Dr Darm 1 Week Treatment (Dr Nase: Please Read and Comment)

[theresakindoflush]

Hi,

I am going to visit Dr Darm's Portland, OR office as soon as I save up $5,000 but would like to start a thread dedicated solely to posts of those who have undergone, or are in the midst of, this specific protocol.
My symptoms are specifically: Redness, Severe Flushing/ Blushing....probably the two most intractable symptoms...even Dr Darm's website comments on how Facial Flushing is very hard to treat.
So if Dr Nase could comment on his theory regarding the efficacy of this method for severe redness/blushing, and those brave pioneers of you who have already undergone this protocol could comment, we could have a pretty decent picture of what we are physically and economically getting ourselves into.......in closing, have hope with this disorder and understand you are not alone, when you feel lower than hell, think about all of those who suffer with you, and the idea that maybe someday you'll be free of this red beast.....all my thoughts are with you [/i][/b]

[keisha06]

Treatment with Dr. Darm:

OK, you asked , here it is (and it is long) I'm doing the 6 treatments over 2 weeks.

Symptoms/History:
Flushing (burning and painful), some burning sensation. Sensitive skin. A few papules, especially after bad flushing.

My flushing came on quite suddenly – personally I believe it to be at least partially hormone related as I went from not really flushing (at least noticeable to me or anything that drew comments from others) to flushing a lot, very red, very hot and painful within about 2 weeks. Prior to the "onset" I can recall a time of some flushing on the cheeks (a few days), but that was approximately 1.5 years before (very high stress time) and then stopped.

My main triggers are heat (threshold varying from 70F – to about 76F if outside with a little wind to keep the air moving) sun, emotion. Flushing is full face, though not very noticeable on chin and forehead, but including ears, very red, very hot and increasingly painful. Prior to coming to Oregon to get treatment with Dr Darm I had several nasty flushes with little in the way to provoke them, that made me think of pouring alcohol on a really bad sunburn.

Did 10 IPL treatments with a derm using the Aurora RF locally (not very knowledgeable, but neither was I at the time – just desperate) – got some relief, especially in the general 'feel' of my skin (crawly, tingly, somewhat painful and raw feeling) but also somewhat in flushing.

Meds: Rosasol (1% metrodiazonole), clonidine
Cleanser: Tolerin Purifying foaming cleanser or Rosacecare Ultra Mild Cleanser
Moisturizer: Rosaceacare
Sunscreen: COTZ or Clinque Super City Sunblock
Supplements: 1000 mg Ester-C x3/day, 100 mg Grapeseed extract 3x/day, 1000 mg flaxseed 3x/day, Boswellia 100 mg x3/day, 50 mg zinc (with copper) 1x/day

Stopped all supplements but Zinc 10 days prior to first treatment, also stopped Rosasol 2 weeks prior to first treatment. Stopped clonidine 2 days prior to treatment. Interesting note on the Rosasol (Noritate and Metrocreme make me flush) I didn't think it was doing much, but within a week of stopping it my skin was much more reactive, not sure if it was that, or the supplements.

Dr Darm has a few different procedures than are sometimes posted – between treatments he likes patients to try out their triggers and see if they are lessening the flush at all. I also kept very well moisturized all though the treatments (those I've had so far). I also have to say how impressed I am by both Dr Darm and his staff – they are very professional (and personable) and extremely knowledgeable. What a beautiful experience compared to other IPL docs I've checked out.


1st Treatment: August 1, 2005
Treatment area: full face and ears.

To create flush: laizercaine – applied 4 times 15 minutes apart prior to treatment. Steam used when getting YAG treatment to keep flush going. Very hot here in Oregon so I was already pretty flushed.

Gensis Yag (paint technique), 1 pass with Photoderm 560 filter, 2nd pass with Photoderm 590 filter (both triple pulse)
Dr. Darm took pictures (during consult and after inducing flush), reviewed history and the pre-treatment questionnaire I sent him. Staff did the Yag treatment, Dr Darm did most of the Photoderm – he was continually checking in when he wasn't in the room. Cortisone crθme used after treatment.

Time: this first appt was from about 1:00 p.m. until past 4:30 (this includes 1 hour to induce flush). Dr Darm and Team were very good at explaining all that they were doing.

Was a little swollen high on the cheeks but went down by the next day (I did ice at least 2 times – 20 min on/20 min off). Used cool paks and also, have small portable fan that works well (can be operated battery or plug in). Was still a little red (I don't have much permanent redness, but am often somewhat flushed) the next day.

Results: hard to tell on the first one in regards to reduced flushing but did notice a significant decrease in pain if I did flush.

2nd Treament – August 3, 2005
Treatment area: full face and ears, top of neck.

