Thursday, July 15, 2010

Waiting for the dermatologist

People aware of my comings and goings know about my ongoing effort to see the dermatologist.

About a year ago, she checked several spots on my face. They were not cancerous, but they were either red and flaky or discolored. She froze some spots off and gave me some cream, scheduling a recheck for six months. I seriously wanted this recheck, both because some of the spots remained and I wanted to rule out serious problems, and also because I thought that clearing up my skin would help me feel more like a normal person. (Not as important as getting my hair back, but still, a consideration.)

Due to cancellations for a variety of reasons, it looked like this visit was never going to happen.

You might wonder if this dermatologist even existed.

On June 21, I was sure it would work. One of her offices is on Route 9, the road I take to get to Dana-Farber. I scheduled a 10:15 a.m. appoinment, followed by my Dana-Farber appointment at 1. I got there 15 minutes late, having missed the medical building and then having to circle back along crowed Route 9. When I called, the receptionist said my appointment had been canceled.

I rescheduled for today at 3:30, following my clinic appointment at 11. Dr. Alyea had said it would be interesting to see if they made me wait. When I checked in, I told the receptionist I had been canceled for being 15 minutes late last time, and I hoped that they wouldn't keep me waiting any longer than that themselves.

Speaking up makes my children glare at me in restaurants. (As in telling the waitress, "Please take this burger back, it's undercooked.") They usually hiss at me, "Now she's going to spit in your food." Hey, I tell them, you're a valued consumer, and you have every right to point out problems politely.

At least today I didn't have to worry about the food.

I waited only 20 minutes and was put in a room. There, I waited another 45 minutes. It was getting late, and I faced the drive home, the hardest part of my day. I finished the New York Times and then started fuming. Next came the inner talk: Nobody died. Nobody is dropping bombs on me. Still, how about showing a little courtesy for the patient?

Wearing an exam gown, and squished in a chair next to my purse and my clothes, I leaned my head against the wall, poked by a piece of equipment on the wall behind me. I fell asleep. Finally, an aide poked her head in. She looked at me curiously, as if wondering why I was in there at all. She went to get the doctor, who came in saying she was very very sorry, someone had forgotten to put my folder out.

I told her my saga, and she said she was angry with the staff. She never would want anyone turned away for being 15 minutes late, since she knows that patients come from all over and often get stuck in traffic. She apologized for the last visit and for today, saying I seemed calmer than she felt about it.

Most importantly, she said she saw no signs of skin cancer. Although my graft vs. host disease has been in my gut, she said some of the redness could also be related to GVHD. She froze some of the spots off and gave me a different cream RX than last time. She also said that the redness and small blisters at the end of my nose could only be fixed by laser, which is not usually covered by insurance. I said I would make some phone calls.

Earlier in the day, I had an unexpectedly short visit at Dana-Farber. I thought Dr. Alyea would order an X-ray of my painful rib from this week's fall, but he said that even if an X-ray did show it was broken, you just let it heal on its own anyway. He thought that it was just bruised. Even though I was tearing my hair out over the incident, he said it was a common thing to do, and not to worry.

My counts remained about the same, good for me but not necessarily for "normal" people. My hematocrit, at 25.3, is still low. I'm apparently chewing up the cells that I am making. He said that this process should just go away by itself. Sodium was up one big whopping degree, to 126 (normal starts at 135) and potassium was hovering just about normal, at 5.3. (Normal is 3.5-5.0).

He lowered my prograf from .5 mg. twice a day to once a day, saying he thought this could help many of my problems. Glucose was the high end of normal, 105.

In two weeks I will get my cholesterol checked. Tonight I switched to no-cholesterol frozen yogurt (vanilla with fudge swirl).

It did not hit the spot.


Diane said...

Well I can't believe you finally got to see the dermatologist. Maybe it was good you fell asleep because it helped you to stay calm. I would be have outraged at the wait, but as you say, no one died and it was good news that your skin is fine (which I think by the way looks great.) Always good to see you for a lunch break between appointments.

Ann said...

The redness and blisters on your nose sound just like the GvHD on my own nose. I find that if I keep the skin moisturized and use the cortisone cream prescribed by my doctor, I can keep it under control. It's still a little red, but not nearly as bad as it was. If I avoid the sun altogether, it disappears.

Anonymous said...


I didn't experience cancer, but I fought to get an appointment with the dermatologist for my acne treatment...I can say I understand your anxiety here!

The real reason I am writing here is because I have a blog thats all about making people feel better. I would like to invite you to tell your story, but telling the good things you are doing to overcome the challenge rather than how you've been challenged by it -


Ronni Gordon said...

Ann, she didn't prescribe any cream. She seemed more into the laser. But then it might just come back, right? I think I'll double-check on that. Thanks.