| .............. Log on 041103.log started at Wed Nov 03 09:22:41 PST 2004 ........... | |
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| aupton | Welcome, Dr. S. Dr Rees is on, too |
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| drsciubba | Hi everyone--Jim |
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| aupton | PN & Darryl, please save your questions until all three of our docs are online |
| aupton | patuk, we will begin in just a moment |
| Darryl | Hello from Darryl in Seattle. OK. I'll save my questions. |
| drrees | Hi, Jim, we appreciate you joining us for todays sdssion |
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| patuk | i have tried your sugestion cyclosporin |
| drsciubba | I'm pleased and honored to be with you. |
| aupton | Hi, Diane and Ktty -- get your questions ready, we'll be starting in a moment |
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| patuk | and found it a great help |
| aupton | Welcome, everyone. Please direct your questions to the doctors, and not to each other. We will try to get to as many as possible in the hour |
| drburkhart | Hello, everyone. I see that our guest, Dr. Sciubba has joined us. We are fortunate to have you with us today. |
| drsciubba | Thanks |
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| patuk | its great to be with you all |
| pn | Any of the Dr's have infomation on Lovenox I have been on it since Feb |
| patuk | never done this before |
| drburkhart | If any of you have contacted us and not gotten a response, please do so again. We try to keep up with the emails but we have gotten many lately. |
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| drrees | Pn- are you on the Lovenox for your lichen planus? |
| aupton | Welcome newcomers. Direct your questions to the doctors, be brief and we will try to get to as many in the hour as we can. The doctors will address you individually. |
| patuk | is there really any new ideas |
| ru | Any thing for dry mouth during sleep.Is there a connection to olp? |
| patuk | im 81 and feel no better |
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| Diane | My gums have a burning sensation most of the time--any suggestions to relieve that? |
| pn | Yes. I have been using it for lichenplanus with some success, do you know why it works |
| mgoodman | I was wondering if lichen planus could cause one to have a high rhumatoid factor. I know that the rhumatoid factor is high for other reasons like arthritis, but my doctors are watching me and I have a low sed rate so it is not clear that is why we were wondering if Lichen planus could cuase one to have a higher than normal rhematoid factor |
| drburkhart | Ru, we recommend biotene toothpaste and they also have a gel that can be used at night. Do you comsume much coffee or tea? |
| drsciubba | Can we try to remain somewhat more coherent? I believe that we still have the Lovenox question open. |
| drrees | ru. There are some ways to treat dry mouth but medications for that depend on your overall state of health. We find that many of our patients with OLP also do have dry mouth. |
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| drburkhart | Caro or BJ do you have a question? |
| ru | A biopsy of two lichen planus on my legs shiowed squamous cells. They were removed. Info re this? |
| patuk | i find biotene mouth wash before bed helps dry mouth |
| mgoodman | please dont' forget my question about the rheumatoid factor. I am not trying to bust in but |
| drburkhart | Dr. Scuibba, Please feel free to address that question. |
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| drsciubba | In assessing dry mouth it is helpful to get a full medication profile as well as a confirmatory LP diagnosis |
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| Caro | My doctor has said no mouth wash, except his 'script, no gum, no soda pop, no tomatoes. Why? |
| drsciubba | I don't know about RF and OLP |
| Cindy | Can soda irritate OLP? |
| drburkhart | Patuk, yes I have heard this before. What works for one person does not always work for someone else. You should avoid alcohol containing mouthrinses. |
| drrees | mgoodman- As far as I know no relationship has been identified between OLP and rheumatoid factor. |
| ru | I use all of the biotene products but still in the mid of the night my dry mouth is still there. |
| mgoodman | Thank you I thought since lichen planus was an auto. disease and that the RH factor indiciated |
| mgoodman | such that there might be a connection |
| patuk | diets have to be watched at all times |
| virginia | when may iask my question been around quite here long time virginia |
| drsciubba | Diet and OLP initiation is not plausible. Dietary factors may accentuate an already or pre-existing OLP condition. |
| patuk | but will there ever be a cure |
| nofa | Type hereTomatoes and balsamic vinegar seemed to bring on my worst problems this summer. |
| drburkhart | Virginia, please ask your question. |
| drrees | Cindy, sodas can be very acidic and therfore could sometimes make your mouth sore if you have lp. That is epecially true if you drink a lot of sodas. |
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| aupton | Virginia, feel free to ask your question anytime |
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| virginia | any connection lp and ibs |
| Didi | Didi |
| drsciubba | If one is to accept the current etiologic models for Lp there does not appear toa dietary etiology |
| drrees | Virginia, no direct connection with ibs that we are aware of. |
| nofa | if you have olp do you have to worry you will get it in other places? |
| Anna | I am just joining iwas busy for a bit |
