Wednesday, February 18, 2009

Lichens: The Ongoing Adventures of Tree Fungus

For the past couple of weeks I've been pondering what I know of skin diseases. To be perfectly honest about my ignorance, I don't think I knew that there are "skin diseases". Conditions we called them; Ailments, or in a pinch, a skin thing.

No one in my immediate family had acne. My high school boyfriend did but that was in the 80's when acne docs usually said to lay off dairy products, chocolate and pop (here in the north, it's pop, not soda - charmingly pronounced "sodie" by my southern steps). One of my step-daus from my 2nd marriage had acne in the 90's and was given an Rx of antibiotics, but acne was the least of her problems so we didn't really pursue it. She didn't care and preventing her from sniffing trash and eating rotten food were higher on the priority list. Acne was just acne. Teenagers got it and around 19-20, it went away. I only ever met one adult with it, a co-worker friend of mine. She went to a derm for some kind of treatment but we never really discussed it and I never thought of it as a disease. It was just a skin thing.

My mother had eczema. It was really bad when she was a kid but improved with age and some alternative treatments she devised through trial and error. Myself, I'm leery of putting Prep H on my face but hey, whatever works. However, I didn't think of it as a "disease", it was just an annoying condition.

I also had a boyfriend in college with psoriasis. He was so self-conscious that he wore jeans and long sleeved shirts even in 90 degree heat. In fact, I'm not sure I ever saw it and you'd think I would have given the circumstances. I do remember that he got "light treatments" for it when he was back home in Detroit and he once explained to me how that was done. Rather like a vertical tanning bed without the bed. I didn't know that was a disease either, an auto-immune disease no less, just like eczema is an auto-immune disease. Until two weeks ago, I didn't know that about either of them. They were just "skin conditions".

Now I have the tree fungus and it's official. The biopsy came back positive which is no surprise to me given the number of websites I've read in the period of time between the leather punch incident and the letter from the derm. While I appreciate all of the helpful advice from others, useful things like "Would it help if you boosted your immune system?" (um, autoimmune disease, here's yer sign). "Try Stridex, it should help" (not pimples but thanks for playing). "You must have some emotional trauma buried deep in your subconsious. Figure out what that is and I'm sure it will go away"; "You eat too much chocolate", "You've always been too thin, that will cause this type of thing, you know" (I can't even think of a response for those, sarcastic or otherwise). The thoughtful advice is sweet but.....I doubt drinking borax is going to be very helpful.

I've discovered strange little quirks that were never really ascribed to a common cause but which now fall into place under as symptoms of the tree fungus skin. Things like intermittent weird fingernails. They'll be fine for months when suddenly they develop these ridges that run from the cuticle to the nail end. Not really ugly, but strange. The nail on my ring finger will even split up the center along one of these ridges. It's annoying when that happens because I've always really liked my hands, especially my nails, and when one splits or breaks, I have to trim them all down and wait for them to grow back out again. I know, it sounds very girlie of me, but when you have largely unkempt hair, don't wear makeup, dress like a farmer, have some kind of shit on every pair of footwear but one and don't have a shopping fetish, having a fondness for your nails isn't much. Now I know the nail thing is the tree fungus. 'Twould never have occurred to me to correlate the two.

Even stranger, from the time I was 19 or so, I've chewed the inside of my mouth. My first ex used to tease me about it, telling me that I was going to chew a hole through my cheek. I was really compulsive about it but always assumed it was a nervous thing like people who twist their hair. Nope, it's the tree fungus. In my mouth. That explains the derm looking in my mouth which I thought was bizarre given the nasty little bumps were on my feet, legs and arms. I asked hub's nephew, the dentist, if he'd noticed that I have this thing in my mouth and he said it's really common, both the the fact of it being there and the subsequent chewing. Common enough that he didn't think to mention it to me until I asked about it. What's odd to me is that having chewed the inside of my mouth for years, I suddenly stopped sometime in my 30's. I didn't even notice I'd quit until ex hub #1, in a fit of nostalgia, asked if I still did it. I realized that I didn't and hadn't for quite some time. But lo and behold, I started again 6 or 8 months ago. Weird, huh?

