Age: 60.0
Sex: F
Vaccine: FLUX(H1N1)
Symptoms: Abdominal discomfort, Abnormal loss of weight, Activities of daily living impaired, Antineutrophil cytoplasmic antibody, Antineutrophil cytoplasmic antibody negative
Clinical narrative: I have little doubt that had I not been a registered nurse and had not proceeded cautiously in treating the symptoms caused by the H1N1 injection taken December, 2009 that my health could have been more adversely affected than it has been. Since receiving the H1N1 injection, I have had health problems which have caused 10 days of attendance violation at work; required me to schedule days off to avoid additional attendance violations, and I have been terminated from my position.  I have since losing my job 5 months ago, felt too physically compromised to even attempt to file for unemployment or seek employment.  Since receiving the H1N1 injection, I have had 3 visits to the Emergency Room for episodes of rash, observed by the ER doctors who provided me with an information sheet for "Rash-Generic". I informed them I had been having this rash for 6 to 11 months since receiving the H1N1 injection. I have made numerous visits to my PCP with complaints of rash, pain, numbness, spasms, and muscle weakness and tremors.  I have had a two day stay in the hospital. I was finally referred to a specialist in Fibromyalgia and he has given me that diagnosis.  The onset of new areas of rash has been witnessed on at least two occasions by another Registered Nurse, after I had told her of the G/I, flu-like symptoms I was simultaneously experiencing. The rash, until November, 2010, was controlled only by taking Benadryl 5 or 6 times daily. If I attempted to stop the Benadryl to stop self-medicating as I attempted each week since this began, healing lesions began to ooze, become itchy and worsen. New rash lesions begin to appear further up the body and the older rash became more active again. My doctor initially stated he believe the rash was parasite bites, but about November 8, 2010, a second doctor diagnosed the rash as vasculitis, and prescribed a month long cycle of Doxycycline.  Up to this date I have had no additional episodes of rash. I have had a 16 pound unintentional weight loss due to gastric distress. Bowel changes occurred which, as a nurse, I recognized by sight as a sign of occult blood. I performed 2 guaiac tests on the stool and it was positive within hours of the onset of stomach distress, which felt 'flu-like' when it occurred. My diet had to be restricted to bland to avoid causing G/I upset. Ranitidine, for food allergies, was not effective in relieving intestinal distress, but Benadryl for general tissue allergic reactions helped my abdominal discomfort.  Even bland foods caused mild G/I complaints and frequent (every 10 or 15 minute) bathroom urges for an hour after eating, a change in my body's habits. This G/I upset continued until I was prescribed Carafate (to coat ulcerated areas in the G/I tract) and Protonix.  I took these medications about 2 weeks and the G/I complaints were resolved by mid December, 2010 - eleven months after taking the H1N1 injection.  I have been able to regain the weight I lost due to the stomach upset which had been present since taking the injection.  My doctor also stated I needed to regain the weight as my weight at that time was too low.  During a pelvic exam approximately August, 2010, the APN had to have the MD verify she was palpating the cecum (part of the small intestine) and not the right ovary. She said she had never felt one that was so prominent and 'squishy'. She thought it was because I was so thin she could more prominently feel it than in other patients. My G/I distress at that time began in the right abdomen (where the cecum is also located) then traveled transverse to the left.  Initial onset of joint and muscle symptoms within hours of the injection began in my left foot and left ankle, then advanced upward to the left calf, left thigh and then both hips. They continued to advance in an upward direction until by August, 2010 my arms and hands were also involved. The right lower extremity had also become affected, although to a lesser degree than the left.  Initial symptoms were constant, intense, burning sensations and slight swelling in the left and right lower extremities. The 'rash' began on the left ankle but over the following months the rash extended even to the trunk and arms. Both lower extremities still are affected with the burning sensation.  Muscle weakness, shakiness, and at times actual fine tremor affected all arms and legs by June or July, 2010. Fine and gross motor strength and control declined. The loss of muscle strength had been accompanied by the spreading rash, which eventually reached the base of my neck, even though taking Benadryl, until the rash was resolved using Doxycycline.  