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Healing 360º: dealing with skin issues
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"She'll need to take this antibiotic for the next 3 week," I said to the parents, aunt and grandmother of my patient as they were packing their stuff on their way home.
The vagal nerve stimulator generator on this little girl with complex chronic problems had gotten cursed with MSSA. The devil was explanted, wound exorcised and the patient already looking great without hints of infection.
"Doctor…" Grandma said suddenly, collecting our looks. "I was wondering if her infection may have been caused by my other daughter's skin rash."
Then my patient's aunt, with a swift, coordinated movement as if she was pulling out a gun, laid out the side of her longest right hand finger. Respectfully without stretching it, she pointed with her other hand at a localized and crusted rash.
"That's herpes. She gets it when she's stressed," mom accurately interjected.
"Yeah, it comes and goes. I make sure I wash my hands really good," a responsible auntie said.
"Is it painful?" I asked, intrigued.
"Yeah, usually it tingles pretty bad before it breaks out," auntie said excited with the building momentum.
"Well, I gotta agree with your sister, and would say that that looks very much like a herpes rash. A herpetic whitlow. It's caused by the herpes virus…" And then I could tell that all pupils in the room had gone from 3 to 6mm. "You see, we can get cold sores, or skin rashes, or genital herpes…" I went on with the Herpes for Dummies in 1 min. And I added that "sometimes another virus, the chickenpox virus, can cause a similar rash that may pop up in the sides of the chest. The shingles."
"You mean this?" asked mom this time. "Because look, I had this for several days now," she said while turning around and lifted her T-shirt to reveal a vesicular, crusted rash in the left of her back, next to an artistic, biblical-like tattoo. And as if I would miss it, auntie herpes extended her compromised finger aiming at the crops.
Keeping in one piece, I wanted to clarify the distinction among all three skin problems. I guess that my patient's dad, who was enjoying his girls' show, felt a bit embarrassed and could not resist the urge for the joke. "Actually, Doctor, and if you don't mind, I've also been having some issues" said while undoing the button on his jeans. We all laughed our lungs out.
After I winked saying that an STD was a possibility, I waved goodbye, wished good luck, and double-dip that stinky and musky alcohol foam. While rubbing my hands on the hallway, I thought to myself: what an awesome Kodak moment.