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I am so sorry about your son. I hope he gets better soon. For the record, I agree with you on this. I also read this today:

A Pandemic of Confusion About Flu's Death Rates The CDC's Figure of 100 Influenza Deaths a Day Is Flawed, but That Doesn't Stop People From Spreading It

By CARL BIALIK
MAY 13, 2009
http://online.wsj.com/article/SB124217724145913411.html

Though the swine flu captured the world's attention, its total confirmed death toll of fewer than 100 people so far provided a point of comparison that many health experts couldn't resist: Garden-variety seasonal flu kills that many people each day in the U.S. alone.

That's according to Ted Epperly, president of the American Academy of Family Physicians, which is among many groups that cite an estimate from Centers for Disease Control and Prevention scientists that flu causes or contributes to an average of 36,000 deaths each year. "This is no little deal," Dr. Epperly says. "I don't want people to think, 'Oh my gosh, we just avoided this bullet with swine flu,' when every day influenza kills 100 people."

But a bullet, it turns out, may never have left the barrel. According to the CDC's own numbers, influenza was listed as the underlying cause on just 849 death certificates in 2006, the most recent year available -- half as many as hernias and a quarter the number killed by peptic ulcers. This number has been flat in recent decades even as the CDC's much larger estimates of annual flu deaths have been increasing.

This discrepancy in death counts highlights a fundamental, and possibly unavoidable, flaw in national health surveillance. The CDC tallies the toll of diseases and injuries using death certificates, but these often are filled out by harried physicians with incomplete information. "Sometimes they're not going to know," says Robert Anderson, the chief of mortality statistics for the CDC's National Center for Health Statistics. "Sometimes they may need to guess. Sometimes they're not willing to guess."

The resulting death counts are often unreliable. Even if they were accurate, though, some public-health officials prefer measures that take into account age at death and survivors' quality of life. Such alternate measures might de-emphasize influenza. According to the CDC's estimates, 91% of all flu victims in the decade through 2003 -- the latest available data -- were 65 or older.

"It's a quick way to get policy makers and the lay public to understand the potential impact," David Shay, a CDC flu researcher, says of the 36,000-death figure he helped estimate, "but it shouldn't be the only measure."

These measurement problems are particularly acute with influenza, because it can exacerbate underlying conditions such as heart disease or precipitate pneumonia or other respiratory illness. The doctors, coroners or medical examiners who fill out death certificates are supposed to list an underlying cause of death, but Dr. Anderson says many who die from the flu never see a doctor. If they do, flu tests are rare because the doctor is focusing on the complication caused by flu.

Dr. Shay and colleagues attempted to compensate for this perceived underreporting of flu deaths by looking for clues in seasonal mortality patterns. If flu's human toll is uniquely resistant to measurement, it is also uniquely measurable by statistical sleuthing, according to Dr. Shay. That's because flu's activity varies each year, in time of onset, duration and severity.

More interactive graphics and photos In a paper earlier this year, he and his co-authors unveiled four different statistical models for measuring flu deaths. Some of these models made use of lab tests from around the country, correlating the fluctuation in positive flu-test results with the waxing and waning in respiratory and circulatory deaths. All four models came up with similar estimates: Tens of thousands of people dying each year from the flu. One of the models produced a 10-year average through the 2002-2003 flu season of 36,171, the basis for the 36,000 figure now ubiquitous in public-health campaigns and media coverage.

This estimate has its skeptics. It's based on lab testing of people who primarily are ill, and not a representative sample of the population, Jimmy Efird, a statistician with the University of North Carolina's Center for the Health of Vulnerable Populations, points out. And it makes use of the same death-certificate data whose flaws necessitated the research, potentially replicating the errors.

Peter Doshi, a graduate student at the Massachusetts Institute of Technology, has gone further in his critique. In a 2005 article in the British journal BMJ provocatively titled "Are US flu death figures more PR than science?" Mr. Doshi criticized the CDC for sometimes confusing deaths caused by the flu with those where the infection was one contributing factor. In an article last year, Mr. Doshi compiled recorded deaths from the flu for the past century and found that the numbers in years of notable outbreaks within the past 60 years weren't that different from years just before and after them.

