Uncultured 

I saw a different resident in family practice today. She’s actually the doctor I saw last time I went in the OB/GYN department for my Depo at the clinic.1 Another rapid strep test was ordered. It was negative. My glands were checked. She mentioned that my tonsils were no longer swollen2 and that a gland in my neck was enlarged. My ears were clear. My lungs were, too. The end diagnosis was still the same: something viral. 

Her suspicion is that the virus my mom has is the same thing I have–and that either the strep piggybacked on it or that it piggybacked on the strep.  She said that if I didn’t improve in a week to a week and a half that I should come back. She said they might have to do a different culture of my throat to see if I’m growing something else in there. I’m hoping it goes away before then. 

I was just glad she wasn’t so dismissive and was pretty compassionate. I think I would have felt better about DK’s diagnosis if he hadn’t been so rude. It’s a lot easier to accept a diagnosis if you are treated like a person.3


  1. The resident who focused on my progress with weight loss & not the stalling out. 

  2. Actually, she asked if I still had tonsils because she couldn’t see them. 

  3. Protip: Never read forums like studentdoctor–it will ruin any positive feelings you have for doctors. 

Weak Little Bug?

I saw another doctor, who I will be calling Doctor Knowslittle, at UAB on Monday morning. He said that whatever was causing my symptoms after 9 days of clindamycin couldn’t be strep because and I quote, “strep is a weak little bug.”12 He also said that I wasn’t feverish because my temperature had yet to hit the 100.4 °F that some doctors still believe is the norm for fever in adults. Fever isn’t supposed to be defined so rigidly anymore.3

Anyway, he thought that I had mononucleosis or “some other virus” now and that that was what was causing my symptoms to worsen. To prove this, he ordered six blood tests: a CBC, blood smear, CMP, EBV, CMV, and a sed rate.4 The results came in this morning–or, at least, he saw them this morning and called me with them. No mono. No Epstein-Barr or cytomegalovirus. But I did have a high lymphocyte count.5 He told me that it “must just be another virus” because, again, he doesn’t believe that strep throat can continue after so long.6

lymphocytes

As my symptoms are continuing to get worse,7 I will be going tomorrow to get checked out by a different doctor. Maybe they’ll have a solution to this whole mess. Maybe they’ll listen and not be dismissive.

But this doctor? I pity anyone who sees him8 and doesn’t get their condition properly treated. If he does this on strep and it’s complications and drug-resistance are so well known, then people with lesser-known issues are totally screwed.

In related news, because it was part of the blood count stuff, my anemia is coming back. Doctor Knowslittle didn’t notice it, but I did. My mean corpuscular hemoglobin concentration (MCHC), which is the amount of hemoglobin relative to the size of the cell (hemoglobin concentration) per red blood cell,9 is low. It’s almost as low as it was in September/October 2012, which was after the small iron infusions, but before the big one. It’s the first time it’s been below normal at that clinic since then. My MCH, which is the amount of hemoglobin per red blood cell, was close (0.7 picograms/cell) to being in the low-range.

mchc

Another big clue is that my platelet is headed back up. If it hits 400, it will actually be too high, and that will probably happen because it’s a known sign of iron-deficiency anemia. It won’t get super-high, but it will continue to go up until the anemia is treated. Then it will drop off again.

platelets

As iron deficiency anemia is one of my primary diagnoses at UAB, it seems like Doctor Knowslittle would have been interested in why my MCHC was low. And that he would have compared the CBC levels from the past few years, but he didn’t.10 And it shouldn’t surprise me that he didn’t, since he’s so well-versed in streptococcus and how it works–and, like I said, that’s well-known shit.11 But a second year resident should be paying attention to this sort of thing. If he doesn’t now, he won’t notice it when he’s in practice on his own, and that could lead to badness.

