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3.  An open letter to Paul (newly diagnosed with DH):  This is an
example of the wonderful interaction that among strangers in the
discussion group.

        I am sharing these thoughts with the list, because I bring up a
few of my own concerns that may lead to some of our enjoyable
philosophical discussions on health management and coping, as well as
celiac disease (CD) in general.

        Comparing Symptoms Is OK

        I assume you received a diagnosis from a dermatologist.
Unfortunately, as specialists who can identify DH (but tend to send you
on your way), they are not the best to educate you on your gut and how
it may be causing problems throughout your body. Any other ailments you
may experience are probably not too bizarre to be attributed to your
body's auto-immune response to gliadin (the protein in gluten grains).
It is common enough on this list to compare symptoms as earthy as
diarrhea and constipation, as seemingly unrelated as bronchitis, and as
minuscule as dry skin.

        Find Some Gut Resource Persons

        In my layperson's opinion, you should contact a local celiac
support group and ask for names of gastroenterologists who know CD and
will sit down and take a health history. You might also call the GI
Department in Charlottesville (is that UVA?). The last resort for an
adult is to quiz pediatric gastroenterologists for names of collegues
who work with adult celiacs. (I have heard it said that if a doctor
tells you that DH isn't celiac disease, find someone else.) It may be a
great relief to you to find out that this, that and the other health
problem may improve with your new diet. Also, it is good to get the
gluten antibody tests done before you are off gluten for very long.
(They are also useful later for comparison.) Then, you and the doctor
may decide that, in order to better adhere to the diet, you need a
biopsy to show both of you how your upper bowel is responding to gluten.
Again, the <before picture> becomes useful in later years. . . .

        If More Doctors Only Knew . . .

        Morbid as it seems, it is reassuring to find out that someone
else on the list or in your local support group gets a cracked lip or a
sinus infection (or whatever) when they ingest gluten. Most of the
people in support groups get GI symptoms because that is how celiac
disease is described in the Physician's Desk Reference. (In my daydreams
there are referrals from dentists!) If you don't have GI symptoms, count
yourself lucky that your skin set off the alarm. For me, my hereditary
threat of developing cancer feels smaller because I have information
that my deceased aunt, uncle and grandparents did not have.

        Waxing Theoretical

        It almost seems like the later in life we are diagnosed, the
more health concerns we have picked up. It seems that had all of us been
diagnosed soon after birth through a screening process, and put on a
gluten-free diet right away; many of our past and current health
concerns (bone, tooth and gum health, mood swings, blood sugar problems,
lactose intolerance, diabetes, rheumatoid arthritis, etc.)  mightn't
have popped up. Water under the bridge, I know, but the threat of
further health problems is a good motivator for me to be strict with
myself and to educate others, especially members of my large and
illness-plagued family. . . . .

           Happy Trails

        So Paul, it sounds like you have inherited a GI disease that
shows up dramatically on your skin. Please take care that it doesn't
show up elsewhere in years to come. To you and all the new participants:
Welcome to the list, be sure to learn how to access/receive the
archives, and happy searching! (i)