Tuesday, January 10, 2012

Mr. Smith goes to UPenn

Bob and I had an 11:45am appointment at the  Perelman Center for Advanced Medicine at UPenn. The drive and directions were easy-peasy, and it took us perhaps an hour to get there. The building is nothing short of spectacular, all glass and chrome and sunlit. We were in awe.

We waited almost an hour to meet with our specialist, but it was well worth it. The dermatologist, a young, attractive African American woman, gave us the kind of thoughtful, informed examination we were hoping for. Here is the outcome...
  • It's unusual for psoriasis to start this late in life (sixty years old).
  • It's unusual to have this kind of full-body, big-red-guy reaction without some kind of precipitating incident. Usually this kind of thing is a response to  something that taxes the immune system -- the flu, a serious injury, major surgery, exposure to something toxic, etc.
  • Bob isn't sick enough to indicate he has a scary underlying disorder--the kind I found described in the medical literature. His version of exfoliative dermatitis was no picnic, but at least he didn't feel sick. People with the serious underlying disorders are very, very ill. 
  • Topical treatments aren't recommended for him, since it would require an all-over-body treatment.
  • She went over the available medications and the pros and cons of each, then she indicated her recommended treatment, which was Humira or Enbrel.
  • She recommended a specific dermatologist to work with in our area.
Bob's skin is about 50% better now, but the doctor said he might have a flareup again when the prednisone wears off. He does not feel comfortable going to the gym, or to his favorite activity, contra dancing, while his skin is this way. He hopes to try some natural remedies --including homeopathy -- before going the prescription route. The prescription drugs are powerful, and the side effects are scary to me, too. But I hope he does not wait too long before starting more conventional meds.

Oh, and he needs to stop smoking. But that's another blog post.


  1. I don't know if he would be open to classical homeopathy, but I have found it to be incredibly effective for myself, my family, and my animals. Particularly with skin issues, which often reflect, as you have already been told, something else going on.

    There are virtually no side effects and my experience is that when the right remedy is used, there is a very quick response.

    However, I do think it's important to find someone who knows what he/she is doing and has studied classical homeopathy in particular. If you were here I could recommend someone very good.

    My husband has struggled with asthma since he was young. Inhalers, etc. helped but did nothing to address the underlying issue. One remedy given in 3 doses by our homeopath completely cleared him up. He has taken one dose of the remedy one time since when it flared up a little - one time in 5 years.

    Similar story with my son and eczema.

    Me with a cyst.

    Horse with hives.

    Etc. etc.

    Hope he finds relief very soon whatever the treatment he chooses!!

  2. Hmmm, I think the doctor must be going down the "auto-immune response" route if she's suggested Humira or Enbrel. My MIL has taken both (not at the same time!) for her rheumatoid arthritis, a classic auto-immune disease. I don't know of any side effects she's experienced other than a lighter wallet, because both are extremely expensive.

    I also think trying homeopathic/natural treatment is certainly worth a shot. That anecdotal evidence from Billie is very interesting. I personally am a big fan of chiropractic (not that it would help Bob, I'm just reporting). It restored my husband's bad back to health and mobility, prevented my son from having a fourth set of ear tubes installed when he was little, and has now helped my doggie with a compressed disc. I'll try just about anything if it's to no detriment!

  3. I just had to say that it hurt my heart to read that Bob doesn't feel comfortable doing his favorite activity, contra dancing. Everyone should be able to dance if they want and he feels up to it. I'll bet nobuddy would care one bit if he still danced!

  4. Oh the lovely immune system. If you guys decide to go the conventional drug route, I was on Enbrel for 2 years and had very little side effects. It is a very easy to use drug and don't be afraid to use the contacts the drug company will supply. (home visiting Nurse, on call Dr's ect)

  5. Sounds like a truly worthwhile trip and a good doctor. Good news indeed that all the really awful possibilities seem to be ruled out.

    Still wish you could uncover the trigger, but if you have effective treatments for the symptoms, that will do. Wishing Bob the very best.

  6. Well at least that's almost an answer ;o) Here's hoping he can find something both helpful and natural that is less scary than Prednisone. Yeesh.

    I'm with RiderWriter though; Enbrel and company are among the drugs of choice for autoimmunes.

  7. If it's ANY consolation, Stacey, everybody I know with an auto-immune disorder, from basic allergies to psoriasis to lupus, has had worse skin flares this year due to the extended warm season and lack of adequate cold snap in the Mid-Atlantic. Two weeks ago, I developed a bad case of dermatitis above my eyes, between my fingers and on the back of my skull that looked and acted a LOT like psoriasis or eczema. Hurt, bled, flaked, itched ... ugly. Couldn't cover with makeup either. I needed a ninja suit.

    Even people w/o auto-immunes have had alligator skin thid season. HOPEFULLY, Bob is just experiencing something akin to the rest of us and it will benefit from a cold snap. You know, basic allergies to mold can cause an all-on body breakout. It has done that to me before. Stay positive. :)

  8. Wow, I'm sorry. My dad has psoriasis so I know a little about it, but he only has it on his hands and feet so he doesn't take prescription drugs for it. I think there are ways to help it without going the prescription route so I'm happy he's checking into them. I've always been leery of most medications (obviously I take medicine if it's necessary, I would never sacrifice my health just to avoid taking them) and especially after my husband had to take Lyrica for nerve pain and now has possibly permanent memory loss. So side effects are something to consider because they can affect your life strongly. My dad always said getting as much sun as possible helped his. Good luck finding something to help!!

