Re: venting AND need advice

[Guest guest]

First I would like to say I would like to slap about everyother nurse I

talk to on the phone. Yesterday my son woke up with a fever and hold his

ear @ 3 am. So I called the drs office for an appointment and left a

message saying he had an ear infection. Here is the nurse- Have you seen a

dr. Me- no, but he has an ear infection Nurse- So I am confused have you

actually seen a dr- like I don't know when my son has ear infection. anyway

thinks for letting me vent too

I ask dr's test questions- 1. What causes rosacea. If he

flushing/vascular problems or admitts he dosn't know, you may be in good

hands. If they have an old or off the wall theory than bye bye. What makes

rosacea worse- the answer should be either the main ones like

sun/heat/discomfort or idividual things, If he says chocolate, bad diet not

enough excersice than again you know he dosn't really know enough about

rosacea. Ask for short & long term goals or plans! You also want to make

sure you dicuss all health problems with him. Also ask him to sit while you

talking. You can tell a lot about drs by all these ?s. I wish you lots of

luck.

>

>To: rosacea-support

>Subject: venting AND need advice

>Date: Tue, 2 Apr 2002 09:19:23 -0800 (PST)

>

>

>I'm the one with the face on fire from yesterday. I feel better (thanks to

>liberal amounts of chilled Aveeno Baby Lotion) but still look like hell.

>Yesterday I decided to try to find a derm.

>

>

>

>First call: I asked if any of the derms there specialized in treating

>rosacea. The nurse must have decided that I was mentally challenged AND 5

>years old because she replied " Yes, they're DERMATOLOGISTS! " I resisited

>giving a smart assed response and asked if any of them specialized in the

>treatment of rosacea. She told me that dematologists were doctors who

>specialized in treating skin conditions, therefore they ALL were experts in

>treating rosacea. If my face hadn't hurt so much, I would have laughed at

>her.

>

>

>

>Second call: " Does this dermatologist specialize in the treatment of

>rosacea? " " No, he doesn't treat rosacea at all. " At first I was offended,

>but my husband pointed out that at least they weren't wasting my time or

>insulting my intelligence.

>

>

>

>Third call: Right off the bat, the nurse asked if I had ever sought

>treatment before, what topicals I had tried and whether or not I had ever

>been on oral antibiotics. If the derm is half as on the ball as the

>nurse... I see him on Monday afternoon. Dr. Carl Raque in Little Rock, AR

>-- don't suppose any of you know anything about him?

>

>

>

>Now, I need to know what questions to ask. Here's my history:

>

>I'm 41and started having rashy cheeks about 8 years ago. Saw a derm and

>was told (during one of my 5 minute long sessions) NEVER to wear make-up

>and to use Metro Gel. Metro Gel did nothing so I stopped using it. I

>eventually found this group.

>

>

>

>I'm oily and my redness is confined to my cheeks. I always have some

>papules on my lower cheeks though they are usually only mildly itchy.

>About a week ago, my entire cheeks became itchy and covered in papules and

>pustules. They have spread to my jaw, chin, eyebrows and forehead.

>

>

>

>What do I ask him?

>

>

>

>Thanks!

>

>Ruth

>

>

>

>---------------------------------

>

[Guest guest]

First I would like to say I would like to slap about everyother nurse I

talk to on the phone. Yesterday my son woke up with a fever and hold his

ear @ 3 am. So I called the drs office for an appointment and left a

message saying he had an ear infection. Here is the nurse- Have you seen a

dr. Me- no, but he has an ear infection Nurse- So I am confused have you

actually seen a dr- like I don't know when my son has ear infection. anyway

thinks for letting me vent too

I ask dr's test questions- 1. What causes rosacea. If he

flushing/vascular problems or admitts he dosn't know, you may be in good

hands. If they have an old or off the wall theory than bye bye. What makes

rosacea worse- the answer should be either the main ones like

sun/heat/discomfort or idividual things, If he says chocolate, bad diet not

enough excersice than again you know he dosn't really know enough about

rosacea. Ask for short & long term goals or plans! You also want to make

sure you dicuss all health problems with him. Also ask him to sit while you

talking. You can tell a lot about drs by all these ?s. I wish you lots of

luck.

>

>To: rosacea-support

>Subject: venting AND need advice

>Date: Tue, 2 Apr 2002 09:19:23 -0800 (PST)

>

>

>I'm the one with the face on fire from yesterday. I feel better (thanks to

>liberal amounts of chilled Aveeno Baby Lotion) but still look like hell.

>Yesterday I decided to try to find a derm.

>

>

>

>First call: I asked if any of the derms there specialized in treating

>rosacea. The nurse must have decided that I was mentally challenged AND 5

>years old because she replied " Yes, they're DERMATOLOGISTS! " I resisited

>giving a smart assed response and asked if any of them specialized in the

>treatment of rosacea. She told me that dematologists were doctors who

>specialized in treating skin conditions, therefore they ALL were experts in

>treating rosacea. If my face hadn't hurt so much, I would have laughed at

>her.

>

>

>

>Second call: " Does this dermatologist specialize in the treatment of

>rosacea? " " No, he doesn't treat rosacea at all. " At first I was offended,

>but my husband pointed out that at least they weren't wasting my time or

>insulting my intelligence.

>

>

>

>Third call: Right off the bat, the nurse asked if I had ever sought

>treatment before, what topicals I had tried and whether or not I had ever

>been on oral antibiotics. If the derm is half as on the ball as the

>nurse... I see him on Monday afternoon. Dr. Carl Raque in Little Rock, AR

>-- don't suppose any of you know anything about him?

>

>

>

>Now, I need to know what questions to ask. Here's my history:

>

>I'm 41and started having rashy cheeks about 8 years ago. Saw a derm and

>was told (during one of my 5 minute long sessions) NEVER to wear make-up

>and to use Metro Gel. Metro Gel did nothing so I stopped using it. I

>eventually found this group.

>

>

>

>I'm oily and my redness is confined to my cheeks. I always have some

>papules on my lower cheeks though they are usually only mildly itchy.

>About a week ago, my entire cheeks became itchy and covered in papules and

>pustules. They have spread to my jaw, chin, eyebrows and forehead.

>

>

>

>What do I ask him?

>

>

>

>Thanks!

>

>Ruth

>

>

>

>---------------------------------

>

[Guest guest]

First I would like to say I would like to slap about everyother nurse I

talk to on the phone. Yesterday my son woke up with a fever and hold his

ear @ 3 am. So I called the drs office for an appointment and left a

message saying he had an ear infection. Here is the nurse- Have you seen a

dr. Me- no, but he has an ear infection Nurse- So I am confused have you

actually seen a dr- like I don't know when my son has ear infection. anyway

thinks for letting me vent too

I ask dr's test questions- 1. What causes rosacea. If he

flushing/vascular problems or admitts he dosn't know, you may be in good

hands. If they have an old or off the wall theory than bye bye. What makes

rosacea worse- the answer should be either the main ones like

sun/heat/discomfort or idividual things, If he says chocolate, bad diet not

enough excersice than again you know he dosn't really know enough about

rosacea. Ask for short & long term goals or plans! You also want to make

sure you dicuss all health problems with him. Also ask him to sit while you

talking. You can tell a lot about drs by all these ?s. I wish you lots of

luck.

