First I apologize to any readers who are dermatologists but damn!
The next convention you attend you need to let your colleagues know how flakey your profession seems.
Let me explain.
I’ve been to dermatologists whose offices looked like the photos I’ve seen of Illegal abortion clinics.
That visit… the Dermatologist in question was allowed to use Liquid Nitrogen but under no circumstances allowed to breach the integrity of my skin. I don’t think that their sterilization practices were lax, but I don’t know that for sure.
(As a rule, if someone is going to work on me with sharp instruments I’m a hell of a lot more comfortable if they tear open the sterile wrappers in front of me. When an instrument has been Autoclaved it’s usually in a paper bag and that bag has a stripe that changes color when the bag and contents have been exposed to temperatures high enough, long enough to sterilize the contents.)
Even at the dentist, I feel more comfortable if they have to tear open the bags to get to the tools. It’s just good hygiene and since I know what I’m looking at, I’m immediately at ease because I’m unlikely to get some horrific disease from the instruments.
I’ve been to dermatologists that cancelled appointments at the drop of a hat.
Ya know… it’s really nice Doctor, that you have a competition sailboat however I worked a ton of overtime so that I wouldn’t be docked for missing the time I’d intended to see you, My GP, The Dentist, and the Eye Doctor on a very tightly and carefully worked out plan in a single day. Your arbitrarily canceling appointments so you can go play on your boat kind of throws a monkey wrench into my works.
Had this doctor done this only once I’d have been ok with it. But the Doctor in question did this 4 consecutive appointments over a period of 6 months.
During that 6 month period I actually got to see this particular doctor exactly TWICE. But it cost me 2 days off at work. Thanks Doc!
Even accepting her staffs proposed reschedules I still got cancelled on.
The NEXT Dermatologist I got to see twice, of the 6 visits four of those visits were with a Physicians assistant.
Great! But I’m paying to see the damn Doctor and honestly the P.A.s range of treatment options were confined to creams, ointments, and unguents.
All of them SLOW to work and as a guy, the last thing I want to deal with is some crap I have to apply 3 times a day and have a patch of skin that’s chronically damaged, tender, and is now a serious sunburn issue.
Especially when I know damn well that the problem could have been dealt with in 30 seconds with liquid nitrogen or a freaking scalpel.
On the occasion when I got to see the Male Doctor himself that’s how we handled it. 30 seconds and DONE. Next!
All of which leads me to todays debacle. New guy about my age.
Paperwork is usual, how are you paying? Can you pay? Will you be paying? I provide the insurance crap, and they get a little snippy when I don’t provide an “Emergency Contact” Who doesn’t live with me. They’re really pushy about this and start asking for my Mother or Father even if they live out of state.
This is RED FLAG #1
If I’m frothing at the mouth twitching on the floor and we’re not having sex… an out of state “Emergency Contact” isn’t going to do them a whole lot of good now are they? My Mother has been accused of being a Witch, but even HER broom isn’t supersonic.
This is about nothing more or less than money because nowhere in their paperwork have they asked for my spouses name. They’re trying to get another datapoint so that IF I skip out on the bill they’ve got someone else to lean on for the fucking money.
I tell the pushy lady that my family is deceased. She replies thats inconvenient, I reply “Yeah especially for them!”
My appointment was for 10:15. I was on site at 9:55 with all the paperwork filled out. At 10:05 I’m ushered into an exam room, where I’m asked to fill out yet another piece of paper.
This paper asks questions like where were you born, how long did you live there, how long have you been here? Have you been exposed to pesticides? My response was, “Who hasn’t?”
The perky nurse who led me into the exam room takes my Weight, BP and Temp. then leaves. Then comes back in asks a couple of questions then leaves, then pops in asks a couple of questions, then leaves, then pops in asks a few more questions then tells me to take off my shirt.
It’s 10:20 I can hear the doctor doing dictation in the room next door.
I know it’s him because of the descriptions of the conditions and I know it’s dictation because he’s saying things then speaking the punctuation. “Patient X needs to get a life(period)”
I’m sitting there with my shirt off, nipples hard from cold a meatpackers freezer would envy and I wait.
At 10:55 I’m not cold anymore because I’m well on my way to being angry. I can hear the doctor dictating away in his office next door and I’m sitting in the exam room hearing everything he says.
Stuff like him talking with someone about lunch and arranging a tee time.
At 11:00 am I’ve decided that for the sake of thoroughness I’m going to wait another 15 minutes. Then I’m leaving.
I’m dressed in Jeans, a T-shirt, and flip flops. Thats the easiest way for the Doctor to see any and all problem areas. I’ve had Dermatologists want me to be in nothing but my boxers and had them check me for funguses, Skin cancers, and all manner of issues. I honestly do make an effort to be attired in a way that minimizes any waste of time.
At 11:08 the Doctor breezes in, “great” I think. Now that I know his business and a significant portion of other patient information including the spelling of their conditions he’s finally seeing me.
He launches in to a well rehearsed spiel that is clearly based on the form I filled out almost an hour ago in that very room.
RED FLAG #2
Without examining me he’s already assumed I’ve got sun damage. With a glance he tells me I have grovers disease. Uh, no, I’m having a problem with a soap I just switched to. I’ll change soap and this will go away in a couple of days.
“No he says, that’s a disease for which there is no cure.”
