Should I Have Just Taken the Tamiflu? [New meta-analysis says anti-virals don’t work, we were duped]

flu-shots-grim-reaper-400x294

Bad flu shot marketing or genius way to sell Airborne?

“Well, if you want to stick around for a flu test, I can give you some Tamiflu.”

“No thank you,” I shook my head.

“Okay, at least let me write you a scrip for cough syrup with codeine so you can sleep.”

“Again, thank you but no,” I said.

The doctor looked at me, bewildered, “Then why are you here? Don’t you want to feel better?”

I do. Believe me, I want to feel better. I’ve been fighting off what I thought was a head cold for over a week and when my cough suddenly got worse, I broke down and took my husband’s advice to go to the doctor. But I didn’t go to get meds, I’d gone to make sure that my cold hadn’t turned into pneumonia or something. Once we’d established my lungs were clear as a bell, I was ready to drag my sorry self home and go back to bed.

Don’t get me wrong – I’m definitely not against doctors or modern medicine or even prescription drugs (I take my anti-depressant every day!). We vaccinated all our children. And antibiotics even saved my son’s life.  But personally I just don’t like taking medicine for normal things my body can handle on its own. Yeah my cough is exhausting and I’d like it gone but it’s not going to kill me and eventually it will get better on its own.

rumplstiltskin

Not relevant at all to the flu but I just had to show you how creepy Rumpelstiltskin is!

On the show Once Upon a Time (a show about fairy tales and enchantments and all that, it’s not important you know the plot but my kids love it so we watch it every week don’t judge me), Rumpelstiltskin (yes, the gold-spinning, baby-snatching evil genius) is fond of saying, “Remember, magic always comes with a price!” whenever someone wants to use a spell to take the easy way out of something. I kind of feel the same way about medicine – it can be a miraculous healer but it always comes with a price, in the form of side effects. Sometimes, like when my infant son came down with a fever of 108 (!), it’s worth paying any price. Even when he got a bowel infection that gave him months of diarrhea because the antibiotics wiped out his gut flora, I still considered the IV antibiotics worth it because at least he was still alive to poop on me.

(And hooooboy did that kid poop all over me. He got the nickname “squishy” because every time we’d go to get him out of his crib, his jammies would be so full of crap he’d squish. By the way, once we got him on a high-quality probiotic it resolved within days. Amazing.)

But for a head cold? Even if the risk of side effects is small, it’s still not a price I want to pay. The flu (as in the real influenza, not a tummy bug) is a different animal though. At its worst it’s a ruthless killer, as evidenced by the 1918 pandemic that killed 30-50 million people in a single year, more than died during the entire duration of World War I. But most of the time the flu is deadly only for the very old, the very young or people with compromised immune systems. It can still be very bad and unpleasant – which is why I choose to get my flu shot every year – but for most of us that get it, we’ll be fine with a little r&r.

Once you’ve got the flu, traditionally there hasn’t been much you can do for it but to manage the symptoms and let it run its course. Antibiotics are useless (or worse than useless since their overuse cause drug resistance) because it’s caused by a virus. But then in 2009, the FDA approved the antiviral Tamiflu, and later Relenza, to help decrease the severity of the flu and even possibly prevent getting it. This news was seen as not just a way to take less sick days but as a veritable miracle, perhaps preventing another worldwide flu pandemic. And for anyone who’s ever seen any pictures of the 1918 flu pandemic, you’ll agree that we’d be willing to pay almost any price to prevent that devastation from happening again. And pay we have. The US alone has spent $1.3 billion stockpiling antivirals.

But that may have been a waste of money, says a new study published jointly by the Cochrane Review and the British Medical Journal that reviewed the data from drug trials (many previously unpublished) involving more than 24,000 people. The researchers concluded “the drugs were of only marginal benefit, shortening the duration of influenza symptoms by just half a day.” They added that they found no good evidence that the drugs prevented the spread of the virus between people nor did it prevent any of its serious consequences, such as pneumonia or infections. But they did find Tamiflu and Relenza increased the risk of psychiatric disturbances, renal problems, nausea, vomiting and headaches.

This evidence directly contradicts the findings of earlier studies. The Chochrane Review, considered by many to be the gold standard in research, said this is because the drug companies withheld data from more than 50% of the people they studied. British Medical Journal editor-in-chief Fiona Godlee said the review was the result of many years of struggle to access trial data previously hidden from view.

Oy. Now, I’m not usually one of those big conspiracy types but this is straight out of a medical thriller. Except without a rakish damaged-but-good-at-heart hero to save us all.  Where is Jack Ryan when we need him?!

But, let us not forget that flu kills 4,000 – 49,000 people a year in the U.S. alone while the number of deaths attributed to Tamiflu is…7. And many community health experts, including the Centers for Disease Control and Prevention, are worried that this negative study will hurt people.

