Just don’t say maverick

Well, I was really hoping to give you some sort of definitive THIS IS THE ANSWER sort of update after our latest appointment in regards to Chickadee’s skin, but I should’ve known it wouldn’t happen that way. I mean, we’ve been trying to figure out this rash for three years now; what’s the big hurry?

The good news is that we started out there seeing the doctor who was taking new patients, rather than the one it had been recommended we see. And after two appointments, we ended up seeing the recommended doctor because our regular doctor was unavailable. And apparently the fourth time’s the charm, because yesterday we saw the department head, Headguy. (For those keeping score at home, that means we’ve now seen every doctor they have.)

“When you come to me it’s because we’re tried the standard stuff and everyone else is stumped,” he said. I’d love to paint him as a brash egomaniac, because that would probably make a more interesting story, but really, he seemed pretty down-to-earth. At first, anyway.

For starters, there was the whole nickel test ridiculousness. We came back from vacation early so that Chickadee could have a repeat nickel test, only I’d spent much of the week preceding vacation making phone calls to set up the test here in our town with our local pediatrician, to save us a trip into Atlanta. That was all fantastic except that our ped then discovered that the necessary patches can only be ordered in cases of 20. As the patches cost $500 a pop and they don’t anticipate doing a lot of nickel patch tests in the future, they wisely declined to order and canceled our appointment.

Only just a TEENY bit bitter that we cut our vacation short for that, by the way.

So we thought yesterday they were going to put a nickel patch on her, but Headguy said, “Really, I have to tell you, I think the nickel theory is misguided,” and I just about fell to my knees while shouting “THANK YOU!” I do not understand why every other dermatologist we see is so gosh-darned ready to believe this child has a nickel allergy, despite both a negative patch test AND the weird summer-ness of it all. Who in the world has a SEASONAL nickel allergy? Oh, that’s right. NO ONE. But no matter how many times we explain that this rash is a summer phenomenon, the nickel thing remains a popular idea which many of her doctors are really reluctant to give up.

But Headguy said no, he didn’t think it was nickel. It didn’t fit. Yay! No patch test. Well, what next? “Honey, do you get a rash and then itch, or do you feel itchy and then you get a rash?” he asked Chickadee.

She thought about it for a moment. “I get itchy first,” she said. He nodded, triumphant.

Headguy outlined an aggressive allergy medication regimen; by putting her on three (!!) different types of allergy meds at once, the hope is to force her system to chill the hell out. He didn’t say it quite that way, but I could tell what he meant. “I think this is allergic reaction and sensitive skin gone haywire,” he explained, and went on to detail the different mechanisms of the different medications and why he thought this may well be the solution.

Well. Part of me wants to get excited about the possibility of a solution, and part of me wanted to smack him upside the head. Because nearly two months ago, one of the other doctors suggested this same attack-the-allergy-angle solution with this trio of meds, and then called us later that day and said, “I consulted with Headguy and he suggested you just switch sunscreens, first.”

I doubt Headguy remembered that. I wasn’t going to bring it up, either. But if this IS the solution, my kid suffered half the summer for no reason. And that kind of blows.

But before I could get too worked up thinking about THAT, Headguy turned to me—very intent and serious—and asked, “How badly do you want to solve this problem?”

Chickadee and I blinked at each other. Ever eloquent, I responded, “Uhhhh… pretty badly…?” He continued staring. I added, “I’m… not sure where this is going?”

“Well,” he said. “I’m a cowboy. I’m the last stop, here. You’re in with me because we’re stumped. And this might work, but if it doesn’t, we’re off the beaten track into an area where it’s more art than science.” I nodded. Do I want a dermatologist who’s a cowboy treating my child? Maybe. But if he pulls a lasso out of his pocket, we’re out of here. “What comes after this may mean making some hard choices.”

I felt like this was a well-rehearsed speech, but I still didn’t know what the heck he was trying to tell me. “I’m sorry,” I said, “I’m still not following the ‘how badly do you want to fix this’ connection.”

“What we try after this is going to be riskier. Have more side effects. Cause more problems. You’ll have to make some choices about how far you’re willing to go.” I nodded, again. Why was he giving us this speech? Shouldn’t we at least find out if the prescriptions he just gave us are going to work? Also, “choices about how far you’re willing to go?”

No one should say such a thing to someone like me. I have an overactive imagination, you know.

So… try the allergy meds. It might work. But if it doesn’t, HOW FAR WILL YOU GO to solve this rash, Mir?

