3.02.2016

What. Is. That!?!

I'm a pretty healthy girl. I have great genetics. I process insulin in such a way that I can eat whatever I want, whenever I want, and I'll never be fat... exact quote from my doctor. Whatever it is that I'm going to die from, it'll have nothing to do with my heart... also directly from my doctor. If I get a cough that last more than a week, I get new abs that last all summer. I am blessed in that the most I have to watch, physically, is my sun exposure. I'm pretty pleased with the lot I've been dealt in that regard. So, keeping that in mind, imagine my surprise when I discovered a hole in my arm!!

This was January 1st, and the end of March 2015... my arm was normal

Late June, of 2015, I went on a canyoneering trip to Moab, Utah. When I returned, I noticed that in the photos, there was a very strange shadow on the back of my upper arm. It was in all the pictures. I looked in the mirror, and I discovered that I really had a hole in my arm!! I felt it, and it was just what it looked like. There was no tissue in that spot! The skin there was a little bit pink right there, and it was as if someone had scooped a little chunk out of my arm! I looked at pictures of my arm the end of May, and there was nothing there. So, whatever it was, I hadn't felt a thing, and it had happened sometime within the last month! I work at a doctor's office, and the thing everyone jumped to, was questioning if I'd gotten a steroid shot in my arm. I know what those marks look like, and it's not quite the same. I also hadn't had a shot in the arm since my flu shot the previous fall, and I always get them in the other arm because I hate having to use a sore arm. That, and if it had been a shot, it was reallllllly given in the wrong spot. A shot in the arm is either given in the center of the deltoid muscle, or in the fat about halfway down the back of the arm. I'd had neither and I wasn't going to put any stock into that theory. Being that I work in a doctor's office, I am able to get several doctor's opinions at once, and nobody really had any theories other than the shot thing.

It was these pictures, and others on this trip, where I first noticed a weird shadow on my arm

I decided I'd have it checked with ultrasound. That was kind of interesting, and very informative. Apparently, in that spot, I had no fat between the muscle and skin. I just lost the fat. There was plenty covering the rest of me, but absolutely zero fat in that spot. So, what was it? How did it happen? Will it get bigger? Will I get more of them? Google is a handy tool when nobody has any clues. At first, I didn't find much, but then I looked up Lipodystrophy, and Lipoatrophy. They both mean basically the same thing, and it was the closest thing I could find to what was on my arm. It is an extremely rare disorder with no known cause, and only a few cases are reported in medical literature. Basically, it's a  degenerative condition of adipose(fat) tissue, and it can be congenital, or acquired, and can be total, partial, or localized. When it's congenital it usually happens in early childhood, and is all over, or just one half of the body. It presents with other symptoms like accelerated growth, quick aging of bones, large appetite, enlarged liver, muscle atrophy, excessive hairiness, high blood pressure, and other extreme things like that. Well, that obviously wasn't me... for lots of reasons. In acquired lipodystrophy, it spreads usually all over the body in different areas depending on type, often happens in childhood and adolescence, 'lesions' may grow in size, is sometimes caused by insulin shots, can be associated with HIV, or may be because of liver problems or autoimmune disorders. One article talked about it being present as part of a connective tissue disorder associated with lipoatrophic panniculitis, that is frequently in adults aged 20-60 years. That's a pretty wide net to cast. Another idea was that it presents with lupus erythematosis most commonly. So of course I had to look up the likelihood of me having liver disease, or lupus. You know how when you look up your symptoms online, you can be very easily convinced that you are at least the beginning stages of what will eventually lead to certain death? That was me. I had to forget about the whole thing for a month or so, and just chill. I'm not going to die because I'm missing fat in a spot on my arm. Sheesh... interwebs.

When I finally started looking at it again, I felt better about it. It hadn't changed at all in size or feel, and I was growing more comfortable with this thing that "adds character". Not that it expounds on my character at all, but whatever. So, I talked with yet another doctor in November of 2015, and she wanted to do some bloodwork. She is someone I love, adore, and respect very much. She has been a great friend, protector, and advocate. Her main concern with this hole in my arm was the thought that it might spread, and if one were to appear on my face, I might never get married! Hahaha, I kind of had to chuckle at that. If a man wants me for my face, I certainly don't want him! She has the best intentions though, so I did lots and lots of bloodwork to find out exactly the what and why. It didn't tell us much. All of it... not much at all. Well, just that my liver is fine, I don't have lupus, and I'm not going to die. But nothing conclusive about its cause and whatnot.

There was one article I happened across that said only one short line that was very relevant, and the only line I've found, to date, that definitely applies to me. It said that there has been at least one case where there was a single lesion of the upper arm. It didn't expound on it any further. I had a single lesion of the upper arm... and there was nothing else about it. Great. Thanks. I found another article that spoke of a study done on 11 patients and 5 of them had a single lesion of the upper arm. Awesome. More. Almost everything I found linked it to some kind of shot. I hadn't had any, so there was basically still no conclusive information. So, what did I do? I got on with life, figuring that it's a weird hole I'll probably have the rest of my life. I was kind of getting used to the "I wish I had fat just disappear for no reason" comments.

On the cruise in January 2016... definitely still deep, and quite pronounced

In January 2016, I went on a cruise. I took lots of pictures, and really didn't think about the hole much at all. There are a Lot of pictures of it. It's deep. It's obvious. It's weird. It is what it is. I had let it go. Then, towards the end of February, I was at Huntington Beach, in California, on a cool, windy day. The water there is quite cold all year round, but we got in anyway. When I got out, I laid on my towel in the sun to dry and soak up the rays. Don't worry, the UV index was only at a 2. After a bit, I sat up and chatted a bit. At one point, I rubbed my arms because it was getting later, and a bit colder. When I rubbed the back of my arm I felt the hole. What I actually felt was a Lot less of the hole!!! I had my girlfriend take a picture of it later, after I looked at it! It was spontaneously filling in!! It is almost gone!!! Now I did gain 4 lbs, so maybe they evenly disbursed over my body and it'll come back when I start eating salads more. Either way, it's fine, and I'll update this in a few months and say if anything new is happening. It's pretty awesome though!! It's even a bit more filled in now than it was at the beach 2 weeks ago!!

This was a few days ago, the end of February 2016... it's almost completely gone!!!
Here are a couple of the articles I did a bit of research from, for those who are interested:

http://emedicine.medscape.com/article/123125-overview
http://www.ncbi.nlm.nih.gov/pubmed/3510652










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