>

>To: rosacea-support

>Subject: venting AND need advice

>Date: Tue, 2 Apr 2002 09:19:23 -0800 (PST)

>

>

>I'm the one with the face on fire from yesterday. I feel better (thanks to

>liberal amounts of chilled Aveeno Baby Lotion) but still look like hell.

>Yesterday I decided to try to find a derm.

>

>

>

>First call: I asked if any of the derms there specialized in treating

>rosacea. The nurse must have decided that I was mentally challenged AND 5

>years old because she replied " Yes, they're DERMATOLOGISTS! " I resisited

>giving a smart assed response and asked if any of them specialized in the

>treatment of rosacea. She told me that dematologists were doctors who

>specialized in treating skin conditions, therefore they ALL were experts in

>treating rosacea. If my face hadn't hurt so much, I would have laughed at

>her.

>

>

>

>Second call: " Does this dermatologist specialize in the treatment of

>rosacea? " " No, he doesn't treat rosacea at all. " At first I was offended,

>but my husband pointed out that at least they weren't wasting my time or

>insulting my intelligence.

>

>

>

>Third call: Right off the bat, the nurse asked if I had ever sought

>treatment before, what topicals I had tried and whether or not I had ever

>been on oral antibiotics. If the derm is half as on the ball as the

>nurse... I see him on Monday afternoon. Dr. Carl Raque in Little Rock, AR

>-- don't suppose any of you know anything about him?

>

>

>

>Now, I need to know what questions to ask. Here's my history:

>

>I'm 41and started having rashy cheeks about 8 years ago. Saw a derm and

>was told (during one of my 5 minute long sessions) NEVER to wear make-up

>and to use Metro Gel. Metro Gel did nothing so I stopped using it. I

>eventually found this group.

>

>

>

>I'm oily and my redness is confined to my cheeks. I always have some

>papules on my lower cheeks though they are usually only mildly itchy.

>About a week ago, my entire cheeks became itchy and covered in papules and

>pustules. They have spread to my jaw, chin, eyebrows and forehead.

>

>

>

>What do I ask him?

>

>

>

>Thanks!

>

>Ruth

>

>

>

>---------------------------------

>

[Guest guest]

> Third call: Right off the bat, the nurse asked if I had ever

> sought treatment before, what topicals I had tried and whether

> or not I had ever been on oral antibiotics. If the derm is half

>as on the ball as the nurse... I see him on Monday afternoon.

Ruth,

As frustrating as these conversations must have been, at least you are able

to get to the derm quickly. In my area, there is a chronic lack of doctors

of any kind, starting with family doctors and the waiting times are

horrible. First of all, I need to be referred to a dermatologist by a

regular doctor, and then it is a question of time. Last year, I called in

June and got a booking for December. Last week, my dentist wanted me to see

a periodontist, so they called his office and they are now booking for

November.

Good luck with the appointment, and please report back how it went.

Alena

[Guest guest]

> Third call: Right off the bat, the nurse asked if I had ever

> sought treatment before, what topicals I had tried and whether

> or not I had ever been on oral antibiotics. If the derm is half

>as on the ball as the nurse... I see him on Monday afternoon.

Ruth,

As frustrating as these conversations must have been, at least you are able

to get to the derm quickly. In my area, there is a chronic lack of doctors

of any kind, starting with family doctors and the waiting times are

horrible. First of all, I need to be referred to a dermatologist by a

regular doctor, and then it is a question of time. Last year, I called in

June and got a booking for December. Last week, my dentist wanted me to see

a periodontist, so they called his office and they are now booking for

November.

Good luck with the appointment, and please report back how it went.

Alena

[Guest guest]

> Third call: Right off the bat, the nurse asked if I had ever

> sought treatment before, what topicals I had tried and whether

> or not I had ever been on oral antibiotics. If the derm is half

>as on the ball as the nurse... I see him on Monday afternoon.

Ruth,

As frustrating as these conversations must have been, at least you are able

to get to the derm quickly. In my area, there is a chronic lack of doctors

of any kind, starting with family doctors and the waiting times are

horrible. First of all, I need to be referred to a dermatologist by a

regular doctor, and then it is a question of time. Last year, I called in

June and got a booking for December. Last week, my dentist wanted me to see

a periodontist, so they called his office and they are now booking for

November.

Good luck with the appointment, and please report back how it went.

Alena

[Guest guest]

> First I would like to say I would like to slap about every other

> nurse I talk to on the phone

Becky, I appreciate your frustration with the nurse, but try to

understand that from her perspective, she has to report to the doctor

the reason for your phone call and appointment request. It's not

unreasonable for her to be confused when you give a medical diagnosis

( " he has an ear infection " ) as opposed to something like, " he has a

fever and is pulling at his ear, like he always does when he has an

ear infection. " That subtly makes all the difference in

communication.

> I ask dr's test questions- 1. What causes rosacea. If he

> flushing/vascular problems or admitts he dosn't know, you may be in

> good hands. If they have an old or off the wall theory than bye

> bye. What makes rosacea worse- the answer should be either the main

> ones like sun/heat/discomfort or idividual things, If he says

> chocolate, bad diet not enough excersice than again you know he

> dosn't really know enough about rosacea. Ask for short & long term

> goals or plans! You also want to make sure you dicuss all health

> problems with him. Also ask him to sit while you talking...

Those are reasonable questions for Ruth to ask, but I wouldn't

recommend " testing " a new doctor by quizzing him/her. If you want to

get a " sense " of a new dermatologist, and assuming s/he has made the

diagnosis of rosacea, you might say something like, " I understand the

cause of rosacea is unknown, but the two main theories are vascular

and immunologic. Which do you favor, or is there a third theory you

feel better explains the condition? " In other words, let the doctor

know what you know, and then let him/her tell you what s/he knows.

Don't interprete a " it's probably a combination of factors " as a

copout, since that's the most likely explanation. There's no right

answer, of course, but it should accomplish what you want while

encouraging good, open communication.

I wouldn't recommend wasting the doctor's or your time asking

information you already know or is readily available in patient

handouts, or theoretical questions that aren't going to make a

difference to your skin. It's totally reasonable for you to feel the

need to discuss this, but ask instead if there's a staff person who

can sit down with you now or by appointment, and discuss rosacea in

greater detail. Explain you have some background information from

self-study, and lots of questions about how best to manage your skin.

With the dermatologist, I would recommend understanding the

prescribed medications -- not theoretical " whys " but practical " hows "

and " whats " such as how the medication is to be used, what side

effects to look out for -- and which should be ignored as part of

therapy, which should cause you to decrease dosage or hold off for a

few days, and which should have you stop the medication completely.

