Plague

So, an interesting weekend. We begin Thursday afternoon, right after I put up my last post. I had awakened Thursday morning with that "I must have slept with my mouth open" dry sore throatiness that usually goes away over the course of a day. I was so focused on Thursday's ultrasound that I didn't think much of it. However, by Thursday night I was in a lot of pain. Mostly on the right side. No fever, no other symptoms. Aha, you say: she has strep throat. (But of course.)

An aside here on medical groups. Since we became very close to our OBs during the pregnancy with D (I did see them daily on their rounds for months, after all) we were hesitant to change doctors when we moved up here to Siberia three weeks after D was born. So, despite the drive, we decided to stay with the practice for any subsequent pregnancies. This means I must also see a primary care physician who participates in the same medical group. I have one I've seen maybe once in three years. It's a 45-minute drive.

Friday morning I am in severe pain and we call my primary care physician (let's call her Dr. Doolittle) and get an appointment that morning. I figured one office visit co-pay, one in-office rapid strep test, one antibiotic prescription and a trip to the pharmacy on the way home and my entire weekend needn't be hellish, right? You can see where this is going.

Dr. Doolittle did a careful exam and decided it was a viral throat infection, localized to one side. She said there were no white spots, no fever... she didn't think it was strep. Apparently my look of absolute disbelief registered on my face since she added, well, it is Friday... so I'll do a swab for a throat culture and write you an antibiotic prescription just in case. But, before you fill it, call me on Sunday for the results of the culture (she said she was on call all weekend and could access the lab results online) and don't start the antibiotic unless it comes back positive. Fine, I said, not wanting to take anything while pregnant unless absolutely necessary. She handed me a prescription for amoxicillin. Skeptically, I asked if this wouldn't cross-react with my penicillin allergy. Oh, no, she assured me.

Two hellish days later, I called Sunday around 10:30 for the lab results. She promptly returned the call to let me know she didn't have the results yet and would call me by 6. No call. The next morning (Monday) I called her office. Oh yes, the receptionist said soothingly (to an admittedly quite irate me), she'd have a nurse call back right away with the results. That call came through today at 10:30, nearly 4 days after the throat culture, and the morning after my first lecture of the summer session. Let me tell you, talking loudly for two hours through a raw throat was just a treat.

Well, you can guess. A "heavy growth of group A Streptococcus" and I should "start antibiotics immediately." No fucking shit, people.

It gets better. I broke all speed limits over to the pharmacy and handed the assistant at the register the prescription, carefully mentioning that I was (a) pregnant and (b) allergic to penicillin, and that I had doubts about my doctor's choice of antibiotic in this case. She consulted the pharmacist, who agreed wholeheartedly and immediately got my doctor on the phone. I left shortly thereafter with Azithromycin, safe for use in pregnancy and for people allergic to penicillin. The pharmacist seemed shocked that any physician would prescribe amoxicillin to someone allergic to penicillin and asked me if I had mentioned the allergy to her. I said I had told not only the woman who checked me in and took my blood pressure, but also asked the doctor outright about her choice of amoxicillin when she handed me the prescription, saying, "And this won't cross-react with my penicillin allergy?" The pharmacist sighed and shook his head. After I mentioned the 4-day wait for the diagnosis he also wondered aloud what kind of doctor's office doesn't offer a rapid strep test to someone presenting with my symptoms. An office about to have one fewer patient, I replied acerbically. I chugged my antibiotic in the parking lot with the last of my morning's forbidden delight, the mocha frappucino.

What do you think? Just change doctors, or dash off an angry letter as well? Am I overreacting? Let me mention that I have been absolutely miserable. I'm normally pretty stoic and this has had me in tears several times. I'm living from dose to dose of Tylenol and specifically mentioned my acute discomfort to Dr. Doolittle in her office Friday and again on the phone Sunday.

In other news, we told my mother-in-law about the pregnancy. We’re out of the closet! Hooray for optimism!