Dr. Ponti Visit #2

She is marvelous.

She listens to my litany, and then she asks, sincerely, "Anything else?"

Before the visit is over she examines me.

She sits down next to me and explains my lab results. There is nothing shocking or unusual really.

I am anemic. She wants me to get on prescription strength iron of 325 mg 2 x a day.
If that doesn't work then she can give me it in iv infusions.

To help my cholesterol and blood sugar she says decrease carbs, increase fiber, and get more exercise. I explain I now get no exercise, and I long for walks and the gym but in 2011 my head will tolerate Nothing. She suggests swimming. I had been thinking that too, that if we went to Texas I would get a pool to get into daily.

She said it can be common to get nosebleeds with flonase and she can still see some blood in my nose, this time on the left, but its better. We agree I should not go back to the flonase. She says to use a saline spray and continue with benadryl.

My bp is 130 over 90 today.

She says continue the Vitamin D at 5000 i.u.s a day.

I talk about wanting to try pure oxygen for my crippling head pain.

She wants me to call the neurologist and talk to her about my head.

In the meantime, she gives me a sample of Maxalt to try.

I wish she were not at all hesitant to try something radically new for me, but I appreciate her caution because she acknowledges "You know, you still don't have a diagnosis yet." Which is true. Dr. Ponti's bedside manner is so opposite the yelling doctor who repeatedly tried to tell me my pain was normal and rushed me out her door.

Dr. Ponti looks at the blistering sizzling spot on my shoulder, and she says, "That looks like skin cancer." I say I know. That it is identical to what reared up in the matter of a couple of weeks in Spring 2009 when I was also very sick and two doctors and I thought it looked exactly like skin cancer. It was biopsied and the results were inconclusive.

We agree a biopsy is in order.

She asks if I mind needles. I say No.
She gives me lidocaine injection first. I ask if she can please give it to me right into the right side of head.
She says, "If I do, then you will just ask me to do it again."
I said, "Yes."
She said "Sorry, I cannot put a needle into your brain."
She then cuts the flesh from my shoulder, and she cauterizes it with a high tech instrument. I barely feel a thing. But the smell of my own burning flesh is strong.
She says, "I think it will be actinic keratosis and it will heal well and you will not have any problems, don't worry." And she tells me how to do the wound care for the next few days.

I am not worried. I have been through all this voodoo before.
I just want relief from my head pain.

But at least I leave her office feeling like she cares, she has given me a pill, she has instructed me to contact the neurologist, she has given me a copy of my lab results, and she will see me again Monday for the porphyria blood draw.

I feel much less alone.

I tell her I am grateful she became a doctor.

Outside the rain begins to fall.

The skies have been strange all day.