Thursday, July 23, 2009

Ivy Donegal and the Curse of the Butt Rash

Chapter II


So…three days and four medical professionals staring at my butt later, a dermatologist has declared that I, Ivy Donegal, am NOT going to die of a killer butt rash. Or at least not any time soon.


Now, you may be wondering…how does one die of a killer butt rash? Well, dear fictitious audience, I will tell you how.

Certain medications have been known to trigger an autoimmune or allergic response within the body, which leads to the body’s own immune system attacking a protein within the skin. This leads to one of two potential syndromes: Steven Johnson Syndrome or Toxic Epidermis Necrolysis. (The name is based on how much of the body is affected, with Steven Johnson Syndrome being the less severe of the two.) Both are extremely rare, affecting about one in a million people every year worldwide.

As a result of this immune attack and protein breakdown, your skin then begins to blister, and rash, and then peel off. En masse. YOUR SKIN PEELS OFF. All over your body.

The outer layer of your skin separates from the inner layer (epidermis from the dermis), and this can even happen inside of certain organs, leading to breathing failure, the inability to swallow, or intestinal obstruction. Your exposed, blistered skin is extremely vulnerable to infection, and patients are best treated in a burn unit. Oh, and if the rash attacks your eyes, which it does in 15-35% of cases, you go blind.

In the most severe form, Toxic Epidermic Necrolysis, between 30 and 40% of patients die. The death rate is lower for Steven Johnson Syndrome, but still disturbingly high at 5-15%. And those that don’t die are often left blind, disabled, or horribly disfigured.

And that is what two different doctors thought I had. On my butt. Because of stupid medication I was taking for a week which didn’t help anything anyways. Gawd.

…The Horror.

Wednesday, July 22, 2009

Ivy Donegal and the Curse of the Butt Rash

Chapter I

It was not so very long ago that Ivy Donegal, seated in the office of her trusted physician, was told of a miraculous pill.

“I have seen it work wonders,” said Ivy’s trusted physician, and Ivy nodded, and Ivy listened. Her physician extolled the virtues of the miracle medication, which had vastly improved the lives of many poor unfortunate patients not unlike Ivy herself.

Ivy nodded, and Ivy listened. Her physician continued.

This particular pill was not often prescribed for the illness that Ivy was, herself, experiencing. It was not approved by any medical organization, or large, governmental, administrative body, for the treatment of Ivy‘s particular problem. It was, it seemed, approved to treat a very different problem, which was a problem that Ivy herself had never had issues with.

Ivy nodded, slightly confused, and her physician continued to explain.

“There are almost no side effects, and the results, I believe, could be dramatic.”

Ivy did like dramatic things, and she particularly liked the potential for results.

“And if you don’t see any improvement, then we can stop it right away. There are no withdrawal effects.”

Ivy did not like withdrawal effects, and with this promise she was convinced. She accepted the prescription, scrawled out by her physician on a tiny square of paper, and she put it in her pocket. She bent down to lift her backpack, and she turned towards the door.

“There is just one thing,” her physician said, with an air of caution which caught Ivy’s full attention. “A rash.”

Ivy turned, and after a long pause, full of tense foreboding, her physician spoke.

“There is only one side effect of this medication, and it is very, very rare. But there is a small chance that you may develop...a Rash.”

Ivy furrowed her brow in an attempt to elicit understanding. Her physician sucked in a long, laborious breath, ever slowly, as Ivy waited.

“I have never seen this rash, myself, but I know it to be a very bad, bad rash. If you have such a rash, you must go straight to the hospital. You will need to be hospitalized. The rash is very, very bad.”

Ivy nodded, resolutely. And then her nod faltered, and paused, because Ivy did not understand things, at all.

“But I have lots of rashes,” she said, and this, of course, was very true.

None of Ivy’s rashes had been worthy of hospitalization, but many were ugly, and many severe. Readers may recall the instance where Ivy shaved her head for charity, and God smote her down with scalpal psoriasis.

Ivy, ever since, had been plagued by chronic psoriasis, along with a host of other equally appealing diseases of the skin. Her skin easily bled, bruised, and blistered. Her skin peeled and purpled with pin-prick purpura. She often had hives, and eczema, and dermatitis, and poison ivy. She had once even come down with a severe case of flesh-eating bacteria, but by the time she saw a doctor the bacteria had transformed themselves into a case of mild sunburn. Aloe had helped. Such was the unpredictable nature of Ivy’s skin.

Ivy told her physician these things, or something similar. Her physician, it seemed, did not care.

“This rash if different,” her physician forebode. “If you have The Bad Rash, you will know.”

And Ivy left her physician’s office, and Ivy went then to visit her pharmacist.


