As noted in my Nov. 26 post, one of the respiratory viruses circulating now is Respiratory Syncytial Virus, or RSV, afflicting both kids and older adults. According to a recent WSJ piece (p. A3, Dec. 3rd, RSV, ‘Flu Infections Surge’):
"Hospitalizations for RSV among kids under 5 are outpacing those for Covid-19, CDC data show. Public-health experts said the crush of patients is likely due in part to a larger pool of susceptible children compared with prior seasons, giving the virus more room to spread as people mingle indoors.
There were also some 1.7 RSV-related hospitalizations for every 100,000 people for the week ended Nov. 26 within the CDC’s 12-state RSV surveillance network."
The latter point is especially important. And while child RSV illness garners most attention - because of the hospitalization levels- adults 65 and older are definitely contributing to the RSV hospitalization ratio.
Sites like Mayo Clinic claim the adult RSV cases are "generally mild" but not the one I have had to deal with, 11 days and counting. Still unable to even summon the energy to walk briefly to the grocery to get supplies. Not on! Just five or six steps entails severe coughing and bloody sputum brought up - not conditions I'd wish to present in a public place. And as a general takeaway let's clear up that this RSV in no short time, "weak sister" to a flu bug. Oh no. Not when it lasts over 2 weeks (for Janice) and approaching that for me. This bug is every bit as bad as every flu I've had since 1968 but I know it ain't flu because: i) there was no fever of any kind, and ii) there were never any muscle, joint aches - as I've experienced with all previous flus. Also, no gastro issues. On the contrary my eating - caloric intake - has not abated.
So amazingly, while the miserable bug struck on Thanksgiving Eve I had no problems consuming a whole turkey thigh and at least 7 ounces of the stuffing I made the previous day. Along with a whole bowl of cole slaw I also made.
Anyway, here are five medical takeaways - extracted from different sites (Web MD, Mayo Clinic, Johns Hopkins, UCHealth) and applied to my own encounter with this microbial beast. (Captured in the above artwork graphic of Dr. Linda Stannard from a transition electron micrograph image)
1- The onset of symptoms can be slow or sudden, so don't make the mistake of going out in public if you have even "mild symptoms". In my case they began with an annoying sore throat and then terrific congestion amplified by sneezing. I knew from then there'd be no visiting on turkey day or having friends visit us. It turned out to be a sound decision.
2- The priority from the first 12 hours on is clearing airways, air passages and keeping them clear. The sheer volume of mucous, blood and nasal detritus this beastie produces is staggering. Indeed, "preternatural", to use Janice's turn of phrase. As I learned, it required constant blowing (of nose) and coughing, as well as outright hacking-retching to get the stuff coming up and keeping air ways clear.
This is why RSV is so critical in kids - children 8 and under- causing so many to be hospitalized. It's because they lack the chest and upper trachea musculature to enable violent expulsion of mucous. In this regard, and as an adult, be prepared for days of doing nothing but expel, expel, expel ....even in the middle of the night. That is when the phlegm-mucous buildup is greatest and you will need to run to the rest room get the toilet seat open and expel noxious looking (brown, orange, red) sputum and deep bronchial detritus which has burbled into your throat - waking you up from a tentative sleep.
3-You will still need to eat - and a lot - to sustain energy, which will be sapped over days from all the nose blowing, coughing, expectoration. Janice asked me to estimate the mass of detritus and mucous we each have expelled since the disease began and I told her with a straight face: "A pound each, plus or minus maybe an ounce."
The bloody thing is, you aren't able to exercise, though you can still eat (I was still able to finish - with Janice - all our 10 lb. turkey and stuffing etc. over four days). The function of the food, eating - for both of us - was to get us through the misery days, especially including the pumpkin pie and ice cream. The problem? The combination of no exercise plus all that holiday food packs on the pounds, likely puts lipid panels, blood sugars into a tailspin. But it can't be helped, and no physician advice to "cut calories while you're ill" will work with this virus.
4- Keep at least a dozen boxes of Kleenex tissues handy - per person. We needed at least that many. Just over the initial span of four days I filled 4 small plastic grocery bags alone with bloodied, mucous-saturated tissues. These were used both during the day an at night - when the congestion was often the worst and required the use of a nebulizer as well as my oxygen concentrator machine, e.g.
While use of the machine - at least for limited periods each night- did manage to keep airways clear at least for an hour or so, the process was often interrupted by nasal mucous buildup. This would be right near where the cannula is placed so I was compelled to get up and blow out the mucous -ok, bloody snot - about 5- 6 times a night. The process ended up saturating 15- 2o tissues at a go, but did allow me to keep using the O2 machine. I always kept at least a plastic empty bag near my bed to collect the toxic waste.
5- As the symptoms ease up don't be lulled into thinking you're done with it. That means no showers until at least the nasal and chest congestion (including any cough) are gone. Then, if you do go out - as I tried to do on Saturday- wear a mask! (I quickly realized I had zero energy after waking up so had to give up within 5 minutes of getting my jeans on.) The mask - which will for sure be worn when I see our primary doc Thursday- is not to do any "virtue signaling" as the idiot Bill Maher has claimed. Rather it's to protect others from a nasty virus that has the potential to kill - if they have weak immune systems or chronic respiratory conditions.
At Day 11, apart from the vast fatigue - which rivals even what I endured with the Hong Kong flu in December, 1968- the most enduring aspect is the brain fog. To give you a small idea, just to finish this post took something like 15 edits, re-dos - over 5 days - on account of encountering assorted random "word salads", non-sequiturs. So bear with me and don't expect remarkable, scintillating posts when I do get back to regular issues!
This RSV bug is serious and don't let anyone tell you anything different. It's out there with the flu and Covid-19 in a microbial horribilis triple threat and you can't afford to be stupid if you want to get through the season intact and not end up on a ventilator in a hospital bed. And if you should get it, your best friends will be Dayquil-Nyquil, Zyrtec, Mucinex and plenty of Riciola (sugar free) cough lozenges- as well as Kleenex tissues.
RSV in Older Adults and Adults with Chronic Medical Conditions | CDC
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