Dr. Shay defends his measurements but acknowledges they aren't exact, noting, for instance, that his models don't take into account temperature and air pollution, which themselves can affect the incidence of respiratory illness.

If people make decisions based on faulty information, says Mr. Doshi, "then this is important and needs fixing."

Improving the understanding of global disease burden has been a priority in public health for several decades, and part of that effort is finding a better tool than body counts to measure diseases. To decide on priorities and measure progress, groups such as the World Health Organization have begun to contemplate a measure called disability adjusted life years. DALYs take into account both the number of years lost -- so deaths of children count more than those of the elderly -- and the quality of life lost when sickness or injury doesn't kill but leaves lasting effects.

Calculating the relative burden of, say, blindness (about a 60% diminution of quality of life) may seem cold calculus, but in allocating limited public-health resources, that's how decisions sometimes are made.

More troubling is just how hard it is to come up with DALYs, which add nuance to death tolls but also devilish complexity. Dozens of countries lack reliable death-registration systems, and assigning weights to disabilities is subjective.

The fundamental premise behind DALYs is also problematic. Someone who dies in middle age, for example, may have fewer years of life remaining than a newborn, but he or she likely has more financial responsibilities, including keeping family members healthy.

Should DALYs be embraced at the CDC, they might lead to a de-emphasis on the flu. Many people who die of flu-related causes are old and sick and may not have lived much longer. Colin D. Mathers, coordinator of the WHO's mortality and burden of disease unit, compares flu's yearly toll to the tens of thousands of deaths attributed to the 2003 heat wave in Europe. Many were quite ill already. "If the heat wave hadn't occurred, they probably would have been dead in six months, anyway," he said.

Dr. Shay says he'd like to find more sophisticated ways of expressing the burden of flu even though he recognizes this might mean the waning of the flu's relative prominence. "We need to express the impact in a variety of different ways," Dr. Shay says, "so people can make the best decisions."
 
Awww, I am so sorry for your ds. If it helps any, I have something too. It's NOT Swine Flu. Hospitalized last week, and on mostly the same meds as your son. I haven't bothered to have my own Albuterol inhaler in the home for 13 YEARS. Whatever I caught really compromised my breathing. My point is that Influenza A (H1N1) may have nothing to do with what your son is going through, there are some nasty respiratory things going around right now. I hope he heals quickly. For me, it's VERY slow going.

BTW, there are other threads about the OTHER thing going around. Some are being told it's a virus that's running around, MANY others in different states (and even in Canada) are being told it's out of control, bad allergies. I was even told probably stemmed from allergies, when my flu test was negative. But I've NEVER had seasonal allergies!!! I believe there's another virus running rampant. A "Wheezerbug" as my former doc called them (gives people who normally aren't even very asthmatic a wheeze).
 
Awww, I am so sorry for your ds. If it helps any, I have something too. It's NOT Swine Flu. Hospitalized last week, and on mostly the same meds as your son. I haven't bothered to have my own Albuterol inhaler in the home for 13 YEARS. Whatever I caught really compromised my breathing. My point is that Influenza A (H1N1) may have nothing to do with what your son is going through, there are some nasty respiratory things going around right now. I hope he heals quickly. For me, it's VERY slow going.

BTW, there are other threads about the OTHER thing going around. Some are being told it's a virus that's running around, MANY others in different states (and even in Canada) are being told it's out of control, bad allergies. I was even told probably stemmed from allergies, when my flu test was negative. But I've NEVER had seasonal allergies!!! I believe there's another virus running rampant. A "Wheezerbug" as my former doc called them (gives people who normally aren't even very asthmatic a wheeze).

Whatever was going around, I got it before the Swine flu came on the radar. I get a "reactive airway" about every 3 or 4 years, and something triggered it two or three weeks ago. No fever but headache, general malaise, congestion and cough. I still have the cough.
 

So how about this? I can't help but wonder how many people were endangered by the push to stifle a panic. My DS's Dr's refused to listen to me about how alarmingly sick he was getting and how quickly...even told me I SHOULD bring him to WDW on Friday! It's now been 1 week (5 days since we would have gone to WDW) and the p.

Whatever your DS has, your DSs MD should have evaluated him, particularly in the context of his pulmonary history. Patients who are predisposed to asthma should cause alarm when their mom's get alarmed. Did he not see him?
 
