Wednesday, September 13, 2006

New Derm

For twelve years I had the same dermatologist. Then I moved to the Portland area, now the Los Angeles area. Each time I moved I faced the fear of finding a new dermatologist. Last week I visited Kaiser Baldwin Park to meet my new derm. To my surprise I liked him a lot! He understood my condition and shared about working with worse cases. I know there are worse cases out there, but I hadn't really thought too hard about it. I could've felt smacked in the face for whining and complaining so much in the past over my less than horrendous case of psoriasis, but I didn't. I felt thankful and glad that it wasn't worse. Usually telling someone who is suffering that it could be worse only backfires. This time it worked for me.

He will keep me on Cyclosporine for the year, then maybe cycle into Enbrel again. Also ramp back up on sunlight and topicals. Perhaps it will be effective this time around? Now at exactly three months on Cyclosporine, I am starting to improve again. The cycles continue, but the stress is much less now that we are settling down. My bp is actually lower than normal, around 120/65! Triglycerides, 296; Cholesterol, 212; Creatinine 0.9. Might start a new diet too. We'll see, I'm not totatlly sold on it yet.

Psoriasis and Moving

[Originally written 8/30/06]

From about week 6 to now, week 11, the psoriasis has been up and down. Sometimes it flattens and the color of the sores begin to resolve. Other times the lesions become quite red and raised. Very few of the original lesions are actually gone completely. I had expected these five weeks on the cyclosporine therapy to bring near complete clearing. But it seems that I have hit a plateau. Sideways. No forward progress.

However, my condition today is at least 50% better, if not more, than when I first started. The side effects are tolerable, any changes in blood work or blood pressure is inconsequential over a relatively short time. Why am I so obsessed with clearing? Certainly my expectations and prior experience have something to do with it.

Last time around I was clear by now. I ramped quickly up to 350mg of Neoral (or about 5.0 mg/kg/day). Dr. Koo suggested that dose and felt that I should have no less than that much. This time around, since I am in the process of moving and settling down, I haven’t had regular access to my dermatologists. Without closer supervision I feel uneasy to increase the dose on my own.

No doubt moving from the Northwest AND Northern California to Southern California has created enough stress to cause me to break out. Having peace in my heart and mind about psoriasis--and other aspects of my life--will help my overall health. I always felt that if I had enough drugs then I could live whatever lifestyle I wanted. Now I see how foolish that path is.