Today I had an appointment with a new doctor, and it went about like they all do.

This doctor was a dermatologist, and I was going for multiple reasons, the first one being that my primary doctor wanted someone with more experience to look at the skin on my very swollen lower legs and the resulting lymphorrhea, just to make sure there was no danger of cellulitis. To be graphic here (skip the rest of the paragraph if you are squeamish), when the legs swell beyond their ability to hold the lymph fluid, it will actually leak through the pores of the skin, as well as through any slight scratch, nick, or wound you might have in the area, and if things don’t improve, swelling-wise, the leaky areas will spread and grow, and turn red. The danger is that the fluid sitting on the skin will cause it to become infected (staph is an issue), which is called cellulitis, and is no joke—it requires antibiotics, and is tricky to treat if your condition continues.

Treatments for lymphorrhea:

• Bandage and wrap the leg, then wear compression sleeves, both to hold the wrappings in place and to apply pressure to the area (doing that);
• Movement helps (at least in theory) to move fluid back up toward the collarbone, which is where you want it to go, to be expelled from the lymph system back into the bloodstream (dancing and vibrating daily);
• Raise your legs (this is only marginally effective, after a prolonged period);
• Manual lymphatic drainage (MLD) massage moves fluid up out of the legs and therefore takes some of the pressure off, allowing the skin to heal (haven’t found a new therapist yet to replace my old one);
• Reduce salt (already done).

In theory (according to Google), if you bandage and wrap and compress, the lymphorrhea should disappear in a few days. Tell that to all of us whose lipedema is propelling this, who have been dealing with it for weeks or months. And imagine the wearying process of adding the washing, moisturizing, padding, bandaging, and compressing of both legs to your daily routine….

The other reason for going to the dermatologist was the usual—suspicious moles and irritating skin tags, plus ketosis bumps on the soles of my feet (also caused by the lymphedema, oh joy).

I wouldn’t say the visit was a total failure, but success? Not so much.

First of all, I got the feeling the minute I entered the office that this was a place for teenagers with acne, not for large elderly women with weepy legs. First clue: I didn’t fit in any of the chairs in the reception room. This is a pet peeve of mine: You would think that, since patients come in all shapes and sizes, an empathetic doctor would know that at least some of the chairs in their reception area should be, at minimum, armless, so everyone has a place to sit comfortably. (Even my lipedema doctor’s office fails this test! Honestly…)

Second clue: The person who escorted me to the exam room asked if I wanted a full body check and when I said yes, she told me to undress and put on the gown provided. Having experienced this problem before, I always bring my own gown along, because the ones they supply are a size 12 if you’re lucky, and don’t meet in the middle, or anywhere near it. So I told her I had my own gown because the ones supplied usually didn’t fit, and she replied, “Oh that makes perfect sense.” She didn’t even realize or notice how inappropriate it was for her to say that. 

The doctor entered and asked me what brought me in today. I explained that my primary care doctor had referred me to her because I have both lipedema and lymphedema, and my doctor was concerned about my lymphorrhea. She had never heard of lipedema. And when I showed her my legs, her reaction was slight, but there was an involuntary recoil. She hastily told me, “I hate to punt, but this is not my area of expertise; there is another doctor in this complex who specializes in wound care, including those with lymphedema, and I suggest, if you can bear adding yet another doctor to your roster, that you go see him, he may be able to help you.”

It’s not that I didn’t appreciate the referral (maybe this guy will help me, plus perhaps prove a resource for things like local MLD therapists!), but she was so obviously not interested in even looking at my legs that I almost felt embarrassed for her. I asked her if she saw any indication of cellulitis, and then she finally poked a little at a red area and said No, they’re not infected, but you should definitely go see him. Then she started to leave the room!

I said, Um, I have some other issues, so she turned around, and I said I had requested a full body check and wanted to talk to her about specific moles and skin tags to see if any were concerning. She had me lean forward and show her my back, and said we should follow the progress of one of the moles there; and didn’t look at anything else. This is a body check? It made me wonder if this was yet another fat-phobic doctor. So I pointed out the two skin tags and one mole on my face, and the larger mole in my armpit, and the white spots on my arm about which I had questions. She quickly said they were all fine, and that she could remove two of them today. I was confused, and asked Which two? and she replied, any two you like, but only two, because that’s all your insurance will pay for. I asked, What if I wanted more than that? can you give me a price? and she sighed and said the receptionist could look it up for me, but it would be more practical if I had her remove two today, and then another two when I come back to see her in six months. (Giving her payment for another office visit.)

Then I talked to her about the keratoses on the soles of my feet (the podiatrist said I should talk to a dermatologist about them, because they would be more knowledgeable), which are also a result of the constant swollen state of my lower extremities. She didn’t know what they were and couldn’t find them, despite my pointing out the major one. I had to physically nudge her finger to the right place so she could feel it. She suggested corn pads. Let’s follow the logic, here. I wear a corn pad to keep one from coming back, but what’s to stop one from popping out in all the places I am not wearing a corn pad? Sheesh.

So…today I exhausted myself by bathing, dressing, driving, and visiting a doctor who was supposed to pronounce on the state of my legs, and in return I got rid of two skin tags from my face and got a referral to yet another person about my primary problem, which has yet to be addressed because apparently even if dermatology is your specialty, some skin problems are just too icky to contemplate. Thanks.

• • •

Determined that today’s outing was not going to be a total waste of my time and precious energy, I left the doctor’s and drove to the closest Ace Hardware store (the one in Van Nuys on Sepulveda Blvd.), and pushed myself and my walker inside.

I acquired the walker used; my cousin Cos’s friend Donna ran a nursing home and asked Cos if she knew anyone who could use an extra-wide walker, and Cos blessedly thought of me. It runs on wheels and has a seat so you can sit down and rest when you need to, but the previous owner had replaced a nut and short screw with a long one that protruded more than two inches into the space above the seat, with the result that when you sit down, you risk ripping a hole in your clothes (I have, twice!). I had been wanting, for a long time, to go replace that with the proper size screw and nut, but the only hardware store in my immediate neighborhood is Home Depot, and I knew I wasn’t physically up to roaming that vast space looking for the proper aisle and some (elusive) personnel to help me, so I had put it off. But it occurred to me that Ace, while being large enough to carry everything, is a lot smaller and with many more employees available, so that was today’s goal.

After entering and looking around, I spotted a desk labeled “Help Hub” (cute name), so I went over and addressed the guy there, showing him the problem. He got the proper length screw and nut and found the right tool to use, then came around the counter, took the old one out, put the new one in, noticed there was a nut missing on the other side, and replaced that, too. He finished by waving off the idea of payment when I asked how much I owed for the repair! I needed a couple of tools (I wanted to make sure I bought something after this favor), and he escorted me to the proper aisle and helped me select the best for the job. It was so nice for a change not to have to DIY. I gave them a 5-star rating on Yelp as my thank you. Buh-bye, Home Depot, hello well-staffed and helpful Ace Hardware.