Sure, I dropped out of medical school ("withdrew" would probably be a kinder, and more accurate description of my leaving as I left before I took a single test). But I still am wired to be interested in biology and to think like a scientist (after dropping out of medical school, I was in an immunology PhD program for 2 years before, you guessed it, dropping out). I have also had to fight for medical care in certain instances (see any of my previous blog posts re: Gwen and reflux to understand my current frustration with the medical establishment). Thankfully, however, I have a doctor for a husband, a determination to solve problems, and the Internet.
Some patients who have the internet drive their doctors crazy. We had one patient like this at the doctors office at which I was a receptionist. I knew she was one of our frequent flyers as her chart was so thick that it was in 4 separate folders. She had already had several MRIs that year, and called one day to ask for another one. Apparently, she had been online the night before looking for things that might be wrong with her. During her search, she discovered that if you get a leak of cerebrospinal fluid that comes out of your nose, it will result in an elevated sugar level in your nose. So what did she do? She borrowed a friend's blood glucose monitor and tested her snot glucose level. She decided it was elevated and that she needed an MRI (as far as I am aware, there is no established proper snot glucose level). This is a condition called cyberchondria.
I don't have cyberchondria. I just have the ability to sort through information, determine what is reputable and reliable (and, despite the title of this post, I do not consider wikipedia a reputable source and it used to drive me crazy when I would sit in Gen Eds and hear people say during presentations, "According to wikipedia..."), and draw conclusions. Thanks to a helpful suggestion from someone at church, tons of internet research, and a phone call with a friend who is a med/peds resident, I felt confident with Gwen's diagnosis of reflux and was ready to demand a prescription for Zantac. Score: Sara 1, pediatrician 0.
After Gwen started her Zantac, she became such a joy to be around. She started sleeping better, and I was thankful that I had ignored the pediatricians advice that as long as Gwen was fed and changed I should just ignore her cries. Then, shortly after her improvements, she reverted in many ways. She was irritable all the time and started sleeping poorly. She had just been around her sick friend, so I thought it was reasonable to take her to the doctor to make sure she didn't need an antibiotic. The doctor looked at her, determined that she was perfectly healthy, repeated that I should just let Gwen "cry it out" as long as she is fed and changed (because that advice worked so well the last time...) and sent me on my way. Upon entering the pediatrician's office that day, I knew that Gwen wasn't really symptomatic. I just noticed a drastic change in temperament right after she performed her favorite hobby at Payton's house: licking toys. I called the triage nurse who told me that I should bring her in, even though she had no fever and no runny nose. I told the doctor that Gwen's little friend had a double ear infection, at which point she cut me off and said, "ear infections aren't contagious." I know that. But the bacteria that caused the infection IS contagious. I didn't have the ability to check Gwen's ears at home, so I just wanted the doctor to give them a looksie to make sure that they weren't infected.
I have had a general malaise all week. I thought I was just worn down from Gwen waking me up so much. I even had a little sore throat, but it was so slight that I didn't think anything of it. Until this morning. This morning I woke up with a worse sore throat. It still wasn't too bad, but I thought I would bust out Keith's doctoring supplies (he keeps an otoscope and an ophthalmoscope in the medicine cabinet) and look at my throat. Upon looking at my throat, I noticed pus coming out of my tonsils. It looked very much like strep throat. Even though it wasn't bothering me too much, I figured I should get a throat culture just in case, especially since Gwen might have the same thing. (The doctor did look into her throat on Tuesday but I think that I caught her illness so early that she was still in the prodromal stage - before you become symptomatic, but you just have a general feeling of yuckiness - where the bacteria or virus is multiplying.) At urgent care, my throat culture came back negative. However, the doctor did say that I likely had a virus that looked indistinguishable from strep throat (white bumps - pus - on tonsils, swollen uvula, red soft palate).
I wondered what that virus might be so I would know what I might be able to expect (they don't diagnose viruses beyond saying "I think you have a virus"). So I jumped on to wikipedia to see what I might have. While I think that wikipedia is not terribly reliable, it is useful for certain topics. For example, let's say I were studying for a test in my old PhD program and I wanted to look up Time of Flight Mass Spectroscopy. The only people who know what that is or who know to look it up are scientists or students studying for a test. Troublemaker Billy doesn't know to play a prank by misstating facts about ToFMS. He is more likely on wikipedia reporting that Fergie met a tragic demise when she was eaten by crocodiles. This story would be picked up by every major news channel, and Fergie's publicist would have to state that she was not, in fact, eaten by crocodiles. Also, while most people don't care to make corrections on Fergie's wikipedia page, scientists are an uptight bunch. If a scientist regularly did ToFMS and realized that the wikipedia entry were inaccurate, he would quickly remedy it. Therefore, I feel pretty confident when researching scientific topics on wiki. That's why, when I found out that adenovirus looks identical to strep throat and is only distinguishable by culture, I felt okay relying on that information. I also learned that adenovirus can lead to pink eye and ear infections. Not that this makes any difference to the amount of time it will take for my body and Gwen's body to rid themselves of infection, but at least I know that if she gets red, weepy eyes or starts crying when I set her down on her back that it might be the adenovirus hard at work.
