Wednesday, October 05, 2011

Just a virus

This afternoon I went to the walk-in clinic near the mall because I wanted to know why my throat was sore and whether I was contagious. I'd never been to this clinic before and I was happy to not have to wait too, too long to see a doctor. They also have a bloodwork lab, pharmacy, xray and ultrasound. The longest lineups were for the clinic - there was no lineup for the lab and only a ten minute wait to get prescriptions filled at the pharmacy.

Anyways. I started off by telling the doctor that I had a sore throat and that I wanted to know whether I was contagious because I wanted to go to Mississauga this weekend (which I can't do if I'm contagious). Later on he wanted to hear my lungs and he remarked on how much I was sweating so I told him that I had sarcoidosis and metastatic breast cancer.

Oh boy, did I get in trouble for that. He told me that I should always, always start by listing my pre-existing conditions and only then tell the doctor the specific problem. He made the very good point that when a doctor walks into the examining room, they've already started thinking about the differential diagnosis and possible tests and treatments. If the patient reveals critical information later, they have to re-trace that thinking. For example, sarcoidosis (which he knew about!) usually affects the lungs so a person with sarcoidosis walking in with an upper respiratory infection or sore throat needs a different set of tests than someone else who doesn't have the sarcoidosis pre-existing condition. I hadn't thought of it that way but of course he's right.

The nurse had taken some of my vital signs and did a swab for a strep test before I saw the doctor. I don't have strep throat and there was no other bacteria in the swab so I have a virus. Sadly, there's nothing that can be done to make the virus go away except time.

He also strongly discouraged me from going to Mississauga because until my throat is completely better and I'm no longer coughing at all, I'm contagious. I'm not as contagious as if I was sneezing or coughing a lot or if my eyes were still goopy... but I'm still contagious. So we'll plan to go to Mississauga next weekend. I'm a little disappointed by that but it's the best thing to do under the circumstances.

One thing that has occurred to me (and that someone pointed out) is that I started to feel sick shortly after my first denosumab treatment. I have my second treatment tomorrow and if I start feeling worse instead of continuing to get better I'll strongly suspect that the treatment is interfering with my immune system.

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