Get a sense of the best you can expect from the prescribed treatment

and by what date, and a sense of the next step if this treatment

doesn't work. And ask for patient information handouts on the

medication, from the doctor and/or the pharmacist.

Asking about long range goals at the first meeting isn't as helpful

as waiting until you're set on a good treatment plan. The short term

goals is obvious -- to initially manage your symptoms, and then get

you on a maintenance plan.

Office dermatology can be a very quick specialty, since so much is

obvious to an experienced physician by just the skin's appearance and

its response to particular agents. Most visits will be under five

minutes, there's usually no medical reason to linger. A quick visit

may feel uncomfortable, especially so if you had to wait and if a

particular doctor's style isn't quickly engaging or overtly empathic,

but try not to have unrealistic expectations from a dermatologist in

that regard. On the other hand, quick care shouldn't feel like a lack

of respect, especially after several sessions. It should feel

efficient, but humane.

I very much agree with Becky that you should " test " any new doctor,

but not by asking questions. Rather, I recommend asking yourself

after several visits if this is a person you trust with your skin. Is

your skin getting better under his/her care and if not, do you have

the sense that s/he understands the lack of progress and has a

reasonable game plan?

Hope that helps. Good luck.

Marjorie

Marjorie Lazoff MD

> >From: Ruth Hooper

> >To: rosacea-support@y...

> >Subject: venting AND need advice

> >Date: Tue, 2 Apr 2002 09:19:23 -0800 (PST)

> >

> >

> >I'm the one with the face on fire from yesterday. I feel better

(thanks to

> >liberal amounts of chilled Aveeno Baby Lotion) but still look like

hell.

> >Yesterday I decided to try to find a derm.

> >

> >

> >

> >First call: I asked if any of the derms there specialized in

treating

> >rosacea. The nurse must have decided that I was mentally

challenged AND 5

> >years old because she replied " Yes, they're DERMATOLOGISTS! " I

resisited

> >giving a smart assed response and asked if any of them specialized

in the

> >treatment of rosacea. She told me that dematologists were doctors

who

> >specialized in treating skin conditions, therefore they ALL were

experts in

> >treating rosacea. If my face hadn't hurt so much, I would have

laughed at

> >her.

> >

> >

> >

> >Second call: " Does this dermatologist specialize in the treatment

of

> >rosacea? " " No, he doesn't treat rosacea at all. " At first I was

offended,

> >but my husband pointed out that at least they weren't wasting my

time or

> >insulting my intelligence.

> >

> >

> >

> >Third call: Right off the bat, the nurse asked if I had ever

sought

> >treatment before, what topicals I had tried and whether or not I

had ever

> >been on oral antibiotics. If the derm is half as on the ball as

the

> >nurse... I see him on Monday afternoon. Dr. Carl Raque in Little

Rock, AR

> >-- don't suppose any of you know anything about him?

> >

> >

> >

> >Now, I need to know what questions to ask. Here's my history:

> >

> >I'm 41and started having rashy cheeks about 8 years ago. Saw a

derm and

> >was told (during one of my 5 minute long sessions) NEVER to wear

make-up

> >and to use Metro Gel. Metro Gel did nothing so I stopped using

it. I

> >eventually found this group.

> >

> >

> >

> >I'm oily and my redness is confined to my cheeks. I always have

some

> >papules on my lower cheeks though they are usually only mildly

itchy.

> >About a week ago, my entire cheeks became itchy and covered in

papules and

> >pustules. They have spread to my jaw, chin, eyebrows and forehead.

> >

> >

> >

> >What do I ask him?

> >

> >

> >

> >Thanks!

> >

> >Ruth

> >

> >

> >

> >---------------------------------

> >

[Guest guest]

> First I would like to say I would like to slap about every other

> nurse I talk to on the phone

Becky, I appreciate your frustration with the nurse, but try to

understand that from her perspective, she has to report to the doctor

the reason for your phone call and appointment request. It's not

unreasonable for her to be confused when you give a medical diagnosis

( " he has an ear infection " ) as opposed to something like, " he has a

fever and is pulling at his ear, like he always does when he has an

ear infection. " That subtly makes all the difference in

communication.

> I ask dr's test questions- 1. What causes rosacea. If he

> flushing/vascular problems or admitts he dosn't know, you may be in

> good hands. If they have an old or off the wall theory than bye

> bye. What makes rosacea worse- the answer should be either the main

> ones like sun/heat/discomfort or idividual things, If he says

> chocolate, bad diet not enough excersice than again you know he

> dosn't really know enough about rosacea. Ask for short & long term

> goals or plans! You also want to make sure you dicuss all health

> problems with him. Also ask him to sit while you talking...

Those are reasonable questions for Ruth to ask, but I wouldn't

recommend " testing " a new doctor by quizzing him/her. If you want to

get a " sense " of a new dermatologist, and assuming s/he has made the

diagnosis of rosacea, you might say something like, " I understand the

cause of rosacea is unknown, but the two main theories are vascular

and immunologic. Which do you favor, or is there a third theory you

feel better explains the condition? " In other words, let the doctor

know what you know, and then let him/her tell you what s/he knows.

Don't interprete a " it's probably a combination of factors " as a

copout, since that's the most likely explanation. There's no right

answer, of course, but it should accomplish what you want while

encouraging good, open communication.

I wouldn't recommend wasting the doctor's or your time asking

information you already know or is readily available in patient

handouts, or theoretical questions that aren't going to make a

difference to your skin. It's totally reasonable for you to feel the

need to discuss this, but ask instead if there's a staff person who

can sit down with you now or by appointment, and discuss rosacea in

greater detail. Explain you have some background information from

self-study, and lots of questions about how best to manage your skin.

With the dermatologist, I would recommend understanding the

prescribed medications -- not theoretical " whys " but practical " hows "

and " whats " such as how the medication is to be used, what side

effects to look out for -- and which should be ignored as part of

therapy, which should cause you to decrease dosage or hold off for a

few days, and which should have you stop the medication completely.

Get a sense of the best you can expect from the prescribed treatment

and by what date, and a sense of the next step if this treatment

doesn't work. And ask for patient information handouts on the

medication, from the doctor and/or the pharmacist.

Asking about long range goals at the first meeting isn't as helpful

as waiting until you're set on a good treatment plan. The short term

goals is obvious -- to initially manage your symptoms, and then get

you on a maintenance plan.

Office dermatology can be a very quick specialty, since so much is

obvious to an experienced physician by just the skin's appearance and

its response to particular agents. Most visits will be under five

minutes, there's usually no medical reason to linger. A quick visit

may feel uncomfortable, especially so if you had to wait and if a

particular doctor's style isn't quickly engaging or overtly empathic,

but try not to have unrealistic expectations from a dermatologist in

that regard. On the other hand, quick care shouldn't feel like a lack

of respect, especially after several sessions. It should feel

efficient, but humane.

