Knowing What’s Good For Me

Wednesday morning I awoke with an unpleasantly familiar sensation of tightness in my upper chest, as if something was squeezing my trachea, making breathing somewhat difficult.  I say this sensation is familiar because it’s a condition I’ve experienced countless times in my life, beginning at a very young age.  My upper respiratory system is my Achilles heel – every illness begins and ends there, with coughing and wheezing and laryngitis.  Oh my.

This week’s malady didn’t quite follow the usual pattern, which is to start with the nasal passages and work its way into the pharynx and larynx, finally ending up in the bronchial tubes poised to attack the lungs if I haven’t been smart enough to get to the doctor for antibiotics.  This time it started right out with a dry, hacking cough.  It wasn’t too bad, though, not bad enough to keep me from sleeping at night or working during the day.

Until today, that is.  This morning, I woke up completely congested and wheezing loud enough to be heard across the state.  My cough had morphed from a polite little bark into the full blown seal bellow that scares the dogs out of the room.

So I headed to my local Urgent Care, where I found eight people in line ahead of me, all of them coughing with varying degrees of severity.  I quickly became the champion in the group, drawing everyone’s attention with my deep bass outbursts.  “My goodness,” I heard more than once, “you sound terrible!”

“You should be home in bed,” my seat partner told me.

“Believe me, I’d like nothing more,” I replied, 90 minutes into my waiting time.

Finally, I was called back into the examining area where I answered the usual series of obligatory questions.  A very gentle Nurse Practitioner in training came in and listened to all areas of my chest with her stethoscope.

“Your lungs sound pretty clear,” she said when she finished.

But the doctor, a nice older woman who looked a little bit like Jessica Tandy, disagreed. “Oh, you’re really wheezing down there,” she said after one listen.  “You may have walking pneumonia.  Let’s get a pulse ox and an X-ray.”

At first my oxygen level reading was rather alarming.  I’m no doctor, but I know that anything under 95 isn’t good, and I was starting out with a 93.  The nurse instructed me to take deep breaths in and out of my mouth, which I did for a few seconds and the level rose to 97.  “Good girl,” I was told, and trundled off to X-ray.

After a few minutes, my doctor returned to the room.  “All clear,” she told me happily.  “It’s just a bad case of bronchitis. I’ll get you a Z-pack and an inhaler to help with that wheezing.”

I know a Z-pack, or Zithromycin, is the treatment of choice for bronchitis.  It’s been prescribed for me on two occasions in my long history of upper respiratory maladies.  Both times, it did absolutely no good and I’ve gotten pneumonia shortly after completing the medication.

“Z-packs don’t work for me,” I told her.

“Oh, what do you take then?” she asked.

“Usually Levaquin,” I replied.

“I would have prescribed that if you had pneumonia, but it’s much too strong for bronchitis.”

“But I’ve taken it several times before for these infections,” I said.

“No, you don’t need that,” she insisted. “The Z-pack is what’s always prescribed for bronchitis.”

Hmm. I was no match for the “it’s always done this way” monster, especially not today, sick and exhausted as I was.  Nor am I surprised that doctors don’t listen to us, even though we might possibly know what’s best for ourselves.   After all they’re  trained to follow the prescribed protocol, and it has been drummed into their heads time and again that not doing so can be dangerous – for the patient, and for themselves and their malpractice insurance premiums.

But still, I’ve spent 55 years with this body.  I usually know what’s good for it and what isn’t.  That’s not to say I always do right by myself, either, although I always have my own best interests at heart.

We’ll see if the Z-pack does right by me this time.

I’ll keep you posted.

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13 thoughts on “Knowing What’s Good For Me

  1. My husband’s corporate insurance started covering the preventive shots for both Flu AND Pneumonia this year. Because, like you, I’m prone to upper respiratory infections, I got both – and you know what? I did not get full-blown bronchitis at ALL this winter.

    Allergies? Sinus? Yes. But no full-blown flu, and no serious bronchial issues.

    My HUSBAND, however, had actual pneumonia.

    Now, if they’d just make an anti-migraine vaccine…

    • I always get a flu shot, but I’ve never had the pneumonia shot. I’ve been pretty healthy for the past couple of winters – the last time I had this was in 2008, which is some kind of record for me.

