Thursday, October 2, 2008

Azithromycin: My savior, My scourge.


As you may have gathered by this point, I've been sick this past week. And it became evident to me within my first two days of illness that what I had was a sinus infection. The women in my family all have messed up sinuses - we're like those dogs who were bred to have smooshed in noses and therefore eternally have respiratory problems, except that we don't look nearly as bizarre and our hair's not as perfectly coiffed and nobody makes us strut in trade shows.

Anyway.

My point is that when I get a sinus infection, I know what the hell is going on. I also know that, without swift action, it will likely at least move into my chest to cause a lovely bronchitis, whose taste has haunted me since childhood, and also possibly migrate over to one or both ears, the pain of which I remember all too well from continual infection between the ages of 5 and 9. See, what with having my chronic illness and all, my immune system is basically raging full blast fighting invisible enemies. So if a lil' bug gets through that initial force, well, it's already withstood all I've got and survived. Which means that I'm screwed - I'm not gonna be able to fight it off with all the vitamin C in the world. All of this spells one course of action: antibiotics.

Now let me make this quite clear: I HATE ANTIBIOTICS. I don't take them unless I absolutely have to. I'm not one of these idiots who wants to take them for a cold or the flu, or for allergies - yeah - that's one of my absolute favorites. Who would choose to destroy all intestinal flora? Their overuse is absolutely rampant in our society, and the results of that are being seen daily in extremely frightening ways - such as the superstrains of staph infections that now plague young healthy people instead of only the very young, the very old, and the sick, and the uber-scary UTIs that are around these days, the details of which are too gruesome to discuss here. So many people are allergic to them too - my sister and my fiance among them. Despite this knowledge and these feelings, the fact is that antibiotics are a lifesaving measurement when used correctly. I am a somewhat enfeebled person, and when it comes to a genuine bacterial infection that's really got hold of me, it's what I have to do so I do it.

There was a time in... 2004? 2005? When I had some kind of something happening, but as is my habit I ignored it. It's not convenient to go to the doctor; I was busy with school and work, and it's expensive, and anyway I always felt like crap so it was probably just that I was sleeping poorly, or having allergies or something, right? I ignored it for too long, and ended up in the emergency room because "it" in fact was an infection that had made its way into my chest, and actually infected my lungs rather than merely causing bronchitis. (At least two of my readers may remember this; I know one definitely will...)

I couldn't breathe. I mean, I could technically, but it was an extremely slow and arduous process, like the worst asthma attack ever for days on end. I was getting so little oxygen that my vision was darkened and spotty. After the night at the hospital, receiving a breathing treatment that helped the breathing but made me violently ill (ever inhaled the entire contents of two albuterol inhalers in the span of two hours? That's essentially what I did), I laid in bed for days and days. I thought I was going to die. I ended up missing two weeks of work, and even after that respite when I returned I was much slower than usual from sheer weakness. I remember clearly that the first time I tried to climb our double-decker staircase at my normal pace I blacked out.

(The genetic history here actually comes from both sides. My father, from whom I got my asthma, was discharged from basic training after his lung capacity was reduced to 30% one day during exercises. Of course, before they could send him home they had to keep him in the hospital for three weeks.)

Ever since that little incident, I've been more careful. I do ignore a lot of things that go on in my body; it's the only way that I can get through a day. But certain symptoms, and particularly anything related to breathing, get my attention and keep it until properly resolved. So when the horrible stabbing pain of neuralgia in my face began on Monday, and was ever so concentrated on the righthand(head) side stretching from my eyesocket clear through into my ear canal, I knew I was in trouble.

Of course, the trouble wasn't only in illness. If you've been keeping up, you'll recall that a few months back I dropped my COBRA coverage and picked up a plan through Healthy NY/Atlantis. Well, I've since discovered that this new plan basically covers nothing - certainly not my doctor.

See, I don't bother with General Practitioners. They just don't get me. They tell me that stuff doesn't hurt when it does, they don't understand why I eat the way I do, they want to test me for things that I already know I don't have (is it your thyroid? it seems like your thyroid. why don't we check your thyroid... for the thousandth time?)... and then when they can't find an answer that they're happy with they tell me I need therapy. Well well. Alright jerkoff, I've been in therapy for twelve years. What else ya got? Well, they got pills. Sleeping pills, pain pills, muscle relaxants, anti-depressants, appetite stimulants, appetite suppressants, uppers, downers, you name it. You name it and I don't want it.

In summary, the GP does me no good whatsoever. Instead my regular doctor is a rheumatologist, and moreover one that specializes in my disease. We skip right over multiple hours/visits worth of bullshit because he looks at my chart, and then examines me, and then says, "right, so you have fibromyalgia. What do you find works best for you?" He approves heartily of my chiropracty and yoga, and even of my veganism "if that's what makes you feel better." He tells me about new drugs that might be good for me and asks if I want to try them; I tell him I'll let him know if my pain levels get beyond the point of endurance and he says "OK, fine, no problem, just want you to know what's out there."

I love my doctor. He's one of the best things about living in New York. But to the new insurance company, he is that dreaded devil: the specialist. They won't cover him, no way no how. I mean, who ever needed that kind of doctor. And so to see him would cost me $250. And, um, I don't got it. So when I know that all I need is a Z-pack, it seems crazy to, say, borrow that from my parents or Jonathan, just so that he can tell me what I already know and hand me a prescription that could have just been called in to the pharmacy.

On Tuesday, this is what I had to convince him of. He, though, was not the trouble. As awesome as he is, his staff are somehow the most evil bitches on the face of the planet. What's that about anyway? Why are all people who work in the fronts of doctor's offices insufferably mean? Last year I needed them to do a very simple thing - call in a prescription for a migraine medication. The doc had told me to ask them to do it. And yet, somehow, I had to get hung up on three times and get into an almost-screaming argument with these banshees to get it accomplished. Now, I know how to talk to people. I'm nice, and I'm patient, and I say please and thank you, and I don't pull out the bitch until I absolutely have to. I have no idea why they made it so difficult, when all I was doing was asking them to do their freakin' job so that I could get a medication that I desperately needed and that my doc wanted me to have.

Needless to say, after that trauma I was not eager to call them up. So I sort of told a fib about why I wanted to talk to the doc, thinking that if I told them the truth they'd stonewall me. Well that backfired bigtime. I got a call back (from one of the banshees, of course) telling me that if I needed to talk to him "about my medications" (the fib I'd told) that I should just make an appointment. So then of course I had no choice but to break down and tell the whole story. That I had a sinus infection, which I knew because my face felt like someone had poured acid into it, that I made up the first story because I have had problems with the front desk before, that I couldn't come in because my insurance won't cover a visit and I can't afford it out of pocket because I've been out of work for six months, that I don't have another doctor.

Man, was that a fun conversation.

Well, being a good doctor, my doc did call me back personally that afternoon - while I was attempting to pick up cupcakes, as a matter of fact. It was a complicated day. And he knows me, and knows that I understand my body and hate pills, and knows that "everyone is going through hard times right now", so called in the scrip for me - but will not do so again until I come and see him. Fair enough. Luckily the insurance does cover prescriptions... now that I've paid the deductible that is, and as long as they're not "mental health related".

So now I'm on the evil stuff, and hopefully it does the trick because if it doesn't I'm totally screwed. It should; I'm still convinced of my diagnosis, and since I only take antibiotics when I have to (and don't have a constant low dose of them in my food) they tend to be pretty effective. So I'll implore you once again, dear readers, to keep your fingers crossed for me.

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