Thursday, February 15, 2007

Dermatology Fun

For years I have had a skin condition called Keratosis Pilaris, which appears as red or white bumps on the outer upper arms and thighs & buttocks, and sometimes the facial cheeks (IT'S HOT!). For some it looks like you have permanent red goosebumps, for me it looks like whiteheads (aka "white pustules" as it was put in my file. Um eww.) and it's worse on my arms, its mild on my thighs and its pretty mild on my face, maybe 10 or so little white bumps at a time. It is genetic and incurable. For most it goes away as they get older, but for others is never improves. YAY me! I get to be in the never improves category. For the most part, it didn't really bother me as a kid, although it was there, I was pretty oblivious to my physical appearance, and likely because I was in the sun all the time the condition was really mild.

Now, as an adult it bugs me. I pick at it, which causes scaring, which just makes the appearance worse. I'd REALLY like it to be all clear and the scars reduced for the wedding/honeymoon so I'm hyper sensitive to it right now.

I have the classic symptoms of it being worse in the winter and better in the summer (the UV rays do good I hear), at least on my arms. Last year, it finally bothered me enough to make an appointment with my NP to get a referral to Dermatology. By the time my NP appointment came around it was summer, and my skin was really mild. ARGH! My NP actually laughed that I wanted a referral. She said they would line her up and shoot her for giving me the referral (FREAKIN HMO CRAP!). Said that lots of people have that and they just deal with it. I just sat there. Looking at her. She said, "What do you want me to do?"


So she did. Begrudgingly. And added to the notes that the patient insisted on the referral. I tell ya, why did she bother seeing me if she would give it to me because I insisted?

So months later, my Dermatology appointment rolled around. I was only seen by a nurse, and she gave me a name for my condition, and told me to exfoliate and use a lotion with AHA twice a day. I also told her that I have been using my boyfriend's prescription acne medication for face acne, so she said, "Would you like your own prescription?". Bam.. just like that. I had some fancy acne stuff, and it was officially in my records that I had acne.

If anyone looks at me, they know I don't have acne. I have always had pretty clear skin, except the arm/thigh thing and the occasional major zit that hangs out for 3-4 weeks.

2 questions here:
How does the referral system save the HMO money, when all I had to do was insist, and then I got any prescription I asked for?
Anyone else have experience with Keratosis Pilaris and have found a solution which works for them? Or even just something to reduce the scaring? I really want to get my arms all cleared up and pretty for the big day.



ML said...

Cherry, I don't have Keratosis Pilaris, so I have no words of wisdom or solutions.

However, I have heard that AHA really does work wonders with scars.

The HMO/referral system is bunk! Everything has to be a big deal and a big run around.

Lalunas said...

No I don't have any advise about the skin situation. But I do have a mouthful to say about HMO's. Which I will not go into. I am glad you insisted on getting a referral. Too bad they did have a doctor actually see you.
Check at the health food shop on Momument in Concord, consult one of their books or assistants there and see what they would recommend.

J said...

I have never been diagnosed, but I have those same bumps. I asked my dermotologist about it, when I was getting a mole removed (OUCH) and he said he has the same thing, and I should use AMLACTIN lotion. I assume it has AHA in it, though I'm not sure what that is. He said he has the same condition, and it works for him. I don't remember to use the stuff often enough to know if it really works. Gina says she uses it to make her feet nice and smooth, so if you want nice feet for the big day, you could use it there as well. :)

As to the referral, your story reminded me of the Seinfeld episode when the doctor wrote on Elaine's chart that she was trouble. HA!

beenzzz said...

I haven't heard of Keratosis Pilaris until just now. I'm sorry the doctor was such a pig about giving you a referral. I swear the medical profession is going down the toilet these days. Patients are sometimes more knowledgeable about their suspected conditions than doctors are. Now they walk around with lap tops and type in your symptoms so they can tell you what they think it is. I'm sorry, but any trained monkey can do that.

Py Korry said...

I think for the most part, HMOs do save money by having your primary as the "gatekeeper." But it seems the bottom line gets in the way of quality care more often than not.

Gina said...

I hate HMO's. But I guess they are better than nothing.

That really did nothing to help you, did it?