Appointment Update .....

The dermo. appt. this afternoon was okay. I waited almost 1 ½ hrs. to see her. Wash U always operates with a patient seeing a PA first and then he/she goes and talks to the dr. and then the MD spends 5-8 minutes with you. It is not my favorite means of conducting an appt., but that is just how they nearly all do it. You never know what the PA is or is not conveying to the physician. It is like a cattle heard going in and out of the office door.

She agreed that the skin is a mess. (I had a big bleeding incident in the car on the way to see her, so redness was at its peak). Like everyone else, she said that the skin “should” heal and remain closed …. there is nothing that you can say to make them think otherwise on the first appointment. It may or may not be an allergic reaction – she said we’ll never really know. Her thoughts were that the skin is so incredibly thin that it breaks down with very little pressure (towel drying, clothing touching it, sock, shoe touching it, etc.) and then it struggles to heal itself. She thought I was itching it while sleeping …. if so I have no recollection of it!

She first suggested this treatment called an unna boot. Basically it is cream medication that is put all over the area and then the entire foot is tightly wrapped in this cast like material and it stays completely covered for up to 6 weeks. It is checked and re-wrapped weekly, can’t drive with it on and would involve weekly office visits ($50 co-pay each visit) for 6-8 weeks. The cast material is supposed to help w/any vascular/healing issues. Not sure what you wear for shoe wear, but a normal shoe would not work. She wanted to put it on today, but that would mean that I’d need to come back on Fri. for a 72 hr. re-check & I am out of town on Friday, so we temporarily held on trying that approach.

I had brought a list of 14 creams that we had already tried. I asked if there was any other cream. She suggested another cream corticosteroid Rx, so we’re going to use that for 1 week and I’m supposed to see her again next Wednesday.

Everyone has a different opinion on this, because another dr. had previously told me that yes the skin is thin on the top of my foot, but not so thin that it should be breaking open & bleeding. I think she thought I had let this problem go on for too long, but we’ve been trying to solve it!

We’ll see what happens I guess ….. She wasn’t in the room more than 5-8 minutes max – it was really quick. I liked her, but it was hurried. (Her husband has a private orthopedic practice, so when I see him it is not associated w/Wash U). My STL orthopod did write an Rx for more pt visits today, without seeing me, so that was good – won’t start this immediately.

Need to make slime base for kiddos working at Monsanto – gotta scoot. Thanks for praying today … will keep you updated!

je