Best. Rash. Ever.

My latest medical adventure has nothing to do with my kidneys. 

On May 30, I started noticing small bumps on my left wrist. They were hard to ignore, since they itched like crazy. Soon I had more bumps on my wrist, then more on my tricep, knee and ankle -- all on the left side. I tried to self treat at home for six days until I couldn't take the itching anymore and went to UM acute care.

The doctor said that this was a rash that I probably got from gardening--even though I told her that I haven't been doing any gardening. She prescribed a steroid cream, referred me to a dermatologist and sent me on my way.

On June 11, I was able to see the dermatologist. By this time, the rash had spread to my right side, including a very painful patch on my right hip. The itching was intense.

I was waiting to hear the dermatologist's rash diagnosis when she said:

"I'm so glad you came here today. You have a lot going on."

Huh?

Soon she was using liquid nitrogen on my face to treat some actinic keratosis (pre-cancerous) on my left cheek. Then she did shave biopsies on two places she said that she was concerned about: one on my right hand and one on my left upper arm, just above my elbow. Neither of these spots were near my rash or had anything to do with the rash, yet they had her full attention.  

On Friday -- 20 days after this dumb rash sent me searching for relief -- the dermatologist confirmed that the two spots were basal cell carcinoma skin cancer. We are now waiting for my biopsy wounds to heal before treatment. The doctor is recommending a basic surgical procedure called curettage and electrodesiccation. It all sounds pretty straightforward and I'm not too worried. I'm not exactly excited about the doctor digging into my hand and arm again, since I'm guessing these will be deeper than the shave biopsies, but I'll deal with it when the time comes. 

I now think my "dumb" rash is a pretty cool rash, since it led to the discovery of my skin cancer. 

The official rash diagnosis, by the way, was contact dermatitis. Ha. I basically got exposed to something that my body didn't like, hence the rash. The doctor looked at the steroid cream the acute care doctor had prescribed, shook her head and with wide eyes said, "That's not gonna be enough" -- delivered in the same tone and timing as the famous Jaws line -- when Martin Brody (Roy Scheider) said, "You're gonna need a bigger boat." It cracked me up. 

Above -- what the first doctor prescribed. 

This is my loot from the dermatologist. A bigger boat indeed!  The rash is now nearly gone, thankfully.

The Cost of One Rituxan Treatment

What's posted above is a cut/paste from a recent billing statement. This is the cost breakdown from one of my Rituxan infusions. And I've had EIGHT so far -- four in July 2014 and four in February 2015. 

My treatments were pre-approved by my insurance company, so my own portion of this bill is not nearly as obnoxious as the sticker price. 

But seriously -- who can afford this stuff? Why is this drug so expensive? I just don't understand our health system.

Fibrils

I was talking to a friend about fibrils the other night, because hey, who doesn't love a good fibril conversation? I was trying to explain why I'm still sometimes uneasy about my fibrillary GN diagnosis, and of course I struggled to verbally make sense of things.

That's when I turned to my good friend Google and found this image:

Fibrillary GN fibrils are typically 15-30 nm.
Amyloid fibrils are typically 9-12 nm.

My fibrils are 9-10 nm.

This means nothing, of course. I don't think Mayo and UM are wrong. My sample didn't stain congo red.

I just think it's one piece of information that is unique to me and -- in the words of C + C Music Factory -- is a thing that makes me go hmmmm.

[Obscure '90s music reference free of charge.]