Ask a Nurse: Getting Vaccinated for Polio as an Adult

Ask a NurseThe ExCS site has teamed with a registered nurse and paramedic with a background in healthcare education and public health. Married to a former-CS, the Nurse would like to share their experience with the healthcare system, and answer any questions former-CS may have!  The Nurse will NOT get involved in diagnosing or giving medical advice, but if there are questions folks have related to going to a doctor, explaining medical terminology, how to advocate for yourself in healthcare, and so on, they might have a perspective that can help. 


tl;dr To get your first polio vaccine, you’ll want to contact your doctor or your local health department for more information. Links at the bottom of the post.

HOWEVER, the assumption is adults are all vaccinated (at least for polio), so adult healthcare providers don’t routinely administer the polio vaccine, and often don’t know what to do.


Recently there’s been a case of polio reported in Rockland County New York, just north of New York City, leading to questions on how to get vaccinated. Polio is a virus that can cause paralysis, most famously in US President Franklin Roosevelt. With the advent of a vaccine however, polio has nearly been eradicated (in 2021 there were 6 reported cases worldwide). To prevent a resurgence (like in measles), vaccination is key. Typically, the vaccination schedule is a 4-dose regiment beginning at age 2 months and culminating between age 4-6 years (for unvaccinated adults it’s a 3-dose regiment).

In the United States, the Inactivated Poliovirus Vaccine (IPV) is the only polio vaccine that has been used since 2000. It is given by shot in the leg or arm, depending on the patient’s age. What this essentially means is the polio virus is injected into the person, but the virus is dead, or inactivated. As a result, there’s no risk of actually contracting polio, but the person’s body develops immunity to protect from future exposure of a live polio virus. This video series from Khan Academy is very useful in explaining polio and the vaccine in further detail: https://www.khanacademy.org/test-prep/nclex-rn/rn-infectious- diseases/rn-polio/a/what-is-polio

The risk of serious complications related to the vaccine are very low, however the complications from getting polio can be quite debilitating. As a colleague of mine once put it, “vaccines are arguably the greatest invention in human history.” They have prevented untold numbers of deaths and life-long injuries. In adults, polio can be fatal in 15-30% of patients who suffer paralytic effects. The vaccine protects against those effects.

If you grew up in a family that subscribed to a belief that medicine was unnecessary, you might not have been vaccinated. The question now is, how does one get vaccinated as an adult? The simple advice, at least in the US, is to call your doctor and get vaccinated by following the schedule on the Center’s for Disease Control and Prevention (CDC) website. The schedule posted by the CDC for adults who have never been vaccinated states adults should receive 3 doses along the following timeline:

  • The first dose at any time
  • The second dose 1 to 2 months later
  • The third dose 6 to 12 months after the second

That said, finding somewhere to get vaccinated as an adult isn’t as straightforward as one might assume. I’ve spent the last few days calling public health departments around the United States, calling private doctors offices, urgent cares, you get the idea. I’ve also reached out to colleagues of mine, one of whom is a vaccine and infectious disease expert, to get help. Nobody has great answers for me. Getting the polio vaccine as an adult, at least in the United States, should not be this hard! The assumption is adults are all vaccinated. As a result, adult healthcare providers don’t routinely administer the polio vaccine, so don’t know what to do, and pediatricians don’t know what to tell adults…

I wanted to get this post up so you’d at least have somewhere to start, but I’m going to keep working on this question. If I get answers and can update this post, I absolutely will. In the meantime, the best advice I have is to call your local public health department and explain your situation. Below are a few links to credible resources you can share with healthcare providers.

List of US state health departments:

Information for Canadian residents:

World Health Organization information:

Information on polio and the polio vaccine through the CDC:

Updated to add – If you are unsure of your vaccination status

Your doctor should be able to order blood tests which should be able to detect if you’ve been vaccinated or if you’ve already had the disease.

You can also try to find immunization records: https://www.cdc.gov/vaccines/adults/vaccination-records.html

Ask A Nurse: Headaches

Ask a NurseThe ExCS site has teamed with a registered nurse and paramedic with a background in healthcare education and public health. Married to a former-CS, the Nurse would like to share their experience with the healthcare system, and answer any questions former-CS may have!  The Nurse will NOT get involved in diagnosing or giving medical advice, but if there are questions folks have related to going to a doctor, explaining medical terminology, how to advocate for yourself in healthcare, and so on, they might have a perspective that can help. 


