PUMPING IRONY: A Kind of Reckoning

This is the time of year when those of us among the senior set are typically subjected to unmerciful nagging from public-health experts about rolling up our sleeves for the seasonal flu shot. And, after a year during which COVID precautions essentially neutralized the influenza bug, the chorus has only raised the volume of its pleas.

“If there has ever been a year to prioritize getting your flu shot at the beginning of the season, this is it,” says Donald Lloyd-Jones, MD, an epidemiologist at Northwestern University’s Feinberg School of Medicine. “The flu will be back this year, and getting the flu vaccine as soon as possible will offer the most protection for you and your loved ones.”

Lloyd-Jones and others are arguing that we may lack immunity against the bug this fall because it didn’t make its normal rounds last year. And with Americans gathering unmasked more frequently these days despite the lingering pandemic, we may contribute to a “twin-demic” if we skip the flu shot — while also running the risk of contracting both COVID and the seasonal bug.

Meanwhile, researchers at Houston Methodist Hospital remind us that a bout with influenza can heighten the risk of a heart attack or stroke. The inflammatory response to the virus, they explain, can stress the circulatory system, making arterial plaque more likely to rupture and cut off oxygen to the heart or brain.

“Apart from its well‐recognized respiratory complications, about one in eight patients admitted with influenza has an acute cardiovascular event, with 31 percent of those requiring intensive care and 7 percent eventually dying,” lead study author Priyanka Bhugra, MD, writes in the Journal of the American Heart Association. “Individuals with preexisting cardiovascular disease have even greater risk of cardiovascular events and mortality associated with influenza than in the general population.”

I have historically ignored such overtures, mostly because I’ve always managed to escape the flu season without having felt the bug’s effects — despite never being inoculated. Evidently, my immune system has been strong enough to fend off the virus when it emerges each fall. And, if the results of a recent American Heart Association poll are any indication, mine is not an uncommon calculation: Three in five of those surveyed reported that they would delay or skip the shot this fall.

So, why did I decide to finally get jabbed? It’s complicated.

I’ve never been persuaded by the sort of fear-based messaging that so dominates our broken healthcare system, but I can’t deny that the pandemic has shifted my thinking. Maybe it’s just dumb luck that I’m still standing after 18 months of COVID’s rampage, or perhaps it has more to do with the fact that I followed the advice of public-health officials, rolled up my sleeve for the vaccine, and thus managed to keep out of harm’s way. For this and other reasons — including my brother’s death at the hands of an aggressive cancer last year — I’ve come to appreciate how vulnerable we become to catastrophic illness when we reach a certain age.

Then there’s Medicare. My Lovely Wife turned 65 last month, which allowed the two of us to disengage from my employer’s health-insurance plan and enroll in an Advantage program that covers dental, vision, hearing, and — most valuable, to my way of thinking — 20 acupuncture sessions each year. And that multilayered decision-making process sparked some lively conversations about our longtime estrangement from the conventional healthcare system and the realities we’re likely to face as we navigate the frontiers of old age.

That doesn’t mean we’re suddenly going to submit to a series of invasive cancer screenings or descend into the pharmaceutical vortex to manage symptoms we’ve always handled with nondrug approaches. Acquainting ourselves with a practitioner at a neighborhood health clinic, however, seemed to make more sense at this point than it has in the past. We can’t assume that we’ll coast through the rest of our days without encountering some troubling health issues, and given the way the system operates, we’ll need to have some connection with a primary-care physician and clinic in order to maneuver as smoothly as possible amid those scenarios.

The whole flu-shot decision, then, came together as a result of surviving COVID (so far), enrolling in Medicare, and connecting with a primary-care physician. I could’ve just walked down the street from my office and paid to get poked at the drugstore, but it felt more like it needed to be part of something larger and more profound. A kind of reckoning.

So, I masked up the other day and walked from my office over to the clinic in the strip mall a block away and declared my intention to become a patient. The receptionist took my name and searched her files for any evidence of past treatment.

“Are you still on Snelling Avenue?” she inquired.

“Ha!” I replied. “That was two addresses ago.”

I later recalled the kidney-stone attack that sent me to an ER — evidently in this clinic’s network — during the Fourth of July weekend 20 years ago. I’d seen a doctor from a different network since then, but only to clean out my malfunctioning ears every couple of years.

She updated my information, reviewed my Medicare card and other relevant documents, and scheduled an appointment for the flu shot. All seemed to be progressing according to plan until I mentioned that I’d prefer to work with the integrative/complementary-medicine practitioner I’d spotted on the clinic’s website. This was greeted with a blank stare.

“You mean the acupuncturist?” she ventured after a moment.

“Yes. She practices here, doesn’t she?”

“Yes, but Medicare only covers acupuncture for lower-back pain.”

“Hmm,” I pondered, deflated. “My back feels fine.”

She reached for a piece of paper listing the four physicians currently practicing at the clinic. “These are the doctors you can choose from,” she noted.

I thanked her and stuffed the paper into my pocket.

At home later, I reviewed my choices — all conventional MDs — and couldn’t help chuckling at my naiveté. Why would I assume a hidebound healthcare network would offer integrative-medicine doctors as a primary-care choice or imagine that an insurance plan would cover a treatment approach proven effective for a multitude of conditions over the past 5,000 years?

I wasn’t worried about my lower back; a steady diet of exercise has always kept it functioning. The discomfort I was beginning to feel was located elsewhere. I may be setting myself up for a major dose of frustration and disappointment. More like a pain in the butt.