make it shorter and less severe. In spite of being down and out for eleven days, I’ve been sicker in times past. I actually spent most of the time reading about Yellow Fever and Cholera. OK, so my choice of recreational reading is a bit odd. I also watched the entire Lord of the Rings trilogy. In one sitting.

I wasn’t being a cad, quite the contrary, I was being a role model. We got H1N1 all over the place. It is hitting young people most severely. As of this writing we still don’t have the vaccine (but will have any day). So the best thing you can do as a sick person is to sit at home and read or watch DVDs, but for God’s sake don’t go expose your friends, co-workers, and innocent bystanders. This was drilled into our heads by our medical director not two weeks before: no heroes. If you are sick stay the hell home.

So I wiped out most of my vacation time in bed. Damn. But I set a good example, both for my co-workers and my patients. And I didn’t make anyone else sick, which is the foundation of good medicine.

My boss thinks the best thing to come out of H1N1 may be a return to common sense disease prevention. The CDC has summarized the forgotten common sense precautions your grandparents knew: Stay home when you are sick. The CDC web site has even added a special section for those of us in the Social Media where we can download public service announcements like this:



Also, wash your hands (properly). Sneeze and cough into your elbow. Don’t share utensils. And color code your damn drinking cups.

OK, I added the last one. But it works. As we were a plastic-cup household anyway, we’ve assigned colors to each family member: my cups are red, Rio’s are green (his favorite color), and Debbie’s are blue.

Flu virus can live on a counter top or on a door knob for about 3 hours; in a nice little swimming pool of a water cup even longer. The best way to catch the flu short of French kissing a sick nurse, not that I did, is to share a drinking cup with a sicko. We’ve found the easiest way to avoid drinking out of someone else’s cup is for all of them to look different.

So to my tree-hugging sisters: we are not destroying the ecosystem; we are simply on the cutting edge of good public health.