To create flush: laizercaine – applied 4 times 15 minutes apart prior to treatment. Steam used when getting YAG treatment to keep flush going, heating pad on back used in for both Yag and Photoderm, 100 mg oral niacin.

Gensis Yag (paint technique and spotting at some broken veins), 1 pass with Photoderm 560 filter, 2nd pass with Photoderm 590 filter (both triple pulse). Staff did the Yag treatment, Dr Darm did some of the Photoderm – he was continually checking in when he wasn't in the room. Cortisone crθme used after treatment.

Redness went down in about 3-4 hours. Used cooling paks and fan (for cooling paks I just use reusable hot/cold paks kept in an ice bucket – so they are cool, not cold, and wrapped in thin soft cloth).

Results: well it was a little harder to get me usual blood red flush going and so far no flush I have had has been as painful as what I was getting before. Had shower the day after, warmer and steamier than usual, and while I did flush it went down much quicker.

3rd Treament – August 5, 2005
To create flush: laizercaine – applied 4 times 15 minutes apart prior to treatment. Steam used when getting YAG treatment to keep flush going, heating pad on back used in for both Yag and Photoderm, 200 mg oral niacin.

Gensis Yag (paint technique and spotting at some broken veins), 1 pass with Photoderm 560 filter, 2nd pass with Photoderm 590 filter (triple pulse). Staff did the Yag treatment, Dr Darm did some of the Photoderm – he was continually checking in when he wasn't in the room. Cortisone crθme used after treatment.

Redness went down in about 3-4 hours. Used cooling paks and fan.

Results: it was once again a little harder to get my usual blood red flush going and so far no flush I have had has been truly painful. I did go out (temp has been mid 80's to 90 hotter than what I typically run into at home) but wasn't actually outside a great deal but went out to eat, walked the mall etc, and when I flushed, it was not as intense (I would call it more 'pink' than red in my opinion, but still pretty good color) went down quicker, and while not 'comfortable' neither was it really painful. Again had a shower, even warmer and steamier, and again, I flushed, but it was less intense and went down quicker.

Did have a few tiny little blisters from spot treatment of veins, used vitamin E oil to keep moist and went down in about 2 days. Created no problem.

4th Treament – August 8, 2005
To create flush: laizercaine – applied 4 times 15 minutes apart prior to treatment. Steam used when getting YAG treatment to keep flush going, heating pad on back used in for both Yag and Photoderm, 200 mg oral niacin, topical niacin.

Gensis Yag (paint technique), 1 pass with Photoderm 560 filter, 2nd pass with Photoderm 590 filter (triple pulse). Staff did the Yag treatment, Dr Darm did some of the Photoderm – he was continually checking in when he wasn't in the room. Cortisone crθme used after treatment.

Redness still going down (just had treatment a few hours ago). Used cooling paks and fan.

Results: it was once again yet a little harder to get my usual blood red flush. Will update for the next 2 as they happen (info after 6th might be delayed as I have to travel home).

Note on Accommodations: I'm staying at the Phoenix Inn Suites, was originally booked at the Shilo in (which is very close to Dr Darms office) but the air conditioning wasn't great so switched to the Phoenix Inn. It is very good, free Internet (hence my ability to post), clean and excellent free continental breakfast. It is only a few minutes walk away, and really, if it wasn't so hot I would easily consider it walkable.

[KHM]

If you do a search I also posted on my 4 treatments.

Am still waiting to see what the final results will look like.

[RedHotCanuck]

Thanks Diane.. That is a great post.

How much did the 5 treatments cost you?

[drnase]

Please forgive me, I should not post on this subject right now.

[theresakindoflush]

I understand Dr Nase, but it sucks.....anyway since im inclined to cynicism, what is the worst thing that can happen after a protocol like this? I mean, can things go horribly wrong? is simply no improvement and the squandering of 5 grand the only bad outcome?
thanks for responses, good luck out there

[Max]

Treatment with Dr. Darm:

... 1 pass with Photoderm 560 filter, 2nd pass with Photoderm 590 filter (both triple pulse). Staff did the Yag treatment...

hi keisha,

thanks for the detailed report. is there any chance you could also post the exact settings used for ipl? (lenght of pulses, time between them & strenght)?

thanks,
max

[keisha06]

I booked for 6 treatments, 4 including my ears and the cost (forgive me I don't have all the details with me) was about $3,200 US. He gives a price break at 3, 6 and 9 treatments. If you are interested you should contact him, he has a great pretreatment package that explains his protocols, costs, pretreatment questionnaire etc.

I'll see if I can get the info on the pulses - Dr Darm is pretty good about giving that info so I can't see why he wouldn't. I'll post when I have it.