Why pray it away, just pop a pill

A question posed recently to me was, “when is it ok to take something for a headache and when should you just tough it out?”  Back in my younger days I might’ve been stricken with a little “Irish flu” after a night of debauchery and believed I should suffer as the price of having fun.  Lately, social distancing and avid masking has helped me avoid the Irish flu but when I do get a headache, regardless of the cause, I treat it.  Fact is, headaches can be debilitating so my short answer is, never tough out a headache.  Now I could end my post here, but since I think you’ll appreciate a little more information, I’ll elaborate.

In the process of deciding just how aggressively to treat a headache, one of the things to evaluate is the cause.  Dehydration, certain foods, lack of sleep and overexertion are all potential modifiable causes of headaches. I typically see if I can address the underlying cause (for example if I suspect dehydration, I’ll try to hydrate), then take some acetaminophen (eg. Tylenol) or ibuprofen (eg. Motrin/Advil), or both.  Point being, I almost always take some over-the-counter pain relief for a headache. Taking a combination of acetaminophen and ibuprofen is safe as they act on pain receptors differently (refer back to this post on medications for more info).  Just remember to eat something when taking ibuprofen as it can be rough on an empty stomach.   

Migraines are another cause of headaches and these can be so incapacitating they require powerful medications that should only be administered in the hospital.  People who suffer migraines may also be sensitive to bright light or sounds, and/or they may feel nauseous or vomit.  Migraines can last for days and people who suffer them typically have been diagnosed previously.  These folks usually know what brings them on and how best to treat them.  If you suffer a headache so debilitating, I’d recommend getting evaluated by a neurologist.    

Two headache causes that should be checked out immediately, ideally in an emergency department, include head trauma and strokes:

If you were struck in the head or suffered some trauma involving the head, get it checked out.  The story of actor/comedian Bob Saget is fresh in the news and highlights the importance of head trauma being evaluated by a professional.  We’ll likely never know what exactly happened to him, but from what I’ve read, it sounds so catastrophic he might have lost consciousness and not have even recognized the head trauma he suffered.  Something similar happened to my uncle once, fortunately his injuries were identified quickly and the ER was able to treat him.  People who suffer severe head trauma tend to have a significant “mechanism of injury” (MOI), meaning whatever caused the injury involved dramatic force.  Getting hit in the head with a baseball bat for instance, or in the case of my uncle, falling off a bicycle.  One big sign of head trauma is called “retrograde amnesia.”  Whereby the victim of the head trauma cannot recall events that occurred in the minutes or hours preceding the traumatic incident.  

Another concerning cause of headaches are strokes (aka cerebral vascular accidents or CVA’s).  Strokes are a leading cause of death and disability and therefore need to be taken very seriously.  Not all people who have strokes complain of headaches though.  Typically they have other symptoms such as a loss of consciousness (permanent or temporary), visual disturbances/blurry vision, weakness on one side of their body or slurred speech.  

In the case of either head trauma or strokes, time is of the essence.  The person should be taken to the hospital, if possible, by ambulance.  This is especially true if you’re taking something like aspirin or other medication, sometimes referred to as “blood thinners” (coumadin, warfarin, etc.) that interrupts the clotting process.  These medications have been implicated in worse outcomes in patients who suffered head trauma.  Due to reduced ability of the blood to clot though, the bleeding in the brain was more significant than it might otherwise be, causing death or disability.

While many headaches are benign (meaning they’re not life threatening) and can be treated at home, some reasons to seek out medical advice include: 

  1. You don’t have a clear reason for the headache and/or it doesn’t improve or worsens over time
  2. Known or suspected head trauma
  3. Signs of head injury or stroke (dizziness, unsteady gait, slurred speech, weakness, amnesia, seizures, etc.)

Other factors to consider in your decision to seek out medical care for a headache could include preexisting conditions, such as hemophilia, or the persons age.  For most people, headaches are an occasional nuisance, listen to your body though.  If a headache feels worse or you’re suffering some of the symptoms listed above, get checked by your local doctor or ER.