Anyway, I will not be seeing DK again and I hope that whoever I see tomorrow (or at any other visit) is a bit more knowledgeable. At the very least, I hope they willing to do the research/get a consultation with their resident to make sure they’re not wrong. It’s better to be a doctor who admits they’re not completely sure than to be one who makes a bad call due to an inflated ego. If people are placing their lives and their health in your hands, you need to know what you are talking about.


  1. That’s why it’s never ever been linked to having antibiotic resistant forms or for serious complications for not responding to antibiotics, right? 

  2. Also, from the Concise Reviews of Pediatric Infectious Diseases article “Macrolide-Inducible Resistance to Clindamycin and the D-Test” by Charles R. Woods, MD, MS:

    Clindamycin resistance is common among health care-associated MRSA strains. Most CA-MRSA remain susceptible to date, but resistance rates vary by region. Pneumococcal resistance to clindamycin may exceed 30% in some areas of the US, while about 4% of group A streptococcal isolates are resistant.

     

  3. The Mayo Clinic says this about fever: “You have a fever when your temperature rises above its normal range. What’s normal for you may be a little higher or lower than the average normal temperature of 98.6 °F (37 °C).” 

  4. But not a blood culture, which could have been used to look for bacterial infections, including strep. 

  5. It is higher than it’s been the whole time that I’ve been going there. 

  6. Lymphocyte counts also go up for bacterial infections. 

  7. A few hours after coming home from the doctor on Monday, my temperature was at 100.5 °F. It took multiple ice packs, several doses of Tylenol, and at least 96 oz. of ice water to get it down into the 99.0-99.9 °F range. Sleep is getting it to 98.1-98.6 °F, but, about an hour later, it’s back in the hot and sweaty range. 

  8. And my dad is assigned to his care, so I’m definitely worried about him. 

  9. NIH 

  10. This is a pet peeve I have with a lot of doctors. If you order a test on someone that has had this test before, then you need to compare the test to the past tests to see how a person’s condition is progressing or declining. If you’re not going to check back, you either shouldn’t be a doctor or you should archive all of their old test results. And if you want to do the last thing because you’re too lazy to actually care about your patient’s history, then you should probably do the former suggestion. 

  11. Okay, I didn’t call it shit, but that works, right? 

And It Was All…Scarlet?

Last night I started developing a rash. When you have as many allergies as I do, rashes are something you pay attention to. And that’s even more true when the rashes occur when you have strep throat. I had two theories: clindamycin allergy or strep complication. One option is no more preferable than the other. 

A clindamycin allergy would mean that my body can tolerate exactly 0 antibiotics used for treatment of strep. It would make it likely that I would need to undergo some desensitization of penicillin. Or I would be fed the line, “maybe your body will fight it off.” A line that would look lovely as an epitaph on my Trail-side tombstone if I died of typhoid while I was in a wagon in search of the Willamette Valley in the mid-nineteenth century.1

A strep complication like scarlet fever would mean potential organ damage or sepsis. One like rheumatic fever could cause heart valve, neuro-system damage, and joint issues. It could also mean that I will have a totally confused medical professional on my hands. Because those complications are a sign the antibiotic isn’t working. And that’s a repeat of the 0 antibiotics situation. 

And what does my family think? It’s scarlet fever unless the rash turns into hives or anaphylaxis. I just need to make it around eleven more hours without dying or completely losing my mind and I may have my answers. 

But, like I said, there are no good answers. 


  1. Why, yes, I am a longtime fan of Oregon Trail

While We Were Out

I had to make a trip to the library and to Walmart on Saturday. I needed to return some books, DVDs, and CDs to the library, and I needed milk chocolate chocolate chips and pancake mix at Walmart. And on the drive, we talked about this bout of strep, the miscarriage she had after my parents got married, the almost miscarriages she had while pregnant with me, & about all the weird things I ended up inheriting from one or both sides of the family–including drug allergies and bad immune systems. 

