Observing rashes / At observere udslæt

The rash has special qualities. It's apparent to observers of a condition, and it's often specific to one single condition. Therefore the Erythma Migrans holds a special property and potential in not only diagnosis but also in research on Lyme disease. It's trivial that a rash means infection, but how about the case where there's a rash but the serological testing says that there is no infection? Should one trust the clinical presentation, or the serology? A rash could be shrugged off as a recent infection that has been defeated by the body. But what if the rash persists for months after a negative serological response? That's what happened to me.

At Bispebjerg Hospital in Copenhagen, I was told by a neurologist and an additional doctor that the combination of twitchy face and toes was highly indicative of infection (especially held against 6-months-earlier symptoms of summer fever with migraine and stiff neck after one identified tick bite, long developing erythma migrans and no medication because I ignorantly shrugged the risk of persistent illness off, even as I had a receipt for Doxycycline). A meeting was held on whether they should proceed to do a spinal tap. I waited in an acute emergency room, and they returned to say 'go' on the test. Hours later, when the results came back, a third neurologist entered the ward where I laid in wait for results, briefing me that the results said 'no infection', and then proceeded to give the following explanation for my symptoms: The twitches were just 'common stuff'. The rash was declared ringworm, with no closer inspection of its characteristics. Personally, I would call this step malpractice, but it follows logically from adhering to serological testing. Although you would have to accept an unreasonable string of coincidences for it to be true:

=> Tick bite
=> Random summer fever with random neck stiffness and migraine and nausea
=> Random distinctively flat ringworm rash developing slowly in size over five months without spreading to other body parts and absence of itching and absence of lightly protruding edges as is to be expected from ringworm rashes according to medical handbooks
=> Random neurological 'common twitches' to suddenly introduce themselves after lifetime of zero experience with such symptoms
=> ....

... And this is where it gets even weirder. For, as I was sent home, I continued to experience twitches more and more frequently over months, until some nights involved lightly shaking through my entire legs as I attempted to fall asleep. And what happened to the rash? It started to disappear spontaneously one day, clearing over a week or so. I had asked for a receipt for ringworm medicine but had not taken any from the tube that to this day remains full in my refrigerator. So the 'ringworm' just cleared with no medication. I have yet to consult a dermatologist on whether this miracle is common among 'ringworm'-patients ...

... So to the list of randomly coinciding occurrences, we should add ...

=> twitches intensifying over several months
=> spontaneous clearing of ringworm-infection

And the cherry on top, here are some pictures of weird skin rashes on my buttocks and around my hips. They have been there at least one year, and I thought of them as stretch marks. But all this weird stuff that's happening with me, it makes me think they should be investigated by a professional, just to know precisely what caused it.

My plan is to visit a dermatologist and ask what they are, and also whether 'ringworm' can clear spontaneously by itself, and be flat.

I've lost the ability to sweat / Jeg har mistet evnen til at svede

A few days ago, I noticed that I felt very warm. I worried that I might have caught a fever, so I took the temperature. It was a 'safe' 37,4c so I scrapped the thought and put responsibility on a high room temperature (the weather outside is GREAT these days, summer has come to town!). Then some time passed and I noticed that I didn't sweat. It felt bizarre to be so warm and yet completely dry. I'm not kidding you, I went and googled "can't sweat lyme" right away, to see if anyone with lyme disease had the same problem. You know, it's my quick'n'fun little standard reaction to bizarre body malfunctions. I found a thread about a few people with the same issue. They mentioned the thyroid as an involved cause, but I'm too unfocused to properly look into that. It's been at least a few days of feeling very hot with no sweat at all. My arm pits are dry as knees. It feels bizarre, that's my best word for it. There's a page on mayoclinic.com about the condition, and it lists progressive neurological damage as a cause, along with some other much less likely causes. It looks pretty bleak when put like that. "Progressive". I know, that's bacteria/autoimmune damage in a box, but I like to think that, as the doctor would say, I'm just stressed/anxious and that's it. By now, with the alternative of long-term IV antibiotics, I almost would prefer to live in a bubble of ignorance. Despite my total lack of stress or anxiety, haha. But ignorance can be my powerful weapon for inner peace, it feels important right now.

http://www.mayoclinic.org/diseases-conditions/anhidrosis/basics/causes/con-20033498

In Danish (with an added rant):

Beklager manglen på oversættelser. Jeg gider knapt nok, fordi google translate sikkert kan gøre et tilstrækkeligt job, og fordi jeg tvivler på at jeg har nogen kun-dansktalende læsere. Men kort sagt stoppede jeg forleden med at svede. Det virkede som feber, for varmen var det første jeg lagde mærke til. Men efter lidt tid bemærkede jeg det totale fravær af fugt på min hud. Jeg er tør som en hytte under armene, og det virker bizart. Jeg fandt en forum-tråd med andre som også har symptomet sammen med andre lyme-symptomer, hvori de nævnte skjoldbruskkirtlen som involveret. Jeg har dog ikke fokuset til at gå i dybden med det. Jeg fandt også en side på mayoclinic.org om udeblivelsen af sved. Den nævner nervesygdomme samt hudsygdomme (hvoraf jeg ikke har nogen hudsygdomme). Jeg har lyst til at besøge en infektionsmedicin-overlæge i løbet af sommeren, bare for at vise at jeg ikke forsvinder ud af systemet gratis, og for at se det overraskede ansigt. Jeg er i øvrigt afslappet og frisk mentalt, så alt det her skyldes under ingen omstændigheder stress. Jeg har en kæmpe buffer i banken og har været min egen afslappede chef i årevis, så jeg er nok Danmarks mest afstressede unge mand. De kommer ikke udenom det flåtbid i opklaringen af min pludselige fremadskridende sygdom.

Det er absurd at erythma migrans-mærket pludselig blev kaldt ringorm, bare fordi ELISA-testen kom tilbage negativt, især når den ifølge Columbia University er mindre end 80% pålidelig. Det betyder jo at hver femte der kommer ind med et fuldstændig spot-on klinisk borrelia-billede pludselig bliver stress-ringorm-syg bare fordi testen tager systematisk fejl. Det er grotesk at systemet ikke tager højde for den systematiske usikkerhed, man kunne f.eks. lade et fast antal 'negativ-testede' patienter blive anset som inficerede i overensstemmelse med upålideligheden i testen.