I very much agree with Becky that you should " test " any new doctor,

but not by asking questions. Rather, I recommend asking yourself

after several visits if this is a person you trust with your skin. Is

your skin getting better under his/her care and if not, do you have

the sense that s/he understands the lack of progress and has a

reasonable game plan?

Hope that helps. Good luck.

Marjorie

Marjorie Lazoff MD

> >From: Ruth Hooper

> >To: rosacea-support@y...

> >Subject: venting AND need advice

> >Date: Tue, 2 Apr 2002 09:19:23 -0800 (PST)

> >

> >

> >I'm the one with the face on fire from yesterday. I feel better

(thanks to

> >liberal amounts of chilled Aveeno Baby Lotion) but still look like

hell.

> >Yesterday I decided to try to find a derm.

> >

> >

> >

> >First call: I asked if any of the derms there specialized in

treating

> >rosacea. The nurse must have decided that I was mentally

challenged AND 5

> >years old because she replied " Yes, they're DERMATOLOGISTS! " I

resisited

> >giving a smart assed response and asked if any of them specialized

in the

> >treatment of rosacea. She told me that dematologists were doctors

who

> >specialized in treating skin conditions, therefore they ALL were

experts in

> >treating rosacea. If my face hadn't hurt so much, I would have

laughed at

> >her.

> >

> >

> >

> >Second call: " Does this dermatologist specialize in the treatment

of

> >rosacea? " " No, he doesn't treat rosacea at all. " At first I was

offended,

> >but my husband pointed out that at least they weren't wasting my

time or

> >insulting my intelligence.

> >

> >

> >

> >Third call: Right off the bat, the nurse asked if I had ever

sought

> >treatment before, what topicals I had tried and whether or not I

had ever

> >been on oral antibiotics. If the derm is half as on the ball as

the

> >nurse... I see him on Monday afternoon. Dr. Carl Raque in Little

Rock, AR

> >-- don't suppose any of you know anything about him?

> >

> >

> >

> >Now, I need to know what questions to ask. Here's my history:

> >

> >I'm 41and started having rashy cheeks about 8 years ago. Saw a

derm and

> >was told (during one of my 5 minute long sessions) NEVER to wear

make-up

> >and to use Metro Gel. Metro Gel did nothing so I stopped using

it. I

> >eventually found this group.

> >

> >

> >

> >I'm oily and my redness is confined to my cheeks. I always have

some

> >papules on my lower cheeks though they are usually only mildly

itchy.

> >About a week ago, my entire cheeks became itchy and covered in

papules and

> >pustules. They have spread to my jaw, chin, eyebrows and forehead.

> >

> >

> >

> >What do I ask him?

> >

> >

> >

> >Thanks!

> >

> >Ruth

> >

> >

> >

> >---------------------------------

> >

[Guest guest]

Someone had to hire the smart, helpful nurse, hopefully it was a

smart helpful physician. You ought to go to him and see what he

says. You'd be best off with a treatment plan which would clear you

quickly, as you seem distressed. Full dose Minocin or Zithromax

and/or low dose Accutane. Wash face with cetaphil bid. No makeup

until clear. Topically, well, let the smart dermatologist figure

that one out based on your clinical presentation. Try ZnO topically

until face stops burning.

>

> I'm the one with the face on fire from yesterday. I feel better

(thanks to liberal amounts of chilled Aveeno Baby Lotion) but still

look like hell. Yesterday I decided to try to find a derm.

>

>

>

> First call: I asked if any of the derms there specialized in

treating rosacea. The nurse must have decided that I was mentally

challenged AND 5 years old because she replied " Yes, they're

DERMATOLOGISTS! " I resisited giving a smart assed response and asked

if any of them specialized in the treatment of rosacea. She told me

that dematologists were doctors who specialized in treating skin

conditions, therefore they ALL were experts in treating rosacea. If

my face hadn't hurt so much, I would have laughed at her.

>

>

>

> Second call: " Does this dermatologist specialize in the treatment

of rosacea? " " No, he doesn't treat rosacea at all. " At first I was

offended, but my husband pointed out that at least they weren't

wasting my time or insulting my intelligence.

>

>

>

> Third call: Right off the bat, the nurse asked if I had ever

sought treatment before, what topicals I had tried and whether or not

I had ever been on oral antibiotics. If the derm is half as on the

ball as the nurse... I see him on Monday afternoon. Dr. Carl Raque

in Little Rock, AR -- don't suppose any of you know anything about

him?

>

>

>

> Now, I need to know what questions to ask. Here's my history:

>

> I'm 41and started having rashy cheeks about 8 years ago. Saw a

derm and was told (during one of my 5 minute long sessions) NEVER to

wear make-up and to use Metro Gel. Metro Gel did nothing so I

stopped using it. I eventually found this group.

>

>

>

> I'm oily and my redness is confined to my cheeks. I always have

some papules on my lower cheeks though they are usually only mildly

itchy. About a week ago, my entire cheeks became itchy and covered

in papules and pustules. They have spread to my jaw, chin, eyebrows

and forehead.

>

>

>

> What do I ask him?

>

>

>

> Thanks!

>

> Ruth

>

>

>

> ---------------------------------

>

[Guest guest]

Someone had to hire the smart, helpful nurse, hopefully it was a

smart helpful physician. You ought to go to him and see what he

says. You'd be best off with a treatment plan which would clear you

quickly, as you seem distressed. Full dose Minocin or Zithromax

and/or low dose Accutane. Wash face with cetaphil bid. No makeup

until clear. Topically, well, let the smart dermatologist figure

that one out based on your clinical presentation. Try ZnO topically

until face stops burning.

>

> I'm the one with the face on fire from yesterday. I feel better

(thanks to liberal amounts of chilled Aveeno Baby Lotion) but still

look like hell. Yesterday I decided to try to find a derm.

>

>

>

> First call: I asked if any of the derms there specialized in

treating rosacea. The nurse must have decided that I was mentally

challenged AND 5 years old because she replied " Yes, they're

DERMATOLOGISTS! " I resisited giving a smart assed response and asked

if any of them specialized in the treatment of rosacea. She told me

that dematologists were doctors who specialized in treating skin

conditions, therefore they ALL were experts in treating rosacea. If

my face hadn't hurt so much, I would have laughed at her.

>

>

>

> Second call: " Does this dermatologist specialize in the treatment

of rosacea? " " No, he doesn't treat rosacea at all. " At first I was

offended, but my husband pointed out that at least they weren't

wasting my time or insulting my intelligence.

>

>

>

> Third call: Right off the bat, the nurse asked if I had ever

sought treatment before, what topicals I had tried and whether or not

I had ever been on oral antibiotics. If the derm is half as on the

ball as the nurse... I see him on Monday afternoon. Dr. Carl Raque

in Little Rock, AR -- don't suppose any of you know anything about

him?

>

>

>

> Now, I need to know what questions to ask. Here's my history:

>

> I'm 41and started having rashy cheeks about 8 years ago. Saw a

derm and was told (during one of my 5 minute long sessions) NEVER to

wear make-up and to use Metro Gel. Metro Gel did nothing so I

stopped using it. I eventually found this group.

