An email that made my day...

I receive hundreds of emails every day. No exaggeration. Email is a wonderful way to make communication more efficient, and at the same time email can be a curse beyond anything I could have ever imagined. Most emails I receive require me to respond in some way. Some I can immediately delete. Some I need to save for future reference. But almost none of the emails I receive cheer me up, make me laugh, or improve the quality of my day. This one was an exception.

A little background: Tuesday was Darrin's 26th birthday, and he had been sick for several days. He still wasn't feeling great, but being the good sport he is he agreed to go with McKenna to a belated birthday celebration for her father. I think the email will explain the rest.

From: Miedema, Darrin [mailto:Miedema.Darrin@principal.com]
Sent: Wednesday, October 28, 2009 9:30 AM
To: 'McKennaSprague@wellsfargo.com'; Altmaier, Greg; 'Justin Meyer'; 'Allison Meyer'; Miedema, Felicia A; 'ALLEN L FELICIA MIEDEMA'
Subject: Best Birthday Ever...

Okay, so I just need to tell you guys how awesome and special yesterday was to
me. I still can't believe it. I've never really been super into birthdays...so I wasn't really expecting anything. But you guys absolutely blew me away!

Thanks Mom and Dad for working with McKenna to surprise me with dinner...and for the sweet clothes from Von Maur!

Thanks Justin and Allison for letting us have a million people at your house, and for TOTALLY selling me on thinking we were just stopping by for coffee, and for the SWEET camera! Incredible present, and very timely. (Way to pay attention Justin! I didn't even know I wanted a camera...but then you got me one, and I'm like, "whoa, yeah I totally want a camera!") And thanks Allison for suggesting the restaraunt...very classy. :)

Thanks G-Unit for basically straight up punking me...HARD. You were the key element in making me believe that there were no further surprise shenanigans after dinner...so what I'm saying is, thanks for lying to my face multiple times throughout the day. Also, thanks for the two best birthday cakes I've ever had...I don't even know which one I liked more....the fighting jungle animals were awesome...but I also love the Pack...can't even decide. And thanks for taking that beautiful portrait of Schreiner, I will forever treasure that. (probably gonna tag you on facebook in it)

McKenna....where to start... Thanks for putting all of this craziness together. Thanks for creating an elaborate enough scheme to actually surprise me! Wow...complex. Thanks for gathering so many people that I love and care about...that was so exciting and encouraging. Thanks for the amazing gifts. Most of all...thank you for loving me! Thank you for being patient and kind and thoughtful and considerate...thank you for being in my life! I love you! :)

I love all you guys so much!
THANK YOU!!!!!!!!!! :)

Darrin Miedema
Defined Benefit Specialist - DRS08

Some days actually make you feel good about being a mom - this was definitely one of them. Thank you, Darrin, for loving us.

What the...?

Something is just fundamentally wrong about snow in October. But that's what we had this past Saturday. Mind you, it was just a dusting and was gone by mid day, but the weather that has followed since then hasn't been much better - near freezing temperatures and a continuous precipitation that has ranged between a drizzle and a downpour. Isn't this the time of year when fall foliage is supposed to be brilliant and crisp Indian Summer afternoons make for great bike rides? No such luck this year. It looks like autumn has completely bypassed us.

Despite the depressing weather, it appears that we have all survived the dreaded flu. Which is no small feat! This week we've had "emergency" H1N1 meetings daily (which kind of makes them seem less emergent and more part of the daily routine) and I have more information about the pandemic than I really care to have. Fortunately, it appears that the virus is milder than anticipated. Unfortunately, it is spreading like wildfire and patients and staff alike are beginning to be impacted. Since I now appear to have obtained my immunity the hard way, I may have to put on a pair of scrubs and help take care of the patients who are coming in sick!