The latest development is the fungus seems to be screwing with my teeth, hence the chat with the dentist nephew. In the past two weeks, I've had to have pretty extensive dental work done on a couple of teeth. Not fun since I'd rather have an eye removed with a fork than undergo a dentist's drill. Shots? Annoying but no biggie. The low pitched, slow drill? Rather like a blowfly trapped in a nasal cavity but not overly distressing. That nasty, high pitched, make you want to rip your hair (or the dentist's) out and run away screaming drill; that one's a problem. So drill, drill, pick, pick, x-ray, drill, pick, x-ray, drill....I've had enough of that. The appearance of the tree fungus shortly before the oral problems, and having conferred with my handy family medical people, would lead me to believe that this synchronicity is not coincidental (ugh, there's that dental again). It's the tree fungus. My, my, isn't this fun?
However, I've done yet more reading of sites offered by my step-dau and it would seem that my case isn't nearly as bad as that of others. So I'm not going to bitch about it (much) and will be thankful that it doesn't hurt, isn't eroding the inside of my mouth, isn't causing oral yeast infections and, hopefully, won't require any more root canals. I'll be thankful that I don't have lupus or Crohn's or RA. I'll wear shorts and tank tops as always and ignore any surreptitious looks from strangers. I'll pretend they're admiring my legs instead. There are worse things and luckily, I don't have any of them.

Saturday, February 7, 2009

Lucky Me, It's Not A Fatal Rash

I have a list of blog topics that I keep on my desk. Occasionally I look at them and start composing sarcastic repartee in my head which, sadly, I promptly forget as soon as I go to bed. I've been meaning to write about my little dinosaurs, about my husband's rather odd, and continually finding himself on the wrong side of the law, son. I have cow stories, goat stories, dog stories and the occasional weird friend story but all of those humorous little things have fallen by the wayside, superseded by tree fungus skin.

You'll recall that I have had issues with toe bumps and the potentially fatal rash. My husband's adamant demand that I make a trip with him to Farm & Fleet in search of appropriate footwear has resolved the toe bump problem. Men's cow shit brown, size 12 farm boots with thinsulate type liners (rated to -30 deg) aren't terribly sexy and make me look like Bozo the Clown while walking but they've kept my perpetually cold feet warm even when it was -27 here at the old ranch. That's the good news.

The fatal rash which turned out to be neither fatal, nor a rash, was diagnosed by the somewhat disbelieving Nurse Practitioner as contact dermatitis. Hubby had changed the laundry soap, a major offense here in my environment where any introduction of perfume or even mild chemicals produce truly unpleasant effects to my skin and internal organs. If it smells nice, it's not getting through the door. If it makes your laundry really soft and has little teddie bears jumping onto the piles, keep that shit away from me or I'm liable to wake up with boils the size of kittens in places I don't even want to hint at.

I was relieved and not terribly surprised when the NP made her proclamation. She offered 3 tubes of innocuous cream to slather on the offending bumps and I made my relatively merry and relieved way home believing relief was in sight. Silly me; I really should know better by now. It seems very few things are easy when it comes to medical, dental or psych care and my body, teeth and brain (such that it is). I, being the true sister of an excellent nurse and a paranoid as well as distrusting patient, covered all the pertinent questions, understood fully what the NP told me and asked what I should do if the not so fatal rash didn't go away with use of the creamy stuff. She looked at me like I'm stupid, medical professionals often look at me like that, and said I should see a dermatologist. Fine. Lovely. I went home fully expecting to have my skin back within a matter of days. Didn't happen.

What did happen is the red, itchy bumps on the soles of my feet turned into scaly, itchy, welt looking things which spread to my ankles. A few days later, I had red, itchy bumps on the front of my calves, the leg kind, not the bovine kind. Then on my forearms, then in select places on my thighs, then on the base of my spine where my jean's tag tends to rub. I was beginning to look like I had mange and it wasn't a pretty picture.

I waited until all but a tiny bit of the creamy stuff was gone and called the only dermatologist out here in the provinces. The nearly incomprehensible receptionist finally figured out I needed an appointment, scheduled one - for two weeks later of course - and I waited apprehensively while worrying about what could possibly be causing this bizarre epithelial outrage.

Finally the appointment day arrived. I had a shrink appointment beforehand, because I like to double up on irritating events, so I toodled off, became annoyed yet again with the shrink and arrived at the derm's office 45 minutes early. Joy. If you know me, you know I don't wait well. And I'm understating just how much I don't wait well....I waited. I went into the office 3 minutes before my appointment, filled out the obligatory 500 page questionnaire and waited some more. And some more after that. In a completely full waiting room; one so full the receptionist, this one a fluent speaker of English, brought out a couple office chairs for people to sit on.

