Why the student health center is not for chronically ill students

Why the student health center is not for chronically ill studentsA few years ago, my rheumatologist suggested that I get a pneumonia vaccine.  For some reason, his office couldn’t do it, so I went to the student health center.

When the nurse went to give me the injection, I commented that she swabbed my arm in a weird place – lower than I was used to getting vaccinations.  She assured me that this was the way the pneumovax was administered.

This occurred on a Friday.  When I woke up on Saturday, I had a welt the size of a quarter on my arm.  On Sunday, I woke up and the welt had grown to the size of a fist.  I also had widespread pain throughout my body and was running a low-grade fever.

An online friend of mine with lupus – and I credit her with saving my life in this situation – suggested that I contact the student health center.  I did, and the doctor on call was totally patronizing.  He hadn’t bothered to look at my chart, so he corrected me and told me that I had, had a flu shot.  I corrected him, and his response was, “Why would you get that?”  (While the pneumovax is most commonly recommended for the elderly, it is also recommended for people who have compromised immune systems) I explained that I have lupus and RA, and that my rheum that it was necessary.  Because who wants to die from pneumonia, right?  He told me that he thought what I was describing was normal, and that if I was still having issues, I should come in to the student health center on Monday.

My friend was not satisfied with this – and after I took a picture of my arm and sent it to her – suggested that I contact the rheumatologist on call at the hospital where my rheum is.  So I did.  The woman had an incredibly thick accent, but I did understand her directive of going to the emergency room.

I called a cab, then called my parents and told them that I was going to the ER, but assumed I would be home in a few hours.  I assumed I would be given antibiotics and leave.  I figured my wait in the ER would be longer than any treatment I would receive.

As it turned out, I ended up in the hospital for three days.  My doctors – and this was a major university, teaching hospital, mind you – told me they had never seen a vaccine reaction like mine.

Ultimately, I was diagnosed with cellulitis, an infection of the tissue that is very serious.  At its worst, the infection spread from my elbow to my shoulder, literally my entire upper arm was engulfed.  It was incredibly painful and scary.

The doctors did not know whether I had an adverse reaction or if the vaccine had been administered improperly.  I don’t think the hospital wanted to throw the student health center under the bus.  But they did tell me that had I waited until Monday like the health center doctor had told me, I may have lost my arm or even my life.  And who wants to die from a vaccine, right?

Once things resolved themselves – I was on medication for awhile and had a recurrence of the cellulitis about six or nine months later – I contacted the student health center.  The head nurse called me and told me that I should never have been given the vaccine, basically that I had “No business of getting it”, despite the fact that my rheumatologist felt that it was necessary.  I also reported the incident to the Vaccine Adverse Event Reporting System and the National Vaccine Information Center.  If anything ever came of it, I am not aware.

Could this have happened to anyone?  Sure.  But a vaccine administered incorrectly to a healthy person has a different result than a vaccine administered incorrectly to a chronically ill person.  While the health center refused to take responsibility and the hospital didn’t seem keen on placing blame directly on the health center, it was clear that my immune system being suppressed was not helpful to the situation.

As a cautionary tale, the pneumovax is due to be administered every five years, which means I am due for one this year.  Needless to say, that’s not going to happen.  And it may never happen, I don’t know – even though because of the situation, the hospital was never actually sure whether or not I actually got immunity for pneumonia after all.

But there is one thing I do know.

Needless to say, in my experience, the student health center is not the place for chronically ill students.

Student health centers are designed to deal with the 18 to 24 year old population who are healthy, when they have the flu, mono, strep throat, or an STD.  They are not equipped to deal with chronically ill students who need more attention than your average, healthy 18 to 24 year old.

So this puts chronically ill undergraduate and graduate students in a complicated position.  If you are an older graduate student, who is working and has an already established life, maybe you have the type of insurance where you don’t have to rely on the student health center.  But if you’re not, the student health center is unfortunately your first line of defense.

In my current situation, it is clear that the student health center does not want to deal with me, and I do not want to deal with them either, given my past experience at another university.  But they have happily and helpfully given me referrals to all of the doctors and specialists I need to see.  And I don’t really need to rely on them for anything else, other than hopefully helping them learn how best to help chronically ill students.

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