Wednesday, December 7, 2011

Peanuts.

Pondering Peanuts. . .


"We recommend that you get a flu shot today, okay? Is that alright with you?" my resident asked Mrs. Coley at the end of their encounter.

"A flu shot? Oh naw. I don't take no flu shots." That answer came out too fast. It sounded like she'd had plenty of practice shooting this request down in her sixty seven years.

I immediately chimed in. "Is there a particular reason why you don't get a flu vaccine, Ms. Coley? Like are you allergic to something in it?"  I was prepared to give her the benefit of the doubt. Her chart had clearly indicated no allergies, but I figured I'd ask anyway.

"Naw. I'm jest allergic to what y'all peddling, that's all. That flu shot make you sick. Sure do. Last time I took it I got the flu."  She leaned down to tie her shoe and then grabbed her purse off of the desk zipping it closed. "Can I go on and go now?"

"I know you probably have heard this but the flu doesn't actually give you the flu," I continued.

"The hell it don't! I don't never get sick and I took that shot one year and next thang I know I was sick. Sniffles and all that. Never again. Uhnnn uhhh, no way." She pressed her lips together and turned her mouth down for emphasis.

"Did you miss work?" my resident asked. He was ready to dive in and prove that her little congestion was no where close to the sho' nuff flu.  But she completely had his number.

"I been retired. And naw, I didn't miss no work. But it slowed me down enough to be a pain in the ass and to know I ain't never taking one again."

I smiled in her direction until she finally met my eyes. Mrs. Coley narrowed her eyes at me and chuckled. She knew this wasn't over. "What you got to say?"

"Ms. Coley, you know I couldn't just leave it be." We laughed in unison. "Seriously, though, a lot of people complain of feeling like that. But having the sniffles is no where close to the real, deal, true-blue flu. And when you start getting up in age, it can be really serious if you get it. Like, hospitalization-serious."

"Who you calling 'up-in-age?'" she teased and then got a bit more serious. She buttoned up her coat--a gesture that also made it clear that she'd already made up her mind. "I hear you, Miss Manning, but I'm alright, baby. But I don't want no flu shots never." Mrs. Coley slid her gloves on her hands crossed them on top of her pocket book. This conversation was over.

So after all that, I just nodded my head and conceded. No need to push the issue.

Mrs. Coley paused for a moment and I guess, felt we deserved a little more explanation. "See, doc, I'm from the country. Where I'm from it jest seem like none of that happen to nobody. The flu. . .pneumonias. . .none a that. Mama had us right in the house and next day was back to work most times. Sure was. See some of this stuff y'all be pushing on us jest don't make sense to me. I ain't never heard a nobody having flu back then and sure as hell ain't seen nobody not able to eat a damn peanut."

"A peanut?" I interjected. I thought I'd missed something.

"What the hell is going on with all these chil'ren that can't eat a damn peanut? No peanuts in this, no peanuts in that! Made in a factory NEXT to a peanut! What the hell! You know two a my grandbabies can't eat no peanuts or even a peanut butter sandwich-- and another one of 'em can't even have a chocolate bar else he'll swell up. A chocolate bar!" She shook her head hard.  "See, I think if y'all would jest let folks alone we'd be better off. Seem like it's something in them shots."

You have to admit that her points were interesting. Now first before someone takes this somewhere heavy--I'm not talking about the whole controversy around kid vaccines. I'm just referring to her points in general. My dad has had similar things to say to me in the past--specifically about how things have evolved. Poopdeck (my dad) is one of eleven kids and on his block there were like three other families with ten plus kids. He says not-a-one of them was allergic to a doggone thing. Nada.

They do both have a point on that one.

So, like, what is up with all these epi-pen requiring allergies? How come that seems to be a non-baby boomer phenomenon? And why can't her grandson eat a chocolate bar and exactly what the hell has happened that's made bringing a home-baked cake into school equivocal to poisoning somebody?  Heck if I know.

I'm sure somebody somewhere has some really technical answer to this that even I, a physician, would have a rough time getting my brain around. I guess I just get so used to pushing those United States Preventive Services Task Force recommendations like "You need a flu shot" on people that I don't always have a chance to stop and ask these kinds of questions.

See?

What I was thinking of saying to Ms. Coley was yeah, I realize nobody took flu shots back then, but those same folks came in from the fields with their rheumatic fever-scarred hearts (that we can now prevent) and laid babies down on their bellies to sleep instead of on their backs (which we also know better about.)  For some of these things we medical folks are on to a little something.  (I wasn't going to tell her about the year that I spent seven full days in bed back in 2000 after getting the flu. Even though I had indeed gotten immunized that year. Errrr yeah.)

But I didn't say any of that. Instead I just sat there respectfully with my resident and listened to her position. Before I knew it, the subject had been changed and that was the end of that. No flu shot and no further discussion.

Hmmm.  

