The Suspense Builds...

This is the fax I sent to the Fancy Dermatology Dept. today. I succeeded in getting an appt. Sept. 1 with another derma on the staff. But that's a long way away, counting in itch-minutes. This afternoon my hematologist said she'd call the dermatologist and see if she could get help for me. There is nothing stronger than Atarax, she said, except Interferon injections, which I don't want to start. She also told me I could take two Ataraxi at a time, assuming these are 10 mg. tablets. I looked and I have 25 mg. tablets.

Oh well.





To: Dr. B, Nurse R



page __1_______ of _____2_____, including cover page





Hello—I’ve left messages yesterday and today because I’m been suffering from severe itching and I believe that you can help me. It is frustrating not to be able to make an appointment or to talk to the doctor.



I have severe itching caused by my polycythemia vera. It had been under control w/ 24-hour antihistamine and hydroxyzine, and two sessions of phototherapy a week, up to 6 minutes at a time. Before, it was 3X week. The last dermatologist I met w/ was Dr. A, because it was too difficult to get an appt with Dr. B.



I had a fellowship in Western Mass from mid-June to mid-July, and found a dermatology office there where I had phototherapy 2X week, building up from 3 minutes to 5.



Mid-July traveled to New Hampshire and Maine, where it was hot and humid. Two horse flies bit me, which triggered severe itching all over. Despite antihistamines, the itching continued, probably exacerbated by severe heat, humidity, and high mold counts. (I'm very allergic to mold, but never had a skin reaction from it before.) I returned to W. Mass. for more light therapy, which helped some.



When I returned to Chicago in late July I was somewhat better, and then worse.I had to begin my phototherapy at square one, starting with 37 seconds/session, twice a week. This Saturday I had terrible itching after riding my bike about 30 minutes, and hydroxyzine helped for only a little while (on top of 24-hour Allegra). Sunday I stayed inside all day and as soon as I walked outside, I would feel itchy. I've called Dr. Brieva a few times yesterday and today, leaving detailed messages that were not relayed in their entirety. I unfortunately missed a return call from Dr. B's nurse, R. The problems:





1. Phototherapy protocol is that after a gap in treatment at Northwestern, the patient starts from square one--getting phototherapy for only 37 seconds at a time. The five-minute sessions in Mass. are not taken into account because every machine is different and they can't be compared. Are there any exceptions to this? Can I get a higher amount of light because I’m suffering?

2.I can’t get an appointment w/ Dr. B until Sept. 24. Because it is hard to get an appt with B, I saw an associate of his, A, last time. She's gone now, on a fellowship, and I suppose she has no prescribing power at Northwestern at this time. Or does she? Or is there another doctor I can meet with immediately?

3.I left two messages for B yesterday (Monday). I asked for an appointment, to talk to him, for a prescription for 3X week, and whether there was anything stronger than Atarax. The nurse called back today, for a few moments when I was away from the phone, telling me he would have to see me before changing the phototherapy frequency. I would be happy to see him but he can't see me until Sept. 24.



I would like, at least, to talk to Dr. B on the phone about having longer phototherapy sessions and more often. I’d also like to know if there is an Rx that is stronger than Atarax.



If this is not possible, I’d like a recommendation for a dermatologist in the Northwestern system who is easier to get in touch with.



Thanks,