Categories
Antivaccine nonsense Medicine Popular culture Skepticism/critical thinking

Stroke: An underappreciated complication of chickenpox that we should never see

An 11-month old boy suffered a stroke after chickenpox, an underappreciated risk of varicella zoster infection. This catastrophe could have been avoided if his parents had just vaccinated his two older siblings.

The vaccines that I most commonly write about are the measles-mumps-rubella (MMR) vaccine, the HPV vaccine, and the flu vaccine, although I have to a lesser extent written about the pertussis vaccine. The reason, I suspect, is that these are the vaccines that provoke the most attacks from the antivaccine movement, the MMR, of course, because it is the vaccine that Andrew Wakefield falsely implicated as a cause of autism, the HPV vaccine because it prevents a sexually transmitted disease and is often the subject of pseudoscientific attacks based on its aluminum adjuvant or false claims that it causes premature ovarian failure or female infertility—or even death; and the influenza and pertussis vaccines because they are imperfect vaccines. One vaccine, however, that I haven’t written about much (if at all) is the varicella zoster vaccine; i.e., the vaccine against chickenpox. Yes, I have written about the shingles vaccine, but not so much about the standard varicella vaccine that children receive to prevent chickenpox.

If there’s one vaccine that’s often derided as “unnecessary” by antivaxers, it’s the varicella vaccine. As they do with measles, antivaxers like to misrepresent the chickenpox as a harmless childhood disease that children get, get over, and then have lifelong “natural” immunity to the disease. For instance, here, über-quack Dr. Joe Mercola dismisses chickenpox as a “relatively benign childhood illness” and the vaccine as providing “only TEMPORARY immunity, and that immunity is not the same kind of superior, longer lasting immunity you get when you recover naturally from chickenpox” while implying that sunlight exposure will inactivate the virus, as though that would work once there’s an active case of chickenpox.

Antivaccine pseudoscience aside, prior to the vaccine:

Prior to the availability of varicella vaccine there were approximately 4 million cases of varicella a year in the U.S. Though usually a mild disease in healthy children, an estimated 150,000 to 200,000 people developed complications, about 11,000 people required hospitalization and 100 people died each year from varicella. Varicella tends to be more severe in adolescents and adults than in young children. The most common complications from varicella include bacterial superinfection of skin lesions, pneumonia, central nervous system involvement, and thrombocytopenia.

There’s also another potential complication: Stroke. A story from last week reports:

In a recent study published in The Journal of Pediatrics, it was documented that an 11-month-old boy suffered a stroke as a result of exposure to the chickenpox a few months prior.

The baby’s mother took him to the doctor after she noticed that he had weakness in his right arm and leg after he woke up from his normal afternoon nap. Tests were conducted on the baby which revealed that he had suffered a stroke, the study said.

Doctors believe that the baby’s stroke was caused by a complication relating to the chickenpox, which they think he must have contracted from a sibling. The boy, along with his two older siblings who were not vaccinated for the virus, contracted the chickenpox two to three months before he woke up with weakness on his right side.

This was also reported last month by NBC News, but somehow I missed it. I’m now rectifying this situation. First, I’ll look at the case report and how this child presented:

A previously healthy, unimmunized 11-month-old boy presented with acute right-sided weakness. On the day of presentation, his mother noted that his right arm and leg seemed to be weak when she woke him from his usual afternoon nap. Evaluation at an urgent care center confirmed right-sided facial weakness, decreased strength and movement of his right upper and lower extremities, and a lack of right-sided support in a sitting position. Computed tomography of the head without contrast was normal. He was transferred to a regional care center where head magnetic resonance imaging and magnetic resonance angiography demonstrated a left middle cerebral artery stroke and irregularities in the middle cerebral artery concerning for thrombus and vasculopathy (Figure, A and B). History revealed that the patient, as well as his older siblings, had primary chickenpox infection 2-3 months previously. The patient had a mild case of varicella, with a few scattered vesicular lesions which resolved without obvious sequelae. Owing to concern about varicella zoster virus (VZV) vasculopathy, he was started on high-dose intravenous acyclovir. A lumbar puncture performed 2 days after admission revealed a cerebrospinal fluid VZV DNA level of 880 copies/mL. Serum was positive for VZV IgG and negative for IgM. He received 10 days of intravenous acyclovir and was discharged home on oral valacyclovir 20 mg/kg 3 times daily.