| pro.parachatgroup.com | [2009] touser Welcome session newcomers. Please address the doctors directly, and keep questions short. Transcripts will be available on the Website after the session. |
| ru | Any one doing research.If so can I be informed if I can be a subject? |
| drrees | nofa. You shouldnt worry about it but you might develop lesions on the skin or genitalia. |
| drsciubba | Other locations in association with OLP certsainly are possible including skin, vaginal mucosa, scalp, nails. |
| Anna | I have been diagnosed with olp in oct. I have had the problem since april |
| drburkhart | Ru, the stomatology center is always conducting some research. The patients who come to the center are usually screened, and there is documentation of all sorts. |
| patuk | i have lost nails nail bed is dead |
| drsciubba | Anna--havee you been treating it? |
| Cindy | Dr. S, how long can one ulcerated area be affected with olp without having biospy done? |
| drrees | Anna, how is your olp being treated? |
| patuk | but at my age who cares |
| Caro | I'm in need of extensive dental restorations. What precautions should my dentist and I take to mitigate OLP? |
| virginia | THE IBS IS MUCH WORSE WITH LP FLARE UP |
| Anna | just with oracort |
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| drsciubba | An ulcerated area itself should not be biopsied, but rather the area of intact mucosa around the ulceration. |
| nofa | Are there any herbal or alternative supplements which have helped olp? |
| pn | Any of your Dr's using Lovenox on patients would like comment, my dr. does not discuss with me, but i inject anyways with some success |
| drburkhart | Everyone, you should let your other doctors know that you have OLP so that everyone is connected. This is especially true for women with OLP and their GYN |
| ru | Need answer to my question re lichen planus and it turning into Squamous cell carcinoma? |
| drsciubba | In terms of dental restorative materials your dentist may wish to use precious metals that are highly polished and procealin. Scrupulous hygiene remains the important issue as well. |
| drrees | Carol, the main thing is that your mouth may get a little more uncomfortable while you are having the work done due to stretching etc. It depends a lot on the location of the lesions. |
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| Barney | My baby is five months now, I plan to nurse him one more month, should I wait then to get my OLP treated? |
| Anna | pn. I came upon Dr Shaw homoepathic treatment Is anyone familiar with that |
| drburkhart | nofa, the only one that we know that is documented is aloe vera. If you go to the ADA website and search on this, you will find some information. It is not for everyone. |
| drsciubba | Also, the manipulation of oral tissues during dental treatment may also aggravate Olp temporarily. |
| patuk | i tried homeopathic but wasnt very good |
| Caro | Drrees and others: I value your responses. Thanks! |
| drsciubba | As far as lactation and treatment of OLP is concerned, I think it rel;ates to the type of treatment is necessary, consistent with your OLP. |
| patuk | will aloe vera drink help |
| pro.parachatgroup.com | [2009] touser POINT OF ORDER: Please address the doctors, not the other participants, and please allow the doctors to do any recommendations. |
| mary | I use Temovate ointment with great success, stress definitely is a factor |
| drrees | ru, I missed that question., I thought you said you had squamous cell that was biopsied and later developed lp. The jury is still out regarding the possible relationship between lp and sq cell. There appears to be a slightly higher incidence in patients with op. |
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| drrees | patuk, there is one report that I know of suggesting the aloe vera helps. However, that has not been our experience. |
| drburkhart | Mary, yes stress does play a large role in outbreaks and has been documented. Stress management and exercise -a healthy lifestyle in general-is important. |
| Devera | Do you prescribe Protopic ointment for oral use? My dr. prescribed it for me and it burned my tongue badly. |
| drsciubba | With due respect to Dr Rees, i have seen all too often oral cancer develop in OLP, in particul;ar the chronic erosive form and in association with typical risk factors for oral cancer. |
| mary | Isn't there a toothpaste for LP? |
| Diane | I use KENALOG on the oral lesions---stress is always a factor |
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| drburkhart | Mary, Biotene seems to be tolerated well by almost all patients. |
| drsciubba | Tootrhpastes should be mild ones. Try children's formula with less detergent and flavors. |
| Anna | Can the Dr give some advice on treatment the oracort helps somewhat My dr advised only to use it sparingly |
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| drrees | Devera, we like Protopic but some patients don't wish to use it because if burns. Others say the burning is not so bad and that it lessens after using the Protopic for a few days or weeks. |
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| mary | Is Protopic a prescription? |
| drsciubba | Many topical steroids may be helpful. Duration and intensity of treatment must be carefully managed and observed. |
| drrees | Mary, yes it is by prescription only. |
| drsciubba | Protopic is a prescription item. |
| buckeye | Type here I have found Children's toothpaste does help, also trident orgininal flavor gum |
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| patuk | what is protopic |
| drsciubba | Children's toothpaste is also a lot less expensive!!! |
| drrees | buckeye, I am curious about how you feel the chewing gum helps |
| buckeye | It puts moisture in your mouth and eases the pain |
| ru | Is protopic a steroid?My dermatologist said it is not and to use it for flair ups/ |
