Archives for October 2014

Selfie

October 22, 2014 By Stephen

I was at the falls with my kids.

The sun was pouring through the mist, the emerald green of the trees and bouncing of the lichen… it was spectacular.

I snapped some shots of the kids and then my daughter asked me to take a “selfie.”

So I leaned down and flipped the camera lens on my iPhone.

I am already in the habit of avoiding eye contact with the LCD screen.

I held it as far away as my arm could reach and I snapped two shots.

My daughter, as any 7 year old would, wanted to see our smiling portrait.

So I flipped around my phone, and tried not to look, but then I couldn’t stop myself. My eyes zeroing in on the biopsy scar on my nose.

My demons won’t leave me alone

I took my daughters hand, it felt so warm and cuddly and small.

We walked up the circular trail to meet my wife and son who had gone up a few moments earlier to use the restroom.

I started to feel the scars, my nose, my cheek. I said I had to go the restroom (although not really) I had to check a mirror to see if it really was like the picture registered it. It felt to me like they were transforming, possibly growing.

The lighting was better in the bathroom, I quickly put my cap back on my head.

We made it to the car, where I saw in the window my reflection with the deep sunken scar on my cheek.

And then I fell apart inside, I felt despair, helplessness and hopelessness.

I started to feel anger toward the dermatology PA who cut my nose apart, I felt anger at myself for going surfing and not protecting my face when I surfaced.

I started to feel ugly, monstrous, and it hasn’t gone away. I feel my scars again tonight.

Santa Clause is coming to town

I dream of waking up one day with these scars gone.

Going back to my previous life when they weren’t part of my life.

If I could just live in that person’s body for a couple days, I promise I wouldn’t take it for granted.

But we don’t know what we have till it’s gone, and then it is too late.

When I woke up today in the cabin and used the restroom I glanced in the mirror. The restroom was poorly lit, without direct overhead lighting and because of this, my sunken scars looked fine, I felt good about myself.

Then the camera revealed the truth? Or is this a deception. I just don’t know anymore.

* PS, I found this Wikipidea entry when I was Googling how to spell “selfie: In April 2014, a man diagnosed with body dysmorphic disorder recounted spending ten hours a day attempting to take the “right” selfie, attempting suicide after failing to produce what he perceived to be the perfect selfie.^[66] The same month brought several scholarly publications linking excessive selfie posting with body dysmorphic disorde

Stop the Madness

October 19, 2014 By Stephen

I went out without makeup on my nose today, inspired by a story I saw on the news about a childhood burn victim.

Her face was horribly disfigured in a car accident when she was 7. Her face had melted off, separated from its bony scaffolding.

The doctors debated whether or not to let her live, trying to decide if she could ever have a descent quality of life.

She hid indoors for years once her childhood innocence had passed, afraid of what people would say.

Then she lifted the curtain.

When she began to see her beauty, what the trauma had taught her, how she had grown as a person… she let go.

She even found love and is now married.

Because love cannot be disfigured, it is pure and unconditional.

Watching her story I realized I didn’t have it that bad.

A modeling agency is doing a photo shoot of her, showing that even when we are disfigured we are beautiful because we are human beings.

So even if I can’t shake the feeling that something is wrong, I can accept who I am.

And even if this means I will spend my life disfigured in the mirror, I don’t have to live this way inside or on the outside.

Love is unconditional, beauty comes from the love we have of ourselves, of our life.

It’s time to stop this madness and live life again.

photo credit: AlicePopkorn

Knowing When it’s Time to Let Go

October 16, 2014 By Stephen

It’s never time to let go.

No matter how shitty, painful, miserable and hopeless you feel.

You must choose life.

It is possible to live in pain, you just do it.

Doesn’t mean its easy!

But what is the other option?

Life is precious, beautiful, fragile and very short.

If you stop and ask yourself what is the worst possible outcome of any given situation? The answer of course is “I could die”.

Humiliation won’t kill you.