I’m thinking to myself “WTF? I know the cure, stop using the soap sitting in the windowsill of my shower.”
Diagnosing Grover’s Disease
A dermatologist might make a diagnosis of Grover’s disease based upon the appearance of the rash associated with it. A skin biopsy is may be needed in order to confirm the diagnosis. Grover’s disease presents a characteristic appearance under a microscope, with separated cells called, ‘acantholysis,’ either with or without, ‘dyskeratosis,’ or abnormal rounded skin cells, being present. The majority of cases of Grover’s disease last less than a year, although the condition might occasionally last longer, come and go, or present with a seasonal variation.
What we have here is a disease that can only be guessed at based on visual diagnosis. The medical community isn’t sure what causes it, why it manifests mostly in middle aged white guys, or exactly how to deal with it.
In my book that’s not a disease, it’s a condition and it’s easily dealt with for me by making sure that I watch the kinds of soaps in my world.
Certain laundry soaps, and bath soaps will cause a breakout. Other soaps will let my skin heal and I’ll be fine for years until someone changes the formulation.
I, as the occupant of this body know it’s habits, quirks and what makes it happy or sad.
This guy wasn’t accessing my internal diagnostics, and we weren’t building a relationship.
He was blowing it and didn’t even know it.
As readers of this blog know, I whacked my big toe back in the fall. Well the nail didn’t actually come off but it’s clear that the damaged old nail is being replaced by new growth.
The damaged nail had blood clotted under it and that permanently discolored the 1/4″ strip of keratin that remains. Big Deal.
The next words out of this guys mouth are “Lets talk about that foot and nail fungus”
I reply “I don’t have any of that.”
“Yes you do.”
“No I really whacked that nail in the fall and this is normal regeneration.”
“No you’ve got nail & foot fungus”
As he’s looking between my toes, I tell him “A man that doesn’t take care of his feet is a man that doesn’t take care of himself.”
The Doctor is looking really hard for nonexistent fungus. He finally admits that there is not any fungal infection and tries to move on, but is clearly off his game now and desperately trying to recover the “Arrogant Doctor High Ground“.
RED FLAG #3
Doctor tosses around another term, ichthyosis. To which I said ” If only, That might help with my SCUBA”
He stumbled then. He didn’t laugh, it was more of a hiccup in his spiel.
Icthus means – fish.
osis in medical / biological parlance means – condition, process, action.
Therefore icthyosis means literally “fish condition”
Thank you Dad & Mom for making me learn Latin / Greek root words.
Problem is, that while this condition can be very serious and debilitating in the more extreme of the 28 varieties. It can also be a very nice catch all for dry skin.
I have a couple of very dry patches of skin on my shins.
I’m sitting in this exam room wondering if this Doctor is trying to intimidate me, terrify me, or get me to sign up for a series of extended, expensive, and annoying procedures.
To be sure… He had no sense of humor.
RED FLAG #4
Doctor says “I know what I’m going to say to everyone before I see them. Everyone is sun damaged, everyone is the same.”
11:15 Doctor hands me papers talking about sunscreens, soaps, and moisturizers and is out the door.
No “I want to see you again in a year”, nothing at all. It was like instead of being a DOCTOR he was just cashing in. He said nothing else to me, he just abruptly left.
I pulled my shirt on, grabbed my shit and headed for the reception area. After checking with the reception lady that she didn’t want to collect a co-pay today, I was gone.
Mind you, all I wanted was a few minutes to deal with any pre-cancerous lesions that I might have. I, like most children of the ’60s am sun damaged, I know this it’s not a revelation or news to me.
I’ve been through the process of preventative skin cancer treatment before, its simple.
Locate any odd spots, freeze odd spots off, swat patient on ass, tell them to go play, and remember their sunscreen. That is all I wanted, a simple yearly check & prophylactic removal of anything questionable.
That’s not what I got… In fact I feel very “Ripped off”! Needless to say, I won’t be going back to that doctor ever!
I was a little pissed off. What a waste of my time, but better to know I’ll need to keep searching for someone that I get along with and who is reliable.
I keep asking myself if my standards are too high. I really need to have a relationship with a physician, I can’t be just another piece of meat to them. I don’t think it’s too much to ask…
After I left the Doctors parking lot, I headed to a shooting range I’d been wanting to check out.
My crankiness at the crappy and I’m sure horrifically expensive medical exam evaporated upon my hearing the familiar PoP pop POP of pistols being fired.
The shooting range redeemed the day and I might just become a member of their organization.
Strange, the things that give us comfort.
Here’s a short update.
The one & only piece of advice I got out of the visit with this jerk was to check out a product called AmLactin.
I’ve been using the Ultra Hydrating cream for about the past month. This stuff is really great and has cleared up the dry spots I mentioned on my shins. I’ve also used a little of it on my knuckles and seen really impressive results correcting the splitting there. If you wash your hands a lot you’ll notice that most of the soaps suck the oils right out of your skin.
I had a case of “Street Fighter” knuckles to beat the band & the AmLactin has fixed me right up.
This stuff is pricy but it works and you don’t need to use huge amounts of it.
It’s mostly odorless and soaks in fast without leaving you feeling greasy. I don’t know a guy who likes having a greasy feeling on their skin all day… (A couple naked greasy hours fine… but all day? Not naked? NAH)
Just figured I’d pass on that little bit of information to all the guys in internetland.