Of course, this child was only 11 months old, which means he was too young to receive the first dose of of his varicella vaccine. That meant that he needed to rely on community immunity (formerly known as herd immunity) to protect him for another month. Unfortunately, having two unvaccinated older siblings in the house guaranteed that, if one sibling got the disease, they all would get the disease. Apparently that’s what happened.

To be honest, I didn’t know that stroke was a potential complication of varicella infection. I should have, I guess, but I didn’t. I knew about complications like meningoencephalitis, acute disseminated encephalomyelitis, Guillain-Barré syndrome, Ramsay-Hunt syndrome, cerebellar ataxia, myelitis, and vasculopathy, but for some reason stroke didn’t click in my mind associated with vasculopathy. The authors of the case report cite a 2014 study listing the neurologic complications of varicella zoster infection, which taught me that varicella-associated stroke generally occurs from 2-26 weeks after rash onset and that such strokes have a characteristic appearance on neuroimaging. I also noted that, in this series, at discharge from the hospital severe neurologic deficits were present in 40% and neurologic deficits persisted at least a year in 1/3 of the children who suffered stroke.

Overall, there is a four-fold increased risk of stroke in the six months after chickenpox, with no increased risk after vaccination against varicella found in a retrospective cohort study of over 3 million children. Last year, deVeber et al reported a decreased incidence of post-varicella arteriopathy after the widespread availability of vaccination in Canada.

Because the disease is less common than it was, thanks to the vaccine, parents are increasingly unaware of its potential complications:

As chickenpox cases became increasingly rare, fewer people remembered how dangerous they could be, said Dr. Tina Tan, a professor of pediatrics at Northwestern University’s Feinberg School of Medicine and a pediatric infectious disease specialist at the Robert H. Lurie Children’s Hospital.

“Everyone thinks it’s a minor illness,” said Tan, who is also chairwoman of the section on infectious diseases for the American Academy of Pediatrics. “There are a number of serious complications.”

Though relatively rare, stroke is one of them, Tan said. “Basically, the chickenpox virus infects the large blood vessels in the brain and causes inflammation in them,” she explained. “The blood vessels can scar and that can decrease blood supply to the brain, which can lead to stroke.”

As is the case in adults, the specific neurological deficits depend upon which blood vessels are involved, how extensively, and which ones clot or occlude enough to cut off the blood supply to parts of the brain. Like adults, children can be left with permanent neurologic deficits, although, depending upon how young they are, they are more likely to recover more function than an adult:

While some people recover with rehab, others live with permanent disabilities, Tan said. “They can have paralysis or seizure disorders,” she explained. “It all depends on which blood vessels are involved.”

In the case of the boy in the report, prospects looked grim. “My read on this is that he will have some type of permanent neurologic sequelae (consequences) from his disease,” Tan said. “And it is possible that he might have another stroke if his arterial disease continues to worsen.”

There is a high likelihood that this child’s stroke could have been avoided if his parents had just vaccinated their older children, but they didn’t and now they have a child who might well be left with permanent neurological deficits.

This is an incredibly sad story, the more so because it was highly preventable. It’s also not just the small risk of serious complications that vaccination against varicella zoster provides as a benefit. It’s just plain humane. I remember getting chickenpox when I was around seven years old. It’s one of the few things I remember vividly from that age, and it’s because the pox made me so very, very miserable. There’s great value in preventing that suffering as well, which is something that we sometimes forget.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

67 replies on “Stroke: An underappreciated complication of chickenpox that we should never see”

Wow. I didn’t know this. Once again, there are consequences to not vaccinating one’s kids. Parents should keep this in mind when they even think about rolling the dice on “natural immunity”.

