"I don't think he knows about second breakfast."

( pregnancy notes )

In other news: Last week the "check engine" light in the car came on, which turned out to mean that we needed a new oxygen sensor. We got the rear brakes done at the same time, for a total bill of $475. That was Friday. Tuesday, the "check engine" light came on again.

I took the car in this morning. Apparently, the car's computer doesn't like the correspondence between the front and rear oxygen sensors, and suggests that the catalytic converter must be broken. The guys at the garage can't seem to replicate the problem: they say both oxygen sensors are reading precisely what they should be. They don't want to replace the catalytic converter unless there's more evidence of the problem - which is nice of them, considering that it would be a $600 repair. Apparently, there's a possibility that replacing the oxygen sensor just caused a temporary glitch that won't recur. So they re-set the "check engine" light, and told me that if it comes on again I can pretty much assume that the catalytic converter needs to be replaced.

Pleasantly, they didn't charge me for the diagnosis. They also went out of their way to make sure I understood that a malfunctioning catalytic converter won't damage the car or lead to a breakdown - it will just mean that we'll fail emissions. I don't want to contribute more than my fair share of air pollution, but it's still nice to know that we could put off such an expensive repair, if we have to.

Flu shots.

Normally, I get my flu shot at work. They're eager to vaccinate us because our immunocompromised patients would otherwise be at high risk of catching the flu from an infected employee.

I asked a couple of the nurse practitioners whether we were getting flu shots this year. One of them told me that the patient clinics haven't received any flu vaccine yet. Apparently, there's been some discussion about rationing within the patient population - saving the vaccine for patients with lower CD4+ cell counts.

So I called my primary care provider. They don't have the vaccine, and they're not expecting to get any in. The nurse advised me to call the health department. So I checked the health department website, and discovered that they don't have any vaccine and aren't expecting to get any in. They recommend calling your primary care provider.

I knew my midwife's office wouldn't have the vaccine, but I called to ask if they knew where I could get it. Nope.

Employee Health at the hospital doesn't have it, and won't be getting the injectible vaccine. They might be getting a few doses of FluMist, the intranasal vaccine, which pregnant women can't take.

I knew there was a shortage, but I had no idea it was this bad.

If it were just me, or just me and the Li'l Critter, I'd be willing to take my chances. I mean, if I were to get the flu, the danger to the baby would be either from (1) fever, which can be safely controlled with Tylenol during pregnancy, or (2) dehydration, which can be treated with an IV. The flu wouldn't kill me, and it wouldn't kill the baby.

But if I got the flu, it might kill one of my patients. I'm not being hyperbolic. I have patients whose ability to mount an immune response is damn near zero.

Meanwhile, in childfree, a healthy college student is bragging about managing to arrange a flu shot for herself. I quote: "I'm feeling good about it, because I keep telling myself I'm taking one away from some little brat who really doesn't need one."