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Thin Skin

 

Butterfly has bumps all over her body. She’s an eleven and a half year old Lhasa Apso, and the doctor says these bumps are normal for her age and breed. One of the bumps is like a tiny pink mushroom growing from her neck. Some of the bumps are small and rounded, above her tail, under her ear, at her hip. But one of the bumps looks like a cauliflower, and it bleeds every once in a while. It may simply be that her taller bumps get nicked when she goes to the groomer, or she scratches them, or bangs them into things accidentally, but from the very beginning, I worried about it. Butterfly’s skin is a light pink, with brown age spots hidden under her white hair, which, along with her bumps, is only really visible when she has a bath and her hair becomes translucent for a moment. I used to count her bumps obsessively before each vet visit, to report on any changes, and find out if this or that one was suddenly going to kill her.

021

Butterfly’s big bump.

The fact is, though, despite her bumps and heart problems and diabetes, Butterfly is pretty hardy. She doesn’t sprain her ankles or tweak her back or whine when she gets her twice daily blood tests and insulin shots, and her feelings don’t get hurt easily. She doesn’t like having her hair messed with though; that’s something she learned from Cricket. She learns a lot from Cricket.

013

“Are we going for walkies yet?”

Cricket is more sensitive. She thinks having the goop removed from under her eye is torture beyond canine endurance. She hears and reacts to every noise in the world. If she eats a little too much, or the wrong thing, it shows up in her digestion and her mood.

010

“Are you talking about me again?”

I have Psoriasis and I am hypothyroid (both since I was a teenager), so my skin has always been sensitive and easily scarred. I have a scratch on my wrist from October that never healed, and just starts to itch out of the blue every once in a while. I’ve read too much of the bible in my lifetime, so I end up feeling like my skin, and my health overall, makes me a leper. But I also, still, have figuratively thin skin to go with the literal kind. If someone tells me that I’m lazy or untalented, I take it to heart. I can build myself back up again, but it takes days or weeks, instead of minutes or seconds, the way it should.

At my last doctor’s appointment, my GP decided to test me for Lyme disease again. I’ve been tested for everything over the years, multiple times. This time around, the preliminary test for Lyme came out negative, but my doctor decided to go on and do the confirmatory test anyway, and that showed that I was positive for Lyme disease in the past, even though I’ve never had a positive Lyme test before, in almost ten years of testing. The doctor wasn’t sure what to make of these results and told me to go to an infectious disease specialist to check it out. I may have dragged my feet and whined a bit, but I went.

In the meantime, my mom went to Google and found that there are mixed opinions about Lyme disease and Chronic Lyme, and the validity of these blood tests, or lack thereof. There’s also, her googling suggested, the possibility that a positive blood test for Lyme, like mine, could be an indicator for some other virus or disease process, as a signal for further testing.

I went to the new doctor, he looked at my blood tests and crossed his eyes and said that he would never have sent my blood out for the confirmatory test, after negatives on the preliminary tests, because of the risk of false positives. He said it five times, in answer to five different questions from me, as if he couldn’t hear me, or had no other answers to give. He said that there was no point in re-doing the test because it would either be negative, or another false positive, because I had no risk factors for Lyme. He had no interest in my medical history, and no curiosity about other possible diagnoses to explain my symptoms.

The fact is, I thought this was a long shot, and didn’t have much hope that a strange doctor would take any of it seriously, but I’m annoyed that I had to go through the motions, just to prove that I’m doing everything possible and not being passive. I am not comfortable with theories that come with no proof at all and seem to be, at best, placebo level positive results (30%), but I’m also not comfortable with the rigidity of western medicine, which prefers to blame the patient when problems can’t be solved, instead of taking on the problem and studying it further.

It’s a relief, instead, to take care of the dogs. When they have symptoms, their doctors believe them, and believe me, and treatments are offered, when possible, and pain and comfort are considered. Maybe, when dogs start suffering from whatever it is I have, the veterinarians will figure out the cause, and treatment, and the doctors for humans will finally take me seriously. But probably not.

010

Harrumph.

 

 

 

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About rachelmankowitz

I am a fiction writer, a writing coach, and an obsessive chronicler of my dogs' lives.