Muscle discomfort in both thighs was constant. Burning in both feet was constant and the burning has extended up to both thighs. Slight swelling in both feet was frequently noted around the heel/ankle area and I had joint or muscle type pain in those areas. I also had muscle type pain in both calves, thighs, hips and lower to mid back.  Unusual bruising occurred until I began taking the Benadryl. The rash, when observed by another registered nurse, was described as appearing to be 'pox' like and left deep scars when not controlled by the Benadryl. Benadryl limited them to a fewer number and more superficial rash. If I stopped the Benadryl, superficial rash became deeper 'pox'.  Muscle pain and deep bone pain were controlled by frequent daily doses of Tylenol and the Benadryl seemed to help control the advancement of the fine and gross muscle weakness, spasm, tremor and pain. I avoided all anti-inflammatories (aspirin, ibuprofen, steroids, and naprosyn) as I did not want to hinder my body's ability to 'fight' the unknown underlying cause. Also they did not relieve any of the symptoms when I tried them on several occasions and they are blood-thinners. I was having bruising problems and what appeared to be blood in the stool I did not want to further aggravate.  All lab values came back within normal limits.  A co-worker died on June 13, 2010 after battling similar complaints following the H1N1 injection. She had all the same complaints of burning, weakness, and muscle/bone pain as I.  She was so disabled that by approximately March, 2010, she was no longer able to work.  Her doctor was treating her for Guillain-Barre.  I spoke with another registered nurse, during July, 2010 who had the same health complaints as I. We pulled up our pant legs and compared 'pox' scars. They were not similar - they were exactly the same. This RN had gone to his PCP, but has had no affirmation of the link between the onset of the symptoms and the H1N1 injection. This RN stated his symptoms were also becoming progressively worse. He stated the burning had progressed to the point that using his fingers to pick up a small, weightless item (ie, a prepackaged pill or capsule) caused pain and burning in his hand and fingers. He stated it was becoming increasingly more difficult and painful for him to use his fingers for fine motor tasks. He stated he was no longer physically able to tolerate a full work week. (The RN who died in June, 2010 had the same complaints of hand pain and burning sensation, loss of muscle strength and inability to open medication packaging. While she was still able to work, I and other co-workers assisted her in completing these fine motor tasks.)  I also observed this RN had suffered an obvious weight loss. I had noticed it several weeks before, but knowing him to be fitness conscious, I had thought it was intentional weight control. The weight loss I witnessed is as I have witnessed in myself. It appeared to be more of a wasting process. His gait obviously required effort. He had complaints of joint pain and stated he had been prescribed pain medications.  A third wo-worker, (Respiratory Therapist) has had similar complaints of pain and burning since taking this injection.  She has now been diagnosed as having Lupus and Reynaud's Syndrome.  I, the two RN's and the Respiratory Therapist referred to in this message all took our H1N1 injection from the same facility within days of each other.  This is a small facility, employing less than 150 employees. Even though I have frequently told my doctors this all began when I took the H1N1 injection, none of them will acknowledge it.  Until this past November when my sister finally got on the phone to my doctor's office and verified I had been having these symptoms since taking the injection, the doctors would not even prescribe the medications which eventually were effective!  ************************************************ OVER-THE-COUNTER medications which I used to control my symptoms: BENADRYL ACETAMINOPHEN I began taking these medications within days of taking the injection (December 22, 2009) and remained on them until December 11, 2010.   ***********************************************************   Medications which have been PRESCRIBED and have resolved or controlled the symptoms: CARAFATE - December 1, 2010 -  PROTONIX - December 1, 2010 - (Settled the stomach and intestinal problems which had caused a 16 pound weight loss. Carafate coats areas that are 'ulcerated' to protect those areas until they heal. I've NEVER had this problem before and after taking Carafate for a short time, I am no longer having this problem nor taking either of these medications. The only change I have made that affects my digestive tract is that I am now able to tolerate and consume a balanced diet.)  GABAPENTIN - December 11, 2010 - It's used to treat pain. It won't 'cure' it, but it treats the pain caused by some neuralgia-type diseases. Dr. diagnosed my complaints as being Fibromyalgia.  DOXYCYCLINE - November 8, 2010 Resolved the 'rash' and 'pox' skin problems occuring on my legs, trunk and arms.