For anyone who is keeping track, it's Sara 2, Pediatrician 0.
Some patients who have the internet drive their doctors crazy. We had one patient like this at the doctors office at which I was a receptionist. I knew she was one of our frequent flyers as her chart was so thick that it was in 4 separate folders. She had already had several MRIs that year, and called one day to ask for another one. Apparently, she had been online the night before looking for things that might be wrong with her. During her search, she discovered that if you get a leak of cerebrospinal fluid that comes out of your nose, it will result in an elevated sugar level in your nose. So what did she do? She borrowed a friend's blood glucose monitor and tested her snot glucose level. She decided it was elevated and that she needed an MRI (as far as I am aware, there is no established proper snot glucose level). This is a condition called cyberchondria.
I don't have cyberchondria. I just have the ability to sort through information, determine what is reputable and reliable (and, despite the title of this post, I do not consider wikipedia a reputable source and it used to drive me crazy when I would sit in Gen Eds and hear people say during presentations, "According to wikipedia..."), and draw conclusions. Thanks to a helpful suggestion from someone at church, tons of internet research, and a phone call with a friend who is a med/peds resident, I felt confident with Gwen's diagnosis of reflux and was ready to demand a prescription for Zantac. Score: Sara 1, pediatrician 0.
After Gwen started her Zantac, she became such a joy to be around. She started sleeping better, and I was thankful that I had ignored the pediatricians advice that as long as Gwen was fed and changed I should just ignore her cries. Then, shortly after her improvements, she reverted in many ways. She was irritable all the time and started sleeping poorly. She had just been around her sick friend, so I thought it was reasonable to take her to the doctor to make sure she didn't need an antibiotic. The doctor looked at her, determined that she was perfectly healthy, repeated that I should just let Gwen "cry it out" as long as she is fed and changed (because that advice worked so well the last time...) and sent me on my way. Upon entering the pediatrician's office that day, I knew that Gwen wasn't really symptomatic. I just noticed a drastic change in temperament right after she performed her favorite hobby at Payton's house: licking toys. I called the triage nurse who told me that I should bring her in, even though she had no fever and no runny nose. I told the doctor that Gwen's little friend had a double ear infection, at which point she cut me off and said, "ear infections aren't contagious." I know that. But the bacteria that caused the infection IS contagious. I didn't have the ability to check Gwen's ears at home, so I just wanted the doctor to give them a looksie to make sure that they weren't infected.
I have had a general malaise all week. I thought I was just worn down from Gwen waking me up so much. I even had a little sore throat, but it was so slight that I didn't think anything of it. Until this morning. This morning I woke up with a worse sore throat. It still wasn't too bad, but I thought I would bust out Keith's doctoring supplies (he keeps an otoscope and an ophthalmoscope in the medicine cabinet) and look at my throat. Upon looking at my throat, I noticed pus coming out of my tonsils. It looked very much like strep throat. Even though it wasn't bothering me too much, I figured I should get a throat culture just in case, especially since Gwen might have the same thing. (The doctor did look into her throat on Tuesday but I think that I caught her illness so early that she was still in the prodromal stage - before you become symptomatic, but you just have a general feeling of yuckiness - where the bacteria or virus is multiplying.) At urgent care, my throat culture came back negative. However, the doctor did say that I likely had a virus that looked indistinguishable from strep throat (white bumps - pus - on tonsils, swollen uvula, red soft palate).
I wondered what that virus might be so I would know what I might be able to expect (they don't diagnose viruses beyond saying "I think you have a virus"). So I jumped on to wikipedia to see what I might have. While I think that wikipedia is not terribly reliable, it is useful for certain topics. For example, let's say I were studying for a test in my old PhD program and I wanted to look up Time of Flight Mass Spectroscopy. The only people who know what that is or who know to look it up are scientists or students studying for a test. Troublemaker Billy doesn't know to play a prank by misstating facts about ToFMS. He is more likely on wikipedia reporting that Fergie met a tragic demise when she was eaten by crocodiles. This story would be picked up by every major news channel, and Fergie's publicist would have to state that she was not, in fact, eaten by crocodiles. Also, while most people don't care to make corrections on Fergie's wikipedia page, scientists are an uptight bunch. If a scientist regularly did ToFMS and realized that the wikipedia entry were inaccurate, he would quickly remedy it. Therefore, I feel pretty confident when researching scientific topics on wiki. That's why, when I found out that adenovirus looks identical to strep throat and is only distinguishable by culture, I felt okay relying on that information. I also learned that adenovirus can lead to pink eye and ear infections. Not that this makes any difference to the amount of time it will take for my body and Gwen's body to rid themselves of infection, but at least I know that if she gets red, weepy eyes or starts crying when I set her down on her back that it might be the adenovirus hard at work.
For anyone who is keeping track, it's Sara 2, Pediatrician 0.
That leakage of spinal fluid through the nose is called CSF Rhinorhea and they do use glucose measurements as a diagnostic tool. Not that she wasn't nuts, but she was right about that.
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