I think the most miserable part of suffering with BDD is the feeling of constant anxiety.

And the whole thing is complete and utter bull shit if you stop and think about it.

The things that make us anxious are usually fears about how the world or other people will perceive us. That somehow in our imperfect state we are unworthy of love. Even the King of Pop couldn’t bear it any longer.

That’s just great, but who is going to tell that to his children?

I have a patient, he is 25 and suffers from Cerebral Palsy. He is in a wheelchair, he can’t walk, he can’t clean or wipe himself, he can’t push his own chair and to add insult to injury he can’t talk. Then one day somebody at Stanford mounted a computer on his chair which allowed him to communicate with the one good arm he has.

Who knew he was not only hilarious, but bilingual and absolutely brilliant? He is also one of the happiest people I know, which makes me joyful around him because if anybody has a good reason to want to off themselves it is him.

I love seeing him in the clinic, after these visits I understand the meaning of happiness and the good life.

Living with BDD can be hell, but nobody ever said life was going to be easy.

Life, even in its most miserable state is better than death, because without life, you are no longer conscious, which may be less painful in the short run, but life, is not yours to take, even your own.

And in death we feel nothing, which is worse than being alive, even in its most painful state.

In caring for the ones we love we don’t “owe” them anything I guess, but if we love them, we will protect our lives. Our children, our friends, our family.. If we care for them we work hard for them and we suffer for them. This may involve some pain, but like I said: it is possible to live in pain.. You just do it.

And at the end of the day, all the fears, the anxiety, the state of despair over our appearance comes down to fear of what the world is going to think of us, how we will be perceived. Even if we have love it is hard to fathom we are lovable. But, we all are lovable. We know others opinions don’t matter, beauty despite what the makers of beauty products and TV commercials try to tell us has nothing to do with our complexion. Just ask my patient.

We are beautiful people, we just need to believe it! and if this is painful, it’s OK, we can live in pain.. We just do it.

photo credit: demandaj via photopin cc

Does BDD run in Families?

October 13, 2014 By Stephen

My body image concerns started at a young age when I struggled with acne, but my lack of confidence began way before this.

I remember a friend of mine in grade school making some off-handed comment about a generic Yankees baseball cap I was wearing and I felt self conscious for months.

I felt the same way about my hair, my clothes, my personality.

My grandmother may have had BDD.

She didn’t like to leave the house, she walked with her head down and she never would take photographs.

I never made much of this until the other day, I started to think about where my BDD may have come from, and if this could be an inherited trait.

I started to worry about my children.

Depression appears to have a strong genetic component possibly multiplied by a factor of 3 if you have a close relative with the condition.

What about Body Dysmorphic Disorder? Does it run in families?

Because BDD is not talked about as much and those who have it tend not to share their concerns, or identify it as such, it’s inheritance patterns are likely to go unnoticed.

This I am sure will change with time.

Last year, I swore there was a girl at my gym with BDD, or maybe I was simply trying to find somebody else to relate to. But I picked up on certain patterns.

She would obsess over mirrors and seem to avoid them at the same time. She was fit, but self conscious, she appeared a bit nervous and anxious. I saw myself in her.

How much of this did I put upon her to make myself feel better? I will never know, but it is the first time I realized that I may be able to spot people with BDD.

So I started looking.

It is hard to find, many are models, lawyers and doctors, people you would never suspect to have it.

Can you spot people with BDD? Can you see it in yourself? Do you suspect a family member of yours may have had it?
photo credit: Pulpolux

Laser Treatments for facial scars – Do they work?

October 10, 2014 By Stephen

$fractional laser therapy for facial scars$

You see images like this all the time. But are they for real?

I have talked a lot about my facial scars on this blog.

I blame them for the resurgence of my BDD and I also blame them for the inescapable nature of the beast.

I blame them for my ugliness and my shame

I blame them for my fear of face to face casual conversation. Something I used to look forward to prior to the unfortunate events.

What is really to blame?