>

>

>

> I'm oily and my redness is confined to my cheeks. I always have

some papules on my lower cheeks though they are usually only mildly

itchy. About a week ago, my entire cheeks became itchy and covered

in papules and pustules. They have spread to my jaw, chin, eyebrows

and forehead.

>

>

>

> What do I ask him?

>

>

>

> Thanks!

>

> Ruth

>

>

>

> ---------------------------------

>

[Guest guest]

This wouldn't be the first time a girl has ever used a " test

question " before

Notice how she will accept as an acceptable response the one of

vagueness, " I don't really know what causes rosacea. " But by giving

an answer, a very direct answer, you risk giving the wrong one and

facing negative judgement. I have a further theory on this, but it

is off topic..

Interesting method. I must say I like it. You're very lucky you're

not contstrained by the HMO system, in which the only quesiton you'd

be allowed to ask is, " can I have a referral? "

Ok, here's a good question.. If I give you three months and follow

your program exactly, will you be reasonably confident my skin will

clear? This IS possible for a good treatment regimen.

> First I would like to say I would like to slap about everyother

nurse I

> talk to on the phone. Yesterday my son woke up with a fever and

hold his

> ear @ 3 am. So I called the drs office for an appointment and left

a

> message saying he had an ear infection. Here is the nurse- Have

you seen a

> dr. Me- no, but he has an ear infection Nurse- So I am confused

have you

> actually seen a dr- like I don't know when my son has ear

infection. anyway

> thinks for letting me vent too

> I ask dr's test questions- 1. What causes rosacea. If he

> flushing/vascular problems or admitts he dosn't know, you may be in

good

> hands. If they have an old or off the wall theory than bye bye.

What makes

> rosacea worse- the answer should be either the main ones like

> sun/heat/discomfort or idividual things, If he says chocolate, bad

diet not

> enough excersice than again you know he dosn't really know enough

about

> rosacea. Ask for short & long term goals or plans! You also want

to make

> sure you dicuss all health problems with him. Also ask him to sit

while you

> talking. You can tell a lot about drs by all these ?s. I wish you

lots of

> luck.

>

>

> >From: Ruth Hooper

> >To: rosacea-support@y...

> >Subject: venting AND need advice

> >Date: Tue, 2 Apr 2002 09:19:23 -0800 (PST)

> >

> >

> >I'm the one with the face on fire from yesterday. I feel better

(thanks to

> >liberal amounts of chilled Aveeno Baby Lotion) but still look like

hell.

> >Yesterday I decided to try to find a derm.

> >

> >

> >

> >First call: I asked if any of the derms there specialized in

treating

> >rosacea. The nurse must have decided that I was mentally

challenged AND 5

> >years old because she replied " Yes, they're DERMATOLOGISTS! " I

resisited

> >giving a smart assed response and asked if any of them specialized

in the

> >treatment of rosacea. She told me that dematologists were doctors

who

> >specialized in treating skin conditions, therefore they ALL were

experts in

> >treating rosacea. If my face hadn't hurt so much, I would have

laughed at

> >her.

> >

> >

> >

> >Second call: " Does this dermatologist specialize in the treatment

of

> >rosacea? " " No, he doesn't treat rosacea at all. " At first I was

offended,

> >but my husband pointed out that at least they weren't wasting my

time or

> >insulting my intelligence.

> >

> >

> >

> >Third call: Right off the bat, the nurse asked if I had ever

sought

> >treatment before, what topicals I had tried and whether or not I

had ever

> >been on oral antibiotics. If the derm is half as on the ball as

the

> >nurse... I see him on Monday afternoon. Dr. Carl Raque in Little

Rock, AR

> >-- don't suppose any of you know anything about him?

> >

> >

> >

> >Now, I need to know what questions to ask. Here's my history:

> >

> >I'm 41and started having rashy cheeks about 8 years ago. Saw a

derm and

> >was told (during one of my 5 minute long sessions) NEVER to wear

make-up

> >and to use Metro Gel. Metro Gel did nothing so I stopped using

it. I

> >eventually found this group.

> >

> >

> >

> >I'm oily and my redness is confined to my cheeks. I always have

some

> >papules on my lower cheeks though they are usually only mildly

itchy.

> >About a week ago, my entire cheeks became itchy and covered in

papules and

> >pustules. They have spread to my jaw, chin, eyebrows and forehead.

> >

> >

> >

> >What do I ask him?

> >

> >

> >

> >Thanks!

> >

> >Ruth

> >

> >

> >

> >---------------------------------

> >

[Guest guest]

This wouldn't be the first time a girl has ever used a " test

question " before

Notice how she will accept as an acceptable response the one of

vagueness, " I don't really know what causes rosacea. " But by giving

an answer, a very direct answer, you risk giving the wrong one and

facing negative judgement. I have a further theory on this, but it

is off topic..

Interesting method. I must say I like it. You're very lucky you're

not contstrained by the HMO system, in which the only quesiton you'd

be allowed to ask is, " can I have a referral? "

Ok, here's a good question.. If I give you three months and follow

your program exactly, will you be reasonably confident my skin will

clear? This IS possible for a good treatment regimen.

> First I would like to say I would like to slap about everyother

nurse I

> talk to on the phone. Yesterday my son woke up with a fever and

hold his

> ear @ 3 am. So I called the drs office for an appointment and left

a

> message saying he had an ear infection. Here is the nurse- Have

you seen a

> dr. Me- no, but he has an ear infection Nurse- So I am confused

have you

> actually seen a dr- like I don't know when my son has ear

infection. anyway

> thinks for letting me vent too

> I ask dr's test questions- 1. What causes rosacea. If he

> flushing/vascular problems or admitts he dosn't know, you may be in

good

> hands. If they have an old or off the wall theory than bye bye.

What makes

> rosacea worse- the answer should be either the main ones like

> sun/heat/discomfort or idividual things, If he says chocolate, bad

diet not

> enough excersice than again you know he dosn't really know enough

about

> rosacea. Ask for short & long term goals or plans! You also want

to make

> sure you dicuss all health problems with him. Also ask him to sit

while you

> talking. You can tell a lot about drs by all these ?s. I wish you

lots of

> luck.

>

>

> >From: Ruth Hooper

> >To: rosacea-support@y...

> >Subject: venting AND need advice

> >Date: Tue, 2 Apr 2002 09:19:23 -0800 (PST)

> >

> >

> >I'm the one with the face on fire from yesterday. I feel better

(thanks to

> >liberal amounts of chilled Aveeno Baby Lotion) but still look like

hell.

> >Yesterday I decided to try to find a derm.

> >

> >

> >

> >First call: I asked if any of the derms there specialized in

treating

> >rosacea. The nurse must have decided that I was mentally

challenged AND 5

> >years old because she replied " Yes, they're DERMATOLOGISTS! " I

resisited

> >giving a smart assed response and asked if any of them specialized

in the

> >treatment of rosacea. She told me that dematologists were doctors

who

> >specialized in treating skin conditions, therefore they ALL were

experts in

> >treating rosacea. If my face hadn't hurt so much, I would have

laughed at

> >her.

