Tuesday, September 26, 2017

Skin: A Cautionary Tale

Inspirational song: Sunshine On My Shoulders (John Denver)

I've often comforted myself that I am doing the right thing being so open about my life, specifically about my medical history, in the belief that I might inspire others. I am also available to inform. In certain situations, I am comfortable wearing the skin of a living, breathing cautionary tale.

I have had a bad relationship with the sun nearly my entire life. By the time I was eight, I knew it was the source of my migraine headaches, even though I would have no idea that's what they were for decades. I suffered through recess and gym class and tennis games with friends and golf lessons, hating the sun, and feeling miserable afterwards. I had that brief stint in my teens where lying out in the sun was considered a social event, and if we wore suntan lotion at all (notice the different terminology), it was SPF 2, and it was only so we were soft and smelling of coconut. By the time I was in college, I knew that I sunburned quickly, and felt like I had the flu the evening after I got one. I stayed in the shade as much as possible for my entire adult life, if I was forced to be outside.

What I didn't do was wear sunscreen. Not until last year, at least not reliably. I wondered whether it would have an effect on me, but I tempered any possible fears with the knowledge that I preferred indoors and shade. I was probably okay, I thought.

I also have been a freak about taking care of my skin. When I was 16, I saw my mom put on eye shadow, and her eyelid skin was a little slow in unwrinkling. From that moment on, I used moisturizer daily, no matter what. I paid attention to the condition of my skin. I don't mean just noticing when my skin was dry or if I had a poison ivy rash. I recognized the position and density of the moles that cover me like a Dalmation. I knew every inch very well. So I was exquisitely aware when I had the feeling that there was a needle broken off in my lip. Problem was, I ignored it for years, thinking it was so small, it couldn't be anything at all. Then, almost two years ago, I got a pimple on the side of my nose. But it wasn't a pimple. If I messed with it at all, it bled. If I picked off the scab, it came back, slightly bigger. Eventually I asked for a referral to a dermatologist.

Turns out the tiny spots were precancerous. The dermatologist would have frozen them off Friday, if I hadn't had the party to attend. She did it today, and acted like they were no big deal. The lump on my nose had to be shaved off, and sent to pathology. I'll find out about that in a few days. As the lidocaine wore off from that, the worse my day went. I took several very (very) unglamorous pictures of my face with nothing but moisturizer, pre and post procedure. Be glad I didn't take any once things went way downhill.

As a postscript: immediately following the dermatology visit today, I had my answer from the neurologist. He said my MRI looked fine (I hesitate to call my brain "normal," all things considered) and the EMG tests were good. He said my vertigo and paresthesia are from atypical migraine. So does this mean the sun is or is not my trigger? This all started at the beginning of the summer. After discussion of potential medications, we learned that most of them were contraindicated with what I am already on. If insurance approves, I could be prescribed Botox for the migraines. Not sure how it will affect my skin. I bet I'll look fantastic though.


No makeup, no glamorous lighting, no kind angles.


When you get too close to the lens, it all gets wonky, doesn't it? 
Can you see the lump on the side of my nose?


I know you can't see the precancerous spots. I couldn't.


This was before the lidocaine wore off. It all went downhill from there.

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