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Pregnancy & H1N1 Facts for Healthcare Workers


April 18, 2013- DMC Harper Hospital Kidney Transplant Program

Christopher Brantley says he will never forget the moment when he realized that he was going to need dialysis for life if he didn’t get a kidney transplant.

 

For the 43-year-old Brantley, a Detroit resident who works as an efficiency expert at one of the city’s major hospitals, the “moment of truth” came in November of 2011 . . . as he staggered along a hallway on grotesquely swollen and painfully throbbing feet.

 

“As long as I live, I’ll never forget that morning,” says Brantley, the father of two children and a Lean Six Sigma Process Improvement Specialist who’s now working on a Ph.D. in Organizational Leadership.  “Up until that day, I’d always been able to convince myself that my chronic kidney disease could be managed.

 

“But when I woke up that morning, I could barely get from my bedroom to the bathroom.  My feet were swollen up as big as basketballs, and they hurt so bad I just wanted to cry.

 

“It was then that I finally admitted to myself: If I don’t get a new kidney soon, I’m not going to make it.”  Deeply concerned, Brantley feared that if he were required to undergo regular dialysis, he might lose his job due to scheduling issues.  He also fretted that he might lose the scheduling flexibility needed for business – and that he would find it much more difficult to care for his children.

 

Fortunately for Brantley, a former top competitor on the swimming team at the city’s Southwestern High School, a friend had already recommended that he visit the Kidney Transplant Program at DMC Harper University Hospital.

 

“I do think I was very lucky,” says Brantley today, “because the doctors and nurses at the Harper Kidney Transplant Program immediately stepped in to help me get the care I so badly needed.  From that point on, I knew I was in good hands – and I actually began to believe that my health might be restored.”

 

 

Like 26 million other Americans now struggling with Chronic Kidney Disease (CKD), Christopher Brantley faced a huge health challenge.  A lifelong Type I diabetic, his kidneys were slowly failing.  By 2011, in fact, he’d already lost all but about six percent of his kidney function.

 

Long a major public-health problem in Detroit, diabetes-linked CKD requires thousands of area patients to undergo kidney dialysis treatment several times a week.  Of the 13,000 patients on dialysis in the state of Michigan, 4,500 reside in Wayne County alone. For this stressed patient population, which is heavily African-American, kidney dialysis provides a vital, life-supporting function. On average, 20 percent of the patients on dialysis will die every year, however.  This average is much higher than for patients with common cancers such as colon, prostate and breast cancer. The good news is that kidney transplant provides a second chance at life and reduces the risk of death per year to only eight percent.

 

The deceased donor waiting list for patients in need of a kidney transplant now exceeds 2,600 – and the average wait-time is around five years.

 

An option for patients on the wait-list is to receive a kidney from a living donor.  A living donor transplant allows a kidney failure patient to get a kidney much quicker than waiting for a deceased donor transplant -- and kidneys from a living donor, on average, last twice as long as kidneys from a deceased donor.  Sometimes, though, finding a living donor whose body-chemistry “matches” the chemistry of the recipient can be an overwhelming and difficult challenge. But the good news for many Harper kidney patients who have a live donor is that the “matching” problem has been partly overcome by the donor and recipient pair participating in a hospital based and national donor exchange program. With this program, if the donor is not compatible to the recipient, the kidneys are swapped in an exchange with another live donor and recipient pair who are also not compatible. Thanks to newer medications and protocols, kidney specialists are now able to perform more transplants in situations where it was previously not possible due to the presence of pre-formed anti-donor antibodies in the recipient, commonly referred to as “desensitization”.

 

For Christopher Brantley, who received a new kidney from a close colleague at work in mid-December of 2011, achieving a successful transplant was literally a life-saver.

 

“I was very blessed,” the joyful Brantley says today.  “First of all, I got an incredible break when one of my co-workers volunteered to give me a healthy kidney.  And I was also very fortunate to wind up at Harper Hospital, where they have a large, multidisciplinary team of specialists dedicated to managing every aspect of a kidney transplant.”

 

At the Harper Organ Transplant Center, kidney specialist (or “nephrologist”) Mona Doshi, M.D., remembers Brantley as “a very positive-minded, very optimistic patient who was absolutely determined to get better.

 

“Christopher brought a very constructive attitude to the process of recovering his kidney health and that was very helpful,” recalls Dr. Doshi, who managed his care during the lead-up to the transplant operation. 

 

“But his successful outcome was also the result of many coordinated efforts by our dedicated team of multidisciplinary caregivers – including transplant surgeons, nephrologists, nurses, pharmacist, dietician, social worker, financial coordinator, immunology lab personnel, and support staff.”                                                               

 

During a successful operation that took place on December 14, 2011, Christopher Brantley received a healthy new organ from his friend at work. After a hospital stay of only five days, Brantley returned to his Detroit home and his two young children, Dominic and Chrisha.  “I had a little pain and a lot of staples,” he remembers today.  “But as long as I live, I’ll never forget Christmas morning, a few weeks later.  There we all were, sitting around the Christmas tree together.  I’d saved up some money and I spent most of it on presents for the kids.  And I told myself: This is the best Christmas of my entire life.”

