An Almost Disastrous First Dermatology Visit

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The empty lobby at the dermatology clinic at lunch time left me feeling quite anxious after I missed my 11:30 a.m. appointment, which I thought was at 1:30 p.m.

Wednesday morning started out quietly enough. I took the morning to rest as I had to work on my Monday day off. I looked forward to my first dermatology appointment at 1:30 p.m. I drove into town around 12:30 to give myself plenty of time. Then it dawned on me.

My dermatology appointment was at 11:30 a.m., not 1:30 p.m.

After double checking my calendar I decided to drive straight to the clinic. Even though the door was unlocked, I only found an “out to lunch” sign on the counter. A call to the scheduling center confirmed I missed my appointment. I’d waited over two months for this visit. Now I found myself one hour late to it.

The scheduler on the phone told me I could take the next available appointment with the dermatologist on May 8th, or with her colleague on May 2nd. She also gave me the option to stay in the clinic office until the staff returned from lunch. I opted for the latter.

As I waited all I could think about is what a disaster the first visit is turning out to be. Being late meant possibly not seeing the new dermatologist for weeks. One little mistake could mushroom into huge consequences for all my treatments.

As I waited all I could think about is what a disaster the first visit is turning out to be. Being late meant possibly not seeing the new dermatologist for weeks.

Awkward Beginnings

Finally, someone returned to the office. I sheepishly asked if she had started working yet, and shared how I felt embarrassed about missing my 11:30 appointment. The receptionist said it was okay, and took my information down. She then asked me to wait until the medical staff returned.

Dr. C’s medical assistant returned and started looking into my situation. He said they could work me into her schedule, but I needed to wait there for up to two hours. Ironically, I ended up getting a 1:45 p.m. appointment, only 15 minutes later than what I first thought. Around 2:00 p.m. the medical assistant called me into the exam room.

I felt anxious changing to a new medical group and system. Right off I felt awkward when I tried to sit on the exam table and asked for a gown.

“On the first visit the doctor likes you to keep your clothes on and sit in the chair,” the assistant informed me. I thought it sounded like rules for a first date, but went with it.

I felt anxious changing to a new medical group and system. Right off I felt awkward when I tried to sit on the exam table and asked for a gown.

Next, he told me the doctor is using an exam recording device that transmits to the Dominican Republic. It apparently helps with documentation so the doctor doesn’t need to worry about writing notes later. I didn’t want to make a fuss on my first visit and told him it would be fine.

Dr. C. walked in a few minutes later. She told me right away that she didn’t have that much time for the visit since I was being squeezed into her schedule.

Having no time to waste, I quickly dove into all my dermatology concerns assuming she could keep up.

Going Over My Treatment Checklist

The bullet list in my phone notes program of items I needed her to address came in handy. Here’s a summary of the decisions we made for my skin treatment:

Tremfya for Psoriasis

Dr. C agreed I should continue Tremfya (guselkumab) therapy. I will need to renew the prescription for it in a few months, but for now I’m set.


Follow my Tremfya journey!

Tremfya (Guselkumab) Week One  

8 Weeks with Tremfya: It’s Working!

16 Weeks with Tremfya: The Verdict?

24 Weeks with Tremfya: A Pattern Emerges


Treating Atopic Dermatitis (AD)

I briefly explained to her the three options Dr. M and I came up with for managing my atopic dermatitis: phototherapy, pulse dosing cyclosporine, and Dupixent (dupilumab)—the new biologic for AD.

Like most dermatologists I’ve encountered, she doesn’t like to use cyclosporine. Dupixent is expensive and difficult to get insurance to approve. So, for now, she will start paperwork for a home phototherapy unit. I’ve waiting since December 15th to get this unit approved, so I hope it doesn’t take too much longer.

Antihistamine for Itch and Insomnia

She thought I should change to hydroxyzine, or Atarax, for my antihistamine. Benadryl doesn’t seem to work as well for me any longer, and doxepin makes me clumsy and very groggy the next day.

I ended up cutting the hydroxyzine in half the first couple evenings. It works well to get me to sleep. Too well when I need to wake up for morning meetings. Hopefully my body will get used to it soon.

Worsening Scalp Psoriasis

She thought I could continue the Dermasmoothe F/S scalp oil, which takes hours in the evening to work under a shower cap. She added a clobetasol steroid foam (Olux) to in addition to the oil/steroid treatment.

I’ve never tried the foam, partly because my scalp psoriasis stayed under control with cyclosporine and other biologics I’ve used.

Leaving the Appointment Grateful

Dr. C told me to return in 8 weeks, then checked her patient list. The appointment took longer than she had time for, putting her behind schedule. She let me know that she did have time at 11:30 a.m. for me and that three patients needed to wait because of my schedule mishap.

I felt pretty badly about the time mix-up, but glad to finally meet Dr. C. She answered my treatment questions and agreed with most everything I wanted to use to treat my psoriasis and eczema.

As I left the clinic I felt grateful I averted what could have turned out to be a disastrous (non) visit to the new dermatologist.

As I left the clinic I felt grateful I averted what could have turned out to be a disastrous (non) visit to the new dermatologist. The kindness they showed me that afternoon included 1) not berating me for my mistake, 2) giving me an appointment that same afternoon, 3) taking on a heavier afternoon patient load, 4) listening to all my concerns, and 5) working with me on each point of my treatment plan.

Next Tremfya Dose

The next day the Tremfya injection arrived via Fed-Ex ready for the 28-week injection next Sunday, March 4th. Looking forward to updating again after that injection.