Why don't we get tested for strep in England?

gold21

Mon, Dec 26 2016, 9:37 pm

amother wrote:

My OB told me that the standard is no longer a yearly test. They have found no difference to prognosis if it is done at a greater interval (I believe every two years), and when you over-test you risk false positives and unnecessary intervention and stress.
There may be exceptions, but this new rule has been applied to me by two different docs in the last few years.

Your OB may not have a choice, its what the insurance will pay.

amother

Khaki

Tue, Dec 27 2016, 12:19 am

gold21 wrote:

Your OB may not have a choice, its what the insurance will pay.

http://www.acog.org/Patients/F.....often

This isn't insurance related. Check out the link above to ACOG.

Note that the routine recommendations don't apply across the board, there are exceptions for women with a history of abnormal test results, as well as low immunity etc.

ETA: And women should still go for a yearly gyn checkup.

seeker

Tue, Dec 27 2016, 12:34 am

Hashem_Yaazor wrote:

I have had strep in my kids go away on its own -- evidenced by the fact that I have a home testing kit and my daughter tested positive at 9:30 one night but felt fine the next day, and I waited it out. A few days later, I swabbed her again when I had another daughter with strep, and she was negative....

Did she have symptoms? Because it could be that some strep germs wander through without actually having an infection. The test strips could pick that up. As I said, my doctor will only treat strep if he sees symptoms of an actual infection. Once actually I went to my regular doctor's office with a kid who had various things going on, but we saw someone other than our regular doctor who ordered a strep culture and it came back positive. I had my doctor follow up on that because it would have been this child's third antibiotic in not very long, so I wanted him to weigh in on how to treat. He looked down her throat and said forget it, nothing to treat here, the test may have picked up some stray strep bacteria but this child is not infected.

seeker

Tue, Dec 27 2016, 12:44 am

amother wrote:

you can diagnose strep with a few criteria such as no cough, certain age, swollen lymph nodes, white stuff at the back of the throat. It's not perfect, but if you don't have these youre less likely to have strep.

However, you can have the exact same symptoms caused by a virus. They have even taken to calling it "viral strep" even though the word strep itself is a bacteria, because the symptoms can be so similar. Hence the use of the test or culture to make sure you're not using antibiotics for no reason.

Oddly, when I had strep last week one of the reasons I didn't run to the doctor was that I didn't see any white on my throat. I've had enough experience with strep... so I said I guess it's just maybe an oncoming cold or something. By the time I did go to the doctor I still didn't notice any white but it was so flaming red and my tonsils and glands were so swollen and painful, I just had to know.

Hashem_Yaazor

Tue, Dec 27 2016, 10:23 pm

gold21 wrote:

1. Many medical professionals disagree with the evidence.

2. This is a new practice in the US and we have not had it in place long enough to know if there will be fallout

3. Even if there are just one, or maybe two, or even three, women who run the risk of falling through the cracks each year in the three year wait for a pap smear, it's better to screen than to rely on potentially-flawed evidence.

4. Why support this practice just because it's what the medical world has decided is best, yet choose not to follow mainstream medical advice with regards to antibiotic usage? You davka should agree that not everything that is medically mainstream is right or sensible.

Classically, pap smears have a notorious false positive rate, with subsequent tests needed anyway months later. Waiting on someone who has a clean history is shown to be fine, because these growths are so slow-growing, and there haven't been proof of anything in the past. Believe me, the decision wasn't rushed to, and as far I remember, this was something I heard 10 years ago at least, which isn't so new.

Who said I choose not to use antibiotics?! I ONE time did not, and waited it out, davka for one child who happens to be allergic to amoxicillin, and we'd be playing with other antibiotics, stronger ones, that she may also have turned out to be allergic too. If it hadn't resolved itself, I would have definitely gone in. All my other positive tests have been treated fine. Please don't paint me as someone who is against medical science. I am actually all for evidence based practice.

Hashem_Yaazor

Tue, Dec 27 2016, 10:31 pm

seeker wrote:

She woke up at 9:30 complaining her throat hurt, which is why I swabbed her, but I didn't look at her throat since her tonsils always looks inflamed (school nurse and ped both noticed that...)
But she felt completely fine the next day and for the next couple days (I think it was Weds PM, and Sunday is when I realized my next daughter had strep, and I retested this daughter that morning and she was all clear).
So it IS possible that it's circulating, makes total sense to me, it could be she had strep in her mouth, without having infected her throat, and it cleared up, and the throat hurting was post nasal drip or something, but my kids don't usually wake up from a sore throat, so I don't know.
She actually had a well visit later that week and she passed all her tests fine, throat looked fine (minus regularly enlarged tonsils), no signs of infection, no fever, no swollen lymph nodes, no heart issues B"H.

Maybe I lucked out, but maybe it's more common than we think. I assume before antibiotics there was strep and some people really got sick with scarlet fever and rheumatic diseases, but the vast majority did have it pass through their body.

Hashem_Yaazor

Tue, Dec 27 2016, 10:34 pm

seeker wrote:

When I had strep in seminary, my clue was that everything tasted disgusting to me. I knew then it wasn't a normal sore throat. There must have been pus or something (no flashlight with me to get a good look!)

******************

Total side point, but to try to prevent strep from re-occuring, it's a good idea to switch to new toothbrushes toward the end of an antibiotic run when it's killed off. This way, any residual germs on the toothbrush won't reinfect you. I thought it was such a simple and sensical piece of advice an urgent care clinic technician gave us, and wish I would have heard it sooner!

gold21

Tue, Dec 27 2016, 11:40 pm

Hashem_Yaazor wrote:

Classically, pap smears have a notorious false positive rate, with subsequent tests needed anyway months later. Waiting on someone who has a clean history is shown to be fine, because these growths are so slow-growing, and there haven't been proof of anything in the past. Believe me, the decision wasn't rushed to, and as far I remember, this was something I heard 10 years ago at least, which isn't so new.

Who said I choose not to use antibiotics?! I ONE time did not, and waited it out, davka for one child who happens to be allergic to amoxicillin, and we'd be playing with other antibiotics, stronger ones, that she may also have turned out to be allergic too. If it hadn't resolved itself, I would have definitely gone in. All my other positive tests have been treated fine. Please don't paint me as someone who is . against medical science. I am actually all for evidence based practice.

Oh ok! I thought you had once mentioned something about antibiotic usage or something. Sorry bout that. It's hard to remember who said what. Totally not trying to paint you any which way at all. Tongue Out

gold21

Tue, Dec 27 2016, 11:45 pm

Hashem_Yaazor wrote:

I had a very bad sore throat like a couple months ago, like really bad, it really threw me off. I went to doc to get cultured for strep two separate times over the course of 10 days. Nothing. Nada. Was viral and I was stuck waiting it out for over a week. Sad

(Even worse, nearly everyone in my family caught it too. BH it's behind us now!)