“We need better antivirals, including combination antiviral treatments, but right now this is all we have got,” said Dr. Tim Uyeki of the CDC’s flu division. “CDC recommends early antiviral treatment as soon as possible for any hospitalized patient with suspected or confirmed influenza. The number of observational studies suggesting the benefit of early antiviral treatment in hospitalized patients keeps growing.” He added that the benefits of Tamiflu, given as a pill or in a syrup and Relenza, an inhaled powder, “greatly outweigh” any side effects.

So, which is it – worldwide corporate conspiracy to foist useless pills on us all or the opening salvo in the war against a disease that has the potential decimate the human race?

My doctor tried one last time to get me to reconsider saying, “I really think you’re being silly. You’re a busy mom! You need to get better as soon as possible.” Her comment struck me as one more example of our go-go-go always-give-100% culture. Maybe I don’t need to get back to my crazy life as soon as possible. Maybe I just need more rest. I left empty handed.

So should I have taken the Tamiflu? Eh, I’m not sorry I didn’t take it (or the codeine for that matter). And I’m feeling better already.

What’s your stance on flu meds? Any of you used Tamiflu? Who wants to write the novel about this conspiracy?

14 Comments

  1. “Who wants to write the novel about this conspiracy?”

    I have other conspiracies to deal with, but I did not know that it helped to be “a rakish damaged-but-good-at-heart hero”.

    I need to work on the rakishly handsome part.

    I laughed as I read this post with my half-empty container of Apo-Ibuprofen 400mg that my doctor prescribed for me January 2013 after a car accident…sits positioned in a prominent if dusty manner in the clutter that is this work-space.

    It is a 50 tab container, and as mentioned…half gone. But I also had several refills that I never filled because I never finished this one.

    My thinking was: the whiplash HURTS…but not enough for another one of those.

    Yet.

    So there it sits.

    When younger, my hours walking through a whiteout blizzard after having fallen through the ice in a river caused me to sleep for three days straight. While I was out, medical type people assessed me as having pneumonia. There is a nursing station in the community, and what is beyond their expertise, they contact the doctor who comes into town regularly. When I woke up, my uncle Jean-Marie was in the kitchen boiling some roots. “Drink the water, gargle the water, chew the root.” he said.

    At least I hope that’s what he said (I was still woozy) because that’s what I did.

    It worked.

    (A side note as you are LDS Charlotte: This brings to mind the scripture Alma 46:40 – “And there were SOME who died with fevers, which at some seasons of the year were very frequent in the land–but not so much so with fevers, because of the excellent qualities of the many plants and roots which God had prepared to remove the cause of diseases, to which men were subject to by the nature of the climate…”)

    I still get vaccinated every year. I may be even more susceptible now after my three day waltz with pneumonia.

    I would use Tamiflu to slow down the spread..benefits of early antiviral treatment and all of that.

    But I don’t overreact.

  2. The book you’re looking for is Ben Goldacre’s Bad Pharma (http://www.badscience.net/books/bad-pharma/). It’s not a novel, but you’ll want to hear what he has to say. There’s TED talks and all, check him out if you haven’t already. And get well soon!

  3. I’m with you, Charlotte, I don’t take meds when I have something that my body should be able to handle on its own. I take my antidepressants faithfully, I’m prone to strep and take my antibiotics when I get it, I’m fully vaccinated as is my son. I’ve never had the flu (I do not, however, get a yearly flu shot) but I wouldn’t take tamiflu if I were to get it. When I have a cold, it’s tea and sleep for me. And I agree that the idea of taking xyz to get well that much faster so we can return to our hectic lives is silly. No! If I’m sick I need to respect my body and rest.

    I’m not sure I think there’s any conspiracy about it, haven’t really researched it at all. My approach just seems like good common sense to me. Although my husband, who is an anesthesia provider, would disagree. When he gets even a sniffle, he busts out every and any med he thinks might help. I find it slightly amusing and slightly sad.

  4. I am with you on not taking meds for things that are going to get better on their own. I am all for vaccinations and all that stuff- I am a firm believer in medicine and science! But if I have a cold, I don’t normally take medicine. It will clear up in 2-3 days if I take the meds or not. Now, obviously something like strep throat- I took the antibiotics!!!! That’s a different story. Oh, quick funny story… About 2 years ago I had a cold and really needed it to clear up because I had a singing performance I had to do. My voice teacher told me to take Tamiflu. But for some reason I thought she said Zicam. OMG ZICAM IS HORRIBLE. Not to be gross, but it gave me the WORST diahrrhea. I don’t know what is in that stuff but it was not good. I would never take that again.

  5. I don’t know anything about Tamiflu, but likely if I was in bad enough shape to actually make a doctor’s appointment, I would have taken the drugs. Not saying you should have, just what I probably would have done.

