Cover Your Mouth: Germs, Autoimmunity, and Why You’re Messing With Our Medication

Hi folks! Things have been crazy with work and travel and a few other things (posts on all of that soon, I promise), but I wanted to pop in an ado a little piece on getting sick. Not the chronic-illness sick that this blog is about (although yes, that too), but the catching of the various flus and colds and enteritis-es and other nasties that float around people. It’s on my mind because I’m currently home with the flu (or something suspiciously flu-like) despite having gotten my flu shot. Sad panda.

Many of my fellow spoonies will already know this, but newer members of the tribe may not, and our general-population friends may not understand about us catching regular illnesses. So I’m taking the liberty.

The immunosuppressed are already at risk of catching every-damn-thing, and it’s right there in the descriptor: our immune systems are suppressed (for our own good–in most cases, it’s our own immune systems working to kill us). So, we don’t have our magical antibacterial armor like the rest of folks–our germ-warriors are old, tired, and mostly retired and not looking for a part-time gig. The castle gates are open, if you will, and nary an archer in sight. Because of this, not only are we at risk to catch any bug making the rounds, we are generally harder-hit by said bugs. You probably know that the flu and similar illnesses are usually billed as extra dangerous for “the very old and the very young.” The immunosuppressed are the invisible unsaid addition to that group–we’re in danger because while healthy folks can get sick (we just catch it easier), healthy folks have responses that we don’t. While you have the flu and feel like hammered shit, we (like the very old and very young) are likely to end up in the hospital because of how hard it hits us. (Ask me about my adventures in the hospital and ICU during a bout of gastroenteritis–essentially, I got a stomach bug and instead o staying at home on the toilet, I almost died.) We’re also more likely to get secondary illnesses like pneumonia, because good times, am I right?

All of this makes sense, you’re probably nodding. Yes, yes, Captain Obvious, I get it, no immune system. What you may not know, though, is that when we get sick, many of us have to stop taking our regular medications. When patients get sick, most rheumatologists take us off of our biologics (injections like Enbrel, Cimzia, and Humira) and our methotrexate. It’s to help not completely nuke the immune system between the suppressants and the illness, but it’s problematic. The way biologics work, they have to build up in your system. (Think antidepressants, it’s similar.) So skipping a week ends up putting you behind, your immune system is trying to rally, which means it’s back to its old tricks of trying to murdalize you. Depending on what you have, your symptoms can flare again–it’s different for all of us, but for me it’s joint pain, stomach problems, and crazy fatigue. If, like me, you carry your symptoms even when your meds are working, it just means things get worse for the weeks you’re waiting to get back on track. And once you’re back on your meds, you have to wait for them to kick in again. Most folks know about the immune system part of us getting sick, but I imagine fewer are aware of the secondary effects of stopping our weekly immunosuppressants.

This is why I am so adamant about telling people to get vaccinated. First, of course, is to protect yourself and your kids from getting diseases y’all don’t need to suffer through. But the other side of it is herd immunity–the more people in the general population that make themselves immune and don’t carry disease, the more I and immunosuppressed folks like me are able to function in the world, come to your parties and funerals, come to work, and generally not die. It’s also why I’m positively rude in reminding people to cover their damn mouths when they go about airports coughing and sneezing as if it were a distance-spitting competition. (I can even do it in multiple languages – Cubre su tos!) First of all, don’t be gross. Second of all, your mother would smack you if she could see you out in public like that. Third of all, I don’t want your damn germs, please-and-thank-you.

I travel with a medical mask not because I’m pulling a Michael Jackson, but because being around so many people (and so many gross people, I swear) is dangerous for me. The added bonus is that people think I’m the one who’s catching, so I get some extra space. But really. Cover your mouths. And try to keep your kidlets from touching and licking everything in sight. You’re killing us.



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