This year’s flu season is certainly not your standard flu season. 2010 brings not only the current seasonal flu variety, but also the pandemic H1N1 virus, commonly known as Swine Flu. These are two separate viruses. H1N1 is not only of great concern for all members of the population, but also of particularly serious concern for pregnant women.

The single most important action, strongly recommended by the Centers for Disease Control (CDC), is for pregnant women to be vaccinated against both the seasonal flu and, most importantly, H1N1. Both the seasonal flu vaccine and the H1N1 vaccine can be administered at the same time, at separate injection sites. There are two methods of dispensing the flu vaccine; either by injection or by a nasal spray (Flu Mist).

For immunization of pregnant women, only the injectable vaccine should be administered. Ob/Gyn practices will be the first to receive the vaccine. Patients should plan to be vaccinated at their Ob office.

Above: Tis the season to be conscious about germs

In addition to the flu vaccines, there is medication available to treat those with symptoms of the flu or those who have been exposed to someone with the flu. Symptoms of the flu can include: cough, sore throat, runny or stuffy nose, body aches, headache, chills, fatigue, and sometimes diarrhea and vomiting. Fever is common, but it is important to note that not everyone with flu will have a fever. If you have symptoms or if you have been exposed to someone who has the flu, call your doctor right away.

Pregnant women with suspected influenza, or experiencing more severe symptoms such as evidence of lower respiratory tract infection or clinical deterioration should receive prompt empiric antiviral therapy, regardless of previous health or age. Most healthy persons who develop an illness consistent with uncomplicated influenza, or persons who appear to be recovering from influenza, do not need antiviral medications for treatment or prophylaxis.

Pregnant women exposed to someone with influenza should consider antiviral chemoprophylaxis. Chemoprophylaxis should generally be reserved for persons at higher risk for influenza-related complications who have had contact with someone likely to have been infected with influenza. However, early treatment is an emphasized alternative to chemoprophylaxis after a suspected exposure. Household or close contacts (with risk factors for influenza complications) of confirmed or suspected cases can be counseled about the early signs and symptoms of influenza, and advised to immediately contact their healthcare provider for evaluation and possible early treatment if clinical signs or symptoms develop. Early recognition of illness and treatment when indicated is preferred to chemoprophylaxis for vaccinated persons after a suspected exposure.

Go to the emergency room immediately if you have difficulty breathing, or shortness of breath, pain or pressure in your chest or abdomen, sudden dizziness or severe or persistent vomiting. Prevention is certainly the best defense–and there are a number of things we can all do to minimize the spread of flu this season.

Wash your hands! Frequent hand washing or use of alcohol-based hand sanitizers is a major preventative measure. Carry a hand sanitizer in your purse, in the car, even a small bottle in your pocket. You can use them just about anywhere at any time.

Cough into your elbow! This helps to keep your germs to yourself.

Keep your hands away from your face! You will not be infected with the flu by touching a contaminated surface — unless you then touch your eyes, nose, or mouth.

Stay away from sick people if you are healthy and from healthy people if you are sick! You do not want to knowingly expose yourself, but remember, if it does happen, call your doctor straight away.

You do not want to spread the flu if you have it. Stay home and stay away from other family members as much as possible and make sure to call your doctor as soon as you have symptoms.

The CDC will continue to update their website as there is new information:

For general information on 2009 H1N1 flu go to:
cdc.gov/h1n1flu/qa.htm

For more information on flu shots go to:
cdc.gov/h1n1flu/vaccination

It’s apropos that the title of my article is “my journey to PFC”. When you move from New York, to London, to San Francisco, are a part of two decades of assisted reproductive technology, and even take the time to fit in a stint at the San Francisco Symphony, you have indeed taken a “journey”.

I was born in New Rochelle, New York and was the eldest of two girls. However, outside of blueberries, hot sandy beaches, and the Easter Bunny, I remember little about my childhood in the United States. At the age of five, my family moved to London and I grew up in the very pleasant town of Enfield. Ultimately, I found my way into nursing. Interestingly, my sister became a sculptor – our parents certainly allowed us to follow our own paths!

1980 marked the start of my journey to PFC. After working for a while at an OR near London, I embarked on a six-month vacation to the United States. When I visited San Francisco, I just loved it. The city was so friendly and open; it was a very different experience. I returned to London where I worked in the operating department of the Royal Free Hospital, but my heart was in San Francisco and, four years later, I moved to the Bay Area.

My first jobs in San Francisco were as an usher at the San Francisco Symphony and a receptionist at a Homeopathic Clinic – a lovely break from the stresses of OR work. I enjoyed my time at both places, but clearly, nursing was ingrained in me. It was only a matter of time that I would find myself back in a healthcare setting. In 1986, I was an IVF Coordinator at an OB/GYN clinic in Berkeley, which was one of the first to have an in-office IVF program. Working with fertility patients was an empowering and positive experience and I learned a great deal in the 4 years I spent there. From there I went back to the OR, wondering if it was my calling. I worked at a surgery center in San Francisco and enjoyed the work and really liked the people.

However, on a whim, I responded to a job listing for an IVF coordinator at the San Francisco Center for Reproductive Medicine (SFCRM). I was told that the position had been filled. A few days later, I decided to call back and ask if I could leave my resume on file with them. They told me that the position had once again opened up. I took the job, and the rest, as they say, is history.

Working at SFCRM was a challenging and exciting experience. It was a rewarding and eye-opening experience—I had the opportunity to see a practice go from a tiny, empty office with bare walls to a busy full-service fertility clinic. I wore many hats during the early stages — I was an IVF coordinator, I purchased equipment, wrote protocols, and on occasion tackled problems with the antiquated plumbing system. Everyone worked exceptionally hard to get SFCRM off the ground and it was a true team effort. Drs. Herbert and Chenette joined SFCRM in 1992 and the practice grew and grew.

In 1999 Drs. Carolyn Givens, Eldon Schriock, and Isabelle Ryan and Drs. Carl Herbert and Philip Chenette joined together to form Pacific Fertility Center as it exists today.

My responsibilities have evolved over the years but my perspective and appreciation towards those who help individuals overcome infertility never wavers. I am truly fortunate to have an incredible team of nurses, medical assistants (MAs), and clinical coordinators. They work very hard together, and are key in providing care to patients as they navigate their treatment at PFC. Each one of them has gone “above and beyond” what I have asked. I think that truly speaks to the type of people they are.

As Director of Nursing, my role is far more “hands off” than it used to be. I do miss the more extensive patient contact, but with such a positive and supportive nursing team, I know our patients are in good hands. Some of my major responsibilities include: helping to ensure that we are compliant with the FDA, maintaining our accreditation and chairing our Quality Improvement Committee. I always have to keep in mind that my department does not function on its own – all departments depend on each other and have to work together to provide the best patient care.

What has made my experience in ART so exciting is that it is never static. When I first started in IVF the greatest improvement was moving from egg retrieval by laparoscopy to the current ultrasound guided method. Since then, there have been so many innovations that it is hard to remember them all. The changes and improvements quickly become the new standard of care.

I can only imagine what the future holds. It’s amazing how many changes I’ve seen over the years. Thankfully, I’ve been fortunate enough to work in an environment where change for the better is ongoing and accepted. This gives me confidence in knowing that we’re doing our best to help our patients.

– Karen Volpe, R.N.