In the era before a vaccine a pediatrician friend of mine’s son developed a superinfection (Staph). The boy was like a burn victim and required over a month in hospital.

My friend left private practice and helped develop both the varicella and zoster vaccines. One additional benefit of varicella vaccination he made me aware of is that the subsequent development of zoster later in life is approximately 5-fold less for the attenuated vaccine virus compared with a wild-type infection.

Well, your pediatrician friend has certainly improved the quality of my life and helped millions more people around the world.

And yes, this is another important point that people should remember: It’s not just about a “common childhood illness”. The virus can live in one’s nervous system for several decades, and strike again later in life as zoster/shingles. So really, the varicella-zoster vaccine provides solid “return on investment” throughout one’s lifespan.

This one – raising awareness about this risk – is doubly important because even people who are not antivaccine can fall into the trap of thinking chicken pox isn’t dangerous and the vaccine unnecessary. So this can actually make a difference with fence sitters who need this information.

My 30 year old was school age when the vaccine came out, and even though he was fully vaccinated at that point, I scoffed at the idea of worrying about chicken pox–even though I had scars that only disappeared in late middle age! So yes, this information is terribly important, even to the better-informed. Now, I have to check to see if he ever got the darn thing–I honestly can’t recall!

My oldest is also thirty years. He got chicken pox when he was in kindergarten, a year before the vaccine came out. The younger son got it at preschool and infected both his siblings.

The other sibling is now a grad student, but then was just a six month old infant. While it was tortuous taking care of a very sick baby, I am so glad we did not have to deal with stroke!

My oldest is also thirty. A year before the vaccine came out the middle child brought chicken pox home from preschool. He infected both siblings which made life pretty miserable. Especially since the youngest was only six months old. So glad we did not have to deal with stroke!

What a coincidence! That makes four of us. My older daughter is also 30 years of age. She was born on the 19th anniversary of the Moon landing and the 200th anniversary year of the arrival of the first fleet in Australia and has a special commemorative birth certificate attesting to this. She was also not vaccinated because the vaccine was not yet available.

Before the vaccine was available in my country my younger sister developed chickenpox. In the six months before I developed my own infection, most of my school went down with the illness. I was likely the carrier and still feel guilty.

Both of my sons have their earliest memory of severe itching, sitting in the yellow, Pinetarsol, bath. I wish it had not been so, but no vaccine was available at the time. (That’s opposed to my earliest memory of being – erm, aggressively – told to shut up during the TV news of the Cuban missile crisis… Talk about a contrast!)

Who would want to put a child through the torture of chickenpox when there’s an alternative?

If/when I have grandchildren, whether or not the vaccine is free, I will ensure that my grandchildren are vaccinated, even if I have to foot the entire cost myself.

I’ve rehabbed a similarly aged child quite some years ago in my pre-doctor life – that was the era before the varicella vaccine, and at that time I was also unaware of stroke as a potential complication of chicken pox. I’ve always remembered her, particularly when the vaccine became available, given the potential to prevent not just chicken pox, but disability and heartache.

When I started reading this article my thoughts immediately went, “No . . . that can’t be. How can they connect a stroke to chickenpox weeks later?”

Wow. I had no idea.

When I did my pediatric rotation in FNP school last year, the pediatrician in the practice quizzed me on vaccines and why we vaccinate: was the disease one that was potentially deadly, disabling, or other? I answered “wrong” on varicella, that it was potentially deadly since I knew firsthand it could lead to sepsis in adults (a patient I cared for early in my career, before the vaccine became available). The doc felt it was more of a disease of inconvenience that nonetheless required vaccination since the disease is pure misery, and takes parents out of work while the child recovers, and can lead to shingles later in life.

Wow. I won’t soon forget this! Poor kid. It does make me wonder why mom didn’t vaccinate; is she anti-vax or just wasn’t keeping up with routine appointments?

