July 9, 2017 | Barbara Vujaklija, RN
How to Protect Yourself From Infection While Immunosuppressed
Unfortunately many medications we take for Autoimmune Encephalitis are intended to suppress our immune systems.This leaves us in some cases vulnerable to infections from microorganisms that may enter our bodies in a variety of ways. So how do we cope? The extent to which you need to protect yourselves depends on a mix of things. Such as which medications at what doses you are on. How long you are on a certain medication. Where you live and what facilities you have available. And many individual factors only you can determine with your Doctor. The following recommendations are for patients with extremely compromised immune systems due to the medication/therapy they are on Your situation may be different please ask your doctor which precautions are appropriate for you. And remember that these may change as medications are tapered or raised.
The single most important thing you can do to stop the spread of infection is HAND WASHING. As a nurse I taught the CDC’s ‘When and How to Wash Your Hands’ course as part of my duties as Infection Control Nurse to staff members and in the local community. AE patients can do a home friendly version of the CDC protocol. First a moment of myth busting. 1) You don’t need hot water to get your hands clean it’s the friction of rubbing them together that dislodges the germs. Your skin couldn’t stand the temperature needed to sterilise your hands. You are just cleaning them. 2) No you don’t need antibacterial soap. In fact it’s a bad idea as it kills off the weak bacteria leaving room for the strong ones to overgrow.
So how do you safely wash your hands?
Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, and under your nails. Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.Rinse your hands well under clean, running water. Dry your hands using a clean towel or air dry them.
When to wash you hands – Before, during, and after preparing food; Before eating food; Before and after treating a cut or wound; After using the toilet; After changing diapers or cleaning up a child who has used the toilet; After blowing your nose, coughing, or sneezing;After touching an animal, animal feed, or animal waste; After touching garbage. (Centers for Disease Control and Prevention. Updated April 17, 2017)
To Jab or Not to Jab – The use of live and attenuated vaccines varies greatly from medication to medication and also dosage. The best thing to do before having any vaccinations while on immune suppressing drugs is to talk to the doctor who prescribed the suppressing medication.
Bet you didn’t think of this – Brushing teeth and flossing twice daily can prevent mouth infections which for folks likes us can cause some serious problems.
Protect that skin – Don’t ignore cuts and scratches clean and cover and monitor for symptoms of infection. Report temp over 100.5 and any other symptoms of infection to your doctor immediately.
Avoid sick people – especially with diarrhea or who are coughing or sneezing DUH!
Practice very safe sex. – Sexually transmitted diseases such as herpes can be a problem for anyone. But they can be very dangerous for people who are immunosuppressed . Condoms may not be enough to fully protect you . Even Saliva can expose you to colds and viruses.
Food should be cooked or if eaten raw thoroughly washed. Use different prep areas for raw meat and cooked meat and also raw vegetables such as salad or scrub thoroughly with a bleach solution between uses. Avoid raw fish and other seafood. Never eat rare ground beef as it has multiple surfaces mixed in with their surface bacteria. Properly cooked steaks that are seared on all surfaces may be eaten medium rare. Cooked that way the surface germs are mostly eliminated.
Crowd Control – Stay out of crowded indoor areas, if you want to go to the mall or the movie theater go when there will be the least people there. Week day mornings are good for malls and matinees for the movies, try to sit near the front in a row with as few people as possible at the movies and in a mall keep a 6ft distance between you and anyone coughing or sneezing.
A word about masks. – The common masks that most of us have encountered are really designed to protect us from sick people. BUT they are most effective if worn by the sick person. If someone is coughing or sneezing in an enclosed, crowded space it does everyone else a favor if THEY wear the mask. The masks you buy at the pharmacy or grocery store are best at trapping large particles like mucus or water covered bacterium or viruses which is what usually comes out with a cough or a sneeze.These fall out of the air at around 6ft. Airborne viruses can go right through, as these are not covered in mucus or water and so are smaller and lighter. So if you are at least 6ft from a cough or sneeze you are generally safe. Of course the CDC never saw my father sneeze! The point is that wearing a mask in public may protect you from germs in a sneeze or cough that is right in your face but unless you plan on spending time with a friend with the coughs and sneezes ( bad idea) there rarely is a need for a mask.
For pet owners – If you must tend to pet feces yourself use disposable gloves and wash hands thoroughly afterwards. Avoid farm animals and petting zoos.
For the gardener – Ask your doctor before gardening. Soil contains many microbes that could pose a hazard. Again check with your doctor and always wash hands after touching soil.
The best strategy is a discussion with your doctor about what is necessary for you. At your level of medications and the environment you live in and your lifestyle. Also the need for any prophylactic medications and instructions on their use.