    If I do get sick – not just a case of the sniffles, but really sick – I usually do take something to help with the symptoms. I don’t enjoy feeling miserable. If some Nyquil will knock me out and ensure that I get a good sleep, I’ll take it. Maybe I’m just a wimp. 🙂

  6. And that is why I get the annual flu shot.

    I feel sorry for children whose parents don’t vaccinate them. It would be worse to propagate the diseases they may catch including those in the recent measles outbreaks. 🙁

  7. My body tends to over-react to drugs. Cold medicine will put me to sleep for up to 24 hours and other times it doesn’t work at all on me. Sleeping pills have never worked on me at all, but the flu shot or anti-biotics make me violently ill. As a result I usually try to avoid the drugs and when I’m sick I stay away from people. I find the best defense is good nutrition.

  8. 1) I LVOE once upon a time and Rumple is awesomely complicated…
    2) Like everything else in life… there are good and bad people, companies, etc. I wouldn’t let the few (or many ) crooked companies deter you from taking medecines when needed. It takes YEARS to develop therapeutics and sometimes it takes years after marketing to “discover” adverse events. Personally, I would rather try (when needed) a drug that was develped by a pharma or biotech and been through fdA approval than try witch medecein (aka homeopathics that have not been tested for safety at all)… most of those “natural remedies don’t even have active ingredients…so not saying Tamiflu is the bomb, jsut saying with some goods, come some bads too,…

  9. The last time I got the flu (10 years ago–I’ve gotten the flu shot every year since), Tamiflu made me feel worse, not better. I’m glad to see that I’m not the only one with adverse side effects from it.

    In general, I try to avoid using medicine since I tend to be really sensitive to it and I’d rather my body just fight it off, but sometimes it is worth it. Currently taking lots of meds for a sinus infection/eustachian tube blockage for which the only symptom was repeated bouts of vertigo and unsteadiness. When the drugs kicked in and I no longer felt like I was either on the teacups at Disneyland or on a cruise ship, I was so happy I started dancing around the living room–to the horror of my children.

    Rest up, eat lots of fruit/veggies, and get better soon!

  10. I avoid as much as possible….especially after 2+ years of antibiotics to rid my body of Lyme disease. I also get my flu shot every fall….with one exception. Year before last I did not get my flu shot, I just never made the time. Well then January (a year ago) rolled around and the flu hit me like a ton of bricks! I’ve only ever had the flu 2 other times, and both time I lost a week of my life/ I simply had no recollection of the week once I recovered each time. So this time they ran the test and offered me the Tamiflu which I jumped at, not wanting a repeat of the last 2 flu bouts. Instead of losing a full week, I was feeling better within 2 days. I also had to take an antibiotic as I had also – in just the day it took me to go to Urgent Care I had also developed pneumonia. It was magical. But so was the Tamiflu. I have never recovered that quickly! And would take it again, should I ever forget my flu shot again.

  11. I avoid as a general rule. Advil is about as hard core as I get. The one exception is codeine cough syrup. When a cough gets so bad that you can’t sleep (and your husband moves to another room), you’re not getting any rest and that’s not going to help you get better. The codeine gives the whole coughing apparatus a break, knocks you out, and sometimes that’s all you need to jump start the ol’ immune system. So my vote is skip the tamiflu and just take the codeine. (True story: once I gave my codeine cough syrup to my 8 year old by mistake, and after a panicky internet search on codeine overdose brought up really scary possibilities, I called poison control — turns out it was ok, he just slept really, really well that night…)

  12. I take enough meds, so unless I was in the hospital (where there are so many icky, scary germs I just want to get out of there as quickly as possible) I wouldn’t take Tamiflu. I haven’t had the the flu in many, many years, but the last time I got it I was REALLY sick, but in no danger of pneumonia…at my very worst would I have taken a pill to make the suffering end even a 1/2 day earlier? Maybe…it was THAT bad!!! Of course I just ASKED for cortisone shots in the mvp joints of 2 of my fingers and they HURT!!!!! But after a day or so they will feel better …hopefully for at least a month so I can make it to surgery to replace them. So I guess my definitive answer is… it depends… on how sick I am, where I am and how much relief will I get?

  13. I’m an icu nurse and this past winter season, there was a huge flu epidemic that actually killed middle aged folks. It was ugly!

    Now I’m really confused that your doctor wanted you to take Tamiflu so late in the game. Studies have proven that Tamiflu should only be given with the first day or two of getting the flu. Otherwise, it is a waste.

    I’ve taken it and I experienced no obvious side effects.

  14. Yeah, I honestly don’t know if over-the-counter cold medications or prescription meds do much to relieve people’s symptoms. If you’ve got a cold and can get through the day– rest, fluids, and time.