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Health Medicine Uncategorized

Lion Scratches

When I was 15 my legs were itchy. I couldn’t sleep. I writhed in agony, with no rash or bumps or any other symptoms. I went to my pediatrician, urgent cares when I couldn’t stand it, and even the emergency room once. No one could figure it out. I had a whole cabinet full of lotions and creams to numb and soothe. Eventually I got a referral to a dermatologist with a 2 month wait before her next appointment. When I finally saw her, she told me about another over-the-counter lotion and sent me away to come back in 2 weeks. Still no relief. When I went back she found a few goosebump sized bumps on the back of my thigh and she squeezed them until I cried to see what would come out. The best she could figure was that it was some sort of keratosis. She prescribed Triamcinolone acetonide cream- basically what I now know to be the steroid cream of choice for itchy skin. She didn’t just give me the little toothpaste sized tube either. She gave me a 1 lb. tub with two refills on it. I was instructed to rub it all over my legs and butt at night and anytime after I showered.
I followed the instructions; I got less itchy. And then it went away all together. I forgot all about the cream when I quit itching and then the itching would come back, so I used it again every night. The tubs of lotion lasted about six months and I used all of them, along with OTC CeraVe. With three tubs of triamcinolone, I did this for about 2 years. When I got to the end of my last thing of lotion, I went back to see the dermatologist. She gave me another refill and I left. Somewhere after this I started to get deep, purple striae on my legs. They were slight at first, then bigger and bigger. “Finally,” I naively thought, “I have a rash that she can see and get rid of!”
I got an appointment. She looked at my legs and frowned.
“Oh no,” she said, “I am so so sorry.”
She asked me how long I had been on triamcinolone.
“Almost three years,” I said, now age 18.
She asked me where I had been applying it, who prescribed it, how often I used it. These are all questions she should have known the answer to. She then explained to me how I slipped between the cracks for proper treatment. That steroid cream is only used to treat the symptoms for a short time and that I never should have used it that long without us searching for a solid diagnosis and treatment.
I had about six long, purple, shiny trenches on each leg.
Turns out that long term steroid use causes skin atrophy. Skin atrophy from steroids can look different on different people and even be more severe than what I have. Basically, I have skin atrophy much like what happens in stretch marks.
“I’m sorry pretty girl,” she said on my way out. “I like to keep my young girls with beautiful skin.”
I don’t know what happened. I don’t know if the refill number on my script got misread by the pharmacy. I don’t know if she was distracted and forgot to order me a follow-up appointment. Maybe my insurance wouldn’t pay for a biopsy and she forgot to revisit a solution. Maybe everything happened at once. I was ignorant and didn’t know to call and bother her office until a permanent solution was found.
I have since grown out of whatever caused me to itch, and I have never seen another doctor prescribe triamcinolone in excess. I now believe myself to have had keratosis pilaris– a relatively common and straightforward diagnosis. It doesn’t really matter what it was though. It won’t make the marks on my legs go away.
Mine is a cautionary tale of the power of medicine in both its healing and harming, and of the health care system’s shortcomings. Several things went terribly wrong in my care; placing the blame on her alone wouldn’t do anyone any good. It could be a lot worse. I still have my quality of life and no function was lost. I know others who get lost in the system aren’t always so lucky. Though there are steps the doctor could have taken to give me better care, I don’t blame her. I’ve seen her waiting room; I would forget some things too, with that many patients in a day. Having perspective from both patient and provider helps me to be more forgiving too.
The scars have since faded to a light pink, but they are still there- thin-skinned, ugly, and obvious whenever I wear shorts.
My nieces have all asked me about them at various ages. Their age doesn’t really matter because they are still too young to understand this medical mishap. Just the other day Addie asked me what happened when she was sitting in my lap. “Do you have an ow-ie?” The shock of the scars’ size was on her face, worried for me.
“It’s okay, they don’t hurt Addie. Some medicine did it to me.”
When I first got them, my older nieces asked me about them, I didn’t know how to explain it. I told them a bedtime story about how I happened upon a lion, and got scratched as I struggled to outrun and escape it. Then they started telling people their aunt got scratched by a lion.
I’ve seen articles where new mommies affectionately refer to their stretch marks as tiger stripes. Paying homage to their battle wounds from carrying a baby; owning them proudly instead of hiding them away. The scars remind them of the sacrifices they made to bring a life in this world. They will never forget why they are there. I haven’t brought any baby into the world, but my lion scratches still mean something to me. I won’t ever forget why they’re there, and though I’m still not fond of them, they remind me of how I fell between the cracks in an overworked, red-taped, short-on-time health care system- and how I, the patient, ultimately paid the price. Every time I look at them, they tell me never to let a patient of mine have the same kind of consequence in any form- cosmetic or otherwise.

