Swollen Lip

One night a few years ago, on my way home for dinner, my lip began to swell. By the time I drove into the garage I looked like Homer Simpson. My upper lip was swollen to the size of my thumb. With my mouth closed, my upper lip covered my lower lip.

For the next few weeks my lips, fingers and toes would swell and then return to normal size for no apparent reason. The soles of my feet and my palms would itch and then, again for no apparent reason, stop itching.

I can’t be 100% sure, but sometimes my windpipe felt like it was restricted.

I spoke to my family physician who sent me to a specialist – an allergist. This guy was good. He said, we can find what’s causing it, or we can fix it. I chose the latter.

Since that time I’ve taken a little antihistamine pill every day. It’s worked. Until the last few weeks.

Once again my lip has started swelling. There’s no itching. There’s no finger or toe swelling. It’s just the lip.

Is this the same thing?

I upped the dose of antihistamine, taking two at once (and making myself very sleepy). So far, it has not stopped the swelling.

I’ve noticed this seems to happen at night, when I’m home. By that time I’m nearly 24 hours into the medication. Is it wearing out prematurely?

Recently, I’ve been eating some blackberries at night. I wonder if that’s what’s causing my trouble? It’s only a guess.

In the meantime, if they’re making a live action Simpsons feature, I’m your boy!

The Modern Diagnosis

Steffie had a pretty bad allergic reaction this weekend. It wasn’t fun for her, or for us. Your child can grow up – but she’s still your child.

As the week went on, the allergic reaction went away. That’s good.

Our family physician said Steffie should see an allergist. I called the to make an appointment with the allergist I see… or anyone in his practice. June – the earliest available appointment is June!

Popular folks these allergists.

I wasn’t sure what to do, so I sent my allergist an email, with a photo of Steffie taken while she was in the midst of the reaction. He took a look and wrote back.

His response suggested what we were already doing was right, and it wouldn’t be necessary to see him until or unless there were more problems.

I’m glad he wrote back, but this is a hell of an imposition on my part, isn’t it? Maybe it’s time to acknowledge the new era and have our insurance companies (or, shudder, me the patient) pay for this service.

As far as I can tell, when my internist or allergist gives me advice from his keyboard, he’s doing this out of the goodness of his heart – literally giving away the work he usually charges for.

My guess is, in some cases, Internet consultation is a good thing. From an insurance standpoint, isn’t this a chance to purchase a more cost effective service for their customers? Shouldn’t the physician be compensated to encourage this?

I am not a doctor (nor do I play one on television&#185). I’m sure those I know will tell me if I’m off base here.

&#185 – That line, “I’m not a doctor, but I play one on television,” was actually used in a TV commercial about 40 years ago.

Blogger’s addendum: And, my primary physician did respond:

If there were something that were more than 100%, I’d agree with you that much. Does the accountant or lawyer or guy at the gas pump EVER give it away for free? I think that our ethic and culture is different, though. Medicine is rightly called a “caring profession.” and when we care, we really do care. So we do it, without listening for the sound of the cash register ringing.

And don’t hold your breath waiting to hear that Aetna or Anthem or, God forbid, Medicare will ever pay me or your allergist for giving you email or even telephone advice. Not in my lifetime, and I plan to torture all of you for many years to come.

Speared Against The Flu

Last week, the television station offered free flu shots. I signed up and then promptly forgot about it when the magic day came.

So, today, following in the footsteps of my wife and daughter, I drove down to my doctor’s office. I call him Steve. He wants to be called Steve. He’s been my doctor for almost 20 years… so Steve seems right.

Helaine, on the other hand, feels better medicine comes from someone with no first name other than ‘Dr.’

There’s really no way I could know if he’s really a good doctor, except to know that he’s smart… and smart counts for a lot in medicine and everything else. And, he’s a good person with a warm heart. There aren’t too many other people I’ve trusted with my life for nearly twenty years. I have never had a second thought.

His outer office was crowded… others getting their shots.

I remember, as a kid, Dr. Levy’s office back home in Flushing. Sidney Levy, MD was our family physician. His wife was his nurse and pretty much ran the place. His office was built into his house. You couldn’t go to Dr. Levy without sitting for hours in that cramped waiting room. It always seemed like there wasn’t quite enough oxygen to go around for everyone there. And, if you weren’t sick when you got there, you could be sure someone with something comkmunicable would be sitting close by.

Dr. Levy was the first person I ever knew who had a Mercedes Benz. He called it his Moishe Benz. Being Jewish, back in the 60’s, there was still a certain uneasiness in buying German.

There were already a mother and her grown daughter when I got to Steve’s today. The daughter was doing business on her cell phone. Unfortunately, she was doing it at a level high enough to include everyone else there. After a few minutes another mother – adult child combo walked in. She was hacking away. A Dr. Levy flashback.

It didn’t take long before it was time to get my injection.

Here I am, 53 years old, and I still panic over the prospect of getting a shot. I have often thought, “How can people become IV drug users? How can anyone take a needle for a good time.”

Hopefully, I won’t get the flu this year. And, hopefully, the soreness in my right arm will soon be gone. Did I mention, I hate getting shots.


A year or so ago, one day without warning, my upper lip swelled to about the size of my thumb. It wasn’t pretty. Though I wasn’t in pain, I couldn’t work because I was scary looking (I thought about posting a photo I took at the time, but it really is gross).

From that time on, I started having episodes where my toes or fingers or lips would swell. If things weren’t swelling, they were itching, like my palms or the soles of my feet.

It wasn’t hurting me, but the swelling would come on without warning and be a distraction. And, of course, I was worried about the unknown. What was in me causing this?

I saw my family physician (I do tech support on his computers, he does tech support on me) who had me take a small battery of tests (probably an AAA battery) only to find nothing.

Then I went to visit the chief allergy guy at Yale/New Haven Hospital. He too could find nothing. But, he was confident, without even knowing what was wrong, that I could be treated. Not only that, he didn’t think we’d ever know what was wrong! But, it made no difference because we’d control it.

There is a great leap of faith necessary to accept a diagnosis like this… and I leapt.

He was right. I started a daily Zyrtec pill and the problems went away. Zyrtec isn’t the most expensive drug you can buy, but it’s not cheap either. My insurance company was paying a large part of the bill and my cost was $60 for 3 months.

Then Claritin left the world of prescription drugs and insurance companies started licking their lips.

With Claritin available over-the-counter, my insurance company decided to remove all the drugs like it from their formulary. Not only wasn’t Zyrtec covered anymore, neither was any generic or proprietary drug in its family. My costs were about to skyrocket.

When I last saw the allergist, I asked if there was anything cheaper to take. There was, and tonight, I got the $7 antihistimine. The pharmacist gave me a stern look and said this was an “old” drug. Though I was taking a small dose, it was powerful. Maybe I should take it at bed instead of with dinner. I might get sleepy.

Now I’m scared.

I told Helaine and she said I was crazy. Why would I let money stop me from taking something that has been incredibly effective? And, as always, she’s right.

If they don’t work, or if they knock me for a loop, I’m only a day away from changing prescriptions again. And now, my insurance company gets added to the ‘do not like’ list.