As many of you know, I’ve been struggling with a horrid “rash” for several months on my hand. It later spread to my other hand and then to my feet in September. These rashes have dominated my life for the last couple of months. It even contributed to my still living in Bogo City! I really wasn’t in a position to take care of myself during the trials of October.

More On My Medical Treatment In The Philippines

In August I was at the doctor wanting Prednisone. I knew that it was going to take to clear this up. I’ve been on Prednisone for the last week. I took my last dose on Thursday. While it is not completely healed it is so much better now. It did eventually get even worse than it looks in this picture. It was great for Halloween, I had my own built in zombie look. I’d hold my hands up to the five year old and freak him out as he is big into zombies this Halloween. The skin would die and flake off. Then it would dry out and split open. The splitting was very painful. There are a couple healing splits in the center of my hand in this picture.

medical treatment in the PhilippinesOnce it moved to my feet, I was nearly crippled. Every time I walked any place at all, my feet would split open. It didn’t take a genius to realize I needed to stay off my feet! I remember one guy giving me a hard time, telling me to walk. After two months of not being able to move around much, I asked the doctor myself if I should just walk through the pain. He said no, you need to let the “trauma” heal. Well, yeah, that seemed obvious but I was actually hoping for a different answer.

It also eventually crawled up the inside of my fingers but it was my feet I was most worried about. The other day, I told Jessie “Well, that’s one way to remove the callus from your feet.”

Getting in the sea helped a lot. Jessie even brought home bottle sea water to soak my feet in. The problem with going to the beach was that it caused my feet to split open. Not nearly so badly as walking around the house or the streets though. I learned that socks helped a lot so I’ve been wearing socks with my crocks. My crocks have little spikes in them. The idea is to stimulate blood flow. Those spikes and the sand though were not pleasant. It was while at Bantayan Island in September that my feet got hit pretty hard. I just walked through it for a few days. Once I walked around a bit it didn’t hurt so much. I think I had ripped it open enough that the tearing stopped. Well, until the next morning and put my feet on the floor and that was no fun at all.

I’m convinced that I have scleroderma. Like lupus, scleroderma is an auto-immune disorder where the immune system becomes confused and attacks your own tissue. One of the things scleroderma causes is deposits of calcium under the skin. This causes a callus like place and the skin become tight, itchy and painful. Many other things look like this though, that includes round worm and eczema. Besides the skin problems, I already know I have an auto-immune disorder and some of my symptoms don’t match lupus completely. Scleroderma often causes GERD, esophageal spams, scaring in the heart and lungs, ringing in the ears. All of which I’ve had for years. Even common to scleroderma is not being able to lay on the right side. I’ve not been able to sleep on my ride side for 10 years or more.  It is probably a symptom of GERD but why does a 21 year old man have GERD?  Why is a fourth grader having esophageal spams? Clearly something has been going on. I also get rheumatic nodules which generally are not present in lupus but are present with scleroderma as scleroderma is often associated with “mixed connective tissue disorder” which means you take on symptoms of several of the rheumatic type auto-immune disorders.  Jessie too is feeling like I have probably have sclreoderma and when it comes to illnesses she’s always in denial about them. Even the lung problems and the swelling I’ve had in my legs and feet could be explained by scleroderma. With the addition of the skin problems, I look like a text book case of scleroderma to this layman. I am a layman though and I know enough about these kinds of things to know it takes a doctor to make the final positive call on an illness like this.

I don’t really expect to get a clear answer but the doctor is doing some test next week for auto-immune disorders and if they are positive he’ll order the scleroderma antibody test. I’ve already done the research though, the test do not prove you do or do not have scleroderma. Same old story I’ve been dealing with since my late 20’s. I  don’t know if I have ever had the test for scleroderma though. With the absence of skin problems the doctors may not have thought it was warranted.

I brought up scleroderma when I was with the doctor at the end of October. What most concerns me is the skin but that also the many doctors were not sure it was lupus even though I test positive for lupus. It is possible to test positive for lupus and not have it! At first the doctor was doubtful as it is rare and more times more common in women. Well, I’m rare so that doesn’t hold much weight for me any more. After reading up on it, he said “I can tell you’ve been doing a lot of reading. I really haven’t recently. I did a lot in the past but did look up scleroderma again recently and the more I look into it the more convinced that I am that is what is going on.

Near the end of the visit, I told the doctor this is not going to get better by treating it with topicals and he agreed. He said “We are not treating the underlying skin condition.” So he broke down and gave me Prednisone after more gentle prodding by me.

