chapter 10: i think you've had a drug eruption

october 2011


we arrived at the dermatologist office in downtown beverly hills.  the building had an antiqued look to it but inside the doctor's office was completely the opposite.  the floors, walls and even some of the furniture were white marble.  very cool,crisp and clean.  my husband and i exchanged glances: "wow!" with our eye brows raised.  no wonder they didn't accept insurance; this was a cash-only establishment. of course it was, because everyone in beverly hills can pay cash for their dermatologist. right? 

not a great quality photo, but you get the idea ...

the staff was friendly.  the knew who i was and advised me the doctor was expecting me.  i couldn't help but notice a silly looking cardboard cutout of a man who i assumed was the dermatologist.  this matched the metallic sculpture of him hanging on the wall.  i hadn't even met the man and i knew i was going to like him.  there was no way he could take himself too seriously.


the nurse called me back to one of the exam rooms and my husband followed me. 


"the doctor will be right with you." she said and left us alone - but only for a short time. soon there was a loud, boisterous male voice on the other side of the door.


"well hello there! you must be amanda." his voice boomed and he walked in.  in front of me stood a short, older gentleman with silver hair and a matching mustache that stuck out 6 inches on either side of his mouth.  you could see it required a lot of goop to make it stand straight out like that.  his white lab coat was long sleeve and went down below his knees. to top it all off, he wore a magnifying glass headset with a lens visor and small light attached.  when the magnifying glasses were pulled down over his eyes, it looked as though he was staring at me through a pair of coke bottles.  i let out a little giggle and he smiled.  clearly, this was not the first time he'd had this same reaction.


i got right down to business. he was a doctor; a busy man who had "squeezed" me in so i did not want to waste his time.  i started reading off my notes and the doctor held his hand out.


"wait a minute. wait a minute.... I am the doctor.  YOU are the patient. It is MY job to rush YOU. Not the other way around."  i looked up at him and he had this sarcastic smirk on his face.  he turned to my husband "she does this at home, doesn't she?" my husband just started laughing and shook his head.


"sorry." i took a deep breath and relaxed as the dermatologist asked me one question at a time.  he listened carefully and made notes on a piece of paper.  he paid particular attention to the medications i had been taking and dates i listed when certain signs/symptoms showed up. 


all of the sudden he opened the door to the exam room. "nurse!" he voice boomed. "get me my drug book and the digital camera." he closed the door and was with us again.


"now don't ever look in this drug book.  it will scare you to death.  you won't even want to drink water from the fountain by the time you're done reading it."  he joked.  my husband sat in the corner and continued laughing.  the dermatologist looked up 2 of the drugs i had been taking since august. 
"you're on 2 sulfur drugs and you've just been to the airshow for an intense dose of sunlight.  i think you might be having a drug eruption."  he stated simply. "i don't think we need to biopsy the rash, i think we need to change your medications."


the door opened again. "nurse!" he called.  "get me danny on the phone."  it made me smile that he referred to my rheumatologist by his first name.  clearly they were friends and i liked that.  i wanted us all to be on the same page. 


a few seconds later the phone rang in our exam room.  the dermatologist put "danny" on speaker so we could hear what was said.  they both agreed that i might be having a severe allergic reaction from taking the 2 sulfur drugs combined with sunlight sensitivity.  they agreed that a biopsy did not need to be done at this time (thank goodness because i was NOT looking forward to that!)  they decided to alter my medications as well as put me on benadryl, give me topical cream for my face, a steroid spray for the rest of my body and call it a day. it sounded like a solid plan. i was happy to be off 2 of my 3 medications.  


"now i'd like to take a few photos of this rash. that way we can see how it progresses if/when you return for another visit."  the dermatologist fidgeted with a small 35mm digital camera.  "i hate these darn things. they never work quite right." he mumbled.   click-click.


"blurry." click-click.


"blurry." he frowned.  click-click.


"they're all blurry. damn thing.... NURSE!" he called out the door one last time. "i need a little help in here with this camera."  i couldn't help it anymore. i started laughing out loud. it was as if we were in a cartoon and he played the main character.  but i liked him.  i really liked him.  he knew what he was doing - except for the digital camera thing - and i trusted him.  that is what was important: i TRUSTED him.  at least he would get this rash figured out and make it go away.


"i've got something i'd like to ask you about." i said.


"shoot." he answered.


"my family is spending a week at the beach in carlsbad.  what kind of precaution do i need to take while i am there?" i asked.


"you, my dear" he began "are going to be the lady on the beach wearing 30 SPF, a very large brimmed hat and are going to be covered head to toe with clothing while sitting under an umbrella." he was so close to me now that the magnifying glasses made his eyes look enormous and his mustache practically poked my cheek.


"i can do that." i answered. i was just relieved that i'd still be able to go and have fun with my kids and family. 


"alright. it's been nice meeting you." he stuck out his little hand for a shake and smiled. "you take care of yourself and i will call you in a couple days to see how you are doing."


"great. thank you so much.  i look forward to hearing from you." i said and i meant it. secretly, i hoped this wouldn't be my last visit to his office.


the dermatologist called me a couple days after my visit just as he said he would.  he was pleased with my progress.   words cannot describe how reassuring it was to have a doctor follow up with me. it made me feel as though i mattered.  as though my "case" mattered to him.  i appreciated that so much and again, was confident that i had found not only 1 good doctor but 2.  the rheumatologist and dermatologist friends were on my team and that made me feel confident.


the following week my family and i went out of town to the beach and we had a wonderful time. the weather was cool and overcast - perfect for wearing long sleeves, pants and a large brimmed hat.  i took the allergy medication and used the spray and creams as instructed.  within a few days the rash had stopped spreading and began to clear up.  no longer did i have the intense burning from inside out.  this gave me some mental relief.  we had conquered the rash, now let's get on with the rest of this mess. i was confident we would get answers, i just didn't know when or how long it would take.  and remember, patience is something i am being challenged on.