COVID-19 vaccines: medical concerns and recommendations

[scjbash]

I reviewed the Israeli study https://www.nejm.org/doi/full/10.1056/NEJMoa2114255, talked to my ICU guys (this was largely reassuring), talked to my hospitalists (some food for thought although not drastic), talked to my colleagues, and rolled up my sleeve at lunch break.

Is the hospitalists' food for thought worth sharing?

[0ddl0t]

24+ hours later and still no booster side effects to report. I don't even notice my arm this time, but I can find a lump under the injection site if I feel around for it. My armpit lymph node is also a bit swollen, but again I don't notice unless I go exploring.

[HeavyDuty]

13 hours post Pfizer shot 3, nothing to report other than fatigue which may or may not be related to the vax.

[YVK]

Is the hospitalists' food for thought worth sharing?

I was looking to find if either service has seen clinically severe breakthrough cases in otherwise previously healthy patients. The ICU folks haven't seen that. The medical team has seen a couple that got them worried but didn't get to ICU level. Basically, at the end I asked whether they were getting boosters themselves. They said they were. Since they saw a lot more covid cases than I have, I thought it was a strong enough endorsement.

[Ed L]

Vicodin? Sweet Baby Jesus

You were able to resume a normal life on day 2. What the hell does that look like? A couple lines of cocaine off a stripper’s ass?

A little context as to why you have narcotics on hand would be helpful. It’s kind of like someone posting on a school bus driver’s forum about taking Vicodin after their vaccine. Seriously, I’m in the odd position of not wanting you to have cancer, but that is about the only good reason to explain why you would be taking Vicodin for a post-vaccine inflammatory reaction.

I was actually shocked by your reaction and checked my prescription. What I took was Hydrocodone, not Vicodin as I had incorrectly written in a previous post. Not that I would know one from the other. I have the Hydrocodone prescription left over from some surgery and other pain issues that I have had. I can't take anti-inflammatories because of ulcer issues. The second day after the third dose I felt worse than any sickness that I can remember in recent times. But I still lobby people I know to get a third dose. And things will likely get worse for me on Thursday painwise since I will be having tendon sheath surgery on my dominant hand for middle and ring fingers. It is a two hour out patient procedure for which I will be under some type of twilight anesthesia. I am not looking forward to the recovery and glad that I have voice recognition software. I supposed to have someone with me for 48 hours afterwards. I think that is just something they tell you for liability reasons and to make sure you don't buy anything stupid. I have my list made.

Judging from your post, this is probably how you imagine my life:

[pangloss]

I got my third Pfizer vaccine this afternoon--about a week shy of nine months since my second immunization. I started feeling really tired 3-4 hours after the shot. That could be because 1) today is Tuesday 2) I had a pretty intense bike ride 1-2 hours after the shot 3) caffeine withdrawal 4) neighborhood social gathering 2-3 hours after the shot [I'm an introvert.] or 5) a much faster than expected response to the vaccine. I took a shower, drank some tea, and have been sitting around for the last hour. I feel much better now, so I'm going to go with some combination of #1,2,3, & 4.

[mtnbkr]

Judging from your post, this is probably how you imagine my life:

Thanks for making me aware of that movie.

It's on Prime and now in my watch list.

Chris

[HeavyDuty]

13 hours post Pfizer shot 3, nothing to report other than fatigue which may or may not be related to the vax.

Somebody snuck in overnight and beat the hell out of my bicep.

[Sensei]

I got the booster (3rd shot) 2 days ago. Yesterday, I woke up with a very sore arm, then gradual fatigue and a headache. Not debilitating but leg day was an absolute no-go yesterday. I woke up today feeling fine. The soreness in my arm is barely perceptible and I’m glad since I’m headed into a week of nights.

[Sensei]

I was actually shocked by your reaction and checked my prescription. What I took was Hydrocodone, not Vicodin as I had incorrectly written in a previous post. Not that I would know one from the other. I have the Hydrocodone prescription left over from some surgery and other pain issues that I have had. I can't take anti-inflammatories because of ulcer issues. The second day after the third dose I felt worse than any sickness that I can remember in recent times. But I still lobby people I know to get a third dose. And things will likely get worse for me on Thursday painwise since I will be having tendon sheath surgery on my dominant hand for middle and ring fingers. It is a two hour out patient procedure for which I will be under some type of twilight anesthesia. I am not looking forward to the recovery and glad that I have voice recognition software. I supposed to have someone with me for 48 hours afterwards. I think that is just something they tell you for liability reasons and to make sure you don't buy anything stupid. I have my list made.

Judging from your post, this is probably how you imagine my life:

Vicodin is just the trade name of hydrocodone mixed with acetaminophen (aka Tylenol).

A significant factor in our prescription drug / opioid epidemic is the practice of physicians, and particularly surgeons, providing too long of a narcotic prescription (ie too many pills) for a procedure. This causes patients to save unused pills for a “rainy day” which is really a bad idea on multiple levels. Several studies have look at this and most patients need less than a week of opiates for surgery with the possible exception of gyn surgeries where the pain lasts a little longer. We now know that using an opiate like hydrocodone for more that 5 days is associated with a small but statistically significant increase in long term use of narcotics one year later. Having “extra” opiates on hand “just in case” is also a problem for family members - think kids who sell them to their friends or spouses who have an secret substance use disorder. You are far better off disposing any unused narcotics than saving them for a rainy day.

I know that I’m sounding like a fuddie dud, but ask me how many lives I’ve seen ruined by prescription narcotics leading to an opioid use disorder. The purpose of my earlier post was to shock you. Now that I have your attention, consider the fact that you just came onto a public forum and described abusing a prescription narcotic by taking it for purposes other than for which it was prescribed. We call that self-medicating and it’s often an early sign that there is a problem.

Bottom line, I suggest that you rid of all the left over opiates in your house and only take such medications for the original conditions for which they are prescribed. They aren’t helping you. I’d also inquire from your surgeon and anesthesiologist about opiate-sparing strategies ahead of any planned surgeries in your future. You might be surprised at how much they can help you.