Finally I was called back, my name mispronounced as usual. Into the exam room I went with the very pleasant nursey person who asked me more questions, wrote them down, nodded cheerfully and said the doctor would be right in. I waited. I scratched a bit; I read several pages in my ubiquitous book and eventually the doctor came in, smirking. I wasn't sure if that meant he had a sense of humor (my preference in medical folks) or was an arrogant ass (the more common affliction of medical folks). He asked me the same questions as the nurse type person - doesn't anyone read the damned chart? He asked how long I'd had it. I told him 3 months to which he replied, "Well you rushed right in didn't you?" That annoyed me so in a slightly curt tone I told him I'd have been in sooner except I had to decide it wasn't going away on its own, it took a week to see the NP, three weeks of using the creamy stuff and another 2 weeks to get an appointment with him at which point he shut up and asked to see the rash type thing.

I showed him one of my arms, he nodded knowingly. Then I showed him my alligator/alien feet, told him the NP said contact dermatitis and he looked at me like I had three heads and said, "No, it's likeanplarlnafst" to which I responded, "What?" He repeated it. I repeated it back. The three heads popped out of my neck again. "Lichen planus", he said. I thought to myself, what the hell is that? Having thought it, I of course said it aloud. He raised an eyebrow and then chuckled. AHA! Sense of humor. Thank goodness because if I'm going to have some weird skin thing, the doctor had better have a sense of humor. He said because of its appearance, it's named for the stuff that grows on trees. You know, tree fungus. I asked how I got it. He asked if I was an IV drug user. Ut oh, this isn't good. He then asked if I associated with IV drug users. "Associated" must be code for did I sleep with junkies. Again, not my cup of tea. Had I had a blood transfusion? Nope. Did I donate blood? Nope. Did I have Hepatitis C? Um, not that I'm aware of, especially since I don't even know how a person contracts Hepatitis C. Did I have a tattoo? That one I have but the time period and place in which I got it precluded my having been exposed to aforementioned junkies, transfused persons, or persons with hepatitis C. At this point, I reached the point of sweating, my ears were ringing, hands were shaking and nausea settled in which normally precedes completely losing control of myself in an embarrassing way in a public place.

Offering no additional information, said doctor informed me that I needed a biopsy and left the room. Hmmm. Didn't sound promising, especially since I still didn't know what the hell it was, what caused it or what to do about it. The nurse came back in, started pulling swabs and needles and odd looking torture devices out of miscellaneous drawers and smiling at me in a "gee, I feel really sorry for you" way. Reenter the doctor who drew a circle around one of the red, bumpy, scaly things on my arm, shot a big bubble of anesthetic into said arm, and, I kid you not, took a tool that looked like a leather punch, smirked at me and jabbed the thing about 1/2 an inch into my forearm. Yikes! It didn't hurt of course due to the pint of stuff he'd already shot into my arm but it was still rather alarming to have a flesh cork pulled out of an extremity. He put a couple stitches in and rolled his little roly chair back to the counter, smirking the whole time. I said the name of the mange type thing again and the three heads reappeared but he agreed that I had it right. I told him my goats were getting ready to kid and asked if they could catch it. He burst out with a snork and said, "You'd think you'd be more concerned about whether your husband could catch it, but no, it's not contagious". I replied that if my husband was going to catch it, he'd have it by now and the doc agreed. I asked how to get rid of it. He was vague. I asked how long it would take. He said, "about 2 years." TWO YEARS?? Not contagious but apparently having some correlation with junkies, transfusions, blood donation and hepatitis C. Not much to go on.

I headed for home, weeping along the way, called my step-daughter and asked her to look it up in her nursing school books. She instead immediately looked it up online and read what she found to me while I was driving. Autoimmune disease of the skin. No known cause. No known cure. Upon reaching home with a sinking and nauseous feeling in my gut, I logged into twitter and found my sister who immediately starting sending me helpful links all of which said the same thing and had lovely accompanying photos.

So the not so fatal rash has morphed into tree fungus skin. As of a few days ago, I can't use a razor to shave my legs so I'm beginning to resemble a yeti. I'm waiting for the biopsy results to come back so the doc can decide on a "treatment program". I don't even like the sound of that. I'm finding novel ways to avoid exposing skin, not terribly difficult given the weather, but spring is looming as is what I'm sure will prove to be a series of embarrassing public displays of human tree fungus. Stay tuned. More to come.