Monday, July 23, 2012

On fourth opinions and a skin rash called pityriasis rosea

As you may or may not know, I was misdiagnosed with ringworm, which, besides making me an accidental virgin, left me stressing out about washing my sheets every three days and Lysol-ing everything I touched. Even worse, the supposed fungal infection was responding to neither topical nor oral medication, further distressing me.

My rash began with a large oval lesion on my right thigh that appeared sometime in the beginning of June along with a mild cold. Over the course of about a month, other, smaller lesions appeared on my torso. Guessing that it might be ringworm, I began treating the lesions with a topical anti-fungal spray to no relief, and that's when I began suspecting it was not ringworm, but something else. A Google search of "rashes that look like ringworm" brought up a common skin ailment called pityriasis rosea, which begins -- as mine had begun -- with a "herald patch" lesion that then develops into a widespread rash. I brought this up with the first doctor I saw, who soundly dismissed me and said it was probably ringworm. This was at Planned Parenthood, so she advised me to see my general doctor for further diagnosis.

My general doctor, however, is whatever moments the doctor on staff at the Haight Ashbury Free Clinic can spare since the only covered care I have is through HealthySF. I spent two hours past my appointment time in the waiting room, and it was only when I broke down and began crying that someone finally saw me ... for about five minutes. With one quick glance, the doctor decided it was indeed ringworm, and prescribed me clotrimazole 1% (which is another harrowing story, but you'll have to ask me about it in person). With a tiny 1 ounce tube of cream I was supposed to coat every lesion (which had further multiplied to cover my entire torso and back) twice a day for a month. Again, the rash did not respond. I ended up prescribed griseofulvin ultramicrosize 250mg twice a day for twenty-eight days. The medication left me tired, achy, and irritable, and after eleven days, no sign of improvement.

Frightening Google searches and few conclusive answers left me anxious and distressed, as if assigned jail time with no certain end date. I didn't know if I was getting better or getting worse, I didn't know if I would be infected for days more or months more, and I didn't know if I was possibly spreading it to anyone who came into contact with me or anything I even touched. Purchasing fresh tubes of cream every few days was draining my finances. I felt trapped and I felt scared, and there was the lingering doubt that it wasn't ringworm after all.

That's when I decided it was time to prioritize my health, and simply pay out of pocket for quality care (or rather, put it on my credit card). So I went to an urgent care center, and again I did not feel satisfied with their diagnosis. The doctor's hesitation made me question her training, and I did not feel confident with her ability. I asked for answers, but, again, received nothing conclusive nor compassionate. I was told to continue washing my sheets, applying a topical, and hope for the best. I sat in the car and cried. I knew something was wrong and I felt I wasn't getting the help I needed.

So I researched a dermatologist and made an appointment. Their schedule was full, but I convinced them to make an appointment for me the next day. I rearranged my work schedule. I couldn't be sick any longer.

I saw Nikki Satovsky with the California Skin Institute, and with incredible bedside manner, she took one look at me and said, "That isn't ringworm." Spying the rashes that had progressed up my neck, she said, "I'll bet it's on your back too, isn't it?" I removed my shirt to confirm it. She said, "Just looking at you I can tell this is pityriasis rosea. It's harmless and it's not contagious and it'll go away on its own. Come back in a month if it's not better." I felt relieved, and with some of my stress dissipated, I saw instant improvement in my skin.

Pityriasis rosea is a common skin rash that affects people ages 10 through 35. They are not sure what causes it, but a virus is suspected, though no research has confirmed it. It is characterized by an appearance of a "herald patch" followed by a development of lesions in a "Christmas tree" pattern that rarely extends to the lower arms and legs or face. In some cases the rashes cause mild to severe itching, especially when irritated. Mine do not itch much at all. Though unsightly, it is not contagious, and resolves itself within six to eight weeks with no reoccurrence. Some research has shown that phototherapy can help shorten its duration. One common thread among sufferers, however, is stress.

Lesions form a "Christmas tree" pattern,
extending outward from the center in sweeping branches.

I've always joked that my body isn't a temple, it's a monster truck rally, and through an active lifestyle and somewhat healthy eating, I've always been able to depend on my body to get me through crushing deadlines, back to back nights out on the town, and the general mayhem I put it through. My body is a good body -- it's strong, it's healthy, it's cute. I love physical activity, I love drinking enough water, and I love taking the stairs instead of the elevator. I make sure my body gets plenty of sunshine and I like to put good food in it. My body and I are a team. I've always seen it as the physical manifestation of my personality -- quirky, adorable, tenacious, and defiant. I confront life head on, and my body has always been there for me, a fortress if not a temple, a battle ram ... sensual and sensuous, my own wonderful body.

But it's true that lately I have been unkind to my body. We have been under a lot of stress. We are trying to figure out where we belong in this beautiful city of San Francisco. We are learning to live without the soft caress of a partner we once loved sharing a bed and heat with. We are adapting to new weather, new schedules, and new geography. My body has been hungry and I've been too far away emotionally to remember to feed it. My body has been tired and I've been too preoccupied to sleep. My mind has been ill and my body has fallen suit. It has finally had enough. It has spoken to me through my very skin and said, "You need to pay attention to me, and we need to rest."

All right, body, I'll listen to you.

There are a lot of issues that have come up through this experience. Among them is how devastating it can be to not have access to affordable, quality healthcare. I am privileged to have been able to seek help outside the confines of HealthySF, and I recognize there are others who cannot afford to pay out of pocket for specialized services. The severity of my plight is minor compared to what I am sure other, less fortunate people have to go through. It should not be this way. Everyone does have a right to good health because it is ultimately less burdensome for us all.

Doctors are not infallible. They are human and make mistakes. Your health is your own and it is okay to be assertive about attaining the care you need. If are uncomfortable with a doctor, it is okay to ask for someone else. Just like the people in our lives, some work, and some don't. Some people make better friends than lovers, and some people make better lovers than friends. Sometimes you and a doctor do not get along. Trust yourself and your body, and get a second, third, or fourth opinion if you have to.

Referencing Robert Mapplethorpe,
whose work inspired my interest in photography.

Part of what's been so devastating about this rash is how unsightly it is, and I never realized how much I love the way my body looks until it was drastically altered. At the same time, I acknowledge that this isn't my fault, it is not contagious, and it is only temporary, so while others have expressed self consciousness about their pityriasis rosea, I do not feel the need to hide it, especially since it needs sunshine to help heal it. In fact, I might spend the rest of my day off lying in the park with a book. I don't know what these conflicting feelings mean about myself or the world around me, but maybe I'll sit down and think about it and then get back to you regarding.

For now I am grateful for answers. For now I am going to bed early and making sure I get at least seven hours of sleep. For now I am taking supplements and eating food specific to assisting my immune system. Perhaps this is a blessing in a red-rash disguise. This is focus and clarity during a turbulent time. So I guess I will embrace it ... my body says I have to, after all.

All photos are my creation.


1 comment:

  1. I love this post. I went through the same thing except my rash tunred into scars that havent gone away. Therefore I can only accept it and have gradually gotten comfortable with showing the scars. I would like to know if this still affects you in anyway.
    Thanks for sharing.