Thursday, April 10, 2014

Right Place, Right Time

As many of you know, Trent is a transplant patient. When someone has a transplant, they need to take anti-rejection medications, which suppress the immune system. This is necessary to prevent the body from reacting and literally killing the transplanted organ, which the immune system sees as an invader. Of course, this leaves the patient susceptible to all sorts of ailments or illnesses that might not affect other people as much. I'm sure that the first things most people think of as they read this are colds and flu, and other traveling bugs. But there are other things as well. For example, transplant patients' suppressed immune systems are less able to fight off cancers. Trent has had some experiences in that arena, but one of the biggest concerns, especially because of his years as a swimmer, aquatics director, and lifeguard, is skin cancers.

He has checkups a couple of times a year, and has luckily only dealt with small basal cell carcinomas rather than the dreaded melanomas. There have been numerous spots burned off repeatedly, and a few surgically removed. Last year, his doctor recommended a more proactive approach. This January, Trent had a procedure that involved application of an acid solution which was then exposed to ultraviolet light. Within a few hours of getting home, he looked like he'd had a horrific sunburn on his face. All of the skin came off, but so did the surface skin cancers and pre-cancers. And his skin looks pretty darn good, to boot. We were supposed to have a followup visit in February, but both of us got some horrible intestinal bug that was going around, and couldn't get in until just this Tuesday.

After the Medical Assistant checked us in and remarked about how good Trent's skin looked, we were alone for a minute or two before the resident, and then Doctor Pacheco, would be in to have a look. I told Trent that I wished I could have a laser treatment on my face, but it's something that definitely is not in the budget. And I don't want it for totally vain reasons. I think that my skin has aged pretty well, especially considering that I grew up in the era of benign neglect of the skin. Sunscreen? Never used it. But I was fortunate to have beautiful skin. It was clear and even in tone, and I never dealt with more than moderate outbreaks of pimples. Gram used to tell me how fortunate I was, and how lovely my skin was. The key word in all of these statements being was

Having lupus come into my life began changing that picture. My skin was now covered with redness on the cheeks, nose, and center of the forehead. From time to time it would look like I had a rash because the red areas would get raised or bumpy. But since I had, in my opinion (and that of many others), beaten death from this illness, I tried to think of the redness as a badge of courage and survival. So what if people sometimes thoughtlessly said kind of stupid things about it, like that I couldn't possibly feel or be sick because my cheeks were so nice and rosy?

Then, to add some more fun to the mix, I ended up having rosacea. Yes, just like it sounds, it can make your skin have red patches. Nothing new there. But it also comes with sores and swelling that look like acne. After all of those years with good skin, it's almost like my face regressed and the skin is taking a trip down Teenage Troubled Skin Lane. My previously smooth skin is now covered with little sores and bumps. It's one of the reasons I hate having my picture taken. If it were simply a matter of redness from lupus, it could easily be covered with cosmetics. But putting cosmetics on sores and such just makes them much more noticeable. 

I could take oral antibiotics, but that could leave me open to what's known as super-infections. And having an autoimmune disorder would make the chances of that even greater. I looked into the possibility of antibiotic gel, but when I went to fill the prescription at a local pharmacy, it was just too expensive. At about this time last year, I managed to get an infection in my toe that forced me to go on two different antibiotics. For a few weeks, my skin was beautifully clear. I'll confess that every time I walked by a mirror, I had to check my skin out. It was still rosy, but it was so smooth and healthy-looking!

So maybe now you can understand me saying that I'd love to be able to get a laser treatment to help with my rosacea. A minute or two later, the resident checked out Trent's face, and there were no signs of problems, thank goodness. He has had a recurring spot on the crown of his head, but that was all. Soon Dr. Pacheco came in as well, and was pleased at the appearance and health of Trent's skin. A decision was made to remove and biopsy the spot on the scalp, and the docs left to arrange for him to be moved to a treatment room in a few minutes. We were surprised when Doctor Pacheco came back in the room in about a minute. Trent started to get up, saying, "Wow, that was fast. The room is ready that quick?"

Doctor Pacheco told him that no, it wasn't, she wanted to talk to me. You see, the Cosmetic (rather than Dermatological Oncology which Trent visits) Department is going to start using a new type of laser treatment that is especially for rosacea. And she asked me if I would be willing to be a demonstration patient for the doctors to learn the new procedure. Yes, a free laser treatment! After making sure that my lupus wasn't active, she said that she and her resident thought I would be a perfect patient to demonstrate the new device. I was immediately excited! I was told there might be pain. No problem, I'm used to pain. In addition to her, there might be more than one additional doctor doing the procedure so that they could have hands-on experience. I don't care. There might be twenty-five doctors watching. Whatever. My skin might turn red or purple temporarily after the procedure. So what else is new? And I would need to become her patient so that she could monitor the progress, in which case she could treat me with whatever type of topical antibiotics would be best for my face. I felt like a kid at Christmas!

At this point, I am hoping that nothing happens to make me lose this opportunity. When I told our friend Marie, who had taken us down to the hospital, she was as excited as a kid as well. When I told her that I had said just five minutes earlier that I wished I could have a laser treatment, she said, "Wow. Some prayers sure do get answered fast!" We are planning on making a day of it. And we got a chuckle out it when I said that it was funny to get so excited about having my face burned off. Not literally, of course! So Trent's appointment happened at the very best time. If we had come in February as planned, none of this would have happened. The plan is to have the treatment on Monday, May 19th. I'm not expecting any miracles. I'll still have the same face, after all. But maybe I will be able to have healthier skin again. And all of this from being in the right place at the right time!


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