Because next month he’s going to suggest leeches. Or amputation. Or a non-FDA-approved application of pastrami to the afflicted areas while in a hyperbaric chamber. Also there’s this new medication that often solves problem skin, but sometimes causes baldness, tuberculosis, or hermaphroditism. I mean, COME ON NOW. HOW FAR WILL YOU GO???

Needless to say, I smiled and told Headguy my money’s on the allergy meds. And we can discuss what comes next when it’s time to do something else.

Give us a week with the new meds before I can tell you for sure whether or not a cowboy dermatologist is a good thing.

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45 Responses to “Just don’t say maverick”

  1. 1
    navhelowife July 27, 2010 at 11:37 am #

    Wishing you all the best with the allergy meds.

  2. 2
    Annette July 27, 2010 at 11:38 am #

    I am dealing with the same thing with pregnancy, though in the case of another life, the leaches or pastrami or even amputation don’t seem that extreme. I love my doctor, but his partners(soon to be ex partners), need their egos cut down to size. I think if a doctor is going to amke a statement like that, he should give your imaginitive brain a couple of tidbits to ponder..I willm pray for Chickie, polease pray for me (us!).

  3. 3
    Shana July 27, 2010 at 11:42 am #

    I once had this insane hive outbreak that lasted 9 months. No one could figure it out…and i was a student in law school and DIDN’T HAVE INSURANCE. Prednisone was the only thing that made them go away. What finally worked was three allergy meds and a med for anxiety. I eventually was able to back off all the allergy meds and no hives since. I hope this works for your daughter! Love your blog!!!

  4. 4
    Joshilyn July 27, 2010 at 11:43 am #

    ZOMGAH! It’s Doctor HOUSE.

  5. 5
    Otto July 27, 2010 at 11:45 am #

    I’m not sure our insurance will cover the pastrami treatment …

    -otto

  6. 6
    Megan July 27, 2010 at 11:54 am #

    Wait- you didn’t holler ‘side effects? Well YEEHAW you sign me up!’

    REALLY hope the allergy stuff works!

  7. 7
    Jess July 27, 2010 at 11:55 am #

    I think Joshilyn is right. Except that House would have sent his flunkies and not seen Chickadee himself, then misdiagnosed her, and… oh, wait. ;)

    I really hope that this works.

  8. 8
    elz July 27, 2010 at 12:03 pm #

    In the “biz” we call the doctors that don’t follow rules the “cowboys.” When it works, the public calls them “medical pioneers,” so it is a good thing, I think.

  9. 9
    Frank July 27, 2010 at 12:06 pm #

    I kinda figured the pastrami was for eating… but that is what ANY Italian worth his salt would tell you to do…. eat the symptoms away with some random seasoned spiced meat product, or VERY HOT PEPPERS fried in oil.
    IN seriousness for a sec, though; I am guessing that what you got is as close to “I havent a farking clue” as you will get from most Docs, and ALL specialists. Most MD’s I know tend to be… er…. set in their ways and dont welcome the challenge. Lets hope this one does. His ‘How far go you want to go’ line of questioning seems to indicate he is willing to take the challenge. Here’s hoping!
    I fully expect to be able to watch a future episode of ‘Mystery Diagnosis’ on this…..

  10. 10
    RuthWells July 27, 2010 at 12:12 pm #

    Oh mercy! Will Chickie’s vegetarianism permit participation in the pastrami cure? HOW FAR WILL SHE GO?!

    Here’s hoping you won’t need to find out…

  11. 11
    Cindy July 27, 2010 at 12:13 pm #

    You have had my utmost sympathy throughout this whole thing. I suffer from allergies. Not like most people with just the runny nose thing but in a rashy, infection-laden, quit breathing kind of way. My mother totally blames her gray hair on me. I pray you find answers with the new meds. I finally hit on the combo that works for me. After 5-6 years on the same stuff, it is starting to be less and less effective. That is common in allergy medications, although they won’t tell you that. I have an appointment with a new allergist next month so I don’t head into the bad reactions. It’s a never ending dance.

  12. 12
    dad July 27, 2010 at 12:13 pm #

    Doctor HOUSE always gets it right and saves the day the third time. Almost like he has a mental block or someting against any earlier success. I always assumed that was because they did not want to have the the last 20 minutes of the program devoted to infomercials or making funny animal silohettes on the screen.

    Real life is not paid for by broadcasters who are required to fit things neatly into predetermined time slots. Should the now recommended drug regimen have the desired result, I suggest you thank him profusely for his diagnostic skills and assistance.