I'm not sure what exactly has jacked us up so much in the last few decades. I'm pretty sure it's not the influenza vaccine, but Mrs. Coley definitely got me thinking all sorts of things like why peanuts and chocolate have become the devil. I guess the point is that I don't think that we have all the answers. Our patients are insightful and their questions can--and should--bring us pause.

President Jimmy and his peanuts.

The late great George Washington Carver . . . the man who took peanuts to a whole nuva level.
  ***
Happy Wednesday, y'all.

15 comments:

  1. I really like this story. I like that the older woman has enough confidence to share her beliefs with you and that you took the time to listen. I think she has some very valid points and I am on her side about the flu shot. Sometimes lay people have to trust their instincts. And I think all these allergies are the unintended consequences of something.

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  2. I'm totally with Ms. Coley. What the hell is going on? (And I don't get flu shots either.)
    Loved this.

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  3. I was just wondering the same thing about allergies yesterday. Peanuts aren't even nuts, they're legumes and who ever hears of kids allergic to beans?
    None of my children or their friends, much less me, my sister, my cousins or the kids i grew up with were allergic to peanuts or nuts or anything that I knew of. I do know of a two people who had severe asthma. I grew up in inner city Detroit. My kids grew up in various small town and rural settings. Out of 9 grandkids, 5 have asthma, one has many severe allergies. I do get my flu shot though. All those germ laden grandkids...

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  4. Caveat: Anecdotal only...
    I read an article a couple of years back that "modern" baby lotions and oils are formulated with peanut oil, heightening a person's sensitivity to them, and potentially an allergy later in life. Compared to babies of my (somewhat) earlier generation, where the only products used by our mothers were Johnson's baby oil and baby lotion...
    Who knows. "food" for thought eh :)

    Mary

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  5. So interesting. I, too, won't jump into the vaccine debate (very significant for me and mine), but I'll say this: my two sons have not been vaccinated, have suffered through the usual childhood illnesses, including ear infections et al and have never been on an antibiotic. I do a lot of preventive care; they see an osteopath regularly (and have since they were eight DAYS old)and are, knock on wood a million times, extraordinarily healthy and resilient. I won't pretend to know what's going on overall, but I do wonder sometimes if we've replaced the devastating illnesses of old with new autoimmune disorders --

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  6. Well, I'm a baby boomer and I grew up with asthma and a load of things that I'm allergic too, like cherries and apples and coffee. I get my flu shot every year and a pneumonia shot every five years. I appreciate this elders view that something is causing kids to be sicker than they should be, but why say the shot gave me the flu. We all know that's a lie and not even a good one. Just say I object to having viruses put into my body, I don't want to be stuck by a needle or what ever the truth is. And I would appreciate it when you all get the flu to please stay out of my cube and don't sit by me in a meeting.

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  7. "Made in a factory NEXT to a peanut!" cracked me up.

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  8. I was thinking the same thing yesterday. My whole time through schooling I knew exactly one kid who had asthma and needed an inhaler. I dropped my 2-yr old off at day care... and turned in his inhaler, which sat next to three other ones. What is going on indeed.

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  9. Interesting commentary, because I've noticed that a whole lot more people seem to have allergies to things (be it peanuts, pet dander, or what have you) than I remember when I was growing up (I'm only a few years younger than you). I see a lot of it in the records, and have seen several theories tossed around to attempt an explanation. I don't know what I'd do if I was allergic to peanuts, because I love my peanut butter! I have, however, gotten the flu shot since I started working for a hospital that encourages employees to get them. (And because I want to help lower chances of exposure for my parents, who are in a prime age group for complications from flu.)

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  10. Is it wrong that this post made me go eat a bunch of peanuts from a mixed nut container?

    My father (born early 1940s) used to complain about my sister using the same knife for the peanut butter and jelly. Family lore was that he was held down as a child and peanut butter shoved down his throat and that's why his throat used to close up just smelling it. Um, that or a peanut allergy?

    I just wonder about how many things were undiagnosed back in the day. Like in Liberia, where we don't fool with that nonsense like food allergies - but is it because child mortality is so high that anybody with these sorts of issues would end up dying and not diagnosed?

    And I concur with no flu shot. Only time I got one, I got sick right after. Probably coincidence, but definitely a negative association.

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  11. Excellent point...I love a patient who can support her reasons for not taking a medication/immunization...

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  12. This reminds me of something our peanut butter loving father, Tony Draper, once told me as we discussed kids & peanut allergies:
    "I'm glad kids weren't allergic to peanuts in the 70s. If one of you had been allergic, you would have always been in the hospital... because I can't give up peanut butter." LOL!

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  13. I wonder too. Honestly, though, I have to wonder whether statistics would show that child mortality was higher during our childhood and if children died instead of living with diseases. An my grandpa's little brother died when he was 5 in the early 20's with something that was poorly understood in rural NC. My son has it now--Type 1 diabetes. I would love to see the data on how allergy rates have changed vs. childhood mortality vs. immunizations.

    Allison in ATL

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  14. Gotta concur with Ms. Coley. What the hell with this peanut stuff? Tonsillitis. That is kickin' it Old School.

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