Of Course

I wouldn’t be me, if I didn’t have some weird confounding, extra medical anomaly, connected to my injury, surgery, or recovery. The funny thing is that I don’t actively wait for it, or expect it. I go through life, expecting normal recovery, and then, “Bam,” something weird happens, and I remember, “You can’t have nice things. You live in a body made of defective spare parts someone found in a bin marked ‘don’t use.’”

Finally, a selfie with Bear! It took a lot of work to get this shot! And it’s terrible.

Finally, a selfie with Bear! It took a lot of work to get this shot! And it’s terrible.

 

With this surgery, this awful, painful, dreadful, and torturous surgery, recovery has been slow, but steady. I’ve begun being able to bear weight on my surgical leg. I’ve begun being able to bend it to almost the expected angle, thanks to the most painful physical therapy session that’s ever been conducted, anywhere, ever, to anyone. Just ask. Or, count the tissues that I cried into, during the actual session. Nothing says grown up strong-woman, like crying in public, while a physical therapist manipulates her knee into what seems like normal positions.

 

But, in the last several days, my knee has suddenly looked like this:

Sure….looks like a bunch of bug bits punctuated by smushy leg brace marks. No big deal? Maybe a spider or something was smashed in there overnight and got a feast?

Sure….looks like a bunch of bug bits punctuated by smushy leg brace marks. No big deal? Maybe a spider or something was smashed in there overnight and got a feast?


But, shortly after, they look like this, and stayed that way, which is concerning:

Ummmmmm. WTF?

Ummmmmm. WTF?

At first, they were raised, and very, very, very itchy, like bug bites. We thought, at first, it was dreaded bed bugs. Correction, I thought it was bed bugs. Bryon wants credit for the singular time he was right, as he was certain we did not have bed bugs. I thought it was a reasonable assessment, as I was waking up with new lesions every morning, they were clustered together in groupings, and they itched. However, I was the only one getting bitten, and they were only biting my surgical leg, which was weird. I tried to justify this by saying that my operative leg must’ve smelled juicier and bloodier with all the swelling at the surface. Ew. Finally, there was absolutely NO evidence of bed bugs, despite tearing the bed apart, and examining every square inch. Even the Orkin man that we called confirmed that we were completely clear. Okay, Bryon was right. Mark it down.

 

It was also a good bet that they weren’t bed bug bites because about 24-36 hours after they itched, they flattened out into these weird flat legions that looked super…well, like I should see a doctor. So, I did. I called my primary care physician, who had no clue what it was. His first thought was a super scary word: vasculitis. I didn’t know what that meant, but he seemed awfully concerned about it, especially for a doctor dealing with me at roughly quitting time.

 

He spent about an hour on the phone, texting pictures and calling back and forth between infectious disease (oh my god!!) and my surgeon, arranging for me to be seen immediately the next day, and brainstorming about what was wrong. The working theory for the night was vasculitis.

 

The next day, my first appointment was with the surgeon. His assessment went something like this:

 

Vasculitis? No! It took me a while to remember where I’ve seen this before, but I think it’s frostbite burns from your ice machine pad….(examines the area for a bit) wait, no…it looks like shingles! It’s traveling along the blah-blah nerve. Yeah, I think it’s shingles…yep, the more I look at it, I’d say my best guess is shingles.

The ten minutes we were there, he became more and more convinced it was shingles, the point that all other diagnostic ideas seemed preposterous to him, or at the very least, far secondary options.

 

Call my primary care doctor back to find out what time, and where to go for infectious disease, and the phone call goes like this:

 

Shingles? No way. Probably vasculitis…Or, some kind of infection….not shingles…nope…no how…anyway…this is where you go.

By the way, she wanted me to just “storm the door,” to infectious disease. In other words, her initial plan was for me to just show up, say that I was sent there, and to just camp in the waiting room until someone saw me, because they all know one another, and if I made a stinker of myself, they’d see me sooner. I was NOT about to do that!