    Then clobber him with his cane.

  13. 13
    Ani July 27, 2010 at 12:20 pm #

    Dear God:

    Please let this work for Chickie because seriously, Middle School is already hell (by definition) and she does not need anything else on top of it.

    And then, a tiny little lightning bolt at Headguy? Totally indicated.

    Love,

    –me

  14. 14
    Acadee July 27, 2010 at 12:45 pm #

    Weird skin stuff in my family was solved by an elimination diet. Did you know that citric acid, mint, cinnamon, cloves, tomatoes, strawberries, chocolate, all sorts of things can cause skin rashes? Before you go to the leeches, I’d try eliminating possible culprits there. It’s not fun, but way better than leeches.

  15. 15
    Katie in MA July 27, 2010 at 12:57 pm #

    I am all aboard the HOUSE train – but I thought House wouldn’t have asked, would have just de-skinned her or something and just ASSUMED you’d be willing to go that far. And I would be, because dude – Hugh Laurie. Ahem.

    Good luck, Chickie, with the trifecta of meds! I have a good feeling about this one!

  16. 16
    Rachel July 27, 2010 at 1:06 pm #

    So, I just stumbled on your blog a few days/week ago. Haven’t read back any re: the rash…BUT I had to comment. I get a rash that sounds very similar. It’s on my arm…it is only in the summer…occasionally gets bad enough that it’s down the back sides of my legs and maybe the insides. Itches like hell. And itches first. Then I get a rash. Anyway at first I was thinking some weird heat rash…then suncreen…then back to heat rash…now I KNOW it’s sunscreen. I haven’t found the ingredient, but I know there is ONE sunscreen that doesn’t do it. Banana Boat Baby “Tear Free” lotion. So many cause it that I just have started sticking to this one…Aveeno does it, other baby ones do it. So I don’t even bother trying anymore. Spray ones DEFINITELY cause it. It’s a miserable rash. And weirder still is I didn’t used to get it…it just popped up one day probably 7 or 8 years ago. No clue. One day I will try to figure out what ingredient it is that’s causing it..but that seems like a lot of work and I know this one works. Good luck on your quest!

  17. 17
    paige July 27, 2010 at 1:27 pm #

    How far are you willing to go? Really?

    I agree. This guy must be the model for House. Sheesh.

    I’m holding good thoughts, prayers, vibes and juju for this to be the answer.

    Because I have to say, my answer, at this point might have been :

    Right up your ass, sir. That’s how far.

  18. 18
    meghann July 27, 2010 at 1:43 pm #

    The comments on this post are why I love the internet so very, very much.

  19. 19
    Half Assed Kitchen July 27, 2010 at 1:49 pm #

    Annette, I had that during pregnancy too! And no doctors, dermos or allergists could figure it out. So I just suffered through. For me it really got bad during the second trimester, then started to ease a little.

    And, I agree. Cowboy doctor should’ve elaborated a little. Methinks he might enjoy keeping you on the edge a little too much.

  20. 20
    Tracy July 27, 2010 at 2:36 pm #

    I would hope that this will work for both Chickie and your sakes. My daughter gets a rash every spring and it clears up by mid-summer. It has gone undiagnoised now for 6 years. She just takes Benadryl and suffers through it for several weeks and then it goes away as fast as it came. I hope Chickie gets relief and finally gets back to normal. The allergy regime may cause her to be more moody and less able to sleep. Good luck!

  21. 21
    Tracy July 27, 2010 at 2:37 pm #

    I didn’t mean to be so negative when I’m really thinking positive. Sorry, it’s the weather. =)

  22. 22
    JennyM July 27, 2010 at 2:37 pm #

    @paige: HA!!!!

    If Dr. Cowboy *isn’t* actually House, he needs to stop watching medical dramas. I wonder what answers he gets when he askes that question. The only logical answer seems to be, “Uh… I’m sorry, what?”

    Here’s betting on the meds. If not, then… well, round ‘em up, ride ‘em in, get ‘em up, get ‘em dressed, comb their hair, brush their teeth, Rawhide!

  23. 23
    Mandee July 27, 2010 at 3:24 pm #

    Much like Shana – I got the unending case of hives in law school (lesson – DO NOT GO TO LAW SCHOOL!). In addition to the 6 months of prednisone, I was on a triple dose of antihistimines. So, when I wasn’t sleeping, I was constantly stuffing my face while bitching somebody out about something. A real pleasure, I can assure you. OH! And I also had random swelling in my facial region – i.e. half of my bottom lip. Good times.