I have my own chickenpox tale of woe. Back in the 1970’s, I contracted the disease at sixteen and lost a week of school (spent it studying AP American history). I gave the virus to my thirteen year old little brother. He ran a fever of 103 for a week and was covered in sores which he scratched open. I remember him walking around bare chested because he could not tolerate a pajama top. Then at nineteen, my little brother got shingles. My brother counts as one of the several thousand who have complications.

So sorry for this poor child. There are certainly unanswered questions given the ages the older siblings must be and how hard it is to become infected with varicella these days in the U.S. I too had no idea that stroke was a complication of varicella disease. A bit of an aside, a single wild-type varicella infection does not necessarily confer lifelong immunity as anti-vaxx ignoramuses like Mercola claim.

A bit of an aside, a single wild-type varicella infection does not necessarily confer lifelong immunity as anti-vaxx ignoramuses like Mercola claim.

Nope. I’ve told this story before, but when I finally got chickenpox in college, it was from someone who had had it before. If it hadn’t been over winter break, I probably would have needed an extra year to complete the “structure of matter” series.

I may have been exposed when my cousin Jerry (with Down syndrome; another story I’ve related before re calamine lotion on his groin, etc.), but I had never had full-blown disease. Perhaps some antibodies hanging around.

Oh, am I aware of that aside. I’m fifty, and the vaccine didn’t didn’t come into being until well after I had my university degree. I’d already had it once when I was rather young, and then once again in high school (where I had caught it from my younger sister, and then caused a minor outbreak at the high school because I was already contagious but not showing during one PE session where the coach got some of us to swap shirts so it would be easier to tell the teams apart).

When there was another outbreak in my university residence in around 1989 or so, one of the people on my floor pretty much went ‘Ha, I’m safe, I already had it.’ He didn’t react well to me pointing out to him that I’d already had it twice myself. I didn’t catch it a third time there, at least.

Only given to siblings of children “at risk” – immunosuppression due to cancer or organ transplant. It IS on the schedule in Australia.

“Doctors [b]believe[/b] that the baby’s stroke was caused by a complication relating to the chickenpox, which they [b]think[/b] he must have contracted from a sibling.”

Yeah, lots of “medical science” here…Doctors believe, doctors think…what a sad joke “medical science” has become!

Okay Aston oh genius one, how many infectious diseases and subsequent complications have you diagnosed? How many studies and publications do you have?

Yeah, thought so.

Your comment is sad. You seem to lack even an elemetary understanding of this subject.

Aston, how many babies under the age of one year with chicken pox have you cared for?

From very personal experience there is no sleep for anyone since the baby is in constant pain. Even if some did not get strokes a few months after, it is not something I would wish on any child.

Nor on any family.

After this experience I think anyone who thinks a child should suffer up to two with covered with dozens of itchy open wounds (pox) are sadistic child haters. So, please explain why you hate kids.

Nice try…(well not really). Your juvenile linguistic manipulation techniques are obvious and don’t work, and really just show that you have no point.

“The patient had a mild case of varicella, with a few scattered vesicular lesions which resolved without obvious sequelae.” Yes, sounds terrifying! Call Stephen King to write a book on the horrors of Chickenpox.

“Doctors believe”…lol. Some doctors believe in God, so I guess that’s proof of a deity too? 60 kids total were examined in the above mentioned study out of millions…wow, call the CDC!!! Its a juvie stroke epidemic!!! Get those vaccine factories working overtime!!! Think of the children!!! The children I say, those poor children!!!

Sounds like a stroke following Chickenpox is about as rare as a severe reaction from the Varicella vaccine. That’s assuming Chickenpox was the cause of the stroke which isn’t known, just conjectured here to provoke parents to buy the vaccine out of unfounded fear.

Aston answer my question:

How many babies under age one with chicken pox have you taken care of personally?

Aston, another request: please provide the PubMed indexed studies by reputable qualified researchers that the varicella vaccine used in the USA causes more harm than chicken pox.

Aston, why do you think kids should suffer over a week of fever covered with dozens of itchy pox, that are actually open wounds that have a good chance of causing secondary bacterial infections?