96 responses »

  1. I go to doctors as seldom as possible but my dogs? We’re there for every little thing. I met a woman a year or so ago who is on the board of NYC’s Animal Medical Center. She said Sloan Kettering is working with them on pet cancers. Amazing.

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  2. My geriatric (16+) pups have loads of warts and other bumps and lumps. As for that doctor, what a jerk. You weren’t there for fun; he should take his quibbles to your referring physician.

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  3. Thanks for your beautiful presentation. Congrats.Please read ENVIUS THOUGHTS in https://nvsr.wordpress.com if time permits.

    Reply
  4. I wish Dr Atkinson was still alive and able to see you. He was Australia’s Sherlock Holmes of family medicine.

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  5. My elderly neighbor used to be a dog groomer and one of her dogs has a similar skin condition. Marianne puts vinegar on a cotton ball and holds it on the bump for a few minutes each day — I have not make comparisons of these bumps, but Marianne claims the treatment is working.
    As per your psoriasis, have you tried arnica? I discovered that while we were overseas and it seems to improve my skin’s condition … I don’t have psoriasis, but am prone to dry skin. Coconut oil helps, too.

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  6. They are our babies. Love them.

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  7. The modern medical profession-Ka Ching-let the cash register ring. The old Chinese system was better, you pay doctor when well-you sick he fix for free.

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  8. What a delightful post (the dog part that is)! I absolutely love the way you describe Cricket! It’s a glimpse directly into her thoughts. Butterfly’s bumps – stressful I know even though the vet says normal. I had a dog, Kelly Sue, who developed bumps as she hit the decade mark. Didn’t see them at first because she had thick black fur. I was new to this state and my new vet told me to pour peroxide on them. I did it once and she had reddish blonde fur in the areas. Needless to say I found another new vet. Lymes Disease can be debilitating with long term effects if untreated or treated in late stages (hubby had it in 1996). However one usually has some type of symptoms if not the typical “butterfly” rash. I’m a nurse but get very annoyed with doctors. I feel that to many we are a diagnosis code as opposed to a person with real concerns and valid questions. Some I feel are extremely condescending and like others have posted, wish they were more like my veterinarian.

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    • Duhhhh@me! I really should have thought about my wording before I posted. Truth be told I’m having a bit of angst this evening over one of my dogs (all is well however). I wanted to comment on what you wrote about having thin skin figuratively for I am the same. Most people don’t realize it because I’ve mastered the art of disguising my feelings as well as perfecting my repertoire of sarcasm. Beneath it all however my skin is like parchment paper in that a slight criticism tears through and stings far longer than it should. Keep hoping I’ll outgrow it but hasn’t happened yet so my hope has faded and I’ve accepted that it’s my destiny. Guess it could be worse but at times ……

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      • Cricket and I have a deal: I will fight for her, and she will fight for me. That way, if we’re being attacked and feel too scared to stand up for ourselves, we know someone is there to speak for us.

    • The amazing thing about the veterinarians my dogs have gone to lately is that they take anxiety and other mood and comfort issues very seriously. And they ask questions about what they eat and how much energy they have and on and on, and take that seriously too. They never tell me the dogs are fine when they’re not. It’s an incredible relief.

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  9. After a merry-go-round of doctors over a period of several years, it finally dawned on me that I wasn’t going to find an answer for my medical dilemmas and that my task was to adapt to my body as it was – wade through the dinner buffet of medicines, sift the Old Testament wheat from the chaff and take the pills that came closest to improving my mood and my ability to function. Beyond that, take naps in the afternoon whenever possible and love your dogs with every fiber of your being. They are the best medicine of all.

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  10. the doggies look
    well loved
    & cared for 🙂

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  11. I wish I could go to a Veterinarian for myself, or a Pediatrician. I love the way the Vet treats my dogs, and I love the way the Pediatrician used to treat my kids. Wish I could find a big-person doctor that was the same way.

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    • Exactly. I wonder if there’s something missing in the training for doctors for humans. Maybe the answer would be to make sure medical students spend enough time playing with puppies during their schooling, to help them keep their humanity.

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  12. What a sweetheart! I had a dog Ellie with recurring tumors. I found a special vet Doctor, Harold Guerney from Aspen clinic in Conifer CO who has developed a form of molecular therapy for dog tumors. It uses subcutaneous daily injections of a special formula. After 3 years of treatment, at one point Ellie had a tumor over her eye that turned overnight into a skin flap.