    But! The good news is that once I weaned off of all the meds, I’ve never had any more issues. Much like Chickie, they never did figure out what caused them (except a compromised immune system), but that regimen was enough to cause my system to chill out.

    Fingers crossed that Dr. House is right and there is no pastrami in your future. Or that at least there’s a vegetarian friendly option for Chickie.

  24. 24
    Karen July 27, 2010 at 3:32 pm #

    Nothing like a good circle-jerk, huh?

    and… “How Far Are You Willing To GO”???? is he for REAL??? what kind of statement is that??? You should have said calmly and with all seriousness ” I’ve given that great thought, and I have made up my mind that I’m willing to cut off your left n_ _ if it means we will get to the bottom of this miserable rash. If that’s your recommendation, I’m ready, let’s get it over with so we can enjoy the rest of the summer, nickel-test and rash-free” .

  25. 25
    Em July 27, 2010 at 4:09 pm #

    @Paige – thank you for the best laugh of the day.

    I’ll tell you what, he better be a cowboy. It is a huge peeve of mine when people label themselves something in the hopes that it will catch on (see also: ladies man, bad ass, fashionista). It automatically buys you the label of Tool in my book and now you need to do some proving. I hope he at least proves his worth as HeadGuy. But if he cures Chickadee’s rash, I will declare him John Wane myself.

    Something just occurred to me, maybe he was flirting with you. Was he seeing what the cure was worth to you, yourself (in a Forrest Gump’s mom sort of way) and if so, that cowboy thing just got a whole lot creepier. I just totally grossed myself out so obviously the next step is to hit “submit comment”.

  26. 26
    Anna July 27, 2010 at 5:01 pm #

    Weirdo from the internet in 5… 4… 3…

    I wonder what would happen if Chickadee put on sunscreen every day for a week in January or February. Controlled environment and all.

    I understand Dr. Cowboy. We had a similar discussion with my daughter’s rheumatologist. She’s on one med that could make her blind and another med that could destroy her liver. But she can walk, so we’ll take the risk.

  27. 27
    MomCat July 27, 2010 at 5:31 pm #

    And you thought Atlanta was a long drive….I heard there is a fabulous allergy facility in Ulan Bator…but, how far will you go?

  28. 28
    bonuela July 27, 2010 at 5:45 pm #

    “You’ll have to make some choices about how far you’re willing to go”. huh? until you just give up and put her down? we are still talking about chickadee and not a horse with a broken leg. right?

  29. 29
    kathy July 27, 2010 at 7:22 pm #

    Omg, Karen#24 had me LOL. And I would totally have said that. I don’t let US docs get away with their god complexes anymore after getting absolutely EXCELLENT health care here in Mexico where every doc I’ve seen has been a dream. no god complexes here at all.

    I say you take Karen with you next time. She’s a keeper.

  30. 30
    Little Bird July 27, 2010 at 8:22 pm #

    I say you take PAIGE with you! If for no other reason than to see the reaction of Dr. Cowboy there.
    Mangoes are also an itchy making fruit, being related to poison ivy and all. We found out the hard way about my super-intense allergy to them. No, not eating one, my grandfather had a mango TREE that had me in long sleeves and long pants every time we visited him… in MIAMI. In the SUMMER.
    The food angle is one road you can take while still going with the triple meds.
    Good luck, to both of you!

  31. 31
    Andrea July 28, 2010 at 8:39 am #

    I was kinda with Anna on this one…a little controlled science experiment but then I realized while I would totally do this to myself, I am pretty sure I would not do it to my daughter. Good try though…
    For now, cross fingers and hope and then, if this doesn’t work, try something else and then–someone else. There is a doc out there who will say “I’ve seen this and here is what it is.”

    Good luck.

  32. 32
    Sheila July 28, 2010 at 9:44 am #

    I sure hope this works for Chickadee. Just in case it doesn’t, however, I’ll try tracking down a vegan who makes tofastrami.

  33. 33
    Randi July 28, 2010 at 9:55 am #

    See, I’m the bad mom. I would’ve been all “wait a second, someone else in your practice wanted to try this and then called me back and told me that YOU vetoed it”. I love throwing doctor’s mistakes in their faces, especially if they act like egocentric maniacs! Best of luck!!