References:

Collins, C. E., Witkowski, E. R., Flahive, J. M., Anderson, F. A., Jr, & Santry, H. P. (2014). Effect of preinjury warfarin use on outcomes after head trauma in Medicare beneficiaries. American journal of surgery208(4), 544–549.e1. https://doi.org/10.1016/j.amjsurg.2014.05.019

Head Injury. (n.d.). Retrieved February 24, 2022, from Johns Hopkins Medicine: https://www.hopkinsmedicine.org/health/conditions-and-diseases/head-injury

Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, et al. Heart disease and stroke statistics—2020 update: a report from the American Heart Associationexternal iconCirculation. 2020;141(9):e139–e596.

Ask A Nurse: A Very Brief Lesson on Medications.

Ask a Nurse The ExCS site has teamed with a registered nurse and paramedic with a background in healthcare education and public health. Married to a former-CS, the Nurse would like to share their experience with the healthcare system, and answer any questions former-CS may have!  The Nurse will NOT get involved in diagnosing or giving medical advice, but if there are questions folks have related to going to a doctor, explaining medical terminology, how to advocate for yourself in healthcare, and so on, they might have a perspective that can help.  


People have been using medications to treat ailments since the beginning of time. For instance, aspirin is essentially the bark of a tree that some person discovered if they chewed, their body stopped aching. That said, medications can be intimidating if you grew up never taking any. I’ve heard stories of people chewing up medicines they probably should’ve swallowed or accidentally overdosing on medicines they felt were safe because they’re sold over the counter (OTC). I’m going to try and give a quick overview of medications. That said, pharmacists go to school for years studying medications. They are a reliable resource and one I use frequently. But here’s a start…

As a quick primer, medications enter the body through several routes.  These routes include: orally (also known as “taken by mouth”), nasally (through the nose), rectally (eww, but it happens), intravenously (IV, meaning directly into a blood vessel), intramuscularly (injection into a muscle, for instance an Epi-Pen for allergic reactions), etc.  There are several other routes, but the important thing to understand is the route can affect how the drug works on your body. For instance, some medications are designed to be ingested, processed by your liver, then released into the blood stream.  This process is called “first-pass metabolism,” meaning the drug is metabolized (or broken down) by the liver first, before being released into your body. Medications specifically designed with this in mind should not be chewed up. By chewing the medications up, some of the medication can absorb faster than intended. If the medication isn’t designed to do that, you may inadvertently overdose on that medication. Of course, with every rule, there are exceptions. Take our friend aspirin, for example.  A 325mg aspirin tablet is typically swallowed, but if a healthcare provider thinks you’re suffering a heart attack (known as myocardial infarction or just MI), they may ask you to chew up the aspirin, so it gets into your bloodstream rapidly and begins acting faster.  (As a side note, never give aspirin to children or anyone with bleeding disorders unless approved by your doctor, it can cause bad things.)  

Some medications like ibuprofen, are deemed safe due to the fact they’re sold OTC.  Ibuprofen (Advil, Motrin, Brufen, etc.) is a common medication used for pain and inflammation but is toxic in large doses and people really should limit how much they take and ensure it’s taken with food.  The big thing ibuprofen causes are stomach ulcers, so I use it sparingly.  Acetaminophen (Tylenol or Panadol depending on where you are in the world), is also toxic in large doses, specifically to the liver.  Again, I try to limit how much acetaminophen I take. One thing to note, common OTC medications are sometimes added to other medications. NyQuil for instance usually has acetaminophen as one of its’ ingredients. It’s really easy to unintentionally overdose yourself if you’re not careful. The label should list “active ingredients” which are typically the ingredients that have an effect on the body. A normal adult shouldn’t take more than 4 grams (4,000mg) of acetaminophen in 24 hours. So if you’re not feeling well and took 1,000mgs of Tylenol every 6 hours, plus a dose of NyQuil before bed, you’d inadvertently overdose on acetaminophen.

