Dear Cyndy,

Dr. Peter Lou apparently is taking Monday off. He's not
in the office today and his secretary promised that he would
return my call tomorrow between patients, which he will be
seeing all day. She doesn't know exactly when I'll hear from
him.

My brother-in-law Peter McPhedran returned my call Saturday
evening. I just looked up his credentials on the Internet.
Six years younger than myself, he is now Emeritus Professor
of Laboratory Medicine and Internal Medicine at Yale. Peter
is wonderfully candid and informal, at least with me. When
I broached the diagnosis of Henoch Schoenlein Purpura, he
said he had never seen a case in an adult, "and of course,
if I haven't seen it, it doesn't exist." He promised "to do
some research in my way" and call me back. He hasn't yet.

Given Peter's extensive exposure to the pathology of diseases
associated with bleeding, that brief exchange suggests to me
that when several years ago the doctors labeled you with the
diagnosis "Henoch Schoenlein Purpura" they were, in the venerable
medical tradition, improvising a diagnosis, which would allay
your anxieties and buttress their own dignity, but that such
an rhetorical exercise is of no predictive value as to what
will happen when 5 ml. of sodium fluorescein are injected into
to your antecubital vein. My own inclination, as I wrote before,
is to consent to the injection on the grounds that it is tolerated
well by patients with the most diverse allergic manifestations,
such as urticaria and asthma. Ultimately, you will decide whether
to tell the retinal surgeon about the purpura, leaving to him
the decision how to proceed and possibly creating those obstacles
to efficient management of disease which arise when physicians 
practice "defensive medicine."

As soon as I hear from either Peter Lou or Peter McPhedran, I'll
forward their advice to you by e-mail.

Jochen