 

For Dr. Doshi, meanwhile, Christopher Brantley’s successful outcome is a compelling example of how the veteran Harper Kidney Transplant Team is often able to use its carefully honed skills to “give patients a second chance at life.”

 

Describing the transplant program, she’s quick to point out that CKD patients often face “an uphill battle” to recover their health.  “Unfortunately, the average life expectancy for kidney dialysis patients is markedly lower than age-, gender-, and race-matched individuals from general population,” she says, “and kidney transplant will partly lower this increased mortality associated with dialysis.  And it’s also true that although African-Americans make up only about 15 percent of the general population, they account for 30-40 percent of those on dialysis.”

 

While noting that April is Organ Donation Awareness Month, Dr. Doshi urged potential donors to consider giving friends and loved ones the most precious gift imaginable: “The gift of a second chance at life.”  Such donations are especially needed in the Detroit area, she added, while pointing out that “at Harper, we’re really proud of the fact that our kidney-transplant program reaches more African-American patients, per capita, than any other program of its kind in the United States.”

 

To learn more about the DMC Harper University Hospital Kidney Transplant Center: http://www.harperhutzel.org/transplant.


WHAT IS H1N1 INFLUENZA?
H1N1 influenza is a respiratory disease that is caused by a type A influenza virus. The current H1N1 virus contains unique genes from pig and human influenza viruses and hence is called the “Novel H1N1 Influenza Virus”. This strain of flu germ spreads from human to human and can cause illness.



Does H1N1 INFLUENZA pose special risks for pregnant women?
Pregnant women are at an increased risk of catching H1N1 or seasonal flu. Pregnant patients with H1N1 infection have an increased risk of complications. Although influenza viruses do not infect the baby while in the uterus, the high fever and any complications caused by the flu can potentially be harmful to the baby.



WHAT PRECAUTIONS CAN I TAKE TO PROTECT MYSELF AND MY UNBORN BABY?
The best way to protect yourself and your unborn baby is to have a vaccination (which is safe during pregnancy). You should also make sure you follow good hygiene practices including:

 

  • Wash your hands often with soap and warm water. Alcohol-based gel hand cleaners are also good to use.
  • Try to avoid close contact with sick people.
  • Talk to your doctor about your concerns.

WHAT ARE THE SYMPTOMS OF H1N1 INFLUENZA?
The symptoms of H1N1 flu are similar to the symptoms of seasonal flu and may include acute onset of:

  • Fever (greater than 100 F or 37.8 C)
  • Cough
  • Sore Throat
  • Stuffy nose
  • Chills
  • Headache
  • Fatigue
  • Some people have reported diarrhea and vomiting associated with H1N1 flu.


WILL THE SYMPTOMS BE THE SAME IF I AM PREGNANT?
Yes, the symptoms of flu will be the same as in women who are not pregnant.




WHAT SHOULD I DO IF I GET SICK?
If you get sick with flu-like symptoms, stay home, limit contact with others, and call your doctor as soon as possible.

  • Treat any fever right away. Tylenol® (acetaminophen) is the best treatment of fever in pregnancy.
  • Get plenty of rest and drink clear fluids.
  • Your doctor may test you for flu or will decide if you need medications to treat the flu.
  • Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash and cleanse your hands.
  • Clean hands often with soap and water or alcohol- based hand rub.
  • Do not go to work, school, or other public places while you are ill.
  • Avoid close contact with other people.
  • Get emergency medical care right away if you have trouble breathing, chest pain, purple or blue lips or skin, severe vomiting and are dehydrated and/or dizzy, unresponsive or confused.


IS IT OK TO BREAST FEED MY BABY IF I AM SICK?

  • Do not stop breastfeeding if you are ill. This will help protect your baby from infection.
  • Be careful not to cough or sneeze in the baby’s face, wash your hands often.
  • Your doctor might ask you to wear a mask to keep from spreading this new virus to your baby.
  • If you are too sick to breastfeed, pump and have someone give the expressed milk to your baby.


IS THERE A VACCINE FOR H1N1 INFLUENZA?
Yes, an H1N1 virus vaccine is expected to be available in mid- to late October 2009. The CDC recommends this vaccine for pregnant women when it first becomes available. This vaccine has been tested in pregnant women and found to be safe and effective.


REMEMBER: The seasonal flu vaccine is not expected to protect against the H1N1 flu, therefore individuals are encouraged to get both types of vaccines.

 

 

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