When the Doctor is Afraid

Ah the joys of seeing Specialists. My dermatologist today was afraid to treat me. It took me a while to realize what he had done. “Everything looks normal.” Patches of flesh, pustules, moles that look like the poster children for little melanoma and the remnants of the allergic reaction to Sunblock… all are normal?

He barely skimmed my chart, he didn’t want to touch me or look at me. Instead he said, “In Six months, when the insurance covers another visit come back and see the new dermatological plastic surgeon. He can take care of those moles.” Moles he had declared normal.

I did get a new prescription to try for the Hidradenitis Supprativa. A topical antibiotic and an oral antibiotic. I am about to take the first dose. I had to drain the blisters first. It wasn’t until I was leaving the hospital pharmacy that I snapped onto the problem. It took the strangest behavior I have seen at a hospital for me to click that the entire experience belonged in the Twlight Zone.

I was the invisible doorstop, a woman tried to shoved past me with a cigarette in hand and I blocked her. I didn’t have to move an inch to perform the act, I just had the entire width of the chair. I can’t suck it in, and as I choked on the smoke of her freshly lighted cigarette I let myself snarl. “Put that damned cigarette out. Are you insane? Taking a lighted cigarette into the hospital could be considered assault.” I didn’t have to think about my words, I just let them flow freely as my mind snapped the puzzle pieces into place.

The world had gone mad! The madwoman did thank me for stopping her. She stubbed the cigarette into her hand and continued her journey inside. I shuddered while seeing the odd spiderweb connections between her obvious challenges and the doctor.

I have three rare skin conditions, additional sensitivities, and other conditions that are also genetic and rare which can change how my skin reacts. I understand the doctor not wanting to treat me. I just wish he had been more direct about it. I am not afraid about the moles he left alone, but, I do find it odd he insists I see a plastic surgeon turned dermatologist. I will obediently have the mole cut off by the better man, but, what if he has the same hesitant fear?

I have run into this a few times. This is the cause of my high Doctor Turn Over Rate. They quit working and usually I fire them. They either run out of coping ability, they run out of knowledge, and they stop working. This one at least offered some suggestions but all were redundant, stymied by my allergies. He didn’t even try.

It is disappointing but I have my vanity for a bit longer. After the appointment my Person and I went to see why his check was short and as a result I wound up getting to eat a bit of fast food (yay Del Taco being Gluten Free) and a pair of clip on earrings to supplement my new ear needs. The dermatologist seemed competent but more comfortable with the able bodied woman or man who doesn’t know much about their flesh. He spent most of the appointment condescending about how Moles don’t exist. I let him, and when given the option of having him cut my head-mole down a peg or waiting six months to have it done right? I chose to wait.

What can we do when our doctors fail us in this manner? Sometimes we have to let them fail. He gave up the option of learning, of trying, and now if my head-mole turns out to be an extensive tumor as the one on my face was, the glory of removing a rare and still unnamed type of tissue is not his. It goes to the next doctor. That is a bit of comfort, as not every doctor is emotionally qualified to take on the harder cases.

He only failed me by not being upfront with his comfort level. When a doctor is afraid, it’s okay to let them go. I forget this at times. I forget that a doctor passing up the golden opportunity of treating me can be a good thing. If your doctor is too afraid, they will make more errors. They will take longer to find answers. I know, as you journey from doctor to doctor hunting for answers this feels painful. It is still better to let some doctors pass and to have other doctors treat you. I would rather have a wait of six months than permanent scarring with recurrent surgery because my doctor did not make the right choice.

For the comments section, feel free to add your own experiences with doctors who are afraid and doctors who fail.

How Rare is Rare?

When every medical diagnosis I have is considered rare, I want to know how rare is rare? Ehlers-Danlos Syndrome, Raynaud’s Syndrome, Celiac Sprue… the entire list is much longer than that and as of yesterday has a new contender. I found myself laughing when my doctor said, “Well, It is rare… but there is a name for the skin condition you have.”