Some medications come packed in huge pills, what my mom used to call “horse pills.”  Often these pills are scored and can be cut in half, then you can swallow each half one at a time. 

example of a pill that can be split in half
example of pill that is designed to be split in half – photo provided by the Nurse

One of my central themes is “the patient is their own best advocate.”  You are more likely to be compliant taking the medication if it’s easy for you to take.  So, if a doctor prescribes medications to you, ask how it is administered.  Most medications come in a variety of forms, and there may be other options for you.  If you forget to ask the doctor, when you go to pick up the prescription you can ask the pharmacist for alternatives.  The pharmacist can call the doctor and check.  You might need to wait a bit longer, but better to have something you’re comfortable taking. 

Personally, my feeling is that there’s no need to “tough it out” or “suffer in silence” when there are treatment options.  Medications can be intimidating and they’re not perfect, but they also enable us to have productive lives.  A simple rule is to follow the directions on the medications box or bottle. If you ever have a question though, the pharmacist is a good resource.  


Additional Former-CS-based Resources

Ask a Nurse: If you’re concerned, get it checked out!

Ask a Nurse The ExCS site has teamed with a registered nurse and paramedic with a background in healthcare education and public health. Married to a former-CS, the Nurse would like to share their experience with the healthcare system, and answer any questions former-CS may have!  The Nurse will NOT get involved in diagnosing or giving medical advice, but if there are questions folks have related to going to a doctor, explaining medical terminology, how to advocate for yourself in healthcare, and so on, they might have a perspective that can help.  


Thank you everyone for your feedback on our first post! This post is in response to a comment from our first Ask A Nurse Post (slightly edited to protect everyone’s privacy).

From our Facebook group comes the following dilemma:

When I am able to access health care services one of my biggest fears is finding out that I had ailments that would have been preventable had I gone sooner (like in childhood) or that the current ailments that I have have progressed and only gotten worse by going untreated…. Am I being irrational? It makes me nervous, I definitely want to go, I have no hesitations about going, but I’m worried.


Ask A Nurse Responds:

Hi all, the feedback from my first post was really inspiring, building on that I’d like to respond to a comment regarding fear of going to see a doctor. From the sounds of it, it’s not that the person didn’t want to go to the doctor or feared how the doctor might react to hearing the person had never been to a doctor, but what the person might find out by going to see a doctor. *

I can empathize with that. I understand that the fear of discovering you’ve been carrying around a preventable or curable illness could be emotionally overwhelming. I’m not sure how to push someone to overcome those feelings, except to say, many things can be solved if addressed early. That and the idea, the more often you do something, the easier it becomes. Going to the doctor that first time can seem intimidating to the point of panic. It goes against everything you’ve been taught. My concern/fear is, I’ve heard enough horror stories of folks in CS who delayed care for so long, that they go past the point of being able to fix it. More than likely whatever you’re facing is something that can be addressed, but you’ve gotta take that first step and see someone. Again, I’m not here to judge CS, I was never in the religion, I grew up Catholic (Catholicism has its’ own set of issues), and as I like to say, I’m a “recovering Catholic.” But, if you’re concerned about a potential illness or nagging pain, get it checked out. The sooner you can figure out the problem, the sooner you can deal with it. 

Whenever you do decide to go to the doctor, how do you know who to see? This blog has a great description on how to find a primary care doctor, and I would encourage you to review that post. I will add though that if you need a specialist, in the US, most health insurances will require you to start with your primary care doctor and get referred to a specialist (as it sounds, a specialist is someone who focuses on a specific field of medicine). For instance, if you’re concerned about some weird heart palpitations, you’d go see your primary doctor first, and then that doctor would refer you to a cardiologist for further examination. This can be time consuming, but it saves money (at least for the insurance company). 

My biggest piece of advice, and this applies to anyone, anytime you do go to the doctor, bring a friend. Preferably someone you trust and who is familiar with the healthcare system. My mom was a registered nurse, when she was older, even though she was an experienced nurse, my sister and I would take turns going with her to appointments (sometimes we’d both go with her, and other times my sister would conference me in via FaceTime). The advantage to having someone with you is they can think of questions you might not or hear things you might not. Doctors can talk fast; another set of ears helps. Reportedly patients forget 40-80% of what is said during their appointment and 50% of the rest is heard incorrectly. I usually tag along to my spouse’s appointments to help interpret jargon and ask questions. Take notes during the appointment too. Most phones have a notes app or something similar. Old-fashioned pen and paper work well too and it’s less likely to be confused as texting 😉

