Honestly admit vaccine side effect costs & better support the “hesitant” to increase compliance

When you get your COVID-19 vaccination—and I’d argue that approximately 99% of those reading this post have a moral imperative to do so—a realistic assessment of the facts suggests that you are likely* experience some uncomfortable side effects though they may be very mild.

News coverage, even in sources specifically geared toward those of us living with chronic conditions, heavily emphasizes the societal good which vaccination will bring—which is real enough—but most writers lean too heavily toward cheerleading at the expense of offering valuable information people need to cope with the particular pressures of their own individual lives.

I would like to stress that those of us more vulnerable than average to infirmity should plan for several days of being less effective in our work and daily lives after vaccination. It’s better to be prepared than to be caught flat-footed after the fact.

Politicians and business leaders who want the economy to boom should be offering solutions to make such preparations possible for the millions of Americans living in and at the edge of poverty who can’t afford to construct such safeguards for themselves.

Roughly 30 million American adults want to take the COVID-19 vaccine but haven’t yet managed to actually get the shot(s). Closer to 28 million are instead “vaccine hesitant,” stating they would probably or definitely not get vaccinated.Redacted official CDC COVID-19 Vaccination Record Card

Sufferers of autoimmune disease, getting your jab may well bring on a flare. That was my experience after my first dose, and I’m glad I dug down far enough through coy, dissembling news coverage and popular health reporting to be forewarned about the risk.

Here’s one published case study in The Lancet regarding the health of one gentleman with rheumatoid arthritis after getting the BioNTech-Pfizer vaccine. This article on Creaky Joints is the most honest that I read, speaking directly to specific reactions people with autoimmune conditions might expect.

I would take that first dose again, however, and I did return for my second shot of the Moderna vaccine.

I began composing this post whilst “enjoying” the resultant joint pains, exhaustion, and headache that came with full vaccination. Dose two also induced half a day of resounding nausea that could have been an exaggerated version of the queasiness I routinely get when very tired.

Side effects from the second shot prevented me from my normal activities—already constrained by my autoimmune disease diagnosis—for about two and a half days.

I.e., I would not have felt safe driving for at least two days after my second shot, nor would I have been healthy enough to go to work.

By comparison, after my first jab, I experienced sudden onset of extreme fatigue, headache, and an odd sensation I only associate with coming down with a virus that I can best describe as “the spaces in my joints feeling stretched out and wobbly.”Analog wall clock showing 12:06

Those shot #1 symptoms popped up about six hours after I received it mid-morning. I went to bed early, and the next day, all the viral infection type side effects were far less troublesome. I felt less than 100% the day after, but able to partake in most normal activities.

I.e., I could have worked through the side effects triggered by my first dose.

My arm ached significantly for a total of five or six days, however, and I developed an uncomfortable swollen feeling in my armpit several days later that was probably my lymph nodes reacting.

On the other hand, in the four weeks after my first dose of Moderna’s vaccine, I experienced the most significant stiffness, joint pain, swelling, and fatigue that I’d had since the pandemic began. Staying at home most of the time while society remained mostly shut down was generally very protective for me against my usual, recurrent autoimmune disease symptoms.

I used far less pain medication than usual between March of 2020 and April 2021. I went entire weeks without needing an NSAID anti-inflammatory or using prescription pain killers. Between my two doses of COVID-19 vaccine, I required at least one of those every day.

I.e., I would have struggled to meet the demands of a full time job plus family responsibilities on many of the days between my first and second vaccine injections.Prescription bottle of pain pills

It is worth noting that this potentially vaccine-provoked flare never reached peaks equivalent to the worst ones I had right after my diagnosis. Also, the flare absolutely could have been coincidental. But, again, it’s the only serious one I had through the entire pandemic right up until I got my first shot.

I’m not arguing against vaccination. I am suggesting some of us might need extra resources to meet our daily responsibilities when we elect vaccination, doing our part to protect the entire community. Stepping up comes with a cost.

I have a healthy, supportive spouse. My large family includes relatively helpful, fit teens able to pick up the slack with household chores. Family members have been able to stagger vaccine appointments so we never experienced side effects simultaneously. Our income is sufficient that purchasing takeout meals or prepared foods is not a burden. I am easily able to reach my regular doctor with any concerns because I’m well-served with health insurance and the means to pay for Direct Primary Care out of pocket—including an option to text message my GP directly for urgent issues outside business hours.

In short, I have the good fortune to control most aspects of my daily life, so I could plan around the reality of vaccine side effects. I had sufficient personal resources to fall back on to meet all of my post-vaccination needs. Far too many Americans are less fortunate, many in more than one of the areas I’ve mentioned.

Speaking specifically to the autoimmune-challenged community, I’ve been delighted to find that my second dose of the mRNA vaccine seems to have abruptly ended the prolonged flare I experienced in the four weeks between shots. After feeling much worse due to its side effects than I had in over a year, by the fourth day post-vaccination, I became more energetic—and had less joint pain and stiffness—than I could recall feeling in recent memory. bandage on upper arm

I.e., my RA flare ended abruptly along with my vaccine side effects from the second shot.