> >

> >

> >

> >Second call: " Does this dermatologist specialize in the treatment

of

> >rosacea? " " No, he doesn't treat rosacea at all. " At first I was

offended,

> >but my husband pointed out that at least they weren't wasting my

time or

> >insulting my intelligence.

> >

> >

> >

> >Third call: Right off the bat, the nurse asked if I had ever

sought

> >treatment before, what topicals I had tried and whether or not I

had ever

> >been on oral antibiotics. If the derm is half as on the ball as

the

> >nurse... I see him on Monday afternoon. Dr. Carl Raque in Little

Rock, AR

> >-- don't suppose any of you know anything about him?

> >

> >

> >

> >Now, I need to know what questions to ask. Here's my history:

> >

> >I'm 41and started having rashy cheeks about 8 years ago. Saw a

derm and

> >was told (during one of my 5 minute long sessions) NEVER to wear

make-up

> >and to use Metro Gel. Metro Gel did nothing so I stopped using

it. I

> >eventually found this group.

> >

> >

> >

> >I'm oily and my redness is confined to my cheeks. I always have

some

> >papules on my lower cheeks though they are usually only mildly

itchy.

> >About a week ago, my entire cheeks became itchy and covered in

papules and

> >pustules. They have spread to my jaw, chin, eyebrows and forehead.

> >

> >

> >

> >What do I ask him?

> >

> >

> >

> >Thanks!

> >

> >Ruth

> >

> >

> >

> >---------------------------------

> >

[Guest guest]

This wouldn't be the first time a girl has ever used a " test

question " before

Notice how she will accept as an acceptable response the one of

vagueness, " I don't really know what causes rosacea. " But by giving

an answer, a very direct answer, you risk giving the wrong one and

facing negative judgement. I have a further theory on this, but it

is off topic..

Interesting method. I must say I like it. You're very lucky you're

not contstrained by the HMO system, in which the only quesiton you'd

be allowed to ask is, " can I have a referral? "

Ok, here's a good question.. If I give you three months and follow

your program exactly, will you be reasonably confident my skin will

clear? This IS possible for a good treatment regimen.

> First I would like to say I would like to slap about everyother

nurse I

> talk to on the phone. Yesterday my son woke up with a fever and

hold his

> ear @ 3 am. So I called the drs office for an appointment and left

a

> message saying he had an ear infection. Here is the nurse- Have

you seen a

> dr. Me- no, but he has an ear infection Nurse- So I am confused

have you

> actually seen a dr- like I don't know when my son has ear

infection. anyway

> thinks for letting me vent too

> I ask dr's test questions- 1. What causes rosacea. If he

> flushing/vascular problems or admitts he dosn't know, you may be in

good

> hands. If they have an old or off the wall theory than bye bye.

What makes

> rosacea worse- the answer should be either the main ones like

> sun/heat/discomfort or idividual things, If he says chocolate, bad

diet not

> enough excersice than again you know he dosn't really know enough

about

> rosacea. Ask for short & long term goals or plans! You also want

to make

> sure you dicuss all health problems with him. Also ask him to sit

while you

> talking. You can tell a lot about drs by all these ?s. I wish you

lots of

> luck.

>

>

> >From: Ruth Hooper

> >To: rosacea-support@y...

> >Subject: venting AND need advice

> >Date: Tue, 2 Apr 2002 09:19:23 -0800 (PST)

> >

> >

> >I'm the one with the face on fire from yesterday. I feel better

(thanks to

> >liberal amounts of chilled Aveeno Baby Lotion) but still look like

hell.

> >Yesterday I decided to try to find a derm.

> >

> >

> >

> >First call: I asked if any of the derms there specialized in

treating

> >rosacea. The nurse must have decided that I was mentally

challenged AND 5

> >years old because she replied " Yes, they're DERMATOLOGISTS! " I

resisited

> >giving a smart assed response and asked if any of them specialized

in the

> >treatment of rosacea. She told me that dematologists were doctors

who

> >specialized in treating skin conditions, therefore they ALL were

experts in

> >treating rosacea. If my face hadn't hurt so much, I would have

laughed at

> >her.

> >

> >

> >

> >Second call: " Does this dermatologist specialize in the treatment

of

> >rosacea? " " No, he doesn't treat rosacea at all. " At first I was

offended,

> >but my husband pointed out that at least they weren't wasting my

time or

> >insulting my intelligence.

> >

> >

> >

> >Third call: Right off the bat, the nurse asked if I had ever

sought

> >treatment before, what topicals I had tried and whether or not I

had ever

> >been on oral antibiotics. If the derm is half as on the ball as

the

> >nurse... I see him on Monday afternoon. Dr. Carl Raque in Little

Rock, AR

> >-- don't suppose any of you know anything about him?

> >

> >

> >

> >Now, I need to know what questions to ask. Here's my history:

> >

> >I'm 41and started having rashy cheeks about 8 years ago. Saw a

derm and

> >was told (during one of my 5 minute long sessions) NEVER to wear

make-up

> >and to use Metro Gel. Metro Gel did nothing so I stopped using

it. I

> >eventually found this group.

> >

> >

> >

> >I'm oily and my redness is confined to my cheeks. I always have

some

> >papules on my lower cheeks though they are usually only mildly

itchy.

> >About a week ago, my entire cheeks became itchy and covered in

papules and

> >pustules. They have spread to my jaw, chin, eyebrows and forehead.

> >

> >

> >

> >What do I ask him?

> >

> >

> >

> >Thanks!

> >

> >Ruth

> >

> >

> >

> >---------------------------------

> >

[Guest guest]

I went through a bit of misdiagnosis with my rosacea. I went to one

derm, who was on the NRS list. She diagnosed me with rosacea, but her

treatments didn't do anything for me at all. I had a bright red face

and lots of bumps. (metrogel and tetracycline and later minocycline)

Next, I went to another derm on the NRS list who said that I didn't

have rosacea at all but acne. He recommended that I take a full

course of Accutane as that would cure my acne.

Then, I tried someone who was a clinical instructor at the University

of California at San Francisco(UCSF) and practiced at their campus.

She was not the NRS list. She said I had rosacea and gave me topical

Azelex/Novacet and oral Bactrim. She also recommended that I get C02

laser for my red, bumpy and slightly swollen nose, but she wanted to

try the topicals and oral meds first. The Azelex/Novacet and Bactrim

seemed to tone down the redness and decrease the bumps. I saw her

again in six weeks and she told me she was pleased that my acne was

clearing up. I asked her what she thought of the rosacea and then

told me I didn't have rosacea. I was a bit confused and asked her

about what she said the appointment before, but she said I had acne

and looked at me like I was from outer space for mentioning rosacea.