Categories
Health Life Recipes

Health

From time to time, while stuffing chips and cherry coke down my throat, I wonder how I am supposed to convince my patients that its easy to be healthy in the midst of their busy lives. Exhibit A. I sit down for most of my day. Standing up in lab makes me angry. I eat cookies and brownies and coffee full of cream and sugar and whatever else I can find to shove into my face. I don’t run most days. The healthiest things I eat are when I bring my lunch and thats usually microwave pasta or a turkey sandwich with yogurt and apples. And Lord knows I don’t get enough sleep.
But eating healthy on a quick stop to Quiktrip is really hard. Their “naked” juices cost 4 bucks and I’m never really sure what all they put in it.
So, today, instead of popping out out bed and studying anatomy like I should, I decided to try something. Ya’ll know I love my juice. It makes me feel good, lotsa vitamins and all. Its pretty filling and energizing too. But my dang juicer that I love so very much is a little high maintenance. You have to clean it right away because fruit beaten to a pulp rots pretty quickly and its really sticky. So I juiced everything all at once. Fresh pressed juice can be stored for up to 5 days in an airtight container. I made six bottles. All I have to do is shake it and its good to go.  So now I have delicious real juice all week and it took like 20 minutes! I’m so happy!
I made a red juice.
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And a green juice.
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The red was- 2 beets, lots of baby carrots, 1/2 lb raspberries, 1/2 lb strawberries, 1 red pear, 3 small fuji apples
The green was- A bushel of kale, 1/2 bag fresh spinach, 2 kiwis, 2 green pears, 2s small fuji apples.
So there’s my small step towards health this week during a busy schedule. Its so much easier to drink all those good sugars and nutrients than constantly munching on kale and pears.
Since its red and green, I thought I would also tell you that it’s 46 days til Christmas and 39 school days left til the semester is over. I have almost made it! WOO!
 

Categories
Health Recipes Running

Three Easy Post-Run Drinks

Water of course. There is very little else that is quite as satisfying after a sweaty run. I’ve heard of water being best for you right after a run when the water is room temperature or just a little bit chilled. Ice water is sometimes too cold and can cause irregular heartbeat. I sometimes put a tablespoon of chia seeds in, wait a couple minutes, stir and then you’ve got fiber and omega-3s in it too!
Chocolate milk is hailed as the perfect post-run drink, and its a favorite of mine too. Something about it having the right ratio of sugar, protein, and carbs for recovery. It’s even better if you drink it within 30 minutes. I use 2% milk and Carnation Instant Breakfast chocolate powder for the extra vitamins that Hershey’s syrup and Nesquik don’t have.
Smoothies. I love smoothies (and juice!) after my runs. Something about the creaminess that chocolate milk with the fresh- or frozen- fruit. Vitamins, antioxidants, and fiber to boot. I love summer for the fresh fruit but this recipe can be used with frozen fruit in the winter, and it makes it extra cold and icy!
Post-Run Smoothie
5 or 6 medium strawberries with the leaves cut off
1 large handful of blueberries
6 oz. cup light vanilla yogurt
1/2-3/4 cup of vanilla almond milk
Blend it and drink!
AND
If you’re like me, you could drink all three after one run!
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Categories
Family Health Life Medicine

Empathy vs. Sympathy

I saw this video a long time ago and I remember showing it to my roommate and we just sat silently after watching it. I’m glad I was able to find it again. Its quick and easy to understand but she covers some deep things in it that I mull over in my head quite often.
I always get chills when she says “I know what its like down here and you’re not alone.” If only I was just able to convey that to people that I want to help. Its harder than it sounds.
[youtube https://www.youtube.com/watch?v=1Evwgu369Jw&w=560&h=315]
My relevant story for today isn’t really any thing compared to the pain and suffering some people go through, but I’m going to tell it anyway because it is what has got me to some realizations about helping people pain- both physically as a future physician, and emotionally with family and friends.
I had a bad sunburn recently. Mostly on my back. It was about two days old and I went running enough to soak my back and my shirt in sweat. It started itching in spots on my way home. Then it started burning. Then I took a warm shower. Then I got out and put some moisturizer on it. Through each of these steps it started burning worse, getting itchy all over. I’m not sure if I was done for from the moment I sweated salty chemicals onto raw skin or if I just kept making it worse, but by this time I was in a fit of excruciating pain and compulsive itching. Rolling on the floor, crying for my mom, rubbing it with my knuckles so that it wouldn’t sting worse from scratching. The only thing that took a little edge off was running the bathtub on cold over my back constantly. My parents were trying to talk me down gently and had to resort to holding back my arms, yelling “CALM DOWN” and watching me twitch and sob and cry.
It was awful. Truly I didn’t think I wanted to live much longer if I had not known it was just a temporary skin irritation. I thought of fibromyalgia and other chronic pain conditions. I thought of how scary it was to not know how much longer I was going to feel like that. To not know when or if I could sleep or eat or enjoy anything. I was begging to go to the ER to get a sedative.
The video popped in my head
“I know what its like down here and you’re not alone.”
I thought of how anyone was ever going to help me get rid of the pain. I was going through everything I knew to make it just a little better or tolerable so that I could sleep or distract myself from the itching til it went away. My mom was just as scared and helpless as I was. My dad was yelling unhelpful things like “SHH” and “Don’t touch it!”
After we thought of cool water and I was sitting with my back under the faucet, my mom just sat there with me as I calmed down and the burning got manageable. I don’t know if the house catching on fire could have gotten me out of the tub. I was scared to move for fear that the flood of relief would leave my body. My mom just sat there.  And for a bit, I was fine. My pain was not gone but I was comforted by the temporary relief I found and the fact that someone else was there, as if saying
“I don’t even know what to say; I can’t do anything to help you, but I’ll stay here with you and just be together.”
That’s what I hope to bring my patients if nothing else: Relief through connection.