H1N1

H1N1 has struck the Miedema household, and I've been getting lots of questions, since I now have first-hand experience. I don't claim to be an expert, but I do sit on the Mercy Medical Center H1N1 Emergency Task Force, so I get pretty up to date information from the Polk Co. Public Health Dept. I also spent time talking with our chair of Infectious Disease, Dr. Dan Gervich, the other day and he is undoubtedly an expert in all things infectious. Here are the most common questions I'm hearing:

What are the symptoms?
Well, for David and I the first symptom was a dry, ticklish cough that got more frequent over a couple of days before a low-grade fever started. For David, he ran a fever between 101 and 103 for about two days. It looks like my fever will be more low-grade - around 100. There are, of course, the general aches and pains; headache; sore throat (from the coughing.) For us, there hasn't been any nausea or vomiting, in fact I'm thirsty all the time which is a good thing.

How do you know it's H1N1?
Good question. At this point the diagnosis is pretty much according to symptoms. The rapid tests you can get at your doctor's office have between 10 and 70% inaccuracy. So some are showing Influenza A, a few are showing Influenza B, and in about 50% of the cases where the rapid test is negative for anything the person actually has H1N1 (assuming they have the symptoms above.) In 99.9% of all cases nationwide, more sofisticated cultures of those that are positive in the clinic are coming up H1N1. So, as Dr. Gervich said, "If it looks like a duck and quacks like a duck...."

When is the vaccine going to be available?
A trickle of nasal (live virus) doses came to Polk County this week. Another small shipment will come in next week. Truth is, there will probably not be enough vaccine to ward this off. In other words, the horse is out of the barn, at least in Central Iowa. If you are patient enough to stand in line at the Polk County Health Department, you might be able to get the vaccine. Right now the vaccine is not available anywhere else in Polk County.

Who can get the vaccine?
Right now the vaccine is being offered to:people between the ages of 2 and 24, pregnant women, and healthcare providers 49 years old or less.

Why is it being limited to those groups?
Because those are the groups of people who seem to be hardest hit. 70% of the deaths nationwide are in people under age 24. Pregnant women have had some nasty complications. Healthcare workers have the potential to spread it like wildfire. Interestingly, as of the October 8 public health update, there had been no reported deaths related to H1N1 in people over age 65.

Does the seasonal flu vaccine help at all?
Theoretically, no. But some very early evidence suggests that people who have had the seasonal flu vaccine are getting milder cases of H1N1. This is very early, so the behavior of this virus remains to be seen.

Is the vaccine safe?
I'm biased on this one. I work in a hospital, so I see worst case scenarios. I encourage everyone to take the flu vaccine, but you have to decide for yourself. All I will say is please decide based on science, not fear.

If I get H1N1 will I die?
Gee, I certainly hope not or I wouldn't be spending this precious time blogging! The vast majority of people will be mildly to moderately miserable for about a week and then will be fine. David is on the upswing - after having 103 fever on Wednesday, he is now out mowing the lawn. The reported deaths are in people who have other medical conditions, such as asthma or diabetes. There is some evidence that morbid obesity is correlated with an increased death rate - that is probably because very obese people have a higher incidence complications associated with sleep apnea. This is primarily a virus that moves into your lower respiratory tract, so if you have lung issues, it is a good idea to see your doctor. He or she may prescribe an anti-viral medication that can lessen the duration and severity of H1N1.

Will taking vitamins, echinacea, or Zicam help?
Can't hurt.

If I get the the symptoms, should I see my doctor?
If you are basically healthy, the answer is probably not. Stay home, drink lots of fluid, take ibuprofen or acetaminaphen (you can alternate the two if you have a really high fever) and sleep. I know it's nearly impossible, but try to stay away from others. Cough into your elbow or a tissue, and wash your hands FREQUENTLY. Label a cup as your own, and do not share utensils. You know, the common sense stuff. If you run into trouble breathing, cannot get a child's fever down, are listless or lethargic more than is normal for being crappy sick, or if you have vomiting associated with the fever, we are recommending that you CALL your doctor and ask for instructions. Clinics are trying to minimize the exposure of other patients and staff, so they may take you right in or ask you to come in an alternate entrance. Or maybe not...pretty much everyone there probably has it also. Unless you really get into an emergency situation, please do NOT go to the Emergency Room. Believe me, the ERs are packed and unless it's a true emergency, you will not enjoy the wait!