Given that vaccination clears lingering symptoms for as many as 41% of COVID long haulers, I was fascinated to observe what could be a related effect in myself after jab #2. Communicating this potential improvement in daily functioning to those who are vaccine hesitant while believing themselves to have had COVID—some of whom never got confirmation of a likely coronavirus infection due to the scarcity of tests early in the pandemic—seems like yet another missed opportunity in public health messaging.

Everyone who wants the economy to rebound fully should take all possible actions to enable workers, especially those at the margins of poverty with limited access to health care, to make, keep, and recover after appointments for inoculation. Full disclosure of the known risks and known benefits—but also realistic potential risks and probable benefits—could bring us closer to herd immunity and full fiscal and medical recovery.

COVID-19 still holds many mysteries for science to uncover. The need to offer accurate information as well as paid time off to over-burdened breadwinners and caregivers so that they can confidently book vaccinations—without risking their livelihood!—isn’t one of them.

America’s front-line, essential workers have already borne more than their fair share of the fight against this pandemic. Today, those who employ these millions should step up with specific support to enable each one to get his or her shots.

* I say “likely” based upon the CDC website stating, for the Pfizer vaccine, “84.7% reported at least one local injection site reaction” and “77.4% reported at least one systemic reaction.” For the Moderna version, they state “[s]ystemic reactions were reported by the majority of vaccine recipients” with over 80% experiencing injection site reactions.

Paper map to plan rail adventure: Rick Steves vs. Streetwise Europe for travel

I am well aware of the fact that there are maps on my phone. I use the internet constantly when planning trips. I also love good old-fashioned paper maps.

I wanted a map of Europe with specific details for planning rail travel. I’d narrowed it down to two brands readily available on Amazon.com, but couldn’t find a single review comparing them both. Today, I’ll try to remedy that for other cartophiles or Luddites with European dreams.

I’ll be comparing the Streetwise Laminated Europe & Major Rail Lines with Rick Steves Europe Planning Map.

Europe map rail train trip plan compare Streetwise vs Rick StevesI specifically chose to assess laminated or coated paper maps that resist tears and spills because those make the most sense for the rigors of travel. Murphy’s Law suggests that we are most likely to get lost after the downpour begins; I’d like my map to function regardless of the weather.

I have also, on occasion, been known to knock over a glass of wine or slosh coffee as the trip planning process gets me all keyed up. The caffeine and alcohol might also factor in this scenario, but I do tend to be excitable even in the absence of stimulants.

Once travel has commenced, I pick up free, local tourist maps commonly available in major tourist centers to get my bearings in a new town. I refer to my phone for turn by turn directions to specific addresses. Still, there is something about taking the large view on an unfolded map that feels like a first step into a journey.

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Thanksgiving lessons learned: one mom’s (grateful) battle to enjoy labor-intensive holidays

I love that Thanksgiving reminds me to take stock and be thankful for the abundance of blessings in my life. I am blessed. I am thankful. I’m grateful for a holiday devoted to that awareness.

Thanksgiving give thanks - 1But then there is the reality of celebrating Thanksgiving in America as a mom. It involves a lot of cooking, a lot of shopping, and a lot of stress.

Let’s all keep in mind that I’m not a great cook. I can produce reasonably healthy and palatable food for my family; I don’t enjoy cooking.

Shopping the gauntlet

I start shopping right after Halloween. I buy the wine as early as possible for obvious reasons. I pick up our family celiac’s favorite gluten free stuffing mix from Trader Joe’s as soon as it arrives for the season.

Pantry goods are easy to buy ahead of the rush, and doing so helps spread out over multiple weeks the costs of a sit down dinner for 20.

I’m grateful for Amazon Fresh delivering my last minute, fresh foods on the day before Thanksgiving. Grocery stores are hellish just before this holiday! Having the items I want dropped off right to my door is a Really Wonderful Thing.

We enjoy seasonal, local bounty direct from family-owned farms in New England via Farmers To You. This year ’round service is especially gratifying as the autumn harvest rolls in. I’ve posted before about my commitment to support our regional food shed with my grocery dollars.

A humanely raised turkey from Misty Knoll Farms as the centerpiece of our feast is something I’m proud to feed my family and friends.

Cleaning the house

As we catalogue my faults, let’s remember that I’m not much of a housekeeper, either. Hosting a large meal raises certain expectations for minimizing the usual daily clutter. Having out of town relatives to stay means prepping the guest room and the downstairs bathroom, too.

I have to confess: this year, I didn’t get as much done as I’d have liked to prepare for houseguests. I struggled to forgive myself for that, but I used up every iota of energy that I had prepping for Thanksgiving in other ways, choosing to prioritize the feeding of 20 people from seven households over the immediate comforts of close relatives.

I’m grateful that I’ve gotten better at acknowledging my limits; I’ll keep working on accepting those limitations with grace.

Planning on the level of a precision strike

The only way a less-than-stellar cook is going to get a meal for twenty on the table in something resembling good time is to create a plan that incorporates all the prep and cooking times for multiple recipes and integrate them temporally. Continue reading