A week later? I’m almost completely healed. I have a feeling though it will take a second round to finishScleroderma it off. Since I’m diabetic, I don’t need to take Prednisone but I can tell you this, I fully intend to get more Prednisone just in case it flares back up. Yeah, yell at me if you want. You ask yourself what you’d do if you couldn’t move around for two and half months!

Trying to get the prescribed medications for my skin has been a nightmare. Jessie and I hopped a bus late last month primarily to go get the solution the doctor prescribed. It is used in hospitals a lot to treat wounds. It helps a lot. It softens the skin and seems to kill the fungus that appears to be on my skin in the affected areas as well. Once we got there, the hospital pharmacy told us they were out of bottles to put it in that we needed to bring our bottles back. We got home to find out that our maid threw two of them away. I think the pharmacy has the freaking bottles but they are hard to come by and didn’t want to give us more. So I spent six hours on a bus and didn’t get what I needed.

I had only very little of it left when we went to Cebu City so I’ve rationed it quite a bit over the last week or so. I finally ran out a day or two ago. I’m willing to bet my hands and feet would be completely healed had I been able to use the solution along with the Prednisone.  Jessie tried to find it in Bogo City again and we were not surprised we could not. I asked her if the local hospital would have it and she said they would. She went down to try there and the guard wouldn’t even let her in. The hospital in Bogo City only prescribes medications to patients admitted to the hospital!

Maybe it is an Asian thing to have all these strict policies that establishments just will not bend. I can usually roll with the flow on this but come on Philippines, I need to keep my feet attached to my body! Yeah, I’m sounding like a frustrated expat complaining about the Philippines because I am when it comes to this.  There might actually be less poverty in the Philippines if business in the Philippines would try a little harder to sell things. Why are they not making a profit on those bottles? But here I am complaining about bottle in a place where shortages are common, when even diet coke can be hard to get. Heck the other day, Jessie couldn’t find sliced bread in Bogo City. 🙂 Back shops all over the place and no sliced bread!  I guess some of this goes along with living in a developing nation. So prepare yourself, if you’re going to live in the Philippines this will be a part of it. Rigid rules people are expected to “fall in line” to and shortages. My patience is probably a little thinner than normal too, Prednisone will make the taker quite high strong and tense.

Medical Treatment in  the Philippines is Much Like the USA

I’m not troubled by the doctors moving slowly to get aggressive with the treatment. I’ve been around doctors way too much and I know about their “Do no harm” rule. I learned long ago you have to give them a little time when it comes to things like this. Just like in the USA doctors usually start off slow and progress. My doctor here has never seen me go from healthy to quite sick in a short time too.  It has been a long time since I considered myself “quite sick” but I do tend to get alarmed too easily as I know where it can go. I have been afraid to walk too.

Things have settled down in my life a bit now. I’m expected the Effexor I’ve been needing to arrive in Cebu City tomorrow and I will soon be in the city. In fact, I’ll probably be there when this article is published. While there, I intend to quit smoking. I need to be away from this computer, I need something to do and I need that Effexor. I’m going to get some of those test run I need and then spend a day seeing some of the things I’ve not seen yet in Cebu City. Hopefully, this time I’ll pull off what I need to do most right now. What I need to do most is to quit smoking because if I don’t, I don’t think I’m going to live much longer. I am hesitant to even mention this. I hate failure and when I write about it, I generally get several stupid and hateful comments. Oh well, yeah, I fouled up when I started smoking again. I really don’t want to be a smoker! It is stupid. I know, you don’t need to tell me. 🙂  Not trying to quit is a failure before I make the effort though so working on my mindset. Hoping Jessie can put up with me and that I can maybe not get too grumpy. Staying busy for a day or two will help. Being in places where I can’t smoke will help. Lots of food will help. haha

I just hope I don’t split my feet open when I’m doing all these things again. I’ve been out of the house a few times at the end of last week. I went to the beach and the local pizza joint. Clearly, my feet are better. That would have been enough to split them wide open in the past. This time that didn’t happen. They are a little extra tender since the trip to the beach. I hope I can continue down this path. I’m sure not smoking will help improve circulation and maybe, just maybe I can return to walking all over Cebu again.

While there are similarities to the approach of doctors in the Philippines to that of the West, there are also many differences in medical treatment in the Philippines. The cost is much lower in the Philippines. In some situations, medical care in the Philippines isn’t quite as start of the art as it is in the West but most of the time it is adequate.

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