New from Ashland, Oregon

[Jfbailey]

Glad to find this forum. I recently moved to Oregon and the care protocol is very different than where I lived in California. Here I am seen by a physician’s assistant only. Besides seeing patients for diseases of the skin, the office sees a lot of clients for Botox, cellulite treatment and who knows what else (I delete the ads they send me.)

After being on Simponi for probably 8 years, I started getting a lot of skin cancer ( new ones popping up weekly) and had to have surgery on spots on my legs 4 times in 3 months. My new rheumatologist said that increased skin cancer was a side effect of Simponi. I stopped the Simponi in December and have fewer incidence of skin cancer already (only planning two surgeries next month!)

However, my psoriasis has flared with a vengeance. I have it all over, including places that I haven’t ever had it (in 45 years with PA). Interestingly my psoriatic arthritis hasn’t flares without Simponi.

My dermatologist Physician’s assistant suggested Skyrizi and asked me to consult with my rheumatologist. (In California, the doctors would have talked directly to come up with a plan…)

My rheumatologist said that Skyrizi wasn’t authorized for PA and suggested Otezla, telling me to discuss with my dermatologist. I decided to try Skyrizi but the dermatologist says now it wouldn’t be appropriate since I have PA. (Huh? I wouldn’t have known of the drug if he hadn’t mentioned it). He said we will talk in a month. 

I am frustrated, itching and moisturizing constantly. Daily new spots appear. 

I’d like to see a doctor who specializes in psoriasis and skin cancers. Does anyone know of a dermatologist near Ashland or Medford Oregon? I looked at the USA psoriasis site and one doctor is listed. Haven’t heard of her or her practice group, but I’ll call tomorrow to see what her focus is.

Sorry for the long —and whiny— intro. But, I know you guys get it. Thanks.

[Kat]

Welcome!

Sorry I live in the southeastern United States so no clue on doctors where you live.  There are some Americans here, but right off I can't think of anyone else from Oregon.  I go to a Skin and Cancer clinic to see my dermatologist and I would think "most" derms would know quite a bit about skin cancer as well as psoriasis.  Call around your area and ask that question.  And tell them if you don't want to see a Physician's assistant (I know I see quite a few of them at various doctors offices here so it's becoming more and more the norm I think)

I also ran into that issue having a dermatologist for skin and rheumatologist for arthritis.  Suggest they consult WITH each other so they are both on board when it comes to treatments.  It helped me quite a bit after I did that. 

You have a lot going on, I hope you get some answers soon on treatment.  I will say Cosentyx worked well for quite a few people here for both psoriasis and psoriatic arthritis.  I wasn't one of them but thought I would mention it.

[jiml]

Hi and welcome to the forum you will find a lot of information here on the various treatments see Prescribed Treatments For Psoriasis so when you do find a good dermatologist and I'm afraid I can't point you towards any specific dermatologist . But do ask about Stelara or Cosentyx as they seem to be well tolerated by many of our members and are good for psoriasis and psoriatic arthritis .
If you have no success finding a new one push for an earlier appointment telling them of the flare and how it's affecting your quality of life
I wish you much luck in your search and hope to hear you manage to get a new dermatologist soon
Jim

[Raxyl]

Welcome to the forum, sorry to hear about your flare ups, unfortunately I cannot help with Dr recommendations as I'm on the other side of the world in Tasmania but I agree with Jim, ask about Stelara or Cosentyx.  Cosentyx has been a game changer for me.

[Caroline]

Welcome to psoriasisclub.

I do agree with the advice you already have had from the others.

You could also say to your derm, let’s treat my psoriasis only, with the skyrizi and forget about the Psoriatic Arthritis.
There always is a chance that your psa also reacts to the bio. The medication and your body do not care if it is authorised or not, that is only a formality designed by people who neither have psoriasis nor are specialised doctors. It is just a piece of paper and a procedure.

Here in Europe it is used for both anyway, so there should be no problem with that. You only have to take care if you have had tuberculosis.

Good luck. !


Caroline

[Fred]

Hello Jfbailey  to Psoriasis Club.

No need to apologise about a long intro, we encourage our new members to post as it helps us answer.

You and your doctirs may be interested in these two threads about Skyrizi

Skyrizi phase 3 data for psoriatic arthritis

Skyrizi goes for psoriatic arthritis

But like Jim said there are a lot of other choices in the link he posted.

As for recommending a Doctor or Dermatologist we don't allow their names to be posted, but if anyone does have any information they can send it via PM to you.

I also made an edit to your post as we don't allow links or promotion of other websites.

Good luck and do come back and ask as many questions as you like and/or give us an update.

Regards.

Fred.

[Jfbailey]

Thank you all for the warm welcome and words of encouragement. I will look into both meds today as well as a new clinic that will enable me to see a doctor. I will let you know how it goes…

J

[jiml]

Hope you have success soon J
I find arming myself with information before I see the dermatologist enables you to have a better discussion and can give reasons you would prefer to try one rather than another

[Kat]

Thank you all for the warm welcome and words of encouragement. I will look into both meds today as well as a new clinic that will enable me to see a doctor. I will let you know how it goes…

J

Good luck J!

[Forest Walker]

Hi, Jfbailey,  

We had a relative who lived in a large retirement community in Medford.  She received good care in the medical system in Medford and lived past 100 years.  If I were living in Ashland, I would seek care in Medford.  Their main hospital center is Providence. Eugene is the next largest area to the north and served by the Peacehealth group, which is also the main hospital system way up here where I live in northern Washington by the Canadian/USA border.

Your instincts about how specialists should communicate with each other and the care you are getting right now are good.  Trust your feelings.  

Do you think that your previous doctor in California could refer you to someone in Medford or Eugene (if you want to travel 2.5 hours north)?

In the meantime, coconut oil might help a little.  Avoiding alcohol might help a little.  

My son went to Southern Oregon University in Ashland for a few years.  And I had family there once a very long time ago.  Welcome to this club.  It has helped me so much since I joined last fall.  Good luck to you.