 

Get to infectious disease, and this is how that visit goes:

 

Nope, not shingles. And, it’s definitely not vasculitis. That’s for sure. Probably not an infection…spots are too different. Gosh, I have no idea, but it sure isn’t right. You need a biopsy on those spots. Need a dermatologist, or at worst case scenario, a plastic surgeon. But, it’s 3 pm, on a Friday. He calls my primary care doctor, and my surgeon to talk over what they think it could be, again. He wonders if it is an allergy to my own cartilage, or the graft, or maybe the bolts. It’s not.

 

Phone call to Primary Care, after I leave infectious disease, to figure out dermatology:

 

Sorry, called five dermatologists. No one can see you today. They’ve all left because it’s Friday. Expected. Got an appointment for first thing Monday morning.

Hilariously, they ask that if I need to cancel it, I do so before 5 pm, otherwise they will charge me $50. How, I ask you, as they have nothing but my name? However, I will not be cancelling, as I’m thrilled to death to have someone cut a chunk out of my leg. It sounds like fantastic fun.

 

Note from all doctors: if I start to run a fever or start sweating at night, or the spots change in any way, I’m to call any one of them immediately, and/or head to the hospital. I’m not sure which one wants the phone call. I’m sure all three of them would call the other two, since they are all fascinated with the mystery spots now. Since I have kind of a cool doctor that takes care of all my doctor referring, finding and records transferring, they are all on the ball with my bloodwork and the whole case, so they are totally invested. Plus, it’s weird, and their most fascinating case of the week…at least. That’s Rachel: Weird Medical Science.

 

So, that’s been my last two days. It was fun to miss a few hours of class on Tuesday because my doctor was playing phone pissing contest about which diagnosis seemed the most appropriate, who should see me first, in what order, and whose schedule was more booked. My surgeon was great though; all he said was, “send her in, whatever,” which was comforting, because he made me feel like maybe it wasn’t a big deal, and he made me feel like he’d see me no matter what, if something went wrong.

Measles...Or Not

Speaking of hypochondria…


You know how it seems like we are living like pioneers in 1857, thanks to the measles outbreak(s) brought on by kooky anti-vaxxers and their fear of survival? According to the CDC, there have already been 764 reported cases of measles this year. This is more than double last year’s total cases, and more than six times the cases in 2017. This year, there have been public health notices regarding measles outbreaks in Los Angeles County, Brooklyn, Washington, New York City, Texas, Illinois, and Rockland County (New York).


I am immunized because I got all my shots as a kid, and because I was in the military. When you in-process, you line up with all your fellow new airmen and wait for a slightly senior-to-you airman to push up your sleeve up and give you approximately 97 shots at once, regardless of your vaccination history. Your arm hurts for, what seems like, weeks, probably because you are concurrently doing endless push-ups and pull-ups on those same arms. I’m pretty sure it’s just the tetanus shot that hurts, but it seems like they all hurt.

 

These new measles cases mean that adults are panicking about their decades-old shots and whether or not they need to be covered with new boosters. If you were born after 1989, you probably had two doses of the measles vaccine, which is approximately 97% effective at preventing measles, versus the single dose MMR (measles, mumps and rubella) vaccine used as far back as the 50s, which was still very effective (93%), but slightly less so. The only way for adults to tell, at this point, whether or not they fall into that “almost” covered, or not covered at all between 93%, 97% or 0%, is to get their titers checked. This is as simple as getting their blood drawn to find out if they have any antibodies that say, “yep, I’m protected from the measles.”

 

All of this measles talk has a purpose, I promise.

 

I was born before 1989, and I was in the military. So, logically, I’m covered for the measles, right? Duh. I have had my measles vaccines. In fact, I have been vaccinated twice over, by anyone’s standards. According to the anti-vaxx crowd, I should either be dead, have super-autism, or be glowing with toxic radiation. That’s how it works, right? Either way, I have no reason to assume I have the measles.  

 

Still, when I got a weird rash on my face last week, that’s precisely what I did. To be fair, I didn’t assume measles…at first. I waited several days before I freaked out. And, I kept the freak out factor very minimum. In fact, I tried to go to my primary care doctor, super casual-like. “Hey man, I’ve got this rash, can I come in? Super chill. No big deal. In fact, let’s forget the rash, let’s just get some burgers and milkshakes. I’m cool, I’m casual. I’m breezy.”