[keisha06]

I asked Dr Darm about the settings he uses and he doesn't like to give them out to anyone but physicians due to the differences in machines - a setting he uses on his Photoderm might do harm if used on another machine. Makes sense I guess why he would want to be careful.

However, if you have your physician or IPL doc give him a call he said he is more than willing to give them the info.

[keisha06]

For those that are interested, here is an update on my 6 treatments with Dr Darm:

5th Treament – August 10, 2005
To create flush: laizercaine – applied 4 times 15 minutes apart prior to treatment. Steam used when getting YAG treatment to keep flush going, heating pad on back used in for both Yag and Photoderm, 500 mg oral niacin, topical niacin.

Gensis Yag (paint technique and some spot for broken veins) – extra pulses, 1 pass with Photoderm 560 filter, 2nd pass with Photoderm 590 filter (triple pulse), upped the joules. Staff did the Yag treatment, Dr Darm did some of the Photoderm – he was continually checking in when he wasn't in the room. Cortisone crθme used after treatment.

Appt ended at about 1:00 p.m. – feeling pretty good by about 4:00 p.m. Did a little iceing as they upped the energy.

Results: it was once again harder to get my usual blood red flush (really really red did not happen until topical niacin applied). I have been less red when waking up, using fans still but low levels, not a lot of cooling – more air movement. Able to sleep relatively warm without a flush – just a little red in the morning (may go away as skin settles). Was out and about more, flushed a little but was pretty light. Went out for lunch and to the mall, then out again later for dinner, a little grocery shopping and the mall – did OK through it all!

Day of 5th treatment: was out and about approx 4 hours after the treatment, dinner, mall etc – no flushing, no discomfort, no fans. About 27 C out.,


6th Treament – August 12, 2005
To create flush: laizercaine – applied 4 times 15 minutes apart prior to treatment. Steam used when getting YAG treatment to keep flush going, heating pad on back used in for both Yag and Photoderm, 200 mg oral niacin, topical niacin.

Gensis Yag (paint technique and some spot for broken veins), 1 pass with Photoderm 560 filter, 2nd pass with Photoderm 590 filter (triple pulse), upped the joules again. Staff did the Yag treatment, Dr Darm did some of the Photoderm – he was continually checking in when he wasn't in the room.

Appt was at 8:00 a.m. so I started using Laizercaine at the hotel at 7:00 a.m. Appt ended at 9:30 and it was back to the hotel and then heading for home (about 10:10 a.m.)

Results: it was once again harder to get my usual blood red flush (really really red did not happen until topical niacin applied - topical niacin really brings out a flush, much more effective in my mind that the oral niacin). I have been much, much less red when waking up, didn't use any fans the night before 6th treatment and able to sleep relatively warm without a flush – just a little pinkish in the morning (may go away as skin settles).

The "release" instructions were not to necessarily avoid all triggers, only those that might precipitate a major flare (antibiotics - Biaxin - to help with this and to hopefully help prevent angio-gensis).

For trip home I packed a lunch container (one of the soft sided thermal ones) with bags of ice and put in reusable cold paks to keep them cool. Used them a bit on the drive home but not much (had air conditioning on in car, but not set really cold).

Had to wait at the Tsawassen Ferry terminal for about 3 hours - it was about 24C (approx 78F), stayed in the shade and walked around a bit. Skin was sensitive but I didn't really flush at all. Ferry ride was no problem.

Following day (Saturday) skin was a little sensitive but not really a problem - didn't flush at all but skin was a little pinkish and warm a couple of times (not for long) - began taking Biaxin this day and resumed use of Rosasol (metrodiazonole). Sunday was a great day - temp was about 24-26C (78-82F) and I had no problems, skin felt fine (little sensitive on one side) but I was outside - both sun and shade (did wear a hat and lots of sunscreen) - I thoroughly enjoyed the day - the first time I have been able to do that since my Rosacea "came out".

So far the results have been excellent. I don't think all flushing has been eliminated but I was (I love to say was) in the moderate - (probably more like) severe range of this. I intend to see how it goes over the next while and if necessary, look at another 3 treatments next spring if the pocket book will allow (which if things go as they seem to be right now, would likely, in my opinion, pretty much eliminate all flushing).

For those that are interested, I'll post over the next few weeks as to any changes/improvements.

I can't recommend Dr. Darm and his team enough - they are so thorough, so caring and personable, and so knowledgeable! The compressed protocol works great and it is so amazing to see the results so quickly - the first 3 (typically) very small changes - but the differences after 4, 5, & 6 were so noticeable - all within 2 weeks! I'm already feeling like I have part of my life back!