Dermatologists Are Dicks

l feel like I need to start this post with a disclaimer so here it is:

Number one, the following are my feelings about my situation and my feelings only.  If you are currently experiencing any form of acute hair loss you must absolutely go see your doctor.  It could be a symptom of a serious health issue.  They will most likely refer you to a dermatologist if they can not figure out an answer, because yes, dermatologists are the experts.

I have the utmost respect for physicians in general.  I feel very privileged to have had the opportunity to work with a number of incredibly talented, compassionate and intelligent physicians over the course of my career thus far.  I’ve watched them work tirelessly in the pursuit of finding the ‘answer’ and see a genuine concern for the patient’s well being.

I also know, that despite my medical knowledge and experience, I am not a doctor.  I will never claim to know more than a specialist on such issues.  I am however a fairly reasonable person who is able to keep medical issues in perspective.  Therefore, if you lie to my face and make me feel bad about my decisions regarding my COSMETIC loss, we are NOT going to be friends.

I did my research.  When something in your life changes so dramatically for no apparent reason its only natural to want to know why.  And when you have to wait months before you can get in to see a doctor, you’re going to want to try and find some answers a bit sooner.  

I read articles, wikipedia pages, pulled up medical journals and spent hours on message boards.  I combed through other people’s experiences and compared them to mine.  I knew it was alopecia, I just needed someone to confirm it.

Warning: Rage is coming.

My first stop was my follow up appointment with the initial dermatologist I had seen when I still had hair.  Remember the one who barely looked at me and then diagnosed me with Telogen Effluvium?  That one.

I walked in to his office bald.  No scarf or wig in sight.  Shortly after I sat down in the room the doctor walked in along with his nurse.  He took a quick look at my lab work, said everything looked normal, and then went to explain our next steps:

‘Ok, so now we have to do a scalp biopsy.’

‘Well, do we really have to do that?’ (Because despite the fact that I put needles in people’s arteries on a fairly regular basis, I myself am fairly needle-phobic).

‘Of course we have to do that.  How am I supposed to treat it if I don’t know what it is?’

After I continued to hesitate about the necessity of a biopsy, he laid this one on me:

‘I’m only trying to help you.  Let me help you.’

SCREW.

YOU.

He walked out of the room after telling me to ‘make another appointment when you change your mind’.

I burst into tears, full on ugly crying as the nurse handed me some Kleenex (thank God for nurses).  I felt embarrassed, overwhelmed and I was LIVID.

I’m not good in the moment but if I could go back these are the things I would have said:

1. You’re a dick

2. Friggin LOOK at me.  I walked in to your office bald, I’m not trying to hide it.  That means that no matter how important my hair is/was to me, I’m clearly coping to some extent.

3. You diagnosed me pretty easily last time without a biopsy.  Why do I need one now? (My mom pointed this one out to me).

 4. You’re a dick

 5. If I can figure out its alopecia by doing my own research, why can’t you?  I’m pretty sure you’ve been a dermatologist longer than I’ve been alive.  Surely this isn’t the first time you’ve seen this?  And since it’s not, why aren’t you being honest and straight forward with me?

6. I’m not dying.  Stop acting like I’m refusing life saving treatment.

7. Piss off

I walked out of his office with my mascara running down my face and an awfully snotty nose.  Needless to say, I won’t be going back.

My next appointment was with the dermatologist I initially had been referred to.  My hair had been trying really hard to grow back and I had some solid peach fuzz at the back of my head.  I was stoked.  Absolutely elated.  I was positive that this was a good sign and that my bout with hair loss would only be temporary.

Again, I walked in to this doctor’s office bald.  Absolutely no attempt to hide it.

The doctor came in to the room, quickly reviewed my chart, took a quick look at me and said

‘I’m sorry you’re going through this.  Alopecia is a hard thing to deal with.’

(Funny how he could diagnose me without a biopsy, isn’t it??)

Ok, I thought, this doctor could be good.  He seems sympathetic and honest.

Wrong.

The next thing he did was take a quick look at my head,

‘Hmmm, not much hair there’

Now, I’m not entirely mad at him for pointing this out, but that one, simple, off handed comment completely crushed me.  I had just begun to pull myself together again and I was feeling so much more confident now that I had peach fuzz on my head.  In an instant he completely destroyed that.  I was right back to square one.

He wanted me to do some blood work,

‘I’ve already had that done’

‘Well sometimes things change’

‘No, like 2 weeks ago.  I had all the blood work done 2 weeks ago.’

Now this is the part that really irritates me, and maybe I expect too much, but he then made no apparent attempt to locate said blood work.  Didn’t check his computer, didn’t say he would contact the lab to find out the results, nada.  If you think you need blood work but your patient has already had it done, wouldn’t you want to know the results?  If not, WHY are you ordering it?  And what if the other physician had missed something?  

So instead of looking up my blood work (which I know was normal, that’s not the point), he came up with this treatment plan:

1. A month long tapering dose of Prednisone (an oral steroid)

2. Rogaine (a topical hair growth medicine)

3. Repeat blood work

4. Latisse all over my head every night (I’m pretty sure Brooke Shields does the commercial for this one.  It’s a serum that you put on your lash line every night to make your eyelashes grow longer.)

5. Come back in a month and we will see where we are at

‘You will have to be patient but I am confident we can get your hair to grow back.’

You doctor, are a friggin liar.

I will explain in an upcoming post about treatment options for alopecia and why they are not for me, but this is what you need to know right now:  generally speaking, the more extensive your hair loss, the less likely it is to grow back.  Also, any treatment becomes less effective.  Call me crazy but I expect a dermatologist to tell me that.

Doctors, take note:  It does NO GOOD to try to give your patients hope if you’re not going to be realistic and honest about it.  It’s rude and it’s irresponsible.  (If I hear the term ‘short term intubation’ one more time..... ;) )

I walked out of that office with a $200 bottle of Latisse in my hand (because of course his office conveniently sold it and I wasn’t sure what else to do), feeling more confused than ever before.  Do I start the steroids?  Do I really need more lab work?  Is any of this really going to work?

(Side note: the Latisse that he wanted me to rub all over my head?  The one that I paid $200 for (and am still irritated about)?  The bottle was 5 ml.  FIVE mls.  FIVEEEEEEEE.  So that was supposed to last me what?  A week?  Also, for $200, the applicators are shit.)

About a month later I had my final dermatologist appointment.  Third time’s a charm.  I walked away from this appointment with tears as well.  Difference is, they weren’t angry tears or frustrated tears.  Just sad.

This dermatologist was honest with me.  He treated me with respect, compassion and understanding.  And even though these words broke my heart, they still meant the world to me,

‘You’re going to lose all of your hair’