I only showed up at Urgent Care because he’s at a conference at Johns Hopkins, for the next THREE FREAKING WEEKS, and I had no choice. He’s still out of the office, actually.

 

I was, frankly, pretty annoyed at him. Not sure if you’ve heard of this new MDVIP thing; but, it’s basically concierge medical care. A lot of doctors cut their patient load down to a few hundred (or fewer) patients, which is great for you, as a patient; however, you pay a yearly fee to enroll in the practice. It works out for the doctor, too, as they work with less insurance red-tape, make a higher profit (the high enrollment fee is cash only), plus they get to practice medicine the way they want to. It makes for pretty personalized care, and a wonderful patient experience. It’s not cheap go to a MDVIP provider, and he was gone for THREE WEEKS, during a “measles” crisis on my face.

 

I digress. I suppose I can forgive him. He’s been there for me at minutes’ notice when I’ve had the flu, a UTI, and a kidney stone, in the past, so fake measles can be forgiven…this time! He’s a great doctor, and always thorough. He’s often too thorough. You can never get out of there in less than thirty to forty minutes, even for a “quick” appointment, and not for waiting, for the appointment.

 

Anyway, back to this rash on my face. It was weird, red splotchy spots that had popped up out of nowhere all over my face, primarily on my right cheek. I’d not had contact with anything new, not eaten anything new, not worn anything new, not used a new soap, nothing. They kind of itched, but not really. They felt raw when I touched them. They were spreading, and they were ugly. The ugliness was my primary concern, of course.

It’s almost embarrassing to show you all this picture because it barely shows the rash, here. But, this is the" “best” picture I have of it. Half of my face is covered by sunglasses, and half of my spots aren’t visible. Overall, it’s a pretty dumb shot to “show off” a rash. But, here it is. And, it’s a HIDEOUS picture of me. It’s probably not the ugliest picture I’ve ever posted here, but it’s still not great! But, you get the idea of what some of the spots looked like.

It’s almost embarrassing to show you all this picture because it barely shows the rash, here. But, this is the" “best” picture I have of it. Half of my face is covered by sunglasses, and half of my spots aren’t visible. Overall, it’s a pretty dumb shot to “show off” a rash. But, here it is. And, it’s a HIDEOUS picture of me. It’s probably not the ugliest picture I’ve ever posted here, but it’s still not great! But, you get the idea of what some of the spots looked like.

 

 At first, I thought they were pimples and that I was having a hideously bad acne breakout. Because I am blessed with normally clear skin, with the exception of pimples that come in singles here or there, I was pretty annoyed to have a baker’s dozen arrive on my face all at once. Still, I slept with those awesome pimple patches on all of the spots, thinking I’d wake up with lots of goopy stickers to peel off in the morning. Nope. All the stickers came off clean, and the spots were just as red and hideous. So, I was annoyed that I’d wasted a ton of those stickers. Plus, there were even more red spots. Hmmm….and grrrrr.

 

In the back of my mind, I thought they looked measle-y, but I knew it couldn’t be, because I’d had my vaccines; however, measles starts on the face as flat, red spots. Check. Logic be damned when you’re a hypochondriac. I posted my rash, now several days old, on FB and one of my friends immediately said measles. Really, I just wanted someone to say, “poison ivy,” or, “leprosy.” Really, anything other than confirming what I was already thinking.

 

This was moments before I went in to a physical therapy appointment for my ridiculous shoulder that is still bothering me. My physical therapist, of course noticed my rashy face. There’s nothing like brining a potentially contagious rash into a medical building where they treat dozens of patients, many of them elderly, a day. You feel like a criminal. Only instead of assaulting the elderly directly, I was potentially leaving behind a microbe to do my dirty work. When she asked what it was, I was forced to tell her I didn’t know. But, of course, she said it looked a little like measles. I explained it couldn’t be, that I was vaccinated, which made her more comfortable, and that I was going to get it checked anyway, which put her even more at ease.

 

So, I went to urgent care….

 

This is how check in went:

 

I’m perfectly healthy, energetic and happy, as I approach the counter. I tell the check-in woman that I’m probably fine, but if I’m not, perhaps I should sit somewhere away from others because I’m concerned the rash on my face is measles. The woman behind the desk looks up at me, looks at my face, smiles at me, and tells me to take a seat. She removes the pen that I used to sign in with from the cup on the counter, throws it away, and then sanitizes her hands, wipes the counter with bleach and wipes her keyboard. Yep. I feel great, so far. The waiting room is empty, except for a single person, so I sit all the way on the other side of the room.