It’s been pointed out that bringing a friend may be difficult given the pandemic.  At many hospitals and doctors’ offices, visitors are limited and, in some cases, not allowed at all.  My solution for this is simply to phone a friend.  Recently, a close friend of mine was diagnosed with a rare cancer.  The family asked if I could help.  As I couldn’t be with my friend directly, my friend simply called me, put me on speaker and gave verbal permission for the medical team to speak with me (some places might require you to sign a permission form).  The physician and nurse then spoke with my friend while I listened in, took notes, and asked questions.  As long as you, the patient, give permission, the healthcare team should never have an issue with you conferencing a friend in via phone (and if they do have an issue with it, well, that’s a red flag).  

Also, feel free to interview the doctor a bit during that first encounter. I’ve shopped around for different doctors. I ask questions about how long they’ve been practicing, how long they’ve lived in the area, stuff like that. All I’m trying to do is build a rapport. If someone gives me a bad vibe, I find someone else. “Bedside manner” is important, especially if you’re looking for a long-term doctor/patient relationship. I also look for subtle things, how do they treat the nurses and other staff members? If they’re a jerk to their staff, they’re not someone I want to give my business to.   

Regardless, nobody is more invested in your health than you. Nobody knows what you are feeling better than you. Trust those instincts. You are your own best advocate. If something feels off, get it checked. Maybe it’s nothing, but the peace of mind afforded by knowing it’s nothing, or at least something that can be dealt with, is better than carrying around that stress in your head.  

*Quick side note, instead of a doctor, you might see a nurse practitioner (NP), or you might see a physician assistant (PA). I personally have been seen by all of the above and have no qualms being examined by either a doctor, NP, or PA, especially for routine stuff. For clarity in this post, I used the term “doctor,” but that could refer to any of the aforementioned disciplines.


Additional Former-CS-based Resources

Ask a Nurse: What to expect when calling 911

Ask a Nurse The ExCS site has teamed with a registered nurse and paramedic with a background in healthcare education and public health. Married to a former-CS, the Nurse would like to share their experience with the healthcare system, and answer any questions former-CS may have!  The Nurse will NOT get involved in diagnosing or giving medical advice, but if there are questions folks have related to going to a doctor, explaining medical terminology, how to advocate for yourself in healthcare, and so on, they might have a perspective that can help.  


Navigating the intricacies of the healthcare world can be difficult, and that’s for those of us who work in the healthcare system! For people who aren’t employed in healthcare but have a fundamental understanding of the system, especially in the US, it can still be daunting.  For those folks who may have never interacted with, (or worse, been made to fear), the healthcare world, it can be downright overwhelming.  I’m a registered nurse and paramedic, though I didn’t grow up in CS, I’m married to someone who did.  As we dated and eventually married, I discovered just how ill-informed and unfamiliar she was with the healthcare world.  Ironically, the healthcare world is very ill-informed and unfamiliar with CS.  In nursing and paramedic school I learned all about Jehovah’s Witnesses, but I had never even heard of Christian Scientists until I met my wife, at which point I had been working in healthcare for nearly a decade. When I would ask friends and colleagues if they had ever heard of Christian Science, many of them would say, “Of course! Isn’t Tom Cruise a Christian Scientist?”  

I’m hoping to use this forum to bridge this knowledge gap and provide a conduit for ex-CS’ers to have a safe space to ask healthcare related questions and get accurate and reliable answers.  I don’t claim to be an expert, but I’m experienced in the healthcare field, I understand the lingo, and I definitely have access to experts.  One thing I can’t do is diagnose or give much medical advice beyond telling you to go see a doctor.  That said, I can help with terminology, how to speak with medical providers, and help you find your way through this crazy system.  

As a new contributor, I want to make this as useful and relevant as I can.  In addition to being a nurse and paramedic, I also have a master’s degree in nursing with a focus on public health.  Having met several ex-CS folks and having read several books and articles on Christian Science, I realized the value of having someone who can help guide those less familiar through the healthcare system.  Questions posted through the site will be routed to me and I’ll answer them.  Of course, this is not a rapid system, if you have a healthcare concern you think requires immediate assistance, go to the hospital or call 911, speaking of, what happens when you call 911?


