Wednesday, October 07, 2009

Differential Diagnosis

In July, I developed strep. Yep, in the middle of summer, during a period where I saw very few people, I somehow developed strep. It wouldn't have been as big of a deal, but my stomach didn't like the antibiotics. Even once the strep was gone, I still had a weezy cough that cough medicine and mucinex didn't really help. The cough reminded me alot of the cough that I had before I went on medication for acid reflux, so I thought that my esophagus might have just gotten extra-more-irritated during the stomach vs. antibiotics battle and began to take a larger dose of over-the-counter generic prilosec than I had previously. (I was also thinking that my recent weight gain probably wasn't helping either.) That didn't seem to help though. I was still coughing, with weezing on and off. I didn't really want to do anything about it, mostly because I felt like it was mostly psychosomatic, a symptom of the larger depression while staying alone at my grandma's house. I didn't want to spend a bunch of money that we don't really have only to be told it was in my head. But my mom was worried that it was contagious and that I might make my immuno-compromised uncle sick, so I went back to the walk-in clinic where I'd been treated for strep. The nurse practitioner there told me that it was bronchitis and to go to a doctor for a chest x-ray if I wasn't better at the end of the antibiotics that she was going to prescribe. On the one hand, I felt... vindicated? because she was telling me that it wasn't all in my head. It wasn't even because I was overweight. It was just being sick. On the other hand, I might be contagious and/or it might be something, or turn into something, serious.

But I was optimistic. I took the antibiotics. On the first day, I felt great. No weezing. No cough. Second day, I still felt fine. After 24 hours, I was no longer contagious, so I could leave the isolation of my grandma's house and go home. But, alas, it was just the placebo effect. By the night of my third day on the antibiotics, I was back to the weezing and coughing. Of course, I felt decent during the daytime, so I didn't take advantage of any doctor's office hours, for a few days. Eventually, though, it was getting ridiculous. Last night, just taking a small bag of trash outside from the basement had me reaching for an inhaler. Plus, once again, if I'm going to help my uncle during his chemo, I have to be well myself, or at least not contagious, so today I went to the doctor. A real doctor, not a walk-in clinic. Well, kinda. All I could get on short notice was a physician's assistant at my former primary care doctor's office, but still.

And..... the diagnosis is...... I'm fat. Ok, well, thankfully the PA didn't say that. But because I haven't had a fever with the cough, it's not an infection, thus neither bronchitis nor contagious. She was fairly sure that it was just severe irritation of the esophagus. She gave me a prescription of a steriod, to help with my breathing, though it will make me a crazy hyper tweeker for the next several days. She also gave me samples of nexium, namebrand and all. Her theory is that I'll only need a protein pump inhibitor, like nexium, for a bit, until my esophagus heals, then I should be able to 'manage' my acid reflux by "eating a proper diet, maintaining a healthy weight, and avoiding things that irritate it, like caffeine, alcohol, tobacco, spicy foods, acidic foods, etc [or everything good]." I have a follow up in three weeks, so we'll see what happens then, but.... Well, I'll write a later post about what I am thinking about all the dieting and not being fat issues. I just hope this really is what is wrong with me and I start feeling better. I guess I'll worry about the rest as it comes along. But this feels like the lamest episode of House ever.

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