 

Moments later, a nurse comes out to get me, wearing a face mask and gloves. She was excessively kind and apologetic for being so overly cautious, and said that she hoped I understood the precautions. Of course, I did! She got me to a room, checked me in and took a look at my face. From her assessment, she said it was hard to tell, but it looked like…hmmm…maybe? In other words, she didn’t know. So, she obviously wanted to wait for the doctor. What she did want me to know was that she was so happy that I came to the clinic and that she wished more people came to check on rashes they didn’t know about because it would help stop spread these outbreaks. This left me wondering what other rashes cause outbreaks, other than measles? Meanwhile, I was apologizing profusely for wasting everyone’s time and for being so ridiculous for coming in, in the first place. All I could think of, was becoming patient zero in Northing Virginia.

 

Next, a PA comes in, introduces herself, gloves up, and puts a mask on. She also apologizes for the precaution and congratulates me on potentially stopping a measles outbreak in its tracks. I am starting to feel like a god damn hero for visiting Urgent Care, instead of like a weirdo with a face rash. She spends about five minutes examining my face, which, trust me, is a long time to have someone centimeters from you face, poking it, shining a light on it, and staring directly at each spot. The end result of her exam was that she just…wasn’t…sure. She thinks that it’s probably not, but she doesn’t want to make the final ruling without a doctor to sign off on it. Just in case.

 

By the way, there’s nothing like a woman with a light squinting right at your face, quizzically saying, “Gosh, I just don’t know…what IS that?” while poking your cheek, as if she’s poking at a piece of rotten meat. It makes you feel just, I don’t know, pretty? Is pretty the right word? Gorgeous?

 

So, that’s two people who are maybe thinking it’s not measles, but they can’t 100% be sure that it’s not, so they need a third party to rule it out for certain. So, now I’m wondering, if it’s not measles, what the hell kind of rash do I have? What did I get into that’s so insanely unique that no one can even identify it?

 

The doctor comes in, this time not covered, not masked, and not gloved. He was also very nice, and congratulated me on being responsible enough to take seriously how contagious I might be to others. I was wondering if, at some point, the entire clinic might be secretly planning a party, or perhaps a parade for me? It really made me feel much better about going in for something so silly, to have everyone be so nice to me. Anyway, he examined me pretty closely as well, and determined it was “just a rash.”

 

His assessment was that it’s basically a “who the hell knows?” kind of thing. He didn’t say that, but that’s my description. I could’ve come in contact with anything, at any time, and been allergic to it. Even with steroids and steroid cream, it still took another week for it to clear up, so whatever it was, I was obviously having quite a reaction to it! He said it definitely looked very similar measles, so there was certainly a reason to feel a little concerned. However, measles tends to start more towards the hairline, and not the cheeks. The more you know, I suppose!

 

He said it might’ve been poison oak or poison ivy. It made me remember that I had, indeed, been rubbing my face in the lawn when I was gardening a few days prior. I was weeding our raised veggie and flower beds, and to take a break, I put my face all over the grass. No wait, dogs do that. So, no, I have no idea what caused the rash. It was just there. And now, it’s gone. And, it wasn’t measles. Of course.

 

So, my hypochondria sent me to urgent care for a disease that deep down I knew I didn’t have, which I was later told I didn’t have. And, all ended well. OH! I forgot the part which Bryon even agreed that it was a good idea to get checked. He was a hypochondria supporter, at least in this case. He, like me, said, “you probably don’t have it, but yeah, get checked. Not a bad idea.” Meanwhile, he was at home, texting me what he was Googling, which was that I didn’t have a fever, and all the CDC reported cases by state. He didn’t feel 100% sure that I was “safe” until he saw that there were no reported cases in Virginia yet, this year. I always know when Bryon is worried, even 1% worried, by his texts, or what he Googles or looks up. He was just a smidge concerned, just like me. A smidge counts. Hope my hypochondria isn’t rubbing off on him!