I am pragmatic enough to know that facial scars alone are not enough to stop anybody from doing anything, it is not the scar but my attitude towards the scar that proves disabling

That being said, I did give laser treatment a try, in hopes that it would help decrease the scar, and give me my life back.

The results?

I had 3 treatments of fractal laser on my cheek scar and my recent nose scar.

They helped some, according to my wife it was noticeable, according to me it is “what it is”, but better than nothing at all.

The shave biopsy scar on my nose is vascular so the laser didn’t help to the degree I had hoped, but time will tell, especially as the scar tissue starts to develop some more and the redness fades.

The Paucity of Information on Facial Scars

As a medical practitioner I have been horrified by the lack of information there is on facial scars and facial scar treatments.

It is something we didn’t learn about in our medical training. We learned how to do very basic interrupted sutures, we learned how to take these out later.

But facial scars last a lifetime, not just the few minutes a person is in the exam room with us.

When I saw the dermatologist about the small growth on my nose he took a shave biopsy and said “no big deal”. For me it is a big deal and is having a serious impact on my life. He cut too deep and left a depressed hypertrophic scar that went into the subdermis which is vascular and now created a red circle on my nose.

When I saw the ER PA who placed 7 poorly done interrupted sutures in my face saying she wouldn’t be able to bring in a plastic surgeon, she lied and she was just trying to get me out of there as quickly as possible. This had long-term consequences and took 20 minutes of her time.

When I asked the professionals if there was anything I could do to make these facial scars better they said no.

When I went online to do some research I found that laser therapy done early can have a big impact, done later (in my case 18 months) it is not nearly as effective.

I also found out that you do not need to close a wound so quickly, in the case of a facial laceration there are techniques that can drastically reduce scaring especially with appropriate follow-up care. So I could have walked out of that ER and waited for a plastic surgeon who could have provided me with a much better outcome.

Lying to my Face

People have a tendency to act like they know all the answers even when they don’t.

I now really regret consulting a dermatologist about my scars. The dermatologist I saw had no idea bout laser therapy but said it would change my skin pigmentation, that it would make it worse, that there was nothing that could be done.

Of course none of this was true. She knew nothing about laser treatment and was speaking out of her ass.

I got a free consult a year later and that is when I found out there are options.

Laser Therapy

I assume there are good laser treatment centers and bad ones. I found one simply by using Google, calling and signing up for a free consultation. The nurse who runs the fractal laser machine sat down with me and right away said I could see a 30% improvement of my deep cheek scar and probably some noticeable improvement on my nose as well. It would take multiple treatments and it was $50 per treatment. Very reasonable!

The treatments took 10 minutes each, Each treatment was separated by 30 days but a minimum of 2 weeks is necessary, and like I said, there has been improvement.

How much of this was from the laser versus simply time, I will never know.

I will post pictures here in due time, when I am ready.

But, if you have had any type of facial scaring I would say at least for now, that you should consult a laser treatment center to see if there is something they can do. You really have nothing to lose.

Some Recommendations for Laser Therapy and Facial Scars

Try to find a center that will give you a free consult. Ask how long they have been doing their job, what their experience is with treating these types of scars.
The nurse who did my 3 treatments was amazing. She promised me she could not make it worse (which was my biggest fear) and she was right. It did only get better. I trusted her, and I trusted her judgement.
If you have a recent scar, also it is a good time to seek consult maybe 2 weeks or so after they have pulled the stitches. The fractal lasers can promote colleen synthesis and speed up healing, so often, as was in my case, sooner is better than later.

I caution you against believing medical practitioners, even specialists such as dermatologists regarding laser treatments. They know nothing about laser therapy and they will lead you astray. Contact a specialist or even a plastics office that does laser treatments and see your options.

There is some hope out there if you have had facial scaring. Yes, I still have BDD, but seeing improvement in my scars has helped, and I think this is a much better option than scar revisions or plastic surgery, which often can make matters worse!

Just look at Michael Jackson.