H1N1: The Latest 

By- Dr. Erik SteeleIf you think you have the flu, this year we want you to think a little differently before you go to see your doctor or the emergency department. We would like to have you think about … not coming? That’s right – consider not coming in. There are a few reasons to consider that approach:1. Most health care workers have not yet been vaccinated against H1N1 influenza (the so-called swine flu) and if all of them get the flu from patients coming in with the flu, we will not have enough health care workers – doctors, nurses, respiratory therapists, etc – to take care of the sickest patients:2. If you are not at high risk for complications, you are not likely to be treated with anything from a doctor except advice, reassurance, and perhaps a prescription that can be called in over the phone:3. You could infect other people sitting in the office or emergency department waiting rooms. The tough part of making this decision is that some patients can get sick enough with influenza – the regular type and the H1N1 influenza – that they really do need to be seen by their primary care provider or the emergency department. How do you know if you, or a loved one, is so sick they should be seen right away, and not stay at home? Well, here are a few guidelines:1. Are you severely ill – too sick to get up and about for food, bathroom, etc.?2. Do you have real trouble with shortness of breath, severe lightheadedness when you are standing, or a severe headache associated with your illness?3. Is the sick person so ill they are less alert that normal, not as responsive as they should be?4. Is the patient too sick to take usual medications?5. If the patient is a child, do they just look ‘lousy’ to you?6. Do they have a significant rash in association with their illness?7. Do they have other health conditions that put them at higher risk of complications from influenza? These include being pregnant, having underlying heart disease (such as congestive heart failure) or lung disease (such as asthma or COPD / emphysema)? If they have any of these problems, call the patient’s physician about the illness and talk to them about being seen, or go to the emergency department if the patient seems too sick to wait.There is also a little questionnaire you can go to on the Web that will help you make this decision. It is available at XXXXXXXXX. You can complete the brief survey, and it might be able to help you with your decision. Don’t bother with the survey if the patient is too sick to wait around. And as always, you don’t have to make this decision alone – if you are uncertain, or worried about the patient (including if you are the patient), call your primary care provider and ask for some help making your decision.