The Foot Thing

mssue said:

Hi Jan,

I don;t know what's up with your foot-I hope you find out soon. My question is -are you in North Carolina????? Wake Medical in Raleigh--Duke Medical in Durham????I live 30 minutes North of Durham--45 minutes to an hour from Raleigh.Let me know if you're that close that would be GREAT!I have an appointment at the Durham Women's Clinic on East Carver St next Tuesday at 11am,they want to do an ultra sound of my uterus and ovaries,then the next Tuesday it's time for a mammogram-I'll do that one here at the Hospital.Anyway--
In the meantime I hope you get the help you need,my thoughts and prayers are with you.

Sue

Yes, I am in NC. I live in Winston Salem, and was seen at the Wake Forest Medical Center, part of the Bowman Gray School of Medicine. My appt with Duke Hosp Dermatology is Dec 17...I hope that it doesn't fall off before then. Ha.

The doctor called and offered to do another biopsy, two places on my foot to see if we can definately rule out Lichen Simplex or rule it in. Not the Holy one, but, my first dermatologist. She has a lot of faith in his highness but, I just need a reason to believe him, not things that are not applicable. So, she understands all that I have been through and is willing to go the gamut with me on it. I get to Raleigh/Durham occasionally. I went to Raleigh to see Fleetwood Mac at Walnut Creek last month. When I come again, I will post and maybe we can have lunch or something. That would be great.

Jan

jamjar62 said:

Jan,

I'm a med tech and I looked up acantosis nigricans in my books. Important to know that its SOMETIMES a manifestation of cancer in the internal organs. Also seen in people with depressed immunity which you might be if you recently finished chemo.

Good for you for questioning his highness. Don't you love docs with the God complex. I once had a MD tell me "I'm a doctor so I can talk to you that way" when he had been rude to me!! He was a short man so I chalked it up to that. Was his highness a short man??? LOL

You are not overreacting at all. Many of us are alive because we insisted that a doctor dig a little deeper or go the extra mile....LISTEN TO US! In the end, you have to be your own advocate and actually its quite empowering (as you know).

Keep us abreast of the situation as you make sure nothing is afoot (couldn't resist the puns).

Blessings,
Karen

Hi, yes, it is only sometimes a reaction to an internal cancer, which is typically in the gastro area. The thing is that I fell into a minority big time with my cancer. It was microcalcifications that were well rounded and spaced apart...atypically not cancer. But, it was not only cancer but, diffuse nuclear grade 3 with extensive necrosis, comedo subtype. Est/pst neg. The area was 2.5 cm so I am like whoa...I had to insist on my biospy for it. The surgeon was shocked. If His Highness had given me any valid reasons for it to be Lichen Simplex, I would have been so relieved. Everything, and I underscore everything, he told me was discounted, and in fact by his own written words, the path report, or the pics that he referenced. It is so frustrating. I hope that it is LS, and not AN. That can be a serious disease. My path report was sent looking specifically for AN or LS. What they reported was:

"There is orthokeratosis and papillomatosis with dilated papillary dermal blood bessels, but, limited acanthosis, vertical dermal fibrosis or other features of acanthosis nigricans or lichen simplex chronicus.

We do NOT favor lichen simplex chronicus. Human papilloma virus testing could be performed on request."

The report does not say that they do not favor AN, and in my mind therefore, does not totally rule it out. Am I making too much of it?

They did the hpv test and it was negative. I am so confused, don't want to make a mountain out of a mole hill, hehe, but, see, I have lost my total trust of doctors, and have learned the hard way to do more research and delve into my health. So, I am insisting on more, and to my first dermatologists credit, she is with me on that, even though she feels that it is not AN. However, I did find several other conditions that could be this thing and none of them were explored at all. I was just told that because I scratch it all the time, Oh, well, in my sleep, Oh well, because I wear shoes all the time, Oh well, never mind the above, it is LS. haha. Not good enough.

SO, I am not seeing His Highness again. He can kiss my arse. Do you have an opinion about doing things to decrease the appearance of the condition? My derm. said for me to use these three things that will thin out the area and reduce the area, hopefully return the color to normal. (the area is growing, now it is over half of the top of my foot and advancing up the front of my leg). I asked her if it would not be best for Duke to see me with this malady at it's worst, rather than clearing up the appearance, which with AN it is difficult to change the appearance as it is due to some other reason, diabetes, cancer, obesity. I am not fat and do not have diabetes as far as I know. So, what is your opinion? I don't want to changes it's appearance so that the other doc can see it, but, it is not until December.

I am sorry to ramble. I am just so upset with all this. Thank you SO much for looking at this in your book. I have read and read about it on the internet and I understand it, and I am terrified of it. I just thought that my foot looked ugly.

Jan