  2. I hope you feel better, Becca. Maybe your general MD can help out if the Zpack doesn’t work?
    It’s been a hellish winter and so many of my loved ones have been sick. My sister had influenza & now a staph infection (on her skin, post flu). My daughter has a sinus cold right now.
    I would come over and cook you a big pot of chicken barley soup – I swear I need a magic carpet! (hugs)

  3. Last October I got an upper respiratory infection. Usually mine starts as yours do. Nose, throat and then bronchitis. This went right to my lungs and I was coughing up all kinds of yucky stuff. They gave me a Z-Pack (and I’ve had Z-Packs before and they never do any good for me either). Well, I finished the Z-Pack and nothing, in fact I got worse. I went back to the doctor and sure enough I had pneumonia and one lobe of my right lung had collapsed. So, I was sent to the hospital post haste!

    Z-packs might be fine for people who haven’t had a lot of infections and have never received a lot of anti-biotics. But, I’ve had sinus infections every year of my life until recent years, and I think my body has built up an immunity to most antibiotics.
    Just recently I got another upper respiratory something. The doctor did not even think about prescribing a Z-pack. She prescribed Avalox. Five pills which cost $60! That was a reduction – they would have been $100 but my insurance company was nice enough to pay $40 of the cost. (This is another topic that really gets my hackles up – insurance companies and the cost of drugs and medical care-grrrrrr!)
    The doctor also prescribed Musinex D and the two really worked. I was well in a week.
    So, doctors don’t always know best. Good for you for speaking up. Maybe when you go back to get a stronger antibiotic, she will listen to you next time.

    • Bonnie, once again it’s obvious we’re related – we have the same respiratory system! Are you allergic to penicillin? I don’t feel any better this morning than I did yesterday, and I’m usually dramatically better after one dose of Levaquin. Added to that, the Z-pack upset my stomach.

      I take Mucinex D too – thanks for reminding me to get going on that.

      As for drugs and insurance companies – don’t even get me started.

  4. Oh, Becca, serious bummer. Yes, my doc does the Levaquin, too. Some of us (sounds like you, too) have challenged bronchial systems and “the usual” isn’t effective for us. Well, I suppose you can give it a try, but don’t hesitate to let your GP know — Which I’m sure you will! Just feel bad when anyone has to deal with this — one of the things I can empathize with. I hope it is short lived and begins to improve rapidly. Hugs, hot tea, and a fuzzy warm blanket to you.

    Oh, my gosh — I just saw the heron fly over the house. Think I’d better head to the ditch and see if he lands! I’ve been waiting…

    • Thanks, Jeanie. Actually feeling a little better now, so maybe I’ll get lucky this time 🙂

      Hope you got lucky with the heron – I’ll be watching for some pics!

  5. Your experience at the Urgent Care Center is one of the things I worry about with the proposed changes to the health care system. These walk-in facilities have absolutely strict guidelines for everything, with no variance possible – because the patient is nothing more than an income source.

    I hate to see the erosion of the doctor-patient relationship. I remember the days when the answer would have been simple – you would have called your doctor, described your symptoms, and he would have made a house call!
    See how old I am?

    Anyway, our advocacy for ourselves is important, but in the future we may be even less effective than we are now. What to do? Some of my friends actually are taking part in the development of a community health network, much like a community garden. Now granted, they’re not going to be doing surgery or cat scans! But they are putting together resource lists, their own guidelines for various common conditions, and ways to treat things such as allergies, infections, and so on with over the counter meds.

    The thing they have going for them is knowledge and relationship – I’d much rather be taking advice from someone I know, and getting input from a retired nurse than just browsing the internet, where even the so-called trusted sites can disagree with one another completely.

    Anyway – I can’t give you any advice about your condition since I don’t even have any experience with it. But I’d be willing to come over and do your laundry while Bella makes that luscious-sounding soup!

    • What an interesting idea – the health co-op. My boss is a nurse with lots of practical public health experience. She’d be great at spearheading a program like that. She’s been thinking about what to do in retirement, too!

      I wish I could take you up on the offer of laundry 🙂

  6. I know this post is old. But I totally agree regarding Z-packs: They do NOT work. I always get Keflex and it will knock out bronchitis in NO time. I have a mild case now, after having been in Ft Lauderdale a few days (hot, cold a/c, hot/cold, back to the north and cold outside, etc.). So I am sick. I’ve been on Keflex for 2 days at 2,000 mg per day. Will be better within 4 days, I’ll bet!

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