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Author Topic: How should I proceed...?  (Read 2131 times)
Tío Riñon
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« on: August 25, 2013, 07:34:22 AM »

I recently met with my nephrologist for my monthly visit.  I pointed out to him that I had purple-ish blotches on my arms and on top of them were bumps (almost like hives).  These areas had been slightly painful to the touch but the pain was diminishing over time.  In fact, the first one no longer hurts at all.  He stated that it might be calciphylaxis and recommended that I go see a dermatologist.  I scheduled an appointment with the doctor that my nephrologist recommended, but she can't see me until mid-September (about 3 weeks).

I researched calciphylaxis online and here in the IHD forum and it doesn't sound exactly like what I have, but perhaps it is still developing.  Given that it is a life-theatening condition, if I do have it, I think that I should be proactive based on what I have read.  Should I wait 3 weeks for a diagnosis or go to another medical facility?  From the description, does it sound like anything else that could happen to ESRD patients? 

Any other ideas or suggestions?

Thanks for your assistance.
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obsidianom
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« Reply #1 on: August 25, 2013, 08:00:03 AM »

Three weeks isnt that long if you are getting better. If however it is progressing and getting worse , you might want to push it up. A biopsy may be the only definitive diagnostic tool. You could ask your nephrologist do do a punch biopsy now as it is a simple quick safe procedure in the office. That could speed things up.
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My wife is the most important person in my life. Dialysis is an honor to do for her.
NxStage since June 2012 .
When not doing dialysis I am a physician ,for over 25 years now(not a nephrologist)

Any posting here should be used for informational purposes only . Talk to your own doctor about treatment decisions.
aharris2
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« Reply #2 on: August 25, 2013, 07:25:53 PM »

Calciphylaxis requires a slice biopsy to diagnose it (the punch is likely to miss the affected blood vessels) or so it was 10 years ago. Calciphylaxis lesions are immensely painful all the time, so the diminishing pain is a good sign. I hate delaying investigation of the lesions, but what is extremely important is that the doctor checking them is familiar with calciphylaxis. Most doctors are not.
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Life is like a box of chocolates...the more you eat the messier it gets - Epofriend

Epofriend - April 7, 1963 - May 24, 2013
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Rest in peace my dear brother...
Tío Riñon
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« Reply #3 on: August 27, 2013, 11:53:55 AM »

UPDATE:  Thank you both for your thoughts.  I followed up with my nephrologist and he encouraged me to get in to the dermatologist's clinic ASAP to have an evaluation.  The dermatologist said that he didn't believe it was calciphylaxis and explained that based on my present condition, I was doing too well for me to have it.   :yahoo;

He took a punch biopsy and will share the results with me next week.  That is a load off of my mind.  Hopefully it is nothing major or at least manageable.
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