Since some of those things are recessive, she felt the need to apologize for passing on those genes. She also decided she needed to apologize for ending up in a relationship with someone who carried similar recessive genes. She said that if she’d known, she would have done things differently and that she realizes a lot of my issues wouldn’t have happened if they’d had children with other people. 

Part of me is glad she is finally acknowledging something that’s been a sticking point in my relationships with both parents. But I also don’t like the realization because it means if they’d done things differently that I wouldn’t be here. I may wish for that sometimes, but I don’t really want it. I don’t like a lot of what I’ve experienced, but I really don’t know if I’d want to change that. 

If I hadn’t been sick or hurt so much, maybe I could have participated in soccer or volleyball or skating or taken dance longer. Maybe I could have had real Christmas trees and fewer doctor appointments. If I wasn’t mentally ill, maybe I would have graduated high school and not gotten my GED, maybe I would have gone away to school, maybe I’d be married and babied.

But things still could have gone badly. Or they could have altered important experiences–good & bad.  

If I hadn’t been abused or bullied, I might not have gotten so involved in online stuff. I would have missed out on amazing friendships that mean so much to me, even if I don’t act like it. If I’d been able to have a “normal” love life, I might not have gotten stood up on what was supposed to be my first date. I also might not have gotten to meet A and have an unconventional, but wonderful experience of important firsts.  

So, yeah, I’d love to have had a happier or healthier existence. I’d love if my parents could have had happy and healthy kids in a happy and healthy marriage–or happy and healthy marriages. But I wouldn’t be me. I might not even exist. And that is something I don’t like thinking of any more than I like being sick, easily injured, or painfully shy. 

I spent so long hating my body for its flaws, my brain for its issues, and my family for bringing me into existence. I don’t want to be like that. Not anymore. So I will deal with my drug allergies and my never-ending strep as long as it means that I get to keep being me. 

Thanks, mom, for wanting to spare me of suffering, but I’m good. 

Oh, lamb chop

There are some really messed up people in this world. Apparently, a few of them are writers. Months after the Kathleen Hale stalked a negative reviewer and Richard Brittain stalked and assaulted a negative reviewer, Andrea Smith and Eva LeNoir have decided to take on the ignoble task of publicly shaming a negative reviewer. This time, it’s being done in literary form. Their book Black Balled has the following description currently:

Two dominant males, two worthy adversaries, in a business that takes no prisoners, will soon learn that fate refuses to be ignored . . .

Black Balled is a story of two people, destined to hate one another for very different reasons–but will something happen to change all of that? A harsh reviewer with deep secrets and fears; a cocky Indie author that takes the bait and ultimately ends up breaking the Cardinal Rule, but what price will he end up paying for that?

Situations are not always what they seem; one of them is in deep denial,and the other is hell-bent on finding something–anything to distract him from his insecurities and the pain he is feeling because of personal tragedy and loss… toss a vindictive ex in the mix, and what you have is explosive and quite . . . epic.

Can they both survive one other?

Get ready for a magical carpet ride with this one!

That might not sound bad,1 unless you take into account the original description or what she said when she changed it.

original description

Babu is one letter off of the name of reviewer Baba, who left a negative (2-star) review on Diamond Girl, a book by Smith. As critical as the review was, it ended with “Give it a try and maybe you’ll love it.” That’s nicer than a lot of people are2 when it comes to critical reviews. So, writing a book as a response? Holy fuckballs! That’s nuts.

But Smith says it isn’t about Baba and that Baba is full of herself. No, really, she did. Smith also seems “surprised” that there was drama over the book and seems to be in total denial that she is to blame for it. She also seems to be in denial that the “buzz”3 is pretty much all negative.

no really

drama of your own making

what the buzz

This also isn’t the first time that Smith has behaved childishly45 when critiqued. This is pretty indicative that she has a problem. If you can’t handle reviews that are 1 or 2 stars, then maybe you shouldn’t publish your work. At the very least, you shouldn’t read the reviews. And if you’re reacting this poorly to the reviews, then get help that you definitely need. This should not be the way any person reacts to this sort of situation.

