A woman contorts her body as she tries to take a photo of a concerning spot on her leg.

Chasing My Tail While Seeking Answers

I was in my kitchen, twisting myself into a pretzel, trying to take a good photo of two spots on my calf. It was not one of those selfies that you take to show off your best side, it was the opposite. To be good, it had to look bad.

I wouldn’t have needed to take the photo if I had kept the dermatology appointment that I rescheduled for three weeks down the road. I go every three months and figured I’m checked so carefully that a few more weeks wouldn’t matter. I had made it based on a schedule that I no longer had. I could have still done it but it was for 9:15 in the morning, two hours from home, through rush hour traffic.

Concerning skin spots

Of course, as soon as I rescheduled it, I figured there was something that she had to look at. Maybe it was the result of “rescheduling anxiety,” which is something I just made up. It’s the feeling you get when you move an appointment and you think it might be the one that you needed to go to in order to avoid a deadly melanoma.

A nurse said to send photos. One little bump was most likely an actinic keratosis. I don’t know about the other. It was red, cracked, and peeling and a couple of inches long. My dermatologist had said to use Halobetasol propionate, a topical steroid, but it wasn’t working.

Sending pictures to the dermatologist

The nurse said to send the photo through Patient Gateway, our online portal. I got a message saying the file was too big. So I sent it to my dermatologist’s email.

I put “gross photo of my shin” in the subject line and wrote:

“Kathleen said to send these through Patient Gateway but even if I made them smaller it said the file is too big. The Halobetasol twice a day on my right leg isn’t doing anything and the other night it itched so much I took a Benadryl. Then there is the little spot above it. It was there last time and I think it’s an AK or something but I wanted to run it by someone and see if I should do anything about it. (Except for not pick it).”

Confusing instructions for an unknown issue

I didn’t hear back. The next day, I picked up a prescription for high blood pressure medicine. Anxiety about my health is one reason I need it. An ointment, Betamethasone, was waiting. I had already used it for a different problem and figured she wanted me to use it for the current one.

However, the instructions were for the old problem, hardening of the skin due to graft vs. host disease, a complication of the stem cell transplant that was part of my leukemia treatment. “Apply topically twice daily under occlusion with Saran Wrap,” the instructions said. So I was supposed to wrap my rash and possible AK with Saran Wrap? Just getting a diagnosis and plan – or finding out you’re worried about something innocuous – can sure take a lot of time and energy!

I called the dermatologist’s office. After pressing 4, then 1, I got through to the nurse. She said she would ask the doctor and call me back. I was away from my phone when she called. I called her back. She said yes to the ointment, no to the Saran Wrap, and explained that sometimes the computer pushes out old instructions.

New spot, same worry

The rash started improving, but the AK didn’t change. Meanwhile, I started fixating on a spot on my wrist. I’m pretty sure it was there at my last visit and wasn’t worth getting worked up about. But Worry is my middle name. I took a photo of it, downsized it, and managed to get it on the messaging center on Patient Gateway. Then I called the dermatologist’s office. The message said everyone was in a meeting. The process started all over again.

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