She seemed very rushed and I don't think she read the notes from the

prior appointment. She at least cleared up my face without

irritating it and I was set to see her again, but she moved her

practice across town and left UCSF.

I decided to try someone else at UCSF. I went to see a derm who was a

full professor at UCSF and had published in a lot of medical

journals. He was not on the NRS list. He diagnosed me with rosacea.

I was a bit pink with some bumps, but not bright red. I had stopped

the Bactrim a few months before and was using Novacet as a topical. I

had to stop the Azelex since it turned me red after about four months

of use. When I asked him about acne, he said I didn't have comedones

so I didn't have acne. I had the typical rosacea bumps. When I see

him, he always remembers that I have rosacea, or at least he reads

the notes he made on me from previous visits. He also takes a close

look at my skin. He is an exceptionally bright doctor and

professional.

I went to four different doctors in the space of 18 months and had

different diagnoses for the same problem. It was really frustrating.

I'm lucky that I live in an area that has many derms and two highly-

rated medical schools. If this guy at UCSF didn't work out, I was

going to go to Stanford U.and get a derm there. (I went to the

Stanford U. acne clinic as a teenager, and they basically did nothing

for me. I wasn't eager to go back there.)

I'd agree with questioning the doctor the first time you see him or

her. Why waste your time and money on someone who isn't going to help

you or even give you a consistent or correct diagnosis in the first

place? Not every derm keeps up or remembers the correct way to treat

rosacea. I wouldn't give that doctor more than a visit or two.

On a side note, my endocrinologist wanted to give me some

tetracycline and suggested I use some otc acne meds when I was a bit

bumpy last year. This was unsolicited; I didn't ask him about my skin

at all. I told him I had rosacea and the acne meds would make it

worse. He said they call it acne rosacea and he wanted to treat the

acne portion. I hope the NRS spreads it message further because some

docs aren't getting it.

Take care,

Matija

[Guest guest]

Sorry it took so long to comment on this, but I wanted to because the

ttopical regime I was given by the UCSF clinical instructor started

tburn and dry out my face. I was using the Azelex once a day and it

turned me pink. I stopped using it because my skin was bleached and

then it was burning on my cheeks and nose. The UCSF full professor

kept me on Bactrim but weaned me off of it. He thought the Novacet

was drying out my face too much and irritating it. He took me off

that and I was put on Metrogel which didn't help, but didn't hurt. I

started using suggestions from this group (oils on the face, gentle

cleansers, Dr. Sy's antiflusing regime - Tagamet and ChlorTrimeton).

My derm was happy that I was better and just nodded when I told him

what I was doing to get better.

Tetracycline and minocycline did not work to decrease inflammation or

papules/pustules. My rosacea seemed immune to them. I haven't tried

doxycycline so I don't know how that works. Other topicals, besides

Metrogel, irritated my face.

The regime you mention may work for you, but it didn't work for me.

About UCSF, they do take people on Medi-cal, state sponsored medical

insurance for those on public assistance and the working poor. I

didn't have health insurance when I saw the clinical instructor at

UCSF but I was working. She reduced her fees which was nice.

Take care,

Matija

>

> > Then, I tried someone who was a clinical instructor at the

> University

> > of California at San Francisco(UCSF) and practiced at their

campus.

> > She was not the NRS list. She said I had rosacea and gave me

> topical

> > Azelex/Novacet and oral Bactrim. She also recommended that I get

> C02

> > laser for my red, bumpy and slightly swollen nose, but she wanted

> to

> > try the topicals and oral meds first. The Azelex/Novacet and

> Bactrim

> > seemed to tone down the redness and decrease the bumps. I saw her

> > again in six weeks and she told me she was pleased that my acne

was

> > clearing up. I asked her what she thought of the rosacea and then

> > told me I didn't have rosacea. I was a bit confused and asked her

> > about what she said the appointment before, but she said I had

> acne

> > and looked at me like I was from outer space for mentioning

> rosacea.

> > She seemed very rushed and I don't think she read the notes from

> the

> > prior appointment. She at least cleared up my face without

> > irritating it and I was set to see her again, but she moved her

> > practice across town and left UCSF.

> >

>

>

> I like the style of the above dermatologist. First combining an

oral

> sulfonamide (bacrim) with a topical sufonamide (na sulfacetamide)

> gets some points from me! And then using azelex once a day only is

> great. I find that if I use azelex twice a day at the outset,

> irritation is to follow. For those who want to use azelex twice a

> day, at least use it hs for 2wk before thinking about doing bid.

Or

> else just use once a day only.

>

> Another note. cea should be heard and not seen... Think about

> this. Once rosacea is not seen anymore, the flush is gone due to

> great treatment, the papules are gone, etc., the only way to tell

if

> someone has it is if they relate it to you by history. Your

> treatment was excellent and worked so it looked like you did not

have

> rosacea.

>

>

>

> > I decided to try someone else at UCSF. I went to see a derm who

was

> a

> > full professor at UCSF and had published in a lot of medical

> > journals. He was not on the NRS list. He diagnosed me with

> rosacea.

> > I was a bit pink with some bumps, but not bright red. I had

stopped

> > the Bactrim a few months before and was using Novacet as a

topical.

> I

> > had to stop the Azelex since it turned me red after about four

> months

> > of use. When I asked him about acne, he said I didn't have

> comedones

> > so I didn't have acne. I had the typical rosacea bumps. When I

see

> > him, he always remembers that I have rosacea, or at least he

reads

> > the notes he made on me from previous visits. He also takes a

close

> > look at my skin. He is an exceptionally bright doctor and

> > professional.

> >

> > I went to four different doctors in the space of 18 months and

had

> > different diagnoses for the same problem. It was really

> frustrating.

> >

>

>

> Once again, my hat's off to you and/or your insurance for being

able

> to afford non network/non HMO dermatologists... If only the common

> man could afford to do this, then we'd be in utopia... Or,

Canada

[Guest guest]

Sorry it took so long to comment on this, but I wanted to because the

ttopical regime I was given by the UCSF clinical instructor started

tburn and dry out my face. I was using the Azelex once a day and it

turned me pink. I stopped using it because my skin was bleached and

then it was burning on my cheeks and nose. The UCSF full professor

kept me on Bactrim but weaned me off of it. He thought the Novacet

was drying out my face too much and irritating it. He took me off

that and I was put on Metrogel which didn't help, but didn't hurt. I

started using suggestions from this group (oils on the face, gentle

cleansers, Dr. Sy's antiflusing regime - Tagamet and ChlorTrimeton).

My derm was happy that I was better and just nodded when I told him

what I was doing to get better.

Tetracycline and minocycline did not work to decrease inflammation or

papules/pustules. My rosacea seemed immune to them. I haven't tried

doxycycline so I don't know how that works. Other topicals, besides

Metrogel, irritated my face.

The regime you mention may work for you, but it didn't work for me.