Ivy went to her neighbourhood pharmacist to fill her prescription and, eyeing the pills, she felt the cold pangs of unease. The pills were very, very small, which meant, to have any effect at all, they must be incredibly potent. They were also the exact size and colour of the toenail clippings belonging to a small child, and Ivy did not find this to be an incredibly appealing image to connect with something she was going to put in her mouth.

She left the bottle of pills, un-ingested, on her dresser, and she waited.

Ivy knew that medication was a think to be treated with caution and respect. She knew that some medications would make her feel tired, and others nauseous, and still others would make her anxious, unravelled, and indisputably insane. Having already spent far too much of her life feeling unravelled and insane, Ivy wished to avoid all such effects whenever possible.

And so Ivy waited, until a day arrived when she had nothing else planned except sleep and television, and neither of these things required her to be conscious, un-nauseous, or sane. Ivy eyed the pills suspiciously, and then she swallowed them.

Ivy waited.

Nothing happened.

Ivy shrugged and watched TV. The next day, she swallowed more pills, and then more, and then more.

The dose was increased very slowly, in order to reduce the chance of the dreaded Bad Rash. A week passed, and Ivy took more pills, and then more, and then more. Nothing happened.

And then Ivy took a shower, because Ivy had grown smelly. And there Ivy experienced a small and undignified thought. Ivy thought, ‘My butt hurts.’ And then the thought disappeared, as small, undignified thoughts are wont to do. Ivy set about a normal day.

Ivy took more pills, as was her custom. She went to work. She came back home. She kissed her puppies.

She realized, then, that her butt really, really hurt, and this concerned her. Ivy set about staring at her butt in the mirror.

There, standing on the lid of her toilet and gazing backwards, over her shoulder, at her exposed bottom-end in the bathroom sink mirror, Ivy discovered what looked to be…a Rash! A small, red rash, to be exact.

Ivy was unconcerned.

Ivy, avid hypochondriac, was not the type to remain unconcerned in the face of a potentially serious bodily event. But the rash, while painful, seemed quite small and benign, and Ivy could not really think of a scenario in which a small rash on her bottom could lead to anything other than discomfort.

Ivy, dear readers, was wrong.

It was shortly thereafter (the next day, to be exact) that Ivy attended a conveniently-timed appointment with a walk-in clinic physician. This was not Ivy’s regular physician, who was, also conveniently, on vacation throughout the most interesting parts of this story.

Ivy needed to renew a prescription for an entirely different medication, which was a medication prescribed to treat an entirely different rash. This was the medication Ivy had been using diligently ever since God smote her down with ironic psoriasis of the scalp. The doctor nodded, wrote and prescription, and then Ivy paused uncomfortably.

“I should mention…” And Ivy paused, and she thought of the rash, and her physician’s dire warnings concerning The Rash, and she weighed this against the thought of a complete stranger inspecting her exposed bottom for what was probably nothing. Ivy sighed. “I have a rash.”

She told the doctor of the rash, and medication, and the doctor looked pale, and concerned, and said, “Oh my.” The doctor asked to see the rash, and Ivy consented. Ivy exposed her skin, and the rash, and the doctor nodded with grave concern.

“I have never seen The Bad Rash before,” the doctor said, consulting a large and cumbersome medical text, “But, according to my understanding, The Bad Rash is a very serious thing. And it looks very much like…your rash.” The physician nodded towards Ivy and her diseased buttocks.

Ivy flushed red with concern and surprise.

Ivy, you see, had been expecting the physician to tell her the rash was nothing. Ivy had been expecting the physician to say that the rash was a result of some incredibly embarrassing hygiene issue, or venereal disease, or fungus best treated with mild soap. And Ivy had been expecting the physician to tell her that there was no rash, at all, except in Ivy’s own head, and for the love of god to please pull her pants up, now.

But the physician didn’t say these things.

She booked an emergency dermatological appointment for Ivy, two days away. She asked if Ivy had been feeling unwell. She advised Ivy that, should the size of the rash or any part of Ivy’s health begin to change, in any way, that she should go straight to the hospital.

And Ivy nodded, and went away.

Ivy was beginning to feel quite nauseous.

When Ivy went home, she looked up the rash on the internet. She still did not know, exactly, how a small rash on her buttocks could be a potentially serious thing…and then she learned. She swallowed. Her mouth was dry. Her stomach churned. She began to sweat.

“My god,” she thought, “I’m dying of a butt-rash.”

And Ivy decided to go to the hospital.


And as you read this, dear readers, Ivy Donegal may be dead, or dying, or lying in a very undignified position while doctors, nurses, and medical students congregate around the small rash on her butt.

Ivy hopes that this is not the case, and the odds are very much with her. But Ivy also knows that death via medically-induced killer butt rash would be a perfect crescendo to a life full of many undignified malignancies, and that laughter, ironic or no, is probably the very safest medicine.

xoxo Ivy