I have become a hypochondriac

I had a nagging dry cough that’s now settled into a slightly sputum productive, but weak cough for the past 4 weeks. Also, I have had more zits desecrating my face the past month compared to the past two years. Then two canker sores snuck up in my mouth within the last two weeks, making me think “hmmm, do I have an immune process going on?” Of course, I checked my neck lymph nodes (the immune response champion) and to my surprise they were slightly larger than normal. Subsequently I felt my forehead and geez, it felt slightly warm.

Boom, I think I have tuberculosis, stemming from hours of coughing-in-my-face patients in my outpatient experience in South Africa. Or maybe, it’s HIV/AIDS from sketchy Viet Nam pedicures, manicures, or some imaginary unbeknownst-to-me-accidental-secretion contact in the hospital. Ridiculous irrational thoughts and questions spin, spin, spin in my head.

In South Africa the differential would definitely be TB first on the list with an immediate sputum smear. In Viet Nam, it’s likely a normal reactive immune process from the dense city population, but pneumonia will always be assumed with immediate antibiotic erythromycin treatment. In the US, it’s plausible to think pneumonia too and a serious consideration for TB, but a nice chest x-ray with correlating breath sounds from physical exam to verify a pneumonia in order to treat with antibiotics or mantoux test for a TB reaction.

In reality, it’s likely nothing and I’m just a worry wart. Why?

• Cough: This has improved and it’s usually toward the night and maybe a sign of returning acid reflux. Or again maybe the bad pollution invading my lungs daily.
• Zits: The weather is hot and sticky. Plus I enjoy the spicy hot pepper too much.
• Canker sores: Everyone gets these and this can be a myriad of possibilities.
• Large Nodes: Did I mention the pollution is wicked here? Plus there are no other large nodes on my body. It’s common in Viet Nam to have slightly large lymph nodes.
• Warm Forehead: My hand is not a thermometer and no one else thinks my forehead is hot.

The HIV/AIDS diagnosis is simply me being illogical. Sometimes it doesn’t pay to know too much or think you know enough. However, TB might be a reality. For now, I’ll drop by the Pasteur Institute laboratory to ease my psychotic mind.