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  13. sallyinthehaven

    I have always thought we might all be better off going to a vet for our own ailments rather than going to a doctor. Every vet I have visited has listened to everything I have said, been sympathetic, interested and taken my concerns seriously – can’t say that about every doctor I have ever been to. Hugs to you all.

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  14. I wish your doctor hadn’t been such a jerk :(. I’m glad that you can count on the vet. 🙂

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  15. Oh my gosh, this brought back memories of a doctor who couldn’t fix me and told me I must be sick because I wanted to be sick. You have my fullest sympathies for the work you are having to put into unraveling your own medical mysteries!

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  16. Wouldn’t it be nice to go to a doctor who actually listened to what you are saying? Hang in there, Rachel!

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  17. I too have psoriasis – did you know Jews have a higher proportion of psoriasis? Strange cos its a religion, not a race! I find if I keep off milk – the casein part of milk – it helps keep it at bay. Pork too, and any kind of shellfish (although Im Jewish by blood, Im Catholic by upbringing! So I used to eat pork.)
    I was made very sick by the medicine/poisons the Drs gave me, so maybe its best you dont let them give you anything at all!
    I infinitely prefer to go to the vets for my own health care!

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    • I actually know a lot of Jewish people who are allergic to shellfish. Wouldn’t it be crazy if some of the rules of Kashrut were actually for the benefit of our health?!!! Or maybe it’s just that, after generations of skipping certain foods, our genes aren’t equipped to digest them.

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      • I’ve certainly always thought the rules on pork were for the benefit of our health. Here in Africa, where it’s hot, porks spoils very quickly – imagine desert dwellers trying to preserve it! And certainly, we share similar digestion and therefore pathogens! As to shellfish, I cant eat them at all and don’t even like the tiny taste I have had of them!

  18. We get rashes too if our fur gets wet and we’re not dried properly – there’s a cream for that we use. Thank goodness we all look after each other and have lovely vets who treat us so well. Pip

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  19. Maggie has lumps and bumps under the skin, though her surgery last year was for something completely different and out of the norm which we noticed practically immediately. She has fully recovered and you’d never know.
    I’m not happy going to a GP for anything these days as there is no continuance of care and basically it’s a pill and goodbye. At least I’m building up a rapport with my current GP, insisting on seeing her each time. I’m lucky that I;m rarely ill, those these past few months it feels like I’m having everything in one go! The slimming programme I’m on is going to be an interesting exercise, especially as my progress will be reported back to the surgery. Not all of us tick the preferred boxes on their tick list, and until GPs see us as individuals (as vets do with our pets), pills are not the answer. 🙂

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  20. Another great post Rachel. In spite of your comments indicating you are a big chicken, you always bravely share your most personal difficulties. I gave up on western doctors years ago, only use them when in extremis. I think because veterinarians must diagnose with the help of pet owner’s, since pets can’t describe their own complaints, there is a much stronger sense of cooperation and collaboration. With doctors it’s more like being in the army, they just expect you to follow orders. Specialists are the worst, their focus is strictly on one compartmentalized little segment.

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  21. I absolutely agree that animal doctors show interest in their patients, their general condition and ailments, they like to help and really care. Sadly, most human doctors seem bored with our problems, they care more for their fees.

    I sympathize with Butterfly. She’s a Superpup !! My mum is a diabetic and she hates having her fingers pricked for blood tests daily.

    I’ve had problems with dairy products since I was a child, but no doctor ever mentioned the possibility of an allergy or aversion. A few years ago, during a five-month trip to Asia I decided to cut it out completely and it really worked. Perhaps you could try some alternative method for your problem, like monitoring your diet for reactions, try eating more fish, drinking more water, have more natural vitamins in your diet, and definitely cut out on sugar and dairy products.

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  22. My Cocker had tons of warts and lumps as she aged, and yes, sometimes the groomer would nick them causing them to bleed. Just like us, our dog’s skin gets a little worse for wear as we age.

    I, too, am hypothyroid and have been on medication since I was 12. I too have skin issues. But what I have found (I’m 56 now so like you, I’ve dealt with this for a long time) is that my skin is worse when either I need a new thyroid medication or an adjustment. Usually, it is when I need a new one.