About UCSF, they do take people on Medi-cal, state sponsored medical

insurance for those on public assistance and the working poor. I

didn't have health insurance when I saw the clinical instructor at

UCSF but I was working. She reduced her fees which was nice.

Take care,

Matija

>

> > Then, I tried someone who was a clinical instructor at the

> University

> > of California at San Francisco(UCSF) and practiced at their

campus.

> > She was not the NRS list. She said I had rosacea and gave me

> topical

> > Azelex/Novacet and oral Bactrim. She also recommended that I get

> C02

> > laser for my red, bumpy and slightly swollen nose, but she wanted

> to

> > try the topicals and oral meds first. The Azelex/Novacet and

> Bactrim

> > seemed to tone down the redness and decrease the bumps. I saw her

> > again in six weeks and she told me she was pleased that my acne

was

> > clearing up. I asked her what she thought of the rosacea and then

> > told me I didn't have rosacea. I was a bit confused and asked her

> > about what she said the appointment before, but she said I had

> acne

> > and looked at me like I was from outer space for mentioning

> rosacea.

> > She seemed very rushed and I don't think she read the notes from

> the

> > prior appointment. She at least cleared up my face without

> > irritating it and I was set to see her again, but she moved her

> > practice across town and left UCSF.

> >

>

>

> I like the style of the above dermatologist. First combining an

oral

> sulfonamide (bacrim) with a topical sufonamide (na sulfacetamide)

> gets some points from me! And then using azelex once a day only is

> great. I find that if I use azelex twice a day at the outset,

> irritation is to follow. For those who want to use azelex twice a

> day, at least use it hs for 2wk before thinking about doing bid.

Or

> else just use once a day only.

>

> Another note. cea should be heard and not seen... Think about

> this. Once rosacea is not seen anymore, the flush is gone due to

> great treatment, the papules are gone, etc., the only way to tell

if

> someone has it is if they relate it to you by history. Your

> treatment was excellent and worked so it looked like you did not

have

> rosacea.

>

>

>

> > I decided to try someone else at UCSF. I went to see a derm who

was

> a

> > full professor at UCSF and had published in a lot of medical

> > journals. He was not on the NRS list. He diagnosed me with

> rosacea.

> > I was a bit pink with some bumps, but not bright red. I had

stopped

> > the Bactrim a few months before and was using Novacet as a

topical.

> I

> > had to stop the Azelex since it turned me red after about four

> months

> > of use. When I asked him about acne, he said I didn't have

> comedones

> > so I didn't have acne. I had the typical rosacea bumps. When I

see

> > him, he always remembers that I have rosacea, or at least he

reads

> > the notes he made on me from previous visits. He also takes a

close

> > look at my skin. He is an exceptionally bright doctor and

> > professional.

> >

> > I went to four different doctors in the space of 18 months and

had

> > different diagnoses for the same problem. It was really

> frustrating.

> >

>

>

> Once again, my hat's off to you and/or your insurance for being

able

> to afford non network/non HMO dermatologists... If only the common

> man could afford to do this, then we'd be in utopia... Or,

Canada

[Guest guest]

Sorry it took so long to comment on this, but I wanted to because the

ttopical regime I was given by the UCSF clinical instructor started

tburn and dry out my face. I was using the Azelex once a day and it

turned me pink. I stopped using it because my skin was bleached and

then it was burning on my cheeks and nose. The UCSF full professor

kept me on Bactrim but weaned me off of it. He thought the Novacet

was drying out my face too much and irritating it. He took me off

that and I was put on Metrogel which didn't help, but didn't hurt. I

started using suggestions from this group (oils on the face, gentle

cleansers, Dr. Sy's antiflusing regime - Tagamet and ChlorTrimeton).

My derm was happy that I was better and just nodded when I told him

what I was doing to get better.

Tetracycline and minocycline did not work to decrease inflammation or

papules/pustules. My rosacea seemed immune to them. I haven't tried

doxycycline so I don't know how that works. Other topicals, besides

Metrogel, irritated my face.

The regime you mention may work for you, but it didn't work for me.

About UCSF, they do take people on Medi-cal, state sponsored medical

insurance for those on public assistance and the working poor. I

didn't have health insurance when I saw the clinical instructor at

UCSF but I was working. She reduced her fees which was nice.

Take care,

Matija

>

> > Then, I tried someone who was a clinical instructor at the

> University

> > of California at San Francisco(UCSF) and practiced at their

campus.

> > She was not the NRS list. She said I had rosacea and gave me

> topical

> > Azelex/Novacet and oral Bactrim. She also recommended that I get

> C02

> > laser for my red, bumpy and slightly swollen nose, but she wanted

> to

> > try the topicals and oral meds first. The Azelex/Novacet and

> Bactrim

> > seemed to tone down the redness and decrease the bumps. I saw her

> > again in six weeks and she told me she was pleased that my acne

was

> > clearing up. I asked her what she thought of the rosacea and then

> > told me I didn't have rosacea. I was a bit confused and asked her

> > about what she said the appointment before, but she said I had

> acne

> > and looked at me like I was from outer space for mentioning

> rosacea.

> > She seemed very rushed and I don't think she read the notes from

> the

> > prior appointment. She at least cleared up my face without

> > irritating it and I was set to see her again, but she moved her

> > practice across town and left UCSF.

> >

>

>

> I like the style of the above dermatologist. First combining an

oral

> sulfonamide (bacrim) with a topical sufonamide (na sulfacetamide)

> gets some points from me! And then using azelex once a day only is

> great. I find that if I use azelex twice a day at the outset,

> irritation is to follow. For those who want to use azelex twice a

> day, at least use it hs for 2wk before thinking about doing bid.

Or

> else just use once a day only.

>

> Another note. cea should be heard and not seen... Think about

> this. Once rosacea is not seen anymore, the flush is gone due to

> great treatment, the papules are gone, etc., the only way to tell

if

> someone has it is if they relate it to you by history. Your

> treatment was excellent and worked so it looked like you did not

have

> rosacea.

>

>

>

> > I decided to try someone else at UCSF. I went to see a derm who

was

> a

> > full professor at UCSF and had published in a lot of medical

> > journals. He was not on the NRS list. He diagnosed me with

> rosacea.

> > I was a bit pink with some bumps, but not bright red. I had

stopped

> > the Bactrim a few months before and was using Novacet as a

topical.

> I

> > had to stop the Azelex since it turned me red after about four

> months

> > of use. When I asked him about acne, he said I didn't have

> comedones

> > so I didn't have acne. I had the typical rosacea bumps. When I

see

> > him, he always remembers that I have rosacea, or at least he

reads

> > the notes he made on me from previous visits. He also takes a

close

> > look at my skin. He is an exceptionally bright doctor and

> > professional.

> >

> > I went to four different doctors in the space of 18 months and

had

> > different diagnoses for the same problem. It was really

> frustrating.

> >

>

>

> Once again, my hat's off to you and/or your insurance for being

able

> to afford non network/non HMO dermatologists... If only the common

> man could afford to do this, then we'd be in utopia... Or,

Canada