A Visit to the Dermatologist

by Aug 2, 2011Hyperhidrosis4 comments

Today I had a full body skin exam to check for signs of skin cancer and to have any potential problem areas biopsied. This is the first time I’ve had such an exam, and I’m glad I did it. I had never been to this particular dermatologist before, so I was already nervous about being in a new office environment. Doctors’ offices are a terrible trigger for my hyperhidrosis. I’m sweating from the time I check in with the receptionist up until the appointment is over. I arrived 30 minutes early since I was a new patient, giving myself ample time to adapt to the temperature in the office. I also downloaded the new patient forms from the doctor’s website to fill out ahead of time, which is an absolute life saver for those with HH. Once my name was called and I was taken to an exam room, my sweating increased. The nurse went through the typical Why are you here? routine, and as I was telling her I noticed there was absolutely zero air flow in the exam room. This is bad news for my body. I would rather sit in an ice cold exam room where the AC is on full blast then sit in a roomful of dead air. Dead air is hot air, and hot air equals sweat.


The nurse set out a paper gown for me (a horrendous article of “clothing” that is totally non-absorbent) and told me the doctor would be in momentarily. Before she left, I asked her if she had a surgical pad I could sit on, since the backs of my legs will sweat right through the paper they roll out onto the exam table. Since I had already explained to her that I have HH, my request for the more absorbent pad didn’t seem as strange. This is important for someone with HH during physician visits. Do NOT be afraid to ask for what you need if it will help to bring you some level of comfort, no matter how small. So there I am, sitting in my paper gown and swinging my feet that are dangling over the table in a lame attempt to generate some air flow. I borrowed a brochure from the counter to fan myself, but once I’m in a full blown episode, forget about it. A few minutes later, in walks the doctor.


Now, every other time the door opens and a physician walks in, I usually see their arm cloaked in a white medical coat reaching around to open the door. Not this one. He strolls in dressed in fitted dress pants, gorgeous Italian leather loafers that look like they’re made from butter they’re so soft, and a tailored dress shirt unbuttoned to the middle of his chest. And he’s good looking with ice blue eyes and blond hair. The first thing I could think was, How YOU doin’? Thankfully, I kept my mouth shut since I was trying to prevent my jaw from dropping. My next thought was that I was going to kill my friend who had referred me to this doctor for not warning me ahead of time that he looked like a model. My third thought was, Super. You’re cute, I’m sitting here nearly naked and sweaty already, and now I’m sweating even more because you’re cute. (Let me point out that I’m happily married to a ridiculously good looking man who happens to be a professional cyclist. However much I’d like him to be the only handsome man in the world, it’s just not in the cards, baby. But he IS the most handsome man in MY world.)


But I’ve noticed that if I know ahead of time what to expect, I can better control the emotions and trigger responses that can happen in a flash. I did my best to get through the appointment without sounding like a babbling idiot because I’d been caught off guard by the scenery, and I believe I was successful. The doctor was very knowledgeable and had definitely heard of hyperhidrosis; there was even a diagnosis code on the patient checkout sheet I handed to the billing department, which made me happy.


My dermatologist will be looking into the long-term use of either Transderm Scop (scopolamine) patches or Catapres (clonidine) tablets for the treatment of my HH. I’ve used the patches before when I had a month-long bout of dizziness for undetermined reasons. One of the side effects of the patch, at least in my body, was extreme dryness, so much so that I developed cotton mouth and had to drink water almost continuously or chew gum. I actually ended up saving one of the patches to use when I was a bridesmaid in a friend’s wedding so that I could be dry in my fancy dress and shoes. It worked like a charm, and I was so thankful to have that option as an off-label use for the prescription.


My skin exam came back normal with the exception of one area that I actually pointed out to him: the very tip of my right ear. Now, why in the world I noticed a mole on the top of my ear that I’ve had for several years, who knows. It’s not like I examine my ears on a regular basis, but perhaps it’s my natural tendency to notice the subtle details of life that allowed me to notice such a thing. But it wasn’t until now that I bothered to have it checked. So, of course, he ends up doing a biopsy on it. The nurse asked me if I wanted to sit up or lay down for the procedure, and I opted to lay down. I can be in the delivery room for the birth of my best friend’s baby girl and cut the cord, but I’m a total wuss if anything is being done to my own body! She injected a numbing agent into the tip of my ear, and then the doctor took a mini razor blade and scraped out a section of my skin. I couldn’t feel anything except for the initial pinch of the needle to numb my ear, but I could definitely see the scraping action out of the corner of my eye. I remarked to the doctor, “Well, at least that part wasn’t sweaty, right?”


By the time the appointment was over, I felt like I had completed a vigorous workout. My HH can really drain me, even if I’m not doing a lot of physical activity. This, combined with me being a Highly Sensitive Person (HSP) who is sensitive to her environment and can be over-stimulated and want to retreat from everything, was enough to make me want to take a nap. My overactive nervous system dominates my psyche, especially in a situation like a doctor’s appointment. I know I said at least twice to my doctor that my condition is socially and professionally debilitating, and then when he had me stand up so he could look at the back of my legs, I wanted to die.


I wore flip flops today, so I was barefoot in the exam room. When I stood on the step of the exam table to get down, my feet left sweat marks. The carpet looked the same way when I was done. So now I’m dealing with the emotionally debilitating part of it, too. It’s mortifying to have my body do this. I’ve had people tell me I’m just psyching myself out and need to simply relax, and while I’m sure my brain automatically makes it worse for me, it’s impossible to relax when it’s physically manifesting itself. I’ve had other physicians mark my chart with the term “white coat syndrome.” It’s not. It’s very hard to make people understand just what it’s like to live with a sweating problem.


So, I’m recovering from the chunk of ear I had removed this morning and now have an awesome headache from it, and I’ll probably pass out when I have to clean the wound tonight with hydrogen peroxide. I’m hopeful that the biopsy comes back benign and that I’ll have nothing to worry about. Lessons from today’s experience?


* Ask for what you need to help yourself better cope with your HH

* Enjoy the scenery, even if it catches you off guard, but remember who truly completes your world

* Wear sunscreen religiously and have an annual skin exam

* Find the silver lining in any situation and make it laughable; this was a really funny story when I told my friends about  it!

* Sit and stand in your truth

* Leave your mark (literally)


August 2011

Until next time, stay cool.

Copyright © 2011 My Life as a Puddle

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