    I will tell you that doctors will do your test and tell you that you test fine and not believe the skin and thyroid are related. It has happened to me more than once. But the one time, my skin was so bad, I stopped taking my medication and in a few weeks, my rash was gone. I went back to the doctor and told him I stopped taking my medication and the rash was gone, now give me a different med. He did.

    My current doc, I had to tell her I needed more because despite my blood test, I was tired, grouchy, gaining weight and my rash was back. She agreed to up it a little, not much, and things improved. I told her, “Look, I don’t want to be in the middle of the normal range. I feel best when my test results are at the top of the normal range.”

    If your PCP is not getting it done, ask to go to a endocrinologist.

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    • My PCP has actually been more responsive than most of the endocrinologists I’ve been to. Doctors just wear me out. Butterfly thinks that her lickies are the best treatment for my skin. I can’t argue with that.

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  23. I am sorry you had this bad experience. I am NOT, however, greatly surprised. In today’s medicine, even with all the advances and knowledge, in my opinion a couple of things have been left out. One is the empathy and caring about a given patient and the other the need to know the answer. Not all physicians are lacking these necessary skills of course, but there are still a significant number who are. With jobs like being a police person, there are a lot of psychological tests to determine who is and is not suited to do that job, and so should there be with doctors. If a person lacks the interest in pursuing an answer, maybe they should do something else and those who go into medicine simply to make a lot of money should be banned. It’s very sad to me that as you said, you didn’t have much hope that a strange doctor would be interested in finding out why in your case. I hope you do find a doctor who doesn’t just accept the false positive theory, but listens to YOU and then decides based on what’s happening with you. The doggies are darling and thanks for brightening my Sunday with them. 😃

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    • I love the idea of a personality test or some such for medical students. As it stands, we decide who gets into medical school based on how well they do in their undergraduate academics, but being a good student doesn’t mean that you are curious or empathetic in the ways a doctor should be.

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  24. I try to keep my family and myself away from doctors as much as possible anymore. Much of Western medicine pays homage to the money God and our animals are now being subjected to everything human for the same idol. I am excited about integrated medicine which is about a whole person approach mind, body and spirit. Disease is dis-ease and usually if you get to the core of what is troubling spirit you have a hope of curing the tangible body. Thanks for sharing your experience.

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  25. You don’t need another opinion from me. Instead, I’d like to say from my heart to yours, Butterfly is getting what no doctor can give her, an incredibly loving and responsible mamma. Bless your sweet heart. ❤

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  26. Dear, there’s only one thing I can say after being in the healthcare field for over 20 years: our system sucks! Period. I’m sorry you have to go through all this and be left hanging. Especially with the worry of Lyme disease. I feel your pain… xo

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  27. I wish I could have a doctor or something to recommend you. You are a very nice person and a talented writer. My dog also has those bumps and I need to keep an eye on her because she scratches some times. You are also a wonderful dog mom. Keep your spirit up like you do. Sending positive thoughts your way.

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  28. Zush is 14 and has cauliflower lumps that she picks on when she suffers angst from her sister…lol…serious, my vet says as long as I keep an inventory of her stuff and any changes, we’re good.Love to you and Butterfly and Cricket! ❤

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  29. I’ve definitely had a lot of my clients come to me with their own human medical issues. The little pink, fleshy bumps are annoying for sure, especially when they nick and bleed. I had a few clients whose dogs had so many that we sedated and removed as many as I could. Always did bloodwork ahead of time and used injectable anesthesia that could be reversed if I needed it. Of course, in a larger city that would be hundreds and hundreds of dollars and they would want to use gas anesthesia (more $$) but in my clinics it made for some happy clients and pups. Keep on what you’re doing and definitely note new ones to the vet!

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    • Butterfly had one of her bumps removes before we got her, when she was almost eight years old, but her vet doesn’t want to risk any kind of anesthesia anymore, and I’m fine with that. As long as the bumps don’t bother Butterfly, and they don’t grow and scare the crap out of me, we’re cool.

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  30. Most older dogs get lumps and bumps, and much of the time they’re not serious.
    Chicki sympathises in the matter of grooming, especially around the face and legs. Tummy is okay, and so is her back, but her displeasure at brushes, scissors or anything else near her face and legs can be quite daunting.

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  31. Ever try a naturopath? They are way more likely to listen to what your body is trying to tell you than an MD.