Whatever was going around, I got it before the Swine flu came on the radar. I get a "reactive airway" about every 3 or 4 years, and something triggered it two or three weeks ago. No fever but headache, general malaise, congestion and cough. I still have the cough.

My "reactive airway" issue is even less often, but it really got triggered with this, whatever it is (NOT the swine flu,lol). My breathing got really affected suddenly on Wednesday afternoon, and my sis came right over with her stethoscope. She took a listen, and my left lung was hardly moving any air. Right wasn't great, but left was alarming. She offered a ride to the hospital or to call the squad. Still can't wean off any of the breathing meds. I'm clock-watching for the next dose.
 
OP, your son may or may not have had Swine Flu... could have been any kind of a zillion viruses going around.

However, as the mother of two children with respiratory issues, I would be quick to find another pediatrician if my child's doctor did not give a good quality level of care. That said, I've taken my kids in to the peds office when they were having issues and the doctor has refused to give them antibiotics because, in the Drs. opinion, there is no reason to (no audible wheezing, etc..) and the illness has later progressed to the point that more powerful medications were necessary.

How old is your son? My kids' pulminologist switched both of them to inhalers with spacers a couple years ago and it has made a world of difference in how easy and quick it is to administer their albuterol and pulmicort.... a handful of breaths instead of 30-40 minutes for longer treatments.

I hope your DS is feeling better soon!
 
I started with a cough two weeks and one day ago when I came home from WDW. I started with the nasal congestion yesterday and am so stuffed right now it is horrible. The cough continues as well.

My dr. (who I really don't care for and am now looking for another one), well the staff in the office, said to hang tough since I do not have a fever. It willl run it's course!!

Yes, I think some are poo-pooing this because people are panicking!!!

I will demand to be seen if the symptoms do not subside in 5 days!!

OP.............I hope your DS is doing better sooon................
 
I called as soon as his symptoms started to show alarming speed in escalation which isn't typical. I brought DS in Wed, and was given Prednisone- and the brush off. Thursday he was much worse with a mild fever and I brought him in to another Dr in the same practice and he gave DS Z-Pac for Bronchitis and was told to be patient, it will take time. DS stabilized in a crummy zone but since the Dr on Thursday told me to give it time I did even though I thought he should have improved more. I mean even his own little body's immune system should have begun to fight it off after a few days... same bug in DD took 3 days and she has Asthma too - she has a lingering cough but is mostly healthy.

So both of my kids just happened to be scheduled to see the Pulmonary Specialist on the 12th so they got into see him. To say the least he was alarmed, wanted to know when DS's follow-up appt with the Pediatrician was scheduled (wasn't one). Gave DS 40mg of prednisone and Atrovent right there and then. Called the Pediatrician on the spot and told him to give careful follow-up. Then he restructured DS's entire Asthma Action plan.

I think I am mostly upset because I feel my concerns over my DS's well-being were pooh-poohed because of the anti-panic mindset. If I had listened to his Dr's and dragged him off to WDW this kid would probably be in intensive care right now under an oxygen tent. As it is my DS can't walk up a flight of stairs in a scrupulously clean unfragranced home, pollen free with AC set at 67 degrees 24/7 without having a major coughing fit. What on earth were his Dr's thinking??? All I can think about is how lucky we are, and wonder how many more people are suffering or are going to suffer because the world thinks we are all crying wolf:sad1:

I am so, so, so very sad...

I'm so sorry to hear that your son is so seriously ill.. I think I mentioned to you on one of the other Swine Flu threads that because your DS had asthma, you most definitely should be more concerned than most..

Having said that, all deaths (to date) in the U.S. have been in people with pre-existing health conditions - which put them at higher risk no matter what "type" of flu they came down with.. It just so happens that I am one of those people who has serious pre-existing medical issues that could result in a fatal outcome were I to catch Swine Flu, regualr flu, or a host of other contagious diseases.. Still - there is nothing more I can do than to take extra precautions in terms of hand washing; avoiding contact with anyone who is sick (regardless of "what" they are sick with); and getting to the doctor pronto if I do feel sick..

I think your pediatrician was 100% wrong in not treating your son more aggressively - given his pre-existing condition - and I think you have every right to be furious with him.. :mad: Hopefully the pulmonary doctor will stay on top of things and your son will make a speedier recovery now..