  34. 34
    Suzie July 28, 2010 at 9:57 am #

    What a mess! I hope the current meds work, and she can find some comfort. I kind of like the doctor, though … as long as he has real ideas behind all the drama.

  35. 35
    Linda July 28, 2010 at 10:08 am #

    My husband suffers from an off&on traveling itch. He had skin testing even though the dermatologists said the allergists would say his blood work didn’t show enough of a reaction to be an allergy. He had the biggest reaction to the tape they used to hold th gauze over the testing area. Of course, the tape dermatologists use is the most hypoallergenic tape available. Now he uses the latex-free bandaids. Otherwise he gets a sore from the bandaid worse than the original injury.
    One reaction he had was to pine which is in a lot more things than balsam products. The doctor said artificial flavorings, like vanillin, are made from pine or related to them( it’s been several years so I’m not sure), so try to avoid them. Especially ice cream, except for strawberry,maybe ones with real vanilla bean.
    So maybe something she eats in the summer creates a reaction. Melons are one suggestion, they’re big for allergic reactions.

  36. 36
    Jackie July 28, 2010 at 1:05 pm #

    use windex…. or at least that is what the dad on my big fat greek wedding said to use. ;-) j/k

    hope this treatment works.

  37. 37
    Mare Martell July 28, 2010 at 1:50 pm #

    *whispers really quiet* maverick

  38. 38
    Lylah July 28, 2010 at 2:47 pm #

    My money’s on the allergy meds, too, but if I’m wrong (and I’m no HeadGuy), I think you’re facing a couple months of artistically placed cowboy pastrami leeches, perhaps in a lovely sherrif star pattern, on rye.

  39. 39
    mom, again July 28, 2010 at 3:15 pm #

    if it does work, you need to so throw it in his face, including the extra costs of extra appointments, the trouble your local doctor went through in attempt to help, the sadness of cutting your vacation short, not to mention the h*ll of having to put up with his obnoxious cowboy thing.

  40. 40
    Crista July 28, 2010 at 5:35 pm #

    Seriously, it’s about time for something to work. Past time actually.

    Totally off topic, but I don’t have time to search for the correct post, I just thought of you when my last 10 minutes looked/sounded (in my head) like this: Oh, I see paper and I need to put signs on the boxes that are going out for donation tomorrow. Grab paper. Now I need a marker. Oh, the dog didn’t eat all his food, I better pick that up before the cats get to it and then leave me a nice present on the floor, oh the kitchen trash is full, let me take that out since I’m fully dressed for once, better put the new bag in so I don’t get irritated at myself later, hmm, the floor’s wet in front of the sink, better wipe that up. the dogs need fresh water. now, what was I doing? oh yeah, marker!…now where’s that paper?…

  41. 41
    Amelia July 28, 2010 at 6:06 pm #

    dude. i am not a doctor. I DO NOT EVEN PLAY ONE ON TV. and i have not even read the comments. (what good am i, then?) but. i want to say this: if the problem IS allergies…you know, if the allergy medicine works…then i would totally head to a pediatric allergist. my daughter has crazy bad eczema, and her (seasonal and food) allergies cause it to flare up. i have talked to friends who are in similar situations, and their experiences indicate that the derms they’ve been to tend to treat the symptoms, while the allergists tend to treat the causes. and allergy shots are no fun, of course, but if they can ultimately help the eczema WITHOUT steroids? sign me up. or her. you know, whichever.

  42. 42
    Jane July 28, 2010 at 9:30 pm #

    oh man, good luck! I really hope things turn around. I can offer no help or information, just good wishes!

  43. 43
    Brigitte July 29, 2010 at 7:37 am #

    Get along, little dogie. :-o

  44. 44
    Terry July 29, 2010 at 8:20 am #

    Wow, a LOT of bitterness toward the medical profession here. If this was straight forward and easy to figure out it would have been fixed by now. Do you people really think the answer has been obvious all along and these folks at Emery just wanted see how far Chickadee and her family were willing to go? A little cowboy sadism? I feel bad for Chickadee and her rash, but these symptoms are very hard to figure out. Hopefully, this round of meds will work and then I would by thankful and not “throw it in the doctor’s face” – honestly what good would that do? Probably make Head Guy sooo glad he took on the challenge.

  45. 45
    Pats July 29, 2010 at 2:07 pm #

    Speaking of “how far are you willing to go”… My son’s dermatologist suggested putting DUCT TAPE over the salve we put on his eczema. As crazy as I thought he was, we tried it. It worked. I’ve never gotten over how nutty that sounded to me.

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