Tuesday, September 9, 2014

Be nice to the medical student

I've succumbed, completely, to the lurgy. What was a head cold has descended South. They threw me out of Masons last night after a five minute coughing bout. As is the case with me, when I'm home, stress free and quiet in a cool, dry environment, I'm fine. Put me in an overheated room with somebody I'd like to belt up, not a good move (another story, not for distribution).

Waking this morning to even more aches and pains, I reluctantly emailed work and told them I wouldn't be in. Then I called the doctors and made an appointment.

A couple of hours later, after a couple of coughing fits, a dose of nurofen (advil), breakfast, shower and a cup of tea, I made it to the doctor's office.

The hill to the doctors felt like Mount Everest. I normally run up it. The stairs up to the doctor's office felt five time as long. Again, not something I'm used to. I live on the second floor - stairs are nothing normally. My right shoulder blade ached on. The coughing stopped after about five minutes while sitting down, waiting for the doctor.

I love my doctors by the way, even if I avoid going to them. When I do go, normally for the biennial undercarriage check as well as times like this when I admit to being ill, they're great. The lot of them treat you with respect, listen to you and are nice people. Okay, you have to pay most of the time, but really, I'd rather pay for great service.

The practice are also a teaching centre and I was asked if I minded if a medical student sat in. "Oh course not," I told them. It wasn't anything that required disrobing or a long discussion.

Turns out, the doctor was lovely, although he sounded a lot like Peter Capaldi. Thankfully I can listen to that accent all day. Half of me wanted to ask him to shout "Fuck, fuck, fuckity fuck!" but thought the better of it.

Gabbi, the medical student was also lovely in an earnest sort of third-year medical student way. She received my permission to examine me.

The normal questions. How long had I felt like this, what was going on, signs and symptoms? She got off to a good start.

As somebody who used to get these chest infection things five to seven times a year, I know the drill pretty well.

The doctor sat back and let Gabbi do her best.

Ears, clear, throat, a little pink otherwise okay, glands up (she went around it the wrong way however). Listened to my chest. Yep, crackles in the middle lobe on the right (Could have told her that - it's why my shoulder's aching). Tap the lungs and they sound strange.  Temperature - normal, but that could be because I'd taken nurofen. No sweats. A bit hot and cold. No energy.

Yep, it's some sort of chest infection - possibly viral, possibly bacterial.

"Are you asthmatic?" she asked.
"Only on cold mornings and when I get sick." This is true. I'm not an asthmatic - I just get a bit wheezy and short of breath when I get chest infections. I'd grabbed a few puffs of ventolin off one of my Freemason friends the previous night before then sent me home.
"But you've never been diagnosed as asthmatic," she pressed.
"No. I get a puffer when I get wheezy."

How to I get it through this chick's head that I know what asthma is. My mother had chronic asthma when I was a child. I get wheezy when I get sick. Don't call me asthmatic. Just give me a puffer and go away. I will throw out said puffer after using it three times once it expires a few years later. Like I always do.

So, what was she going to do with me asked the doctor.

Here's where she came unstuck.

Fluids, bed rest, ... ventolin...

Oh alright - I'll take the bloody ventolin.


Yes, I'll take them too.

"Amoxycilin?" she asked.
"No." I told her. "Doesn't work on me anymore. Had too much of it in the nineties. And you haven't asked me if I'm allergic to anything" I added.
"Are you allergic to anything?" She asked.
"Sulpha drugs and bananas."
"What does that mean? asked the doctor.
"Don't give me bactrim... gives me a rash... looks like measles." I whispered at her.
The doctor asked her what she would prescribe if I said I couldn't take amoxycillin.
"Cyclines? Clarythromycin?" I whispered to her.

They worked out what to give me.

She took my blood pressure. After a bit of a muddle, it came out well - 135/90 - brilliant for me.

What else did she have to tell me?
"What about other medications?" I prompted her.
"Oh, are you on any other medications?"
"Yes." and filled her in on the details.
"Ah, the antibiotic might diminish the effect of the other medication."
"Cool - that's not a drama."
"And keep on with the nurofen." she told me.
"No." I said.
"Why not."
"Umm, what contraindicates the use to nurofen?" I asked.

The doctor's smiling at me by this stage. "If Pand was in my class I'd have her on the ten second rule - not allowed to answer until everybody else had a change to say somehing. She knows her stuff."
"I don't know why she shouldn't take nurofen."
"You've just told me I'm asthmatic. Nurofen and asthmatics don't mix. Constricts your chest."
"And get some panadol." she told me.

It was quite fun putting the medical student through her paces.

As for me, I walked away with a reluctant prescription for ventolin and antibiotics, a sick note for two days and the knowledge that this is not in my head. I also know that I will be throwing out the ventolin puffer in two years after using it about three times. Ah well.

I will follow doctors orders. I've spent the afternoon in bed and gently pottering round the flat. Thankfully it's quiet at work, though I'm not happy about being off as I don't get paid. Health, however, is far more important. Let this go and it could turn into pneumonia.

Yes, I know when I'm beaten.

Tomorrow I hope to be up and around and bright enough to do some course work. May as well.

Here's hoping.

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