I will keep him in my thoughts and prayers..:hug:


I also wanted to add that my DD, her DH, and my DGD came down with something horrible around the week of Easter or so - just before the Swine Flu hit the news.. Extremely tired; terrible coughs; chills and fever; aching all over - it was bad.. My son-in-law never gets sick - and he was sicker than a dog.. I was still at their house (hadn't moved up here to the lake yet) and I "quarantined" myself from them - either in my bedroom or downstairs in my scrapbook room.. I used the downstairs bathroom only (they were using the upstairs bathroom) and anything I had to "open" in the house (door handles; fridge; cabinets; drawers; etc.), I used my sleeve or the bottom of my shirt so I wouldn't be touching anything with my bare hands.. I got very, very, very lucky and didn't "catch" it - but based on their symptoms, they very well could have "had" Swine Flu.. We'll never know - because they didn't see a doctor and they didn't have the type of pre-exisiting health conditions that could have landed them in the hospital..

So I guess what I'm saying is that anyone with pre-existing health conditions should be more careful - and monitored much more closely by their doctors.. I'm very, very sorry that your DS didn't get that type of care..:sad2:
 
HAs your son been diagnosed with Swine FLu? I don't get your vent at all. YOU are your sons best health advocate, whether there is a pandemic or not. If you think there is something wrong with him then it's your job to raise holy hell until you get him taken care of.

I see NO reason for anyone to panic about the Swine Flu or the bird flu or SARS or whatever. It's not even a blip on the radar and I fail to see how anti-panic mentality has anything to do with your sons lousy care (which it sounds like he got initally).

There is RARELY a need for any kind of panic.
 
I totally get your vent. Regardless of whether your son had swine flu your doctor decided that you were panicking BECAUSE of the media coverage and wrote off your concerns. Not good at all. I would also want a better doctor in this case, I don't like doctors that come to conclusions based on their own opinions about larger trends that may or may not involve the individual patient.

We had this problem when we brought our son in to get evaluated for autism after being urged to do so by speech therapists, our family doctor, his preschool teacher, and development specialists. When we got to the pediatrician who was the gate keeper to the neurologist I introduced myself and he imediatly told me I talk to loud (I really don't and everyone I tell this story to goes *** on that one) and looked at DS for about 30 seconds and said ADHD. Luckily I had brought all the paperwork from the preschool teacher, the speech path, and the devepmental specialist who had observed him for about six hours. After that he went on to say how horrible children with autism are and that they all bite and told me if our house wasn't so loud he'd be fine.....not that he'd ever been at our house, but we did get our referral to the neurologist. Fortunately he was a fill in for somebody on vacation and that was the last time we dealt with him!

Getting brushed off sucks....the rise in autism isn't causing the same sort of panic swine flu is, but there are clearly people in the medical community who feel that it is over diagnosed to the point that they won't look at the kids who are clearly having issues without a biased eye. The fact this is happening with an infectious disease is scary, especially when it clouds judgement to the point they won't even consider a high risk patient could be sick with anything.
 
I understand where you're coming from OP. I couldn't get my daughter's dr. to call me over the weekend and I had to take to the ER twice. Then on Monday, she was doing a bit better and the dr. wanted to see her on Tuesday. Monday night I quickly got very ill (5:38pm to be precise), bad headache, fever 102, cough, chills. On tuesday I had a fever, but the Doctor didn't want to see me, but I had to take DD in with DH. I was so sick, she couldn't avoid seeing me. After waiting there for 1 1/2 hours, the nurse took my temp and it was 104 degrees! Now I'm wondering if I have swine flu after reading those articles or maybe some other influenza, but she never tested me for it. Instead, I've got directions on how to cure my sinus infection and amoxicillin, which I don't have alot of faith in, but at least DD finally has a nebullizer, prednisone and antibiotics for her bronchitis.

I think that our doctor does not listen to me because she either thinks I'm a hypochondriac or is just old and has in her mind that everything is allergies or the common cold. It's very frustrating...
 