What to expect when calling 911

Calling an ambulance can bring on a fair amount of anxiety.  With rare exceptions, most people don’t call an ambulance very often in their lives.  When they do, it’s because they need emergency care for themselves, or a loved one.  Now when you dial those three numbers, like you’ve probably seen on TV, someone answers the line asking “911 what’s your emergency?”  After ascertaining the nature of the emergency, other dispatchers will begin to direct the appropriate ambulance to your location.  Once the ambulance arrives, the responders will begin asking you questions.  Most will be pretty easy to answer.  Obviously, they are going to ask why you called 911, they’ll ask for your name, date of birth/age, and, (now we get into the tricky part), if you have any medical history (which you may or may not know).  They’re also going to ask if you have allergies to any foods or medicines (which again, you may or may not know).  They’re going to ask if you take any medicines routinely. As you’re already in a vulnerable state, a ton of emotions are probably flowing through you.  Fear, pain, embarrassment, & shame are all possible emotions and feelings you may have.  You also may not want to get into the intricacies of CS and Mary Baker Eddy.  So, if you don’t know your medical history, the easiest thing to do is tell the EMS providers that you grew up in a family that didn’t use medicine, and you either don’t know or are unsure of your medical history or allergies.  They might raise an eyebrow for a second, but believe me, we’ve encountered stranger things (I won’t mention the guy I picked up once, with the thing, in the place, it shouldn’t be), so not knowing your medical history won’t shock us.  

There are some patients that believe calling an ambulance will speed up the process to see a doctor.  I can tell you for a fact, this isn’t true.  I have definitely brought patients into an ER, via my ambulance, and been told to bring those patients to a chair in the waiting room.   Others may believe if they call 911 for a loved one, the ambulance has to take them to the hospital, also not true.  If you call an ambulance for a loved one, and the person is over 18 years of age and of sound mind, if they tell the EMS providers they don’t want to go to the hospital, they can’t take them.  They may be bleeding out all over the street, but if they say they don’t want to go, and EMS takes them against their will, that’s kidnapping.  Legally, the EMS providers can be arrested and charged.  Now, this isn’t to discourage you from calling 911 if you need it.  You should absolutely call 911 if you think you need help. 

Point is, most of us who got into healthcare did so because we genuinely want to help people.  So, when you tell us you’re not sure of your medical history, most healthcare providers are simply going to note that fact, and continue treating you.  One thing to never do, is be afraid to ask questions.  If a provider is saying something that doesn’t make sense or is unclear, ask them to clarify.  Tell them to explain it to you like you’re a 5th grader.  We throw around jargon almost as badly as the military (the first time I worked in an ER someone had written next to the patient’s name “SOB,” which I thought was a bad attempt to warn staff of a difficult patient, actually it means “short of breath”).  

As intimidating as it might be, do your best to get clarification if you don’t understand something.  Providers may get frustrated, especially if they believe they already clarified something, but as I tell my wife, push the person to give you an answer that you understand.  Some ex-CS’ers I know never attended biology class or sex education in high school or college.  There may be things we in healthcare assume everyone knows, but if you haven’t even taken a high school biology class, you may have a severe blind spot.  

Truth is, even though you’ve called 911 for an emergency, rarely is something such an emergency that providers don’t have time to answer questions.  I once treated a patient who was CS, and was as close to dead as you can get while still alive.  The patient’s spouse allowed me to treat their loved one, and despite how sick this person was, I was still able to provide the necessary care while explaining everything to the spouse and ensuring they were comfortable with the treatment I was providing. 

In any case, calling EMS can provoke some anxiety, but it’s better to call them and find out later you didn’t need to, than to not call them, but realize later you should have.  To quickly summarize:

  1. Understand the EMS provider may be a little thrown when you mention your background.
  2. Despite that, they should still treat you respectfully and with compassion.  
  3. Get clarification and ask questions.  

I hope this quick snapshot was helpful.  If it was, leave a comment and feel free to ask me questions.  Like I said in the beginning, I want to make this as relevant and helpful as I can for you; so, if there are questions or specific topics you’d like to be covered, let me know.