Diagnosing what ails you: my doctor rarely does actual testing when I present with a mild illness. She rules out COVID or flu ("were you vaccinated?" Yes) and then just says: rest + fluids. I had a really persistent "cold" last winter (3+ months long) and initially got the same answer; after a couple months she prescribed an antibiotic and I finally got better. I'm not one to request an antibiotic for every sniffle, but I wonder how long should I be sick before I ask for more ... testing?
Pardon my intrusion, and please do not interpret my reply as offering medical advice. A respiratory illness that lingers over months with mild symptoms is annoying, but seldom a severe bacterial infection that requires strong antibiotics. Azithromycin (Z-pack) is often used to treat Mycoplasma, which is a subject of this week's newsletter, as much for its ani-inflammatory properties as its anti-infective ones. Mycoplasma infections will actually resolve on their own without antibiotics, but it will take time, and the overuse of antibiotics causes resistance and renders the medications ineffective when you need them most. In the absence of fever, a cough that produces lots of ugly-looking (brownish) phlegm, or rapid breathing/shortness of breath, the current recommendations are to treat supportively unless the lung exam suggests there is an area where the breath sounds are muffled or absent. And then you should get an xray to exclude a focus of pneumonia. Of course, these recommendations only apply to healthy people without underlying lung or immune-compromising conditions. Only your own doctor knows how best to treat you.
Diagnosing what ails you: my doctor rarely does actual testing when I present with a mild illness. She rules out COVID or flu ("were you vaccinated?" Yes) and then just says: rest + fluids. I had a really persistent "cold" last winter (3+ months long) and initially got the same answer; after a couple months she prescribed an antibiotic and I finally got better. I'm not one to request an antibiotic for every sniffle, but I wonder how long should I be sick before I ask for more ... testing?
Pardon my intrusion, and please do not interpret my reply as offering medical advice. A respiratory illness that lingers over months with mild symptoms is annoying, but seldom a severe bacterial infection that requires strong antibiotics. Azithromycin (Z-pack) is often used to treat Mycoplasma, which is a subject of this week's newsletter, as much for its ani-inflammatory properties as its anti-infective ones. Mycoplasma infections will actually resolve on their own without antibiotics, but it will take time, and the overuse of antibiotics causes resistance and renders the medications ineffective when you need them most. In the absence of fever, a cough that produces lots of ugly-looking (brownish) phlegm, or rapid breathing/shortness of breath, the current recommendations are to treat supportively unless the lung exam suggests there is an area where the breath sounds are muffled or absent. And then you should get an xray to exclude a focus of pneumonia. Of course, these recommendations only apply to healthy people without underlying lung or immune-compromising conditions. Only your own doctor knows how best to treat you.
Thank you! As a teacher of young children this is good information to have. We have been in school for two weeks and all the “sick” is happening!
Thank you! Appreciate all your hard work.