I understand where you're coming from OP. I couldn't get my daughter's dr. to call me over the weekend and I had to take to the ER twice. Then on Monday, she was doing a bit better and the dr. wanted to see her on Tuesday. Monday night I quickly got very ill (5:38pm to be precise), bad headache, fever 102, cough, chills. On tuesday I had a fever, but the Doctor didn't want to see me, but I had to take DD in with DH. I was so sick, she couldn't avoid seeing me. After waiting there for 1 1/2 hours, the nurse took my temp and it was 104 degrees! Now I'm wondering if I have swine flu after reading those articles or maybe some other influenza, but she never tested me for it. Instead, I've got directions on how to cure my sinus infection and amoxicillin, which I don't have alot of faith in, but at least DD finally has a nebullizer, prednisone and antibiotics for her bronchitis.

I think that our doctor does not listen to me because she either thinks I'm a hypochondriac or is just old and has in her mind that everything is allergies or the common cold. It's very frustrating...
------------------

Please be careful if you have other pre-existing medical issues.. If you develop breathing problems, don't ignore them - and demand the test from whoever sees you - be that your doctor, an Urgent Care Center, or the ER..

Hope you feel better very soon - and your DD as well! :hug:
 
The allergens are horrible this year. There is also a LOT of smoke in the air from field clearing in Mexico, right now. That smoky air mass covers most of TX, and could creep in to other nearby states, causing problems for those with asthma and other existing health issues.

OP, I'm sorry your son is so ill. Have they put him on TamiFlu or other anti virals, or even tested him for any influenza?
 
Luv...you are criticizing your doctor and so am I. I am NOT criticizing you, OK? But his health care people that you pay. I am saying this up front.



I called as soon as his symptoms started to show alarming speed in escalation which isn't typical. I brought DS in Wed, and was given Prednisone- and the brush off. Thursday he was much worse with a mild fever and I brought him in to another Dr in the same practice and he gave DS Z-Pac for Bronchitis and was told to be patient, it will take time. DS stabilized in a crummy zone but since the Dr on Thursday told me to give it time I did even though I thought he should have improved more. I mean even his own little body's immune system should have begun to fight it off after a few days... same bug in DD took 3 days and she has Asthma too - she has a lingering cough but is mostly healthy.

Chuck S. no-one has put my son on any sort of anti-viral at all. Also, they haven't run a single test which didn't occur to me until you asked. Even now I do not have any firm diagnosis, they are treating symptoms and hoping it works. The Dr's have not exactly been on top of their game in my eyes.



No, they haven't been on top of their game.

Anti-virals are for the very first day or two of the flu, and all they do is reduce the symptoms by a day or two. MAYBE. So it's too late for those and IMO that's not a very good benefit anyway.

This is from clevelandclinic.org.

"Some corticosteroid medications include cortisone, prednisone and methylprednisolone. "

"Steroids work by decreasing inflammation and reducing the activity of the immune system."

In addition, your doctor has run NO tests, but has your son on a powerful antibiotic, for inflammation of the bronchial tubes, but he doesn't know WHY there is inflammation.

I used to react with "bronchitis" to any old thing that came around. Bronchitis didn't mean bacteria or virus for me, it meant "something is bugging her body and this is how she's reacting". My ped did cultures EVERY single time we got sick, and did them on both me and my brother, even when we were sick at the same time, because he knew that there are many things we could react to. We also reacted in different ways...I got "bronchitis" and my brother reacted with croup, even when we did have the same things.



Your doctor is giving your son steroids which reduce the immune system's means of working, and giving abx for no solid reason. These are the reasons your son's immune system hasn't really kicked in yet...it's being suppressed and circumvented.

I would fire that MD in a heartbeat.


I hope your son turns around soon. Ever since I had my tonsils (first line of immune system response) out when I get sick it goes to my lungs. I went from allergies to exercise induced asthma (the summer after I had my tonsils out, as a young adult), to full blown asthma (which I've now mainly gotten rid of with a more "whole" diet and taking care of myself better). My illnesses get SCARY since they just go right on down...and I still get sore throats (big selling point of the tonsillectomy that I wouldn't get sore throats!). I use alternative care now, because the medical care wasn't helping and was starting to hurt me. I hope you can figure out what's going on with your guy, and can BOOST his immune system. I would suggest a probiotic asap, to help repair what the abx are doing in his belly, and to boost the immune system. Best of luck to you; it's HARD when the people you've hired to help actually hurt instead.
 


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