Yes, these do actually exist! They can be purchased at your local CVS pharmacy. You will understand as you read through this blog.
It looks like I am turning into a Patient Advocate with my history of health problems and working in a medical lab. I saw the report today about a man who traveled to the U.S. from Liberia and fell ill after he arrived here. When I saw this story on FOX news, I decided to sit down and write a post even though I am dealing with my own health issue right now. This news story today goes along with the idea I had for this next blog, and I think now is a good time to publish on this subject.
For those of you who don’t know the news story, a man from Liberia boarded a plane last week, flew through Brussels and Washington D.C. and finally arrived in Dallas. He felt fine during the flights. However, several days after arriving in Dallas, he began to feel ill. He went the the ER where he told the nurse that he had just traveled to the U.S. from Liberia. Now, a red flag should have gone up in the nurse’s mind immediately, but it didn’t for some reason. This information was never forwarded to the treating doctor. As a result, he was given some medication and released. He came in contact with quite a few people while he was symptomatic. His conditioned worsened and he returned to the hospital where it was finally determined that he had the ebola virus!
Clearly the nurse dropped the ball on this one by not putting two and two together. Liberia is being ravaged by ebola, and this patient should have been put into isolation immediately. Of course, he should have never been allowed to leave the hospital in the first place.
Now, let me tell you the story of my medical nightmare over the past several weeks. As I said in a previous post, I have been dealing with some back pain. It turns out that I have what appears to be a urinary tract infection. During my first visit to the ER (I went three times…..yes, three!), they talked to me, assumed I pulled my back during a workout and sent me home with pain meds and a muscle relaxant. About a week later, I notice cloudy urine, and I was feeling worse. I went to CVS, bought some AZO test strips, tested at home and found out that I had a urinary tract infection.
Commentary: First of all, this was a misdiagnosis in the ER. I diagnosed myself by going the the store and using an over-the-counter test. So, I spent probably several hundred dollars to go to the ER and get a wrong diagnosis, and I went to the store and spent $10.00 to get the correct diagnosis.
Continuing with the story….I went to my doctor’s office and a urinary tract infection (UTI) was confirmed. I was put on Cipro. I took that antibiotic for a week and didn’t improve. In fact, I was having worsening back pain and extreme weakness. I took another AZO test strip which was strongly positive, so I went back to the ER. This time, I had a very young doctor who talked to me about my symptoms, pushed on my back and lower abdomen a few times, and determined that I needed to change antibiotics. So, she put me on Levaquin. She left, and a few minutes later, the nurse came in. She gave me a Levaquin to take and made the remark “Even if your urine comes back normal, she wants you to take this Levaquin now.”
Commentary: First of all, Cipro and Levaquin are in the same class of antibiotics. Both are fluoroquinilones. If the infection is not responding to Cipro, would it be the best choice to switch me to Levaquin? Probably not. If the bacteria is resistant to Cipro, there is a pretty good chance it’s going to be resistant to Levaquin. That’s not for certain, but a better antibiotic could have been chosen. Second, the nurses remark about if the urine “comes back clean” was absurd. It was strongly positive about an hour prior to this remark, and it had been positive repeatedly for about a week and a half. Does she think it’s just magically going to disappear into the sky somewhere? Or does she think I’m lying? When she came back into the room, she told me that “yes, you do have a bladder infection.” I responded, “I know.”
Back to the story. As I talked more with the nurse, she proceeded to tell me that she had never heard of AZO test strips. I had to explain to her that you could test your own urine at home with these strips. This conversation started to give me a headache. Later, as I was being discharged, she decided to tell me how to deal with back pain. She asked about my mattress, and I told her I had a tempur pedic. She looked at me with a blank stare and told me she “didn’t know what that was”. I explained to her that it was one of the best mattresses on the market today.
Commentary: Now, I can understand the average person not being aware of AZO test strips. But for a nurse in a hospital ER to not be aware that you can test your urine at home is scary. Secondly, if you are going to give out advice on back care, it is a really good idea to know what you are talking about. I left the hospital that day with all the symptoms I had plus a migraine headache.
I woke up the next day feeling the worst I had felt during this whole ordeal. After talking with the doctor on call, I once again returned to the ER determined to find the cause of my problem. This time they took me a bit more seriously, and I finally received care from some exceptional nurses and an excellent doctor. First of all, they took me off Levaquin as the doctor noted that both Cipro and Levaquin were fluoroquinilones. “Thank God,” I thought to myself. “I finally got a good one!” A bunch of blood work was done along with a CT scan. It was determined that I had an infection confined to the bladder (thank goodness) that was resistant to Cipro and Levaquin. I was put on Macrobid, which is in an entirely different class of antibiotics. I am still struggling with this infection, and I will see a urologist in the next few days.
Commentary: I have to give my kuddos to the team that worked on me during that last visit. That is how patients should be treated! But, I couldn’t help but think how much money and time was spent on me during this whole ordeal. Being a microbiologist, a thought came to my mind that made my laugh, although it is actually sad. I know how to grow microorganisms just like they do in the lab. And believe it or not, it can be done at home. All the materials needed can be purchased at your local grocery store. The only problem that I can see is in the actual identification of the microorganism. So, I thought to myself, “Even though insurance will cover quite a bit of this, I have probably spent a couple thousand dollars trying to get a diagnosis here. But I could have done almost the entire thing myself for about $50! After all, I diagnosed myself with the AZO test strip. It would probably cost about another $40 to get the plate, gelatin, sugar, etc. needed to grow the culture. I really would just need a microscope and a few other items, along with a doctor’s signature after I go into the office, tell them what bacteria it is and what antibiotic I need.” I shared this story with a few friends, and we were laughing so hard…..I mean belly laughing!!
OK, so my point is this: We, as patients, have to weed through some of the bad doctors/nurses to finally get to the good ones. Book smarts are great, and thank goodness that we have smart people around to help us. But what really makes an exceptional doctor/nurse is his/her ability to think outside of the box and to really listen to the patient. Don’t think that since someone doesn’t have the “classic” signs of a disease, then they aren’t sick. I have seen more missed diagnoses than correct ones. Here are a couple of examples. Thirty years ago I went into the ER extremely ill with nausea, vomiting, severe abdominal pain in the center of my abdomen. I was diagnosed with the flu and was about to be sent home when the doctor went on his gut instinct and ordered some bloodwork. Turns out I had a ruptured appendix – not just inflammed, but ruptured! If I had been sent home, I wouldn’t be here now. And then there was my dad who went to the ER for back pain. He was given pain meds as they assumed he pulled his back. It turned out that he actually had lymphoma. But the worst was that it took 17 years to finally be diagnosed with adenomyosis…..yes 17 YEARS! According to the Endometriosis Foundation of America, the average time for a diagnosis of endometriosis is 10 YEARS!
Pay attention to your patients. LISTEN to them and write everything down, even if it sounds unimportant to you. If that nurse in Dallas had done this, we wouldn’t be looking at multiple people being possibly exposed to the terrible ebola virus, and panic wouldn’t be setting in across the nation right now. Think outside the box. Do the necessary tests the first time around, and don’t make the patients return over and over again to the ER. By doing this, we actually can reduce the cost of medical care….and I am quite sure you will be hard pressed to find someone who is against that idea!