I wasn’t even aware I had a skin condition. I always thought I was just dirtier than the other girls, and that my skin just sucked. I used to shower up to six times a day, though that made little to no difference in the quality of skin. I have lesions, blisters, boils and abscesses constantly. I thought this was normal, and that everyone got them at least sometimes. The name of this condition? Hidradenitis Supprativa. This condition is considered an actual disability according to the government.

I know why personally. For one, there are days when I can barely move my arms and walking, beyond the agony of the broken bones and hip issues I already have can be made worse by the damaged skin in my groin. Psychologically some of my most depressive days are the result of being infected, sweaty, and often worrying over spreading infection to others. Now that I know the name of the disease and have some knowledge I am aware that I am not going to infect anyone with it. It is rare. It is genetic.

I want to know what the mortality rate is with this disease. Some might say zero but I remember just wanting to die when I had my first really bad abscess. I was at work, and my nice shirt was ruined by the pus and blood because the boil burst before my break. I hid more shame, and beyond wanting to hide, run, or just cut my breasts off I considered killing myself. The never ending work of trying to get everything done, trying to be clean enough? That day I could not fathom selling anything, hefting the heavy boxes of dishes, and what about the smell?

Infection is not a clean smell. Neither is sweat. Being a teenager I never felt pretty. It took me becoming an adult to start seeing past the little things. Still, attending a friend’s wedding my thoughts were how to make certain my formal wear would not retain the odor of my sweat, on how to make sure that no one could tell. I am now entering the mourning stage of a new diagnosis. I mourn the times when I cut out my own abscesses. I did that last week. I have never once considered seeing a doctor when my breasts split open. It happens so often, that it is normal to me to self care.

This brings me to another point where I was accused of Self Mutilation as a teenager. Beyond having actual issues with that due to the severity of my depression, there were times when I was told I had to have cut myself in order for my body to be so gory. I was sent to a therapist for it. My body has scars, open wounds that have been around longer than some of my siblings, and my mind has been shaped by this disease.

The other effect of more rare diseases that are incurable is this. Can I escape being disabled? How inevitable is it for some of us to wind up with our bodies breaking us down? My body is out to get me. How can I function like this? What is next? Is breathing going to become a forbidden act because of something rare and genetic?

How can something like this really be rare too? Some of the research I did today indicates it is related to acne, though it is not acne. What if it is not as rare as all that? What if more people have it, undiagnosed and are losing out on their quality of life?

At this time there is no treatment. I will be updating my disabilities page, and I will find ways to help others like me. The more people who know, the more the odds of a treatment being created increase. I currently treat the breast area with a steroid cream, though, this is dangerous to do for your genitalia, and therefore half of my effected area is untreatable.

There is nothing that relieves the pressure, beyond bursting the abscesses. There is nothing that relieves the burning sensation, and there is nothing I can use to cut down on the sweat. Sometimes saline solution helps to dry me out, but, there is nothing that has a permanent or even reliable effect. Antibiotics have helped some, during the worst part of the cycle, yet not for me.

I am tired of being rare. I am tired of waking up in the middle of the night and squeezing puss out of my breasts. I am tired of denying myself sex, when I truly want it, because I fear being disgusting or the pain is too great. Sex is important to most people, me included, but my body is attacking itself and eventually my genetalia may be scarred so deeply that I can no longer function sexually.

In a long term relationship, this has an effect. It is not positive. As a woman, I have had a lot of challenges facing my femininity, partly because of this disease, but this adds another facet. If I cannot pleasure my partner, and vice versa, what are the long term side effects psychologically?

I am rare. I am one of the rarest people you will ever meet. My pain is rare. My skin is rare. My eyes and hair, and my entire body is a rare example of surviving despite it all. So is yours. So is the man on the street corner in the business suit. So is the single mother. Rare is not rare at all. For every diagnosis of a rare condition, countless others are never discovered. Statistics are faulty, when not every case is discovered, so how can we truly understand rare?

Info Links on Hidradenitis Supprativa:

http://www.hs-foundation.org

http://www.hs-usa.org

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