Mono, ah, mono

To all those who were expecting to see me at SfN, the DC bloggers meetup, or the upcoming ScienceOnline09, I apologize: I am really sick. And it all started, as catastrophes always do, with a cat.

Shortly after Election Day, my feisty tortoiseshell cat (above, looking angry as usual) was suffering from a bacterial infection. Unfortunately, the local vet's staff were unable to handle her, and in the process of the examination, she bit me through the arm. The bite swelled up and changed color. Nasty. But I've had cat bites before, so I was unconcerned.

The next morning, however, I woke up with swollen, rock-hard lymph nodes in my neck, a sore throat, and a mild fever. It got worse. Then it got even worse. Two days later, with everyone declaring I must have the vaguely disco-esque "cat-scratch fever", I was sick enough to give in and go to the urgent care clinic. Since there are none in DC, at least none on my insurance plan, I had to drive over into Virginia. And wait there. And wait. In the end, it was three hours to see a doctor.

Actually, to clarify, I didn't get to see a doctor. She or he was called out on an emergency. But a young NP came in to test me for the obvious culprits, strep and mono. The mono test came back positive. At 32, I'd finally come down with the kissing disease! How embarrassing! (Although probably less so than "cat-scratch fever.")

For the next few days I took a steroid (to reduce the swelling in my throat so I could breathe without struggling) and an antibiotic (not for the mono, which is viral, but for the cat bite, which by this point was a three-inch black-and-purple ring on my arm). Eventually things got a little better, and I could swallow and sleep a little. I was on the mend - or so I thought.

Unfortunately, it turns out they gave me amoxicillin. At the risk of violating nettiquete by shouting: NEVER TAKE AMOXICILLIN IF YOU HAVE ACUTE MONO! You will likely come down with a measles-like rash all over your body. (It's like the mono bonus expansion pack.)

The rash is a fairly common reaction, and there was no excuse for the nurse not to realize the conflict when she prescribed the antibiotic, since she did the mono test herself. In fact, when I felt well enough to do some Googling, even before the rash set in, I realized the potential problem and stopped taking the antibiotic early (against my instincts - I always take the full course of an antibiotic to prevent antibiotic resistance). Within the day, I got a follow-up call from the clinic - it seems the doctor had reviewed my file and wanted me to, ahem, stop taking the antibiotic early. (No explanation was given for this unusual instruction.)

Unfortunately I didn't stop in time, because I came down with the rash anyway. Fun! I was exhausted AND itchy AND looked like I'd been rolling in poison ivy!

In addition, everyone was afraid to approach me. But as the CDC states, most adults have had the Epstein-Barr virus which causes mono already, and are immune. (Many people don't get full-blown mono, so they may not know they've already had the virus). If you're not coughing all over the place, it's darn difficult to pass mono on: you have to exchange saliva, which I don't usually do with my coworkers and friends. All of this means there is no need to quarantine someone recovering from mono. So please, if a friend of yours has mono, try to be sympathetic, and don't leap back, pushing a desk or a chair between you (as happened to me more than once).

The best part of all of this came when I received the bill from the urgent care clinic. Let's see: I sat in a room alone for three hours, coughing up blood, without even a glass of water (did I forget to mention their water main was broken?) I got a mono test, a strep test, and a throat culture. I didn't see an MD. And for this stellar service, they billed my insurance $780. What?!

My insurance didn't cover most of it, but since the clinic was in-network, I sincerely hope they're not going to try to get the balance from me. They'll have an earful coming if they do. Or maybe I'll just cough on them. Mmmm, have some mono!

This experience led me to reflect even more than usual on the absolutely horrible situation faced by people without insurance - especially in this economy. Two large DC-area grocery chains, Giant and Wegman's, just announced they will be offering free antibiotics this winter. They will fill prescriptions for a number of common generic antibiotics at no cost through mid-March. The list varies by store; Giant is offering 36 generics while Wegman's offers nine. Obviously, this is a good PR move for both stores. On the other hand, generic antibiotics are hardly the most expensive drugs putting a crunch on consumers' wallets; if you don't have insurance, you're less likely to go to the doctor in the first place to get a prescription - especially if they're going to charge you hundreds of dollars. And it goes without saying that free antibiotics won't help people with the flu, mono, or other viruses.

Anyway, I felt better briefly in November, but I relapsed in December (probably my own fault - I went to the gym) and have been coughing and exhausted ever since. I understand that the symptoms of acute mono can last up to 6 months, so I have to be proactive and start taking it easy if I hope to recover. So I won't be traveling for the next month or two, and I probably won't be blogging as much. I'm also going to have to forego standing outside all night to secure a place on the parade route for Inauguration, which is truly depressing. As is missing ScienceOnline09, where I hoped to meet many of my fellow bloggers. However, there is a silver lining: you only get mono once.

Usually.

That, and the cat feels a whole lot better.