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Tuesday, March 20, 2012

Pilomatrixoma

The follow up post to our Copenhagen trip is coming, but it has been temporarily delayed.  Earlier this week as I studied my 13 year olds face, I felt an ominous maternal instinct, that the growth that I hoped was just a nasty white head, was something more nefarious.  Two years ago, my oldest daughter developed a little white head on her face, that would not go away.  It grew and changed, and after six months of us watching it with curiosity, brought her to our doctor for review.

Our family doctor, who knows her stuff, referred us to a dermatologist, who biopsied it and referred us to the plastic surgery department at the Children's Hospital.  Such an innocuous little zit ended up being a rare, benign tumor called a pilomatrixoma.  Within three weeks she had been evaluated, photographed, and scheduled for an outpatient, fully sedated, surgical excision.

Even though the surgical procedure was minor, it's location was incredibly anxiety provoking.  On her cheek in the middle of her face.  Her wonderful, beautiful perfect face that I fell in love with the moment I laid eyes on it.  Ok well after they wiped her off a little bit, and she pinked up,  and they put a little hat on her to hide her cone head, it happened pretty fast.  The surgeon said there would be a scar, but she would do everything that she could to keep it as minimal as possible.  She also told us that pilomatixomas were genetic, and once the individual had one, they had a higher rate of developing another, before the age of 18 and if we ever thought she was developing a new, to contact the doctor as soon as possible to prevent complications.

Fast forward to my now 13 year old, and another whitehead?  How many weeks had that been on her face?  I started paying more attention.   [This past weekend we gave her face a herbal steam and a clay mask to help draw out whatever was lurking beneath. If is was just stubborn acne surely that would have some visible effect.] Monday night, I studied her face as closely as I dared,possible without causing a there was no change, and my gears started spinning.  Here we go again, but this time far away from home in a system I had not yet attempted to navigate.  I admit I was hoping to avoid getting sick at all in Sweden, at least the kind of sick that would require medical attention.  I had been naively hoping to discreetly keep myself out of the Swedish medical system. OK you can stop laughing now.  I know it was naive, a  frequently wellness challenged family of five,  avoiding all doctors for 3 years, but dreams are free, even when they border on delusions.

So Tuesday I woke up before dawn, and unable to quiet my worries and return to sleep, I began to plot my course of action.  I started by calling the main medical hotline Vardguiden to speak to an on call nurse.  She connected me to the person who gave me the number of a doctors office near my home.  These are the primary care physicians known as Husläkare, 'house doctors', except I'm not sure they come to your house.  I will look into that and let you know.  Had to wait for them to open, and then called to set up an appointment.  The nurse/receptionist there informed me that there was a long wait for appointments but if I wanted to be seen right away they had open clinic each day from 8:15-9:00 and I could come and be seen by a husläkare the same day.  I had already sent my teen off to school so it would have to wait till Wednesday.

Desiring to continue to meet my anxiety with concrete action, I started calling people to figure out what I had to do.  I knew I would need a dermatologist and possibly a plastic surgeon preferably of the pediatric persuasion.  I had no idea where to start, but coincidentally we had just received our shiny new expat insurance card in the mail, just the day before, with a handy dandy 'We accept collect calls'.  I took this as a sign, and I called them to see what kind of resources they had in Sweden, to steer me in the right direction.  They turned out to not have very much information because my request was rather narrow, but the very helpful lady told me should she would put in a request for the resource team and they would start  searching for the doctors I needed.

It isn't that surprising that the insurance company had no contacts in Sweden.  If you are living legally in Sweden, you usually have a personummer (a personal number, much like a Social Security number in the States).  With that personummer you get access to education, child care, social benefits, and medical care.  No question.  No exceptions. No preexisting conditions. The only thing that private insurance may get you, is faster access, in non acute medical situations at private hospital that may have a shorter waiting period.  Honestly, it is still all a little sketchy to me how the Swedish system operates, but I now have the opportunity to learn more.  As a parent my primary question is how do I get my child the care she needs?  What are your questions about socialized medicine?


More later,
Karen

UPDATE: So my family friends don't worry, the day after I took the teen to the husläkare, she woke up with the cyst portion gone, so the odds are in our favor that it is not another tumor.  However the process of referral has been set in motion, so into the Swedish system we go.  This should be interesting.


2 comments:

  1. What kind of herbal steam did you use? Perhaps that helped the cyst portion come out? My daughter has this same condition and I am hoping for an alternative to surgery to get rid of her second one that has now appeared. Thanks so much for your story!

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  2. Hi,
    Thanks for your comment. The herbal steam was a floral chamomile combination that I had around the house, nothing too fancy. I remember it was terrible nerve racking to have the surgery the first time. Our surgeon in America said that the earlier they are removed the less chance there is of scarring, but they rarely go away without being surgically removed. The doctor in Sweden said that after age 13 it is very uncommon for a pilomatrixoma to form, and that in our case the second one was probably an infected sebaceous gland. I don't know how old you daughter is but I wish you the best of luck in helping her get better!
    Best
    Karen

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