Good Afternoon,

I am 39yo Female former smoker. 5 foot 4.5 and 150 lb. I am on atorvastatin for familial hypercholesterolemia, limotragine for OCD, Co-Q-10, and Zyrtec. I also use a nicotine patch and lozenges but have been smoke free for over a year.

This is part asking for advice and part rant.

Please note I have no formal education in healthcare but I loved knowing how things work and have read 100s, if not 1000s, of articles on pubmed. If I find a concept I do not understand I open a new tab and try to grasp that then go back to the tab with the original article. If I see a news story about a health issue I always try to read the original article they are referencing instead on a reporter's interpretation of it.

Ever since I was a young child when I would get an upper respiratory infection, after a few days, I would develop a dry cough and then a productive cough. Half the time I will cough up blood it gets so bad. In my hometown in the Midwest I would go to my PCP or an urgent care, get an Rx for a z pack and (if it had gotten bad enough) some Prednisone.

Fast forward to around 10 years ago when I moved to my current location. It is next to impossible to get a script for the zpack here. I know most upper respiratory infections are viral but I have been diagnosed with mild asthma and I have seen several articles stating that bacteria like to colonize in the lungs of asthma sufferers. The immune system being distracted by a viral infection gives these colonies an opportunity to multiply. Also, I got an overall Ig-G count last year and it came back in the 500s, so I am mildly immunocompromised in the first place.

Fast forward to this week. On Monday I had a sore throat and temp of 99.1 (high for me but not technically a fever). I was also extremely tired. Tuesday same thing so I took a COVID test and it is negative. (SARS-CoV-2 has never really given me any lower respiratory issues. Probably because of the vaccine. Still getting it in membranes of upper respiratory but places with lots of blood vessels where my vaccine induced IG-G army is patrolling is protected.) I had just gotten back from a cruise with a friend and she was also having the same symptoms, even though she lives 4 hours away, so I know whatever I was initially infected with is contagious.

Yesterday I knew this would spread to my lungs if I didn't do something. I don't like Prednisone, which is used to suppress the immune system from overreacting so I wanted to nip this in the bud and not give my immune system something to over react to. I called my PCP and they were booked up until Friday. I then called my asthma doctor's office and all of those providers were out sick.

There are a few walking in clinics at grocery stores here so I made an appointment online. In the past I had never been able to get an antibiotic from them but figured it was worth a try. I called the clinic to get the fax number because, maybe if I asked the asthma office to fax over the low IG-G data, they might be more understanding. Turns out that clinic is not even allowed to prescribe them .

Finally I decided to pay $150 to go to an urgent care. The provider was very reluctant and said he would give me a script but that I should wait a couple days and only fill it if I had gotten worse. He told me my body would become resistant if I take them too much. (I didn't feel like arguing).

Last night I started getting my familiar dry cough and it is worse today so about an hour ago I filled the Rx.

Rant: I understand antibiotic stewardship. It's an existential threat. However, I when I get a script for antibiotics I take the full course, which hinders the chance of bacteria with mutations that make them more fit against that antibiotic from multiplying. I don't take them often. I only need them once or twice a year. Meanwhile, when I was in India I could buy them over the counter. And farmers have found that giving young livestock antibiotics makes them grow faster. So while people like me have to suffer, cows and pigs get them for the sole purpose of making the farmer more money. Tell me that's not a tragedy of the commons.

Advice Needed: What can I do in the future to get a zpack without having to beg and grovel? I know my body.

Thanks,