I’ve received criticism in the past on various things and reacted negatively from it. I’ve also worked on not letting it get to me. Maybe the writers who end up obsessing over, stalking, shaming, and assaulting their critics should do the same. If they don’t want to try therapy, then maybe they can listen to music or meditate or paint or do something. But this sort of behavior is just messed up. It seriously reminds me of the wise words of Mary Cooper on The Big Bang Theory:

Oh, lamb chop, we can quibble what to call it, but I think we can both agree it’s creepy.

Except that it’s not just creepy. It is absolutely 100% fucked up. Reviewers shouldn’t have to worry about their personal safety because some writers can’t handle a negative review. And it’s becoming increasingly more obvious that that’s something reviewers are going to have to consider. I wouldn’t be surprised if this sort of act or the acts of other authors leads some people who write reviews to back away from doing so in the future. I also wouldn’t be surprised if it makes reading in general less enjoyable for some. And that not only hurts Smith and LeNoir, it hurts the whole industry, reviewers, and people who just read as a hobby.

I don’t think there is any way that Smith and LeNoir could repair the damage to their careers that they have done with this book, but it would be nice if they would admit that their behavior is reprehensible. It would be nice if they would actually step up, put their grown up panties on, and apologize.


  1. Although it still sounds pretty fucked up like this. 

  2. including me 

  3. Is it really “buzz” if people are really talking about the book exhibiting a writer’s predatory behavior? 

  4. Comments to reviewers on Amazon

  5. More comments to reviewers on Amazon.com 

How to Succeed in Laughing at a Star Trek Character Without Really Trying

Wait. So is the Federation President from Star Trek VI1 a Shih Tzu or a Maltese? The series says he’s technically Efrosian, but I think he looks like a Shih Tzu. My mom says Maltese.

via Instagram


  1. Played by Kurtwood Smith of RoboCop & That 70’s Show fame. 

To the Edge of Nowhere 

I’ve felt like crap lately. Actually, crap is putting it mildly. 

Right before my thirty first birthday (last month), my mom got a virus. And we thought that I did, too. Her fever was over within a week. Mine is still here. Actually, it’s gotten higher. Her symptoms were coughing, sneezing, congestion, and vomiting. Mine were fatigue, coughing, and congestion–the congestion went away, coughing got a little less severe, and the fatigue is still being a pain in the ass. I also had a stye or two pop up, which oddly fits with the next part, because styes are my body’s portent for this condition. 

On the twelfth of this month, I noticed I now had a sore throat. So, on Friday the thirteenth, after a month of feeling like shit and having a temperature around two degrees higher than it usually is, I went to the doctor. 

I had strep. 

The doctor had to search for a suitable drug for someone who can’t take Ceclor, Septra, Zithromax, Penicillin, Levaquin, Cipro, and Biaxin. He almost went with Doxycycline, but it’s more of a staph treatment. For strep, it does a less than stellar job. He chose Clindamycin, which I’d encountered before as part of an acne treatment I went through years ago. 

I took the pills every time I was supposed to and kept assuming that I’d start feeling better soon. Soon hasn’t come yet. Actually my fever is getting worse, as are the symptoms. Now I have ear pain, headaches, muscle weakness and pain, worsened tachycardia, more shortness of breath, and insomnia. The insomnia is from the fever–I can’t sleep properly with a fever. Everything else? Who knows?

I do know that I have the wait until Monday morning to see the doctor again. And I know that if the Clindamycin must be changed, then my medication choices will be limited. I also know that might mean I have to be hospitalized so I can be desensitized to penicillin so it can be used to kick this infection’s ass. And that scares me. Actually, I’m scared by other things this time. 

I’m trying to remember that my body has always had trouble kicking out bacterial infections. When I’d have strep in elementary school, it would take multiple rounds to rid me of it. I’m probably just repeating that now. Hopefully that’s what is going on. 

I just am really ready for the strep to go away.