How Many Urgent Cares Does it Take to Get a Diagnosis (or tips on leaving voicemails about your vagina)

     I started leaving voicemails about my vagina in late November 2016. I had a gnarly urinary tract infection a month before. The UTI was classic – it started as a general level of discomfort and evolved into feeling like my pelvis was on fire. Peeing was painful, not peeing was painful, and by the time I made my partner drive me to urgent care, I had blood in my urine. That was the first of 6 urine samples in the next two months.
     The urgent care I went to for that first UTI took one look at the blood in my urine and the look on my face and gave me 7 days of Bactrim to treat the infection, Pyridium for the immediate symptoms, and diflucan in case the antibiotics gave me a yeast infection. I got better, my pee stopped turning macaroni and cheese orange (a side effect of the Pyridium) and I made it through midterms no worse for wear besides a hacking cough.
      While I was home for Thanksgiving my little sister dragged both me and my hacking cough to another urgent care (this time in VA). One CBC and one chest X-ray later and I had a walking pneumonia diagnosis, a prescription for extra strength cough medicine, a 10 day round of antibiotics, and an albuterol inhaler just in case.
      Back in Atlanta after Thanksgiving, the pneumonia reduced to just a tiny wheeze when I laughed, but in its place, a general level of itchiness in my pubic region. I figured that the meds for the pneumonia gave me a yeast infection, but I didn’t have the tell-tale signs of yeast – I had some discharge, but it was clear, not white, it didn’t look like cottage cheese, and it smelled more like fish than baking bread. I made an appointment with the student health center, and the physician I saw gave me a pelvic exam. The conclusion was BV – bacterial vaginosus, an infection, like a yeast infection, that causes vaginal and pubic itchiness, somewhat funky discharge, and a general lack of sexiness. Not to worry, I got a prescription for 7 more days of meds, a lot of yogurt, and a probiotic for the inevitable hell 3 weeks of antibiotics was wreaking on my vaginal and gut flora. That doctor also gave me a prescription for diflucan, a lecture about talking to my partner about the possibility of a sexually transmitted infection, and a warning about drinking while on antibiotics. I thought my days of itchiness had to be coming to an end.
       I did well on the antibiotics, and I took them through finals at the beginning of December, finishing just in time to celebrate my 26th birthday with the glasses (read: bottles) of wine I had been craving. A day and a half after finishing the prescription, I started feeling off again, but it was slightly different. Rather than feeling itchy, I just felt a general level of discomfort, like I had to pee all the time, even after I had just gone, as well as some cramping in my lower abdominal area. The NP I saw at the health clinic had given me her direct line in case my symptoms didn’t clear up, and I gave her a call.
     “Uh, hi, Elizabeth? It’s Krystyna. You saw me for BV two weeks ago? I still don’t feel great, but not really itchy any more, just kind of uncomfortable? and like I have to pee all the time? But not as bad as a UTI. I’m actually not sure if it’s my genitals or my urethra. You know what, this is probably too much for a voicemail; can you call me if you think I should come in? Thanks!”
    I followed that classy voicemail up with a call to the student center to try to make an appointment, only to get their voicemail. “Uh, hi, my name is Krystyna and I think I have a vaginal infection maybe, or a urinary one? Anyway, I think I need to see someone. Can you call me back?”
     (It took me about five of these miserable voicemails to come up with a system that got me an appointment without leaving my entire reproductive history on the messaging machine. For the record, “pelvic infection” gets the point across, saves you from having to say “vagina” or “urethra” and keeps you from stumbling over “urogenital”.)
     In spite of my exceptionally engaging voicemails, I never got a call back to schedule, and the night before I am planning to fly to Phoenix to see a girlfriend, I wind back up in urgent care. They listen to my symptom description (moderate discomfort, suprapubic pain, no back pain, some clear but odorless discharge), take a urine sample, tell me I don’t need a pelvic exam, give me another round of UTI meds and send me on my way.
     I think you can see where this is going. I did alright through the meds, although still felt a little off, and then 30 hours after my last dose of antibiotics, the fire breathing dragon was back in full force. At this point I really start to worry that something is seriously wrong with me. As I always do in times of great stress and medical need, I turned to the internet (you can see what I found and what I tried here, here, and here). I saw one more urgent care doc when I went back to VA for Christmas with the exact same results, until I finally got a referral to a urologist when I went back to the student center in January.
     Things I learned from this experience: 1. Urgent care is not a great substitute for a primary care doctor. 2. If you need something from your doc, don’t be afraid to ask for it. I asked the last urgent care doctor to give me both a pelvic exam as well as taking a urine culture, because I thought it would be helpful to have a snapshot of what the whole system looked like at that time, and it gave me peace of mind that something wasn’t being overlooked. 3. Taking 5 courses of antibiotics over a month will likely give you all sorts of GI issues. 4. Having your feet in stirrups literally never gets less weird.
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