Got the shot... my arm is killing me! But... no swine flu for me! Hopefully I won't be infected in the next 2 weeks while I"m waiting for it to take effect. Wouldn't that be a crapper!

I went to get my H1N1 shot today and much to my surprise, the clinic had closed its doors to new people at 5 o'clock due to being at capacity. Damn. I'm gonna have to find someone to give me the shot at work or something.

h1n1 myths

Some valuable resources for dispelling h1n1 myths:
http://aap.org/advocacy/releases/swineflu.htm

the webcasts of Dr. Bernstein from Dartmouth are very good:
http://www.aap.org/audio/cisp/bernstein2.mp3

rumors about guillain barre and the vaccine are rampant. This Vancouver Sun article tackles that question head on:
http://www.vancouversun.com/health/Separating+myth+from+fact+debate+about+vaccine/2149677/story.html

a quote from the novartis prescribing highlights:
"The 1976 swine influenza vaccine was associated with an increased frequency of Guillain-Barré syndrome (GBS). Evidence for a causal relation of GBS with subsequent vaccines prepared from other influenza viruses is unclear. If influenza vaccine does pose a risk, it is probably slightly more than 1 additional case/1 million persons vaccinated."

Some people when reading product monographs don't really understand what they're looking at. Listed in the monograph, especially in the CPS, there are study results showing every possible side effect that was seen in vaccine trials, often there are tables showing the number of people in the control group vs. vaccine group who had a certain effect. These effects aren't always statistically significant and often the incidence of the effect is higher in the non-vaccine or non-treatment group. These adverse events often happen in such small numbers in the studies that there isn't enough power to establish a cause and effect relationship. I.e. if there were fewer pulmonary embolisms in the group taking the vaccine that doesn't mean that the vaccine protects you against having a PE.

In addition, every medication has risks associated with it and we have to critically think about the level of risk. If there is a 1 in 100 000 risk of having a certain complication, but in our group the risk of dying from the disease is 1 in 30 000 (not actual statistics from any known disease or treatment) - we have to decide whether we accept the 1 in 100 000 risk in exchange for protection against the 1 in 30 000 risk.

awake

Last night I was awake from 1:45 am until 4 am with no hope of getting back to sleep. Why? Who knows. What did I do with these wee hours? read my book and cursed the fact that I'd be struggling today. And, boy did I struggle. I could hardly keep my yawns in and my head in the game. I slacked. I almost fell asleep in heme rounds and the only thing that kept me awake was free candy.

Please if there is a god, let me sleep well tonight.

Tis the season of darkness when I have to get up in the morning. I'm finding it a hard adjustment. I keep convincing myself I can get up later and later because I still feel so tired. This is just about the time of year I wish again that I had a sunrise alarm clock to turn on a light for me!

I'm slowly getting my exercise mojo back. I bought a new bike this weekend and that definitely helps. 2 x 1 hour rides after work so far this week and I'm hoping to do at least 4 during the week and a longer ride on the weekend. Unfortunately, it might rain tomorrow and I'm not sure about my bravery going out on my new oh so skinny tires in the rain.

I bought a Devinci Silverstone SL4 - I will put up a picture when blogger lets me. It's awesome, but has pointed out to me how out of shape I am!

Ben finally killed the fly.. Hallelujah!

Not much is happening around here, so that's why the posts are scant. I'm behind on writing wedding thank-you cards (about 1/2 way through) and even more behind on studying and those kinds of things, but keeping my head above water in the day-to-day. It's funny though, all of Ben and my friends seem way busier than we are. We try to make plans with people and without making them 4 weeks in advance, nobody is available. Is it that we just don't have very many friends? Probably.

Ben applied for a mortgage today.. and then called me afterward to tell me about it. Somehow I think that's a bit backward ?

There is a fly in my apartment that has been alive for 2 months and mocks me with his alive-ness. I cannot kill him no matter how many times I bludgeon him with a tea towel - not that a tea towel can really bludgeon all that hard.

Today is the first time in a long time that I'm dreading going to work tomorrow. Actually, I am really dreading Wednesday when our university "big brother" comes out to oversee our clinic day. It's a funny thing to be scrutinized and feel that if you let yourself down, you might just let your whole program down.

So far peds has been busy. and independent. and busy. A different kind of busy from obs - more scut on peds and more trying to figure out what the heck I'm supposed to be doing at each moment. I have found a good mentor though and have been following his patients. It makes it harder here because different people cover their own patients instead of the on-call doc. I haven't had much exposure to high-risk deliveries or NICU yet but hopefully I'll get called for something one of these days. I'd like to use my NRP before I lose it.

In other news, my birthday is tomorrow. I got up this morning and someone asked me the date and I realized I had no clue - and had forgotten my birthday was the next day. What am I doing for my birthday? Not much. It's thanksgiving so we're all going to the cottage. I don't feel very birthday-y this year. Maybe it's because I'm tired, maybe it's PMS, who knows.