30 December 2008

Do Not Impregnate

An era has ended today, I went to see a dermatologist. Shocker, I know, considering I've been avoiding them for abt a decade like the plague - but, right now, I am the plague, or so I look like, so I ran out of options. It was a tad surreal, especially bcs every other sentence was punctuated by 'Now remember, YOU MUST NOT GET PREGNANT until 2 months after the treatment is over' bcs I am taking - as of this very morning - acne pills (your Accutane, I think) that would ensure a cute three-eyed... something. This is a bit ironic considering I managed to fully skip the acne phase - and only rightly so, if you think abt it, had I had psoriasis and acne as a teen I doubt I'd have attained adulthood.

I liked her though, I told her right away I wasn't the most compliant of patients and that I was a bit wary of dermatologists and she asked 'Why's that do you think?' and dear Dr., how much time do you have? There was the one who prescribed pills that amount to chemotherapy and require regular blood tests and liver biopsies and can cause liver and skin cancer, not that he saw fit to mention any of it and my skin wasn't even bad at the time; the one that took one look at me and snorted and said 'You came to see me over that? That isn't bad at all, you should see some of my other patients' and my skin was bad at the time; the one who kept saying I couldn't possibly get a lesion on the parallel limb as well in more or less the same place every time I got a new one even though it is my body and yes, actually and sadly it is very possible; the one who kept trying to convince me to take off all my clothes even though I'd smelt a perv and told him I only had it on my knees and elbows, which I showed by lifting the appropriate clothing - this one also required a 'Oops, so sorry' elbow in the belly bcs he stood entirely too close - so yes, it's been a pleasure, often.

The truth is, this is the worst my psoriasis has ever been, EVER, and I do need help, I cannot ignore it any longer. I have a whole battery of blood tests for the 3rd week of January and I think I can trust her, I asked whether she was asking for C-reactive protein, it is a marker for acute inflammation and this is why no one wants my blood or my medulla, people with psoriasis live in a perpetually infalammed state and mine is probably the worst it's ever been, say my body antennae, but it is an excellent measurement that also allows you to monitor the efficacy of the treatment and you think, in all these years, I ever managed to convince one doctor, ONE, to have something as basic and important measured? NO. Fuckers. So no, small surprise I don't much trust derms but her I actually do, I asked her and she looked at me like I was crazy and said 'But of course!' and was shocked that mine has never been measured. Bless her. She also gave me a timeline for improvement, she said I should start seeing a difference in a fortnight to 3 weeks and this is YET another bloody thing that the former derms never did, they hummed and hawed and never told me how long to wait till something changed and if you're dealing with someone with psoriasis you have to, there is no such thing as a treatment that works for everyone and we become tired of the schedule, to note:

Daily in the morning - An oral retinoid, the first time I actually swallow a skin treatment
Mon, Wed, Frid - Cream on body lesions only
Tue, Thur, Sat, Sun - Cream on body lesions only
Mon, Wed, Frid, at night - Scalp Foam
Daily - 40E facial cream for eyebrows and eyelids, a brill and novel place to have lesions on
Daily - KPL shampoo
Moisturiser - Body, Eucerin; Face, Hyseke 50

Can you hear my glee? I surprised myself by becoming excited abt this visit but the treatment itself is a bloody pain, especially in the Winter in non-central heated homes. But I have a time frame that helps me be compliant, I hope, and the pills causing dry mouth and eyes doesn't faze me much bcs I should use artificial tears anyway, so maybe now I'll remember. On the really horrid side, I only bought abt half of the meds and have already spent 102 E, and I will get the rest this afternoon. Even with discounts it really is a luxury to have psoriasis, not to mention that things like the shampoo or the SPF facial cream have no discounts at all even though the medication makes me dangerously sensitive to light - and I'll probably only say this this one time and I cannot believe I am actually going to say it but - THANK GOD IT'S WINTER! I'd have to forgo the sun and then I'd be pissy. Well, pissier.

Am I hopeful? Against all odds I am, yes. I need to take care of my skin and the year is ending, I also need for Life to see I am serious abt it. I told her I'd be as good as possible and she replied 'Nonsense, you'll be ALL good and that is that!' [Love her!] 'We're going to make you better, you'll see, but you need to help me help you'.

Dear Doctor Derm,

you complete me.

your recalcitrant patient

5 furballs:

Kristin said...

Its a miracle...you found a competent dermatologist! I really hope this treatment works for you.

lorem ipsum said...

I took Accutane in 1996, for cystic acne. I'd had it since adolescence (skipped the regular kind as well) and since my father had it and grandfather had had it until the day he died I knew it wasn't going to go away. In fact, the morning I had my appointment one had cropped up on the back of my ear.

I recall the packaging (may be different from yours) with a silhouette of a pregnant woman and the red bar going through it, on the punch-out bubble for EVERY PILL. There was also an illustration of the possible birth defect (VERY large alien-like head).

Be warned: I had every side effect in the book, so it is possible. And it got worse before it got better. Within a day or so my skin went absolutely bonkers. I had peeling palms and I don't remember what else but I did have to give up driving at night because my newfound sensitivity to headlights blinded me. On the upside, as a photographer (then) I had little need of a safelight in the darkroom.

Did it work? Sort of. I don't get cystic anymore, but I have regular acne now, zits that clear up in a matter of days instead of weeks or years (to just move somewhere else). But twelve-plus years later it's still working, so if you get any modicum of relief from this, dear Lioness, it will have been worth it. Good luck.

P.S. My word verification is FROCTING. Isn't that wonderful?

Anonymous said...

Isn't it wonderful when you find a doctor who not only knows what she is doing but is likeable as well? So rare. So wonderful.

I hope the treatment gives you fast and complete relief. Psoriasis sucks dead bears! Hopefully by summer you will be ready to go out and enjoy the sun again.

My verification word is hydrat. Don't forget to hydrat!

Anonymous said...

Mine is vighted.

I am hopeful as well for you! I love my doctor and hope yours is just as awesome.

lorem ipsum said...

It's been more than a week. How is it coming along?