Of Flu Shots and Z Packs

Everybody gets sick but some get sick more often than others.  As health care providers most nurse practitioners enjoy a robust immunity bolstered by constant contact with germs and sometimes people (usually children) coughing or sneezing in our faces. There are preventative measures anyone can take to reduce your changes of getting sick.  Handwashing is key.  I make it a habit to thoroughly wash my hands as soon as I enter my house, in addition to the usual instances. Being up to date on immunizations, including a yearly flu shot is probably the second most important thing you can do. The third is lifestyle — eating healthy food, staying hydrated and well-rested.  Even if you do all these things, you could get sick.  And most of the time, unfortunately, there isn’t a quick fix.  I am amazed at the people who present with a day or 2 of cold symptoms and demand an antibiotic — usually, and specifically a “Z-pack.”  I always take the time to discuss the likelihood of a viral illness, home measures to help you feel better and the healing power of time. Many people will listen politely and repeat their request, citing that the last time they were sick, this did the trick.  I review the potential side effects, sparing no detail.  Then I usually suggest they wait for a few days, sometimes giving them a “prescription to hold” so they don’t have to come back.  We both know they are going to fill it right away but it’s my way of taking a stand for what we call antibiotic stewardship.  What’s particularly curious is these same people who are so quick to put an antibiotic into their system will refuse a flu shot because of potential side effects (very few and benign) or because “the last time I got the flu shot, I came down with the flu.”  Which is of course impossible.  It’s an inactivated vaccine.  They could have been coming down with a cold at the time of the injection (I discourage getting the shot if you are feeling at all under the weather at the time.), or caught some other virus in the waiting room.  The funny thing is, health care providers, for the most part, practice whet we preach.  We get the flu shot every year and we resist taking antibiotics unless we are sure we have a bacterial infection, which is the only kind of infection antibiotics can resolve.

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