Shots from The Battery

At twenty-eight, our definition of health care until recently has consisted of an annual physical, a couple of trips to the dentist, the gyno for Di, and maybe a visit or two to the dermatologist each year.

Easy-peasy: schedule an appointment, show up on time, pay the $20 insurance co-pay, and go on our ways.

Most people our age are fairly healthy and have thus avoided any additional exposure to the evil realm of hospitals, specialist doctors, expensive tests, multiple diagnoses, and referrals to more specialist doctors for more expensive tests that apparently comprise the American health care system. Most of us assume that if and when we ever need the services of the health care system, a trip to the doctor to solve our ills will be simple enough. Which is mostly true, I suppose, in a majority of cases.

But what if your affliction is more than a sore throat, winter cold, ingrown hair, or something of that ilk? What if the process seems to break down somewhere before the diagnosis? What if there actually is no known diagnosis? What if no one seems to be able to help you?

We’ve all heard medical horror stories, and ours is nowhere near the top of the scale, but it was a very scary awakening. Di’s experiences in the past 4 or 5 months have changed our perception and given us a dose of reality regarding health and medicine.

Our reality-check began suddenly one morning last December when Di woke up to discover her legs covered in hundreds of these tiny pink dots. They stretched from her ankles at the top of the sock line to just above her knee near her lower thighs; some clustered together, others peppered randomly across the skin.

She looked as if her legs had been a test-palette for a new flamingo-colored Crayola marker.

This was, of course, more than slightly concerning, as nothing had been present the night before, and the symptom had apparently materialized quite rapidly as we slept. They mildly resembled chicken pox or measles, although all of the spots were flat and did not seem to change color when pressed. She experienced no pain or itchiness at the eruption sites, just these odd looking polka-dots. Our first thought was that she was undergoing some weird allergic reaction, perhaps caused by a new pair of pants she had worn for the first time the day before.

These pics were taken Dec. 27, about 2 weeks after the first batch of spots appeared:


Click images for larger view (she’s gonna kill me for posting these!)

So off she went to see doctor #1, a family physician at a local urgent-care facility. He was a young guy, about our age or a year or two older, and seemed quite “green” according to Di. Anyhow, he ruled out an allergic reaction immediately, took some blood for testing to make sure the didn’t have a rare hemorrhagic illness called Thrombocytopenia, and finally decided that she probably had Rocky Mountain Spotted Fever, a tick-borne illness that has a funky pink rash as a primary symptom.

For comparison, here’s an actual pic of RMSF:

So doc #1 prescribed her a powerful antibiotic and sent her on her way.

2 days later the spots had increased in both density and quantity and were slowly creeping up her legs to her waistline. About that time, we got call from Doc # 1’s office, and it was a nurse letting us know the hemorrhagic test was back and negative and Di probably wasn’t going to start bleeding out of her organs. According to them, her blood-work indicated she was as healthy as could be and shouldn’t worry at all about the spreading leprosy on her lower body as long as she kept taking the antibiotics prescribed to her(which, appeared to be making the condition worse, btw).

At this point, we had become more than a bit skeptical of the Rocky Mountain Spotted Fever diagnosis, mainly because she had no other symptoms of RMSF - like a fever. So, we began pouring over the available info on websites like WebMD, YourDiagnosis, WrongDiagnosis, and countless others.

Our novice research led us to believe the spots on her legs were probably petechia, which are described as ’small red or purple spots caused by a minor hemorrhage.’

Scary shit for sure, but most of the possible causes of petechia were even more so:

* Bolivian hemorrhagic fever
* Cerebral malaria
* Congenital syphilis
* Crimean-Congo hemorrhagic fever
* Dengue fever
* Duke’s disease
* Ebola
* Endocarditis
* Henoch-Schönlein purpura
* Leukemia
* Typhus
* Scarlet Fever
* Schamberg’s Disease
* Kawasaki disease
* Kawasaki fever

Now I remember Typhus and Scarlet Fever as annoying obstacles that popped up while playing the Oregon Trail as a child on an Apple IIC back in the 80’s. Neither were good to have, and if anyone in your party contracted either of the bugs, it wasn’t long before they were buried along the trail and the wagon-train moved on without them. Although we had no idea what some of the potential illnesses even were, seeing Ebola and Leukemia included on a list of potential diagnoses was not comforting in any shape, form, or fashion.

So, after about 5 days with no signs of improvement whatsoever and with both of us convinced Doc #1 was in over his head, we decided a second opinion was in order.

Enter Doc #2 over at Roper-St. Francis, a recommendation of several friends and a co-worker. This Doc at least seemed like he’d been out of med-school for more than a few months, and purportedly treated many patients with unusual illnesses, so we were moderately hopeful.

Doc #2 immediately discounted Rocky Mountain Spotted, then proceeded to take lots of blood, 2 painful biopsies, and performed a huge battery of tests over a two-week period. The best answer we got was “non-specific spots,” which earned us a referral to Doc #3, a Rheumatologist.

By this point, it was mid-January, and the spots had spread up to her stomach and had gotten unusually creative. Instead of the clusters and random spots, they were beginning to form little lines and shapes. Over 100 of the little bastards created what resembled a Nike swoosh on her right calf, and she had a various array of convex line segments and abstract shapes elsewhere. It seemed to us that these things were obviously evolving to consciousness. We thought maybe they were trying to communicate. They had obviously become self-aware, and some of them had apparently signed an advertising contract with a very well-known sneaker maker.

Anyhow, it was a three week wait to see Doc #3, which was supposedly a short waiting time to see this dude. The spots seemed to be improving mildly by the time her visit came, and after a short exam the Rheumatologist confirmed the spots were indeed petechia and he thought she possibly had vasculitus. He prescribed a low dosage of prednisone, a steroid, told her to take it daily and to halve the dosage each week, and the receptionist scheduled a return visit in 2 weeks.

The causative factor is still undetermined by Doc #3, and although she’s been back to see him three times and has undergone several super-expensive tests, nothing in the results appears even moderately abnormal.

Now this is where we honestly need a real-life Greg House. Vasculitus is usually symptomatic of something else, so the equation looks something like this: Pink spots = Petechia = Vasculitus = ???

Doc #3 seems equally perplexed that the spots recently disappeared completely, just as quickly and mysteriously as they came. So we still have no idea what caused the scourge or if it will ever return… It’s now 5 months and many visits later, and Docs #1, 2, and 3 still can’t say for sure what exactly happened or why.

But, I can assure you one thing; diagnosis or not, or even cure or not, the bill is never forgotten. Oh, no. And don’t even get me started about struggling through the insurance claim process, deductibles, co-insurance, out-of-pocket, and various other billing jargon that came along with the whole mess.

We’ve found about a half-dozen accounts around the net with other people, mainly females, describing nearly the same account above, with the exact same result; most of their docs have no clue either. And everyone seems to have the same mysterious disappearance of the spots after about 2-3 months. Some of their physicians think it could be adult-onset Henoch-Schönlein purpura, but Di’s Rheumy denied it’s even a possibility as HSP primarily occurs in children.

Who knows, maybe it was an old-fashioned smiting - folks are always telling us we’re both due for one.

So, Mr. smitey-pants, if you’re taking requests;

When it’s my turn, I prefer green spots, please.

-nate