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A Grey-Zone-Thinker Gets Her 1st Flu Shot

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I am a 51 year old patient and caregiver advocate, and this year I received my first flu shot. The pandemic has made it clear that this choice was not about me.
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I recently tweeted about my experience with the flu shot, a first at
51 years of age. I would like to massage the word limitations of that
thread into something more fulsome, hope it offers pause, and augments
your perspective in this time of fear and reaction.

I am not a doctor, so it’s an honour to be asked to pull my words
forward in this space. In the healthcare realm I identify as a
patient, caregiver, and MAiD (Medical Assistance in Dying) advocate.
I have been watching the pandemic unfold from this lens, pondering
what is no more and what might become.

I have strong opinions about advocacy work as rooted in lived
experience; I have a huge responsibility to the stories that I bring
forward as they are mine. I have begun to look at advocacy as a job,
and my story as my qualifications. And so it is with those
qualifications in hand that I want to speak about why I chose to
receive a flu shot.

I have trouble with the world in which we live at present because I am
a grey zone thinker. I like the question, “What if?” And this is a
time of wide swings and polarization. I find myself taking a lot of
quiet. But I also think that quiet facilitates spaces for those whose
voices are often silenced.

I have chosen to speak about my flu shot because . . . well it feels a
bit hands-across-the-grey zone. I was afraid. I still am. But my fear
is overridden by a new and current understanding of what it means to
be part of a whole, in this case – society.

At the age of 14, I found my first bald spot. If you know anything
about the autoimmune expression Alopecia Areata, you know it is unique
to the person that it impacts. In my case the loss was slow, with one
period of regrowth in my late teens, and then progressive loss over
decades. I lost my eyebrows in my 30s, and now in my 50s my leg hair
is finally going, which is a rather cruel yet welcome joke.

The Alopecia community is where I got my start as an advocate. We
live with what might be dubbed an aesthetic disease, and I was like
many in that for years I noted I was “not sick.” Now I like to speak
of the shades of this disease expression. My immune system is on
hyperdrive, and it is confused. No, I do not feel sick.I am also
privileged in not managing other autoimmune expressions beyond the odd
bout of iritis and irritable bowel.

The expression of alopecia areata – hair loss – is predominantly a
personal, psychological, and social one to manage. I choose to live
my life “uncovered,” but I know my fellow community members who choose
to cover are living with the same fears and insecurities that I have
integrated into each day over the 37 years since that first small
patch.

And it is my alopecia “qualification” that has shifted my thinking
over time regarding some of our more common health terminology. You
will note I use the word “manage.” I think it’s the apt verb for what
I attempt to do with my health on a daily basis. But I also think
manage is a more realistic word than “cure.” It acknowledges that I
am in relationship with my body, and that I invite healthcare into
that relationship.

The other word I stopped using as my experience with both alopecia and
advocacy grew, was “cause.” I prefer the word “trigger,” and in using
it I give a nod to all of those alopecians who have argued and debated
and commiserated with me over the years. My view of my alopecia is
that it commenced after the introduction of a new and sudden stressor,
but I know others in community who believe that equally unique triggers
brought on their fall.

And so I round back to the flu shot, to vaccination. At this point in
my narrative I am hoping it does not surprise you to hear me say that
I believe two things can be true at the same time. My feet are
planted comfortably in the grey zone when I make this statement, but I
do get a little uneasy as I step into these next words.

There are those that believe their alopecia was triggered by
vaccination. The hard stories I have heard or read in this regard are
from parents, whose children lose their hair within days of a booster
or other age-based vaccine. Some of these parents shift their beliefs,
which I guess puts them in the same boat with those we now label
“anti-vaxx.” But others hold two truths not unlike me. They know the
vaccine will protect their child, and they believe – sometimes with
the fortunate support of a medical professional – that it also
triggered an autoimmune response.

So I have just explained my fear of the flu shot. My hair is gone,
but where might my confused immune system turn next? Of course I have
had the flu over the years, and my management of it also lulled me
into thinking I “faired well.”

Then along came Covid. It may be a polarized world, but the pandemic
has also elevated the concept of the collectivity in our mindset.
Collective trauma. Collective fatigue. To be sure we experience this
global event differently dependant upon a myriad of factors, most
particularly the social determinants of health. But the collective
consciousness is what has shifted people such as myself. Did it cross
my mind that a covid vaccine might trigger an autoimmune response?
Sure. Did I hesitate to get both of my shots? No.

I shared my decision to get a flu shot for the first time with a
friend who is a few years old than me. I was surprised to hear that
he too, was now choosing to receive his first. “I realized that this
is not about me,” he said, when I asked what had changed. “Covid has
made me realize that I am doing this for others.”

My friend is right, and there are a lot of things right now that are
not about me. This kind of collective push has also brought with it
the realization that there is no “us and them,” which can be a hard
pill to swallow when witness to some current human behaviour. I think
that is why I chose to speak up on Twitter about my flu shot. Hands
across the grey zone.

Take a good look at me, for I am just like you. I am managing fears,
sometimes more aptly than others. I am changing and challenging myself
from within those fears. And I am doing my best to listen to a range
of voices such that I hear how fear differs within this collective we
call society.

And now I will be silent so you can let my words soak in.

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Jana Buhlmann

Jana Buhlmann is a patient, caregiver, and MAiD (Medical Assistance in Dying) advocate who lives on the West Coast of Canada.

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SoMeDocs, short for Doctors on Social Media, is a physician-created & led health media company that aims to build a beautiful catalogue of verified online healthcare voices. Our goals are to teach educated professionals tools for personal success, and to showcase them to the world, and facilitate the connections needed to grow. Join us.

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