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    • I’ve tried a bunch of different avenues, but I have to stick to the ones that are covered by my health insurance at this point. Early on, I went out of network, thinking the next doctor would be the one to figure it all out; but I was always wrong, and it got to be very expensive.

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  32. Choppy got a bump behind her ear this year. Did I immediately bring it up at her annual checkup? You bet I did (it was nothing to worry about, which I had pretty much decided after consulting the fount of all information, the Internet. Still, good to have confirmation.)

    As for the specialist, it sounds odd that he just immediately discounted the previous tests, particularly if there is a chance a false positive indicates some other problem.

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  33. Have you investigated Chronic Fatigue Syndrome? It is also very difficult to diagnose. But I believe the singer Cher was diagnosed with it. I hope you get well soon. Love, Maggie (the Pitbull) Woof!

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  34. So well said! I have had similar experiences with medical issues.

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  35. My dog has the same califlower type lump. My vet said it was nothing to worry about too. My old dog, who was 15 when she passed away, had all sorts of little lumps on her body for years and seemed fine. They never bothered her. The vet said it’s normal for an older dog. I hope I’ve helped to ease your concerns?

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  36. Max is a bit lumpy too. I tend to have them checked if they get too big, hold my breath and then cry when Dr. Dave pronounces yet another lipoma.
    You, however, should keep screaming about Lyme – it’s evil and frequently misdiagnosed.

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  37. Bilbo has a few lumps and so far they seem to be nothing. I found one in my arm and after envisaging all sorts of dire causes, it turned out to be an accumulation of fat a lipo something. Phew!
    My thoughts, given you thyroid situation, woud be to look at auto-immune diseases which are notoriously difficult to diagnose. I have quite a few skin problems with the dermatomyositis but I also get ezcema and it’s winter here and I can’t help myself from getting in the shower and turning the heat up. My husband has a terrible skin thing where his skin thickens and cracks and gets very painful.
    We get your feelings of leprosy.
    Hope you’re getting a few answers and some respect.
    xx Rowena

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  38. Wasn’t it Job who had all those health issues? Hope yours turn out to be false alarms. The growths in Clare’s mouth were just lumps. She is now 11 and perhaps we grow lumpy as we beome older?

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  39. Christine's Journey To Weight Loss!

    My old dog had the same bumps and she wasn’t Lhasa Apso. She was cocker spaniel Shih Tzu, and my Aunties had just Shih Tzu and the all have those bumps. As they were old, there is nothing we can do about it.

    My old do only had one or two but my auntie’s dog has more then 4 of them and they were leaking and smelly. But they were not hurting the dog.

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  40. I don’t know what your options are as far as insurance etc, but if possible, I would try changing to a different provider or at least requesting a second opinion. Our health is too important to be dealing with a**holes…

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  41. Lyme Disease seems to be one of those ones doctors fight about. I know there are some who don’t even believe it exists. It’s never good to be “an interesting case” in medicine, unfortunately.

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  42. I totally understand about the disinterested attitude of some doctors. I had been telling mine for a few years that I thought I had chronic fatigue, that I couldn’t sleep, that all my joints and muscles ached and that I felt like I was dying. It took an ENT to figure out the reason for all these symptoms. It turns out I have central sleep apnea and my brain does not tell my lungs to breath when i fall asleep,so i awaken over 81 times in 1 hour. I have been falling asleep in my cereal bowl, at red lights, in meetings. But She is so kind and understanding, and says once I get this machine to help me breath, I will be a new person! Bring it ON!!! Thank you for looking at my blog…zzzzzzz……

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  43. Found this link to home remedies for skin conditions – for humans, but I would think they could also have value for pets: http://trendingpost.net/trending-health-news/get-rid-of-warts-skin-tags-age-sports-blackheads/?utm_source=SC&utm_medium=140&utm_campaign=2443

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  44. Don’t lose hope on your own search for medical understanding. Remember that no physician on earth knows your body as well as you do. A doctor is simply a consultant you use when you know something is wrong, but don’t know what it is. Failure to find the cause is theirs, not yours.

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  45. I do think there’s lots of inefficiency and “waste” in the US medical health system, and unfortunately false positives for tests are not as uncommon. Better to get minimally tested! =)

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  46. I had to keep reading. Were you writing about me? 🙂

    Reply

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