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Michael's Personal Photos & Treatment Diary for 2003
January 13, 2003: We made it to another new year! Lots going on in our world right now so I appreciate you taking the time to read my little diary. Next treatment scheduled for January 31!
January 31, 2003: #14. Wow, 4 months since my last treatment! Everyone at Dermsurgery commented on the continued fading and we forgot to take pictures (again)! Sorry! I promise "before" shots next time. Dr. Friedman did a few extra zaps on my lip (which is always painful) but everything else was minimal discomfort. The only changes from the routine were injecting some more chemical into the scar area on my cheek after the laser to help soften the scar tissue. Also, he removed a nodule of fibrous tissue from the side of my nose that has slowly grown over the years. He called it an angiofibroma and said it is very likely caused by underlying vascularity from my birthmark. I also have another one on my nose which is much smaller and less noticeable. They are going to biopsy it for safety sake but I'm not worried about that. A couple of injections of anesthetic and a quick "clip" and it was gone. I had asked another doctor a couple of years ago who was treating me (who shall remain nameless) about removing it and he counseled not to saying it could leave a bad scar area. Dr. Friedman pooh-poohed that and said it would heal up just fine. Guess who I trust? So my nose is back to its only-broken-5-times symmetric shape! One thing I like about Dr. Friedman is his injection technique. A lot of doctors just shoot the stuff into you as quickly as possible which can be painful. Dr. Friedman does it very slowly and I never feel a thing.

I'm actually writing this the following Monday after my Friday treatment. I had virtually no swelling this time and most of the purpura has faded away except on my temple. I took Arnika again for 3 days but other than that no cold compresses or analgesics for pain. Next treatment scheduled for the end of March. Thanks for checking up on me :).
(06/17/03) Like father, like son ... almost!
(06/17/03) Like father, like son ... almost!
(10/24/03) Goatee shorn in prep for #15
(10/24/03) Goatee shorn in prep for #15
Spring & Summer 2003: I'm taking the Spring and Summer off from treatments as I am spending a lot of time outside these days. While I always wear sunscreen I do tan a bit and the laser isn't as effective. So I should get back at it sometime in early Fall.
October 13, 2003: I'll be speaking at the 2nd VBF Port Wine Stain Conference in NYC in a few days. On 10/24 I'll make my way to Houston for #15. Egads! Just two weeks ago I made a business call on a new client and was greeted by "Were you in a car accident?" as our first in person verbal exchange. Interestingly enough, it honestly doesn't even faze me anymore. I didn't miss a beat and just said "It's a birthmark, but don't worry, I'm used to people asking me about it." And we went on from there and everything was cool. Remember, it's yours to be angry or not.
October 24, 2003: Wow it has been busy! Last week I was in Houston picking up a new minivan for my family, the next day I left for NYC and the 2003 Port Wine Stain Conference where I opened the conference with a speech, then back home for a few days before heading back to Houston for my 15th laser treatment.

I had the good fortune of seeing Dr. Roy Geronemus for a clinical consult while at the conference. He recommended I get more aggressive with my treatments. It has been awhile and it looks like portions of my birthmark are returning. One of the many interesting comments made by Dr. Geronemus during his lecture was that unless the pws is reduced to a certain "point" it has a higher likelihood of "recurring" or "progressing" (interesting debate on those two terms at the conference as well between the docs).

The topical anesthetic research program that Dr. Friedman was a part of has ended so none of the good stuff was available. I opted to go without topical and just use the DCD on the VBeam. And I did remember to get pictures taken! The DCD settings were 30/30 (30ms delay and 30ms spray). The VBeam was set on the maximum of 10mm spot size with 7.5J/cm2 and a pulse width of 1.5msec for those of you keeping track. Dr. Friedman agreed that my pws appeared to be coming back in places and highly recommended we get back on a regular program for 2004. So I already have an appointment for January!

One interesting wrinkle I threw Dr. Friedman's way was my request to have the treatment performed while in the Trendelenburg position. This little tidbit came courtesy of the newsgroup and a patient of Dr. Stuart Nelson's, who has been using it. The Trendelenburg position, for those of you racking your brain from pre-med, is a supine position with the feet higher than the head. You guessed it... blood flows into the head. From Dr. Nelson's lecture, the idea is to engorge the smaller venules in the lesion, getting them to expand to a size more readily affected by the particular frequency of the pulse dye laser. I'll keep you posted as to whether or not it was worthhile.

So the usual.. corneal shield, fan held by Denise, lots of zaps without too much pain... gotta remember to B R E A T H E. It was over pretty quickly. I even hit Dr. Friedman up for a quick zap on a vascularity (read "varicose vein") that had popped up on my right calf muscle. Heaven forbid, am I getting vain in my old age?
October 27, 2003: Three days post and I'm healing up nicely. No scabbing but plenty of purpura. I figure another 2-3 days before it is all gone. I'm staying out of the sun and not engaging in strenuous activities though I did move 20 wheelbarrows of dirt on Sunday for a gardening project. Ooh... my aching back!
My Personal Photos & Treatment Diary for 2004