Categories
Health Life

Let's Talk About This Whole Juice Cleanse Thing

When I last updated you on Day 2, I was about to have my cashew banana shake for dinner. I did drank it again and was feeling fine. After that, I went to Lowe’s with my parents and started thinking about the benefits I had gotten from solely juicing for two days. Honestly, there weren’t very many.
Is juicing healthy and beneficial? Yes. Does it constitute a balanced diet on its own? No
At this point I really really really wanted actual food with substance, and I began to get a headache. And then my parents stopped at Chili’s and the whole thing was settled. I decided to listen to my body instead of depriving it just to complete the arbitrary three days.
I needed food. At Chili’s, I had chips and salsa and a cup of potato soup. Though it wasn’t much food, I was completely satiated.
I finally had energy again!
I will say that it is a pretty amazing feat to eat only fresh fruits and vegetables and it did make me feel healthier in my mind, knowing I was getting so many vitamins and consuming things straight from a farm. But, I didn’t feel particularly cleansed of toxins or stool like I was expecting to. Also, I did lose a lot of water weight and felt like I had tighter muscle tone. Though, that could be because my muscles were breaking into their glycogen stores for energy, haha.
On the first day before I started I weighed myself. So there’s that. Take it as you will.
Day 1 – 117 lbs
Day 2- 114 lbs
Day 3- 115 lbs
Day 4
The next morning (Day 3) I was not hungry at all, but I ate some raw cashews for my last day’s dinner juice because they were delicious and crunchy and so what difference does it make if I puree them or eat them plain? Then, I had my morning green juice just because it tastes so good.
Life is much better when you can juice and eat what you want.
What did I learn from this?
“Juice cleanse” is probably just another fad diet. And yes, I got sucked in. None of us are immune. Fact is, a balanced diet is just that… balance. One food group will never get you whatever it is you are looking for from your food.
I’ve always gone off of all things in moderation. I eat what I’m craving, usually whatever I want. I don’t eat much, I walk a lot, stay active, and work out and run when I can.
I did explore lots of yummy juice combos and found out easy it is to get a lot of different colors in my diet. And, I think it really did help my digestive system. I had a couple people interested in the “digestive cleansing” that may/may not occur. If you have no interest in my bowel movements, feel free to stop here. To any men reading this : I still uphold that girls do not poop and all of the following is a lie.
Day 1- I went to the bathroom and felt emptied completely, though it was too soon to be from the juice and was probably just a regular stool.
Day 2- My stomach was crampy and I was bracing myself for diarrhea, but it never came. Stool was pretty soft though.
Day 3- This one’s sorta weird. But here it goes, I had wayyy more stool than usual and the beets made their appearance! Since I have never eaten beets before it was new to see dark red stool tinge the water pink and not want to call an ambulance.
So there you have it. I usually have a pretty slow digestive system but the juice seemed to regulate things and I felt like I was passing yesterday’s food each day (which is good) and was emptying completely. Very little discomfort and no diarrhea like I was expecting. I also noticed that without sips of soda and greasy chips, I hardly had any gas whatsoever.
My Take Aways:
1. Juice! Juice a lot, juice a variety of fruits and veggies- and even nuts! But don’t ONLY juice.
2. There is no cure-all, miracle food to make you feel magical all the time. (I knew this- I just was in a little juice bubble and had high expectations)
3. Try new things!
4. Be happy, be healthy! Just like the cheerio’s honey bee tells us.
 

Categories
Medicine

Anti-Vaccine Article

Anti-Vaccine Article
I have discussed and argued and thought and gotten legitimately angry about this issue. We discussed this for a class even and, my classmates specifically brought to light the fact that anti-vaxxers have such a foothold because they are extremely vocal about “preventing autism” and other false things. For the most part, I’ll let you do what you want- by all means put egg yolks in your hair and add protein to your drinks if you think it works.
But this- vaccines- are serious. It affects children that cannot be vaccinated due to legitimate health reasons. It destroys our herd immunity. People are dying of completely preventable, already eradicated diseases. So, supporters of vaccines have to speak out.