Obviously mentioning the pain and distress of sick kids is considered “juvenile linguistic manipulation techniques” by someone who has never taken care of a very very sick baby.

“The patient had a mild case of varicella, with a few scattered vesicular lesions which resolved without obvious sequelae.” Yes, sounds terrifying! Call Stephen King to write a book on the horrors of Chickenpox.

Most cases of SSPE are preceded by mild and even asymptomatic measles infections.

“Doctors believe”…lol. Some doctors believe in God, so I guess that’s proof of a deity too? 60 kids total were examined in the above mentioned study out of millions…wow, call the CDC!!! Its a juvie stroke epidemic!!! Get those vaccine factories working overtime!!! Think of the children!!! The children I say, those poor children!!!

Drama queen and strawman.

I think you missed the ‘characteristic appearance on neuroimaging’. Meaning, it is possible to attribute the stroke to chicken pox.

Aston,

Please actually read the article and, if necessary, the supplied links before you comment.

Firstly, you are commenting on what the journalist said and attributing that to the doctors.
Secondly the diagniosis was based on actual evidence:

the boy and his two siblings had documented varicella 2-3 months previously.
the magnetic resonance arteriography showed changes in cerebral blood vessels typical of those of varicella vasculitis.
the cerebrospinal-spinal fluid contained varicella DNA
the serum was positive for varicella IgG

All you’ve done is embarrass yourself.

Perhaps Mercola takes the sanguine view that those who are unable to recover “naturally” in a non-immune community don’t deserve the unnatural protection of community immunity. Nature knows best in its merciless culling of the weakest.

“Nature knows best in its merciless culling of the weakest.”

When humans were hunter gatherers, as nature intended, those too weak and incompetent at it were culled, also as nature intended. Too many weak individuals have survived ever since the invention of agriculture, first in a long line of similarly unnatural innovations up to and including vaccines.

Maybe.

Abstract
The proposition that the Neolithic Revolution, characterized by the beginning of agriculture or irrigation or urbanization, was associated with a significant rise in mortality has been widely discussed and mostly supported over the last halfcentury. The case is found in the medical or epidemiological literature, especially that in the ecological tradition, and in works on anthropology and palaeodemography. This paper examines how these ideas developed and questions whether this near-consensus could prove to be fallible.

Caldwell B.K. (2006) Was There a Neolithic Mortality Crisis?. In: Demographic Transition Theory. Springer, Dordrecht

And the corollary of this is? To paraphrase Hobbes, life as you describe it was short, nasty and brutish. Is this something we should welcome today? If so please forego modern medicine, sanitation, dentistry and any mechanical invention that postdates Neolithic times. Oh and if any of your ancestors’ lives were saved by any of the above, despite this natural culling, aren’t you arguing against your own existence? Sorry but this particular argument makes me see red.

Tan writes,

Basically, the chickenpox virus infects the large blood vessels in the brain and causes inflammation in them.

MJD says,

Making it less basic (more complicated), the stroke may have been induced by an immune mediated vascular reaction secondary to distant infection.

Linnemann CC, Alvira MM (1980) Pathogenesis of varicella-zoster angiitis in the CNS. Arch Neurol 37:239–240.

Note: The vaccine Varivax (varicella) is safe to use if you’re worried about delivery-system sensitivities.

http://latexallergyresources.org/sites/default/files/news-attachments/Latex%20in%20Vaccine%20Packaging.pdf

Linnemann CC, Alvira MM (1980) Pathogenesis of varicella-zoster angiitis in the CNS. Arch Neurol 37:239–240.

I’ll bet my bottom dollar that you haven’t even read this, as short as it apparently is. There’s just something about copying and pasting links by someone who couldn’t make an en dash if his smarmy ass depended on it.

Yeah, I’m sure that an article dug up from 1980 trumps the opinion given by specialists in paediatric neurology in 2018

In fact as long ago as 1991: https://adc.bmj.com/content/76/6/522
This article does mentions the mechanism in your 1980 article as a suggested alternative mechanism

But this more recent study from 2016 does not even mention the alternative mechanism suggested in your 1980 article. They have found the virus in the CNS and varicella DNA and IgG in the CSF.

