Sunday, March 22, 2009

TBG Takes: Zyrtec, Flonase, Allegra, Astelin, Formula 409, the Neti Pot & Prednisone

With Messiah Obama attempting to solve all of America's problems by Memorial Day, I thought I'd give him a first-person account of what he's up against with health care. Quick background: I've had a nagging, annoying cough since February…of 2008. It came and went for the first few months, but then it invited its friends, cousins and co-workers to come live in my upper respiratory tract.

September 2008: I visit my primary care physician. My $25 co-pay gets me 10 minutes of doctor's valuable time. He explains the same common causes of a chronic cough that I found the night before on this website. I receive a prescription for the treatment of acid reflux (which I've never had in my life) and a recommendation to try an over-the-counter allergy medication. My doctor specifically mentions Zyrtec due to its "non-drowsy" characteristics.

A month's worth of Zyrtec set me back another $27.99. And, if anyone out there wants to re-live their college days – or, more specifically, the un-caffeinated feeling from those 8:00 AM freshman Philosophy classes – you should pop one of these lil' white pills. Turns out they DO induce drowsiness (says so right on the back of the bottle). Lord knows I need to feel sleepier after 10 hours of reading the agate type of defense contracts.

October 2008: I follow-up with my PCP. Neither medication is really working, although I did notice a negative difference when I missed a day of the Zyrtec. The doctor wants me to stay on both, but only the Zyrtec seems to serve a purpose. He schedules chest x-rays and a spirometry exam, which both come back clean.

January 2009: My cough's getting worse. I feel completely fine, save for the fact that I sound like I invented emphysema. I call my PCP's office and ask for a referral to an ENT specialist. The doctor's office instead recommends that I see a pulmonary expert. I've had ridiculous sinus issues since the ninth grade. I can feel the crud running from my sinuses down the back of my throat. My independent – and, admittedly, incomplete – research points towards an ENT, but I'm essentially overruled. Oh, and, it'll be five weeks before the pulmonary people can see me.

February 2009: I meet with the pulmonary specialist. She immediately wants to pursue the allergy avenue ("Oh, you have a cat? You'd be surprised how many people are allergic to cats and don't even realize it!"). Eleven years of my non-reaction to "Whiskers" has obviously been some sort of biological lie. She writes me up for Flonase and Allegra. This is awesome. I know it's not going to work, but then again…it might. It MIGHT!

Neither one works and by the middle of the month, I'm waking up in the middle of the night with shortness of breath, wheezing and an imaginary elephant atop my chest cavity.

I call the doctor on Monday, February 23rd and am told that she'll call me back later in the day. Her nurse calls me around 4:45 PM to tell me that the doctor never made it into the office today. I'm told the doctor will be in on Tuesday and she'll call me as soon as she can.

On Wednesday, the doctor finally calls back – apologizing for being out of the office on Monday AND Tuesday. She prescribes something called Astelin to replace the Flonase. It didn't work either, but on the plus side it felt like spraying Formula 409 up my nose. Singes the nostrils. For the next few weeks, I self-medicate with a topical cocktail of Vicks Vapo-Rub and, yes, this thing. Mrs. Bootleg's idea. Ah, desperation.

March 2009: So, this past Monday, I met with the pulmonary doctor again. I tell her that none of the meds have worked and my symptoms have only gotten worse. Her eyes widened, an ear-to-ear grin creasing her face. You'd have thought she had unexpectedly found, oh, say, $25 in an old coat pocket. "I'm prescribing prednisone and montelukast", she explained. "I'm certain this will be the mix that works for you."

OK, so…this one WILL work? What the hell was your diagnosis last month…practice?!

And, dig these side-effects for prednisone: trouble sleeping (!); weight gain (!!); mood changes (!!!). It's a steroid! The "good" kind!

I've been on this stuff for nearly a week. I'm sleeping a little better, but I'm still coughing. And, in six days, I've gone from 167 lbs. to 172 lbs., despite a loss of appetite and a diet that's mostly been chicken, fish, fruit and fruit juice. I did try'n slip in a Kilt Lifter earlier in the week with dinner, though. Spectacularly bad idea, alcohol with these two new drugs. Sorry for the unexpected Boston Marathon, heart, lungs and sweat glands.

Hopefully, next month's random doctor guess will go better with beer.

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