Thursday 1 February 2018

Seeing a doctor about a rash.

Aaround 6 years ago - I got a really bad rash on my lower left leg, which was painful, almost purple in colour, with the skin very dry and it appeared to be spreading. I went to our hospital here - which doesn't have an A&E - signed in and was asked to wait. This was just after 8 in the morning ... and I eventually saw the doctor at 4.00pm! There was a Dengue epidemic at the time, so I realised my problem was possibly not as life-threatening, and as it was my first visit to the hospital I wasn't sure if this was the norm!
When I finally got in the young doctor was very apologetic - he knew I had been waiting hours, and explained that he was the only doctor, with two nurses, for a population of around 10,000, funding was terrible, and he, in fact, hadn't been paid for months! He had a look at my leg and said he thought I should go and see a dermatologist in Seabra, some 70kms (40miles) away, but prescribed some cream. Next day I drove to Seabra, only to find that the dermatologist only holds a clinic twice a month, and the next one is 10 days away! I try to make an appointment but they tell me to just turn up on the day.
The rash spreads a little and also appears on my left arm, but not so bad, but by the time the clinic day arrives it is somewhat improved. I drive again to Seabra arriving just before 9.00am, and take a ticket - the ticket is just to be checked in at reception - so take a seat. After about 90 minutes my number is called, so I register, pay the R$300 (at the time about £75) consultation fee, and am told to come back at 11.30! I go and wander round Seabra for a couple of hours and come back and am told to take a seat again and my name will be called.Around 2.00pm I am called and see the dermatologist. He looks carefully at the rashes and tells me he thinks I should have some blood tests and come back again, but gives me a prescription for some more cream! I did tell him I had done some work in my garden and wondered if it was a plant allergy, something like poison ivy.
He gave me a piece of paper with a list of the tests he wants me to have done, so I take that to the local testing clinic back home and they tell me these will cost R$380 (£95), so I have some blood taken, and give them a urine sample, and wait for the results to come back - about 5 days. I then have to wait for the next dermatologist clinic, during which time my left leg heals, but I get another smaller rash on the right leg, and also some irritation on my right arm.
Clinic day and I head for Seabra, earlier than before so I arrive there at 8.15 (they open at 8.00) and the place is heaving! I take a number and this time it takes 90 minutes to get processed! When I am finally called my appointment is at .... 4.00pm! So I go home - rather than spend over 6 hours in Seabra. I am back there at 3.30 and am told to take a seat in a different waiting area, but that he is running a "little late". It was 7.30 before I get called in! He looks at the test result, looks again at my (by now much improved) arm and leg, and proceeds to tell me I have "sun insensitivity"! As I drive that it why it was worst on my left arm (left hand drive here) and leg! I explain that I only drive my car to come to Seabra, and in the intervening period I use a motorbike, so surely this "insensitivity" would manifest itself in other areas of my body - and that I felt, as I explained before, that it was possibly caused by a "poison ivy" type of plant in my garden that I was allergic to?
He repeated that it was a sun sensitivity and that I should cover up in the sun, and use SPF80 sunscreen all the time! Then said if it got any worse I should come and see him again! I finally got home around 9.00pm!
Fortunately I have not had the problem since, but am still not at all convinced it was caused by exposure to the sun - and I do not cover myself in factor 80 every time I go out - but I did learn a lot about the state of the Brazilian medical system - and that time is relative here!!

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