Just to add:

This article is even clearer on the likely mechanism:

https://pdfs.semanticscholar.org/7d6f/2ac7ba8ff2dad2dcc97579f732179fb9132d.pdf

The likely mechanism by which VZV causes stroke is by direct infection of cerebral arteries, which leads to a spectrum of both inflammatory and noninflammatory pathological changes including thrombosis, necrosis, dissection, and aneurysm formation. Various animal studies have identified afferent fibers from trigeminal and dorsal root ganglia to both intracranial and extracranial blood vessels, thus providing an anatomic pathway for transaxonal spread of virus.
Pathology — In autopsy studies of patients who died of VZV vasculopathy, pathological and virological analyses have revealed herpes virions, VZV DNA, VZV antigen, and multinucleated giant cells within the walls of cerebral arteries.”

And their opinion on the role of autoantibodies:

“A potential role for autoantibodies to phospholipids and coagulation proteins during or after varicella has been suggested, although the contribution of these transient autoantibodies in the occlusion of cerebral arteries is unclear

Thank you for talking about the dangers of chicken pox. Our healthy 3 year old died in 1994 just 21 days after his first pox mark. It never occurred to us that he was not coming home from the hospital. It was “just” chicken pox. My husband caught it from my son and wasn’t allowed to visit him. I still didn’t get that he was dying when they told me to call my husband to come. I replied that my husband had the cp and wasn’t allowed in. The vaccine was approved the following year. We had two more boys after we lost Aaron and glady vaccinated them. They are healthy 17 & 21 year olds now!

Claudia, I cannot imagine the pain of your loss, it brings tears to my eyes.. Thank you for sharing.

Oh, please, accept my grief at your loss. I’ve seen too many children with chickenpox – my own and others – in a country without free chickenpox vaccination, to accept that the suffering should be a natural event. But a death… I have no words to express my grief at such an unacceptable and unnecessary event.

I’ve had measles, rubella and chickenpox over 55 years ago (probably more like 60) and don’t remember either measles or rubella but I sure remember chickenpox. Now that I am a stepfather to a 1 year old, I will make sure that she is vaccinated for everything possible.

Any parent that doesn’t vaccinate their children is just plain stupid.

Ashton take stupidity elsewhere. If you have facts bring them forth with citations. Don’t try to parse a translation of a scientific work to fit your ill conceived thoughts.

He didn’t even do that. He just logged in to slap snark against the medical profession because he could.

I got the chicken pox when I was three (from my neighbor), years before the vaccine came out. It was a pretty average case, meaning I was miserable. I still vividly remember waking up in the night and going to find my parents to ask for more calamine lotion. They told me I couldn’t have any more, it was too soon, and in that moment I realized that there are things in life that my parents could not make better.

I know this is a realization everyone comes to at some point in their lives, but three was awfully early.

No one should have to experience that.

Chris says: Aston answer my question:How many babies under age one with chicken pox have you taken care of personally?

Why would you want an anecdote from me about babies with chickenpox? Don’t you know the plural of anecdote is not data? Thus whatever anecdote I could share with you to answer your question would simply be unscientific.

Nearly totally OT, but I figured this was the closest place to put it: My 79-year-old father has a DVT in his leg and was prescribed Xarelto. Am I wrong to be alarmed by the side-effect profile? (The price is also absurd.) I’ve already told him to get on the blower to find out whether he could take warfarin instead, but hell, there are professionals here.

Warfarin dosing can be tricky. It requires constant monitoring of his INR to make sure he is not over coagulated. It interacts with many medications that either counter or prolong its action, and you have to avoid foods rich in Vitamin K because those also interfere with the action of warfarin (vit K is necessary to start the coagulation cascade). It affects a number of coagulatoin factors (the coagulation system is quite complex), including some factors that can temporarily increase coagultion, so a “bridge” with heparin is often required. There is an antidote: IV vitamin K. You have to stop warfarin a week before surgery.

