College and Immunosuppression: Be Ye Forewarned!

I am reposting some older articles as I work through new posts that are more time intensive and requiring some researching. So here’s an old one for you..

If I learned what not to eat in middle school, I learned to never underestimate immunosuppression in college (among other more fun activities).

It only takes one to take down an entire dorm!!! This lady is the index case...avoid her.

It only takes one to take down an entire dorm!!! This lady is the index case…avoid her.

College dorms are like breading grounds for disease where every winter when 1 person gets sick up in there the whole dorm will start dropping like flies (I’m being dramatic here but there’s truth in jest). If you’re a college student taking immunosuppression and ESPECIALLY if you are living in a dorm you need to take extra care of yourself to prevent getting sick. It may sound stupid but go buy a little bottle of hand sanitizer and hand cream. You should use the hand sanitizer before you eat etc (be sensible about it no need to go insane you can live your life) and the hand cream because that hand sanitizer will dry out your hands eventually. I don’t think you need to change your life to help stay healthy (we all know you’ve got enough going on as it is) but there are some simple things you can do to stay healthy. Im going to run through a few times when I got sick while taking immunosuppression. I’m telling you this because you may not be really aware (or care) about the fact that the medications you are taking are serious. Your doctor has likely given you a straight laced warning about your inability to fight off infection but if you’re anything like I was you probably heard the doctor’s advice and forgot it five minutes later. I’m here to tell you I WAS AN IDIOT for not paying attention to my body when I felt myself getting sick.

 1. Sophomore year college: Medication: Remicade.

This happened on a Saturday morning with virtually no warning. I had been taking Remicade for some time and fortunately I was in okay health (I had symptoms but they were manageable). I recall vividly that Friday night all I felt was my throat was a bit ‘scratchy’. It was not painful really at all and I could swallow without difficulty so I thought nothing of it and went to bed. . . The next morning I wake up around 6 am and my face feels all sticky and wet. I walk over to the bathroom and my face was covered in blood (Walking dead much?). My throat went from feeling basically normal to bleeding everywhere in like 8 hours…yes that escalated quickly. I went to emergency clinic, got antibiotics for simple Strep throat and was fine.

2. Sophomore year college: Medication = Remicade.

I woke up one morning feeling a bit ‘off’. I hadn’t noticed feeling like I was coming down with anything the previous days but that day I felt more tired than usual, had difficulty getting out of bed and was a bit dizzy in the shower. THAT IS WHERE I SHOULD HAVE CALLED A DOCTOR. Of course I didn’t and started the walk to class. There was a slight hill outside of my dorm that you would hardly notice was incline that I needed to walk up to get to class. Walking up I knew something was seriously wrong. My heart was pounding, I was really short of breath and I had to stop to allow myself to catch my breath. I was in really good shape at the time and I knew this wasn’t good or normal, I called my mom and said we need to go to the ER. Long story short I ended up having pneumonia and mono. I WAS SCHEDULED FOR REMICADE THE FOLLOWING WEEK SO WE CALLED MY GASTROENTEROLOGIST AND LEFT A MESSAGE JUST TO BE SAFE (clearly my mom was with me).

I got a call back two days later by my very concerned GI doctor. He explained that he never had a case of a patient with Epstein-Barr virus (which causes mono, and can in certain circumstances cause some forms of cancer which is rare) needing to receive Remicade so he emailed a friend of his at Children’s Hospital in Philadelphia for advice. This GI doc called mine within 2 hours and explained that he only put 1 patient with mono on Remicade and this man developed cancer because of it…suffice it to say I was thankful my mom made me call the GI doc.

3. First year medical school: Medication = Humira.

My little sister lives in the same area that I do. She was my first responder when I got pneumonia and fainted first semester of medical school and spent 13 hours in the ER with me.

My little sister lives in the same area that I do and she stayed with me for 13 hours in the ER! She’s was/is my first responder when I got pneumonia and fainted first semester of medical school. Picture from the ER (we were bored)

Again I had no real indication to think of I was getting sick. It was a Saturday morning and I was walking up a hill to school to go study. I had to stop, catch my breath and let my heart rate normalize (not normal for me).  I get up to the building, settle in and start feeling freezing cold, chills, nausea and just horrible. I called my new GI doc and he said to go to the ER. I had pneumonia and severe dehydration which caused me to faint in the ER. Like the other times it came on very quickly with little indication I was getting sick.

I’m telling you this stuff not to freak you out or make you unduly nervous about taking or starting immunosuppression. Quite the opposite actually, you and your doctor clearly determined that you need the stuff to get into remission and feeling good again. But you have to be cognizant of how you are feeling. I wish in college I would have asked myself some of the following questions just in my head each day. Do I feel normal right now? How is my breathing? Have I been coughing? Do I have any tenderness anywhere? Am I drinking enough water? Are any of my roommates or close friends sick? These are pretty simple check list kind of questions you can ask yourself to save a big headache. Comment with some ways you all use to make sure you stay healthy (aka not getting more sick) while on immunosuppression?

It helps to have a sense of humor on things even when times are tough

And at the end of the day it always helps to have a sense of humor in life even when times are tough

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