Xarelto doesn’t have that problem, and so it doesn’t require the regular blood testing warfarin does. It in a Xa clotting factor blocker. There is an antidote for this now, though it is fairly new. It just got FDA approval a year or two ago. You only have to stop it 24 hours before surgery.

It’s always a risk vs benefits equation with meds. If he can tolerate it, and afford it, he may find Xarelto complicates his life less. He should talk to his doctor about the side effects and risks of both if he is concerned.

There is an antidote for this now, though it is fairly new.

That’s good to know; thank you. I mean, I’d like to keep him around for a good while longer. I may move down there if I win my disability case. He’s too isolated.

I agree. Coumadin is cheap to purchase, but it’s a pain in the ass to monitor and interact swith so many drugs and food items. I’d go with the newer drugs for sure.

I relayed the information to him. He’s still going to talk to his doctor, but then he said, “That money’s coming out of your inheritance!” We have always been a family of modest means, and I would much prefer a live father to some chunk of cash. (The 20 mg tabs are $10 apiece for him. For six months.)

Dang Narad, I hope everything works out. For both of you. If you win your case you should be able to be on Medicaid even in Florida, right? I was talking to my therapist today and she was like, “Clinically you absolutely should qualify. I mean, people who struggle a lot less do. But the fact that you’re working some probably works against you.” Which is, like, whatever. I’d rather have a job and a life anyway, but I keep having episodes of varying degrees from time to time. To be honest, though, for a while recently I wasn’t really staying on top of my meds the way I should, probably because my diurnal cycle was all out of wack, which happens in the summer usually. I’m doing better with the change in light and temperature, and I’ve been taking my meds and feeling somewhat better. Like I have the slightly doped, spaced up SSRI feeling, but it’s worth it, and it’ll fade to a large degree.

Is your father a veteran? If so, he may qualify for free meds through the VA, especially if he can make a service connection to the DVT.

Otherwise, I would check with local social services to see if he qualifies for any programs to help him (or you) pay for his medications. He can probably get a short term discount from the manufacturer as well. You might look into a Medicare Part D plan to see if you can find one that will pay for his meds, that isn’t too expensive.

I had chicken pox when I was six (caught it from my little brother). I was off school sick for a month, partly because it was discovered that I was severely allergic to calamine lotion (went into anaphylactic shock and everything). Once I was out of the hospital after that nasty scare I just had to suffer through the rest of the infection which was pretty bad. My parents made jokes that my chicken pox had chicken pox. In fact, in my grade school photo of that year you can still see some of the lesions (and that was long after the pox first showed up). I’ve also had shingles which was not fun and I wouldn’t wish that pain on anyone. I still have some residual nerve damage from it. Let me say this, if the vaccine had been available when I was a kid, damn straight I would have gotten it. I’ve gotten the shingles vaccine. The minute I got the okay after my bout of it was over, I was in getting that shot, I didn’t care how much it cost (in my neck of the woods shingles vaccines are not covered by our healthcare system – it should be as far as I’m concerned). I encourage my friends with kids to get the chicken pox vaccine.

I got chicken pox when I was 32 before the vaccine became available. Somehow I managed to avoid it as a child. I was really miserable, then had cough and low grade fever for two weeks thereafter. Many people seem to think that back in the time before vaccination adults didn’t catch these diseases which isn’t true.

But.. just a little time after that I had my first ever delay in periods. These delays got progressively worse over the next few years when I was finally diagnosed with the Premature Ovarian Failure. Obviously, there is no way to say for sure if my POF was in any way related to my catching chicken pox, but NIH articles on POF list it as one of probable factors. So while I’ll never know for sure if this infection was what caused my POF, it is certainly a possibility. I sure with the vaccine had been available just a little bit earlier.

Comments are closed.

Discover more from RESPECTFUL INSOLENCE

Subscribe now to keep reading and get access to the full archive.

Continue reading