| pn | although the lovenox has helped my olp i still get dry skin on my genitals is the skin permently damaged from years of cortisone use |
| drsciubba | Protopic is a drug developed tp treat exczema and has been found to be an excellent alternative to steroids in some cases where the initial lesions are not tto severe. |
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| drrees | buckeye, Gotcha that makes sense. The reason I was curious is that some gums can actually cause olp on rare occasions. |
| drburkhart | From the emails that we get from many people, we find that a large number have been diagnosed clinically, watched and followed. It is important to stress the fact that some cases turn out to be something different. So, biopsy is important in diagnosis. Especially, long-term with follow ups when needed. |
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| Anna | Is it normal to have burning, my tonquefeels at times scalded |
| patuk | how often is biopsy neede ive had two |
| patuk | both time olp flared up more |
| drsciubba | If Lovenox is helpful, it is beyond me as to its mechanism, given its indication in the management of DVT, etc. |
| BJ | rather than biopsy, my oral surgeon used a stain - if the stain STAINS then it might be precancer? |
| drrees | pn, that is a possibility. I think you should ask your gny doc. |
| drsciubba | "Stains" are useless in estabnlishing ANY diagnosis. |
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| Devera | I am currently taking Dapsone. Have you seen good results from its use? |
| ru | I have also lost half of a nail which does not grow back. Will it ever? |
| Diane | My dentist diagnosed my oral lp visually--should I ask for a biopsy? He seemed definate |
| KARENK | what kind of doctor should I use for regular followup visits and how often(OLP) |
| Cindy | Dr. S, as a patient of yours, I am following your highly regarded advice with favorable results other than one continual erosive area. Any other suggestions? |
| drrees | patuk, we tend to biopsy whenever there is a significant change in the lesions. That may be what happened with you. |
| drsciubba | Stains are usually used to establish the presence of dysplastic or precancerous lesion as a screening tool and nothing more. |
| drburkhart | Patuk, your healthcare person should decide this. If you think there is a change, then go back. Even if it is not time! Repeated biopsy is needed if there is change or the lesion is not responding. |
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| pn | i am signing off if any drs. want further info with my success with lovenox you can contact me by e-mail |
| buckeye | my insurance company told me to dr with a dermatologist rather than an oral surgeon; is this correct information or should an oral surgeon be consulted? |
| drsciubba | Cindy: |
| drsciubba | Cindy--can you amplify your question? |
| mary | I have found the gum often burns, so I don't chew much gum |
| Verapaula | Type here my question is could there any relation between OLP and ischemic colitis |
| pro.parachatgroup.com | [2009] touser Welcome session newcomers. If you have a question, please address the doctors directly, and keep questions short. Transcripts will be available on the Website after the session. |
| drsciubba | Good Idea!! |
| drrees | buckeye, dermatologists certainly treat these types of oral conditions but there are oral medicine dental specialists and oral pathologists who do too. |
| Anna | What is Lovenox |
| ru | It is 26 months that I have had this OLP and now LP. Will it ever go away? |
| drsciubba | Lovenox is used to treat deep vein thrombosis |
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| drsciubba | Skin Lp usually recedes in a few years; this is usually not the case for OLP |
| drrees | Verapaula, ischemic colitis should not be related to olp. However, some types of bowel diseases can create lesions in the mouth. (Not OLP) |
| patuk | many things you talk about are not known in the uk |
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| mary | Same question as ru, I have had OLP for 29 years, do you think I am stuck with it? |
| joni | Type here |
| patuk | but i see dermotoligist and maxiofacial clins |
| Caro | Since my question about gum has generated so much response, I feel the need to explain its importance to me. May I? |
| drsciubba | You may well be stuck with it, however, you amy wish to try other management strategies |
| Devera | Is there a connection between OLP and deep vein thrombosis? |
| drsciubba | No |
| Anna | I have two sisters with sarcoidosis is there any connection |
| drsciubba | No |
| drrees | patuk, there are many very knowledgeable oral medicine experts in the UK. If you e-mail Dr. Burkhart later we can probably suggest someone. |
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| Cindy | Dr. S. a previous ulcerated area which was lased and cut out by a previous dr, but is now being treated by you with tacrolimus ointment plus immune suppressant for 6+months just won't go away |
| patuk | thank you drrees |
| drsciubba | See Dr Stephen Porter, Ann Hegarty or Crispian Scully at The Eastman Institute |
| buckeye | dr - please expand on "other mgmt strategies" |
| drburkhart | Mary, have you tried stress reduction techniques such as yoga, tai chi or anything like these? |
| Caro | Is there a correlation between OLP and a history of smoking? |
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| ru | Who is doing research? |
| mary | No I haven't Dr. B, that is a very good idea--since I am the type A |
| drsciubba | An thorough evaluation of your OLP should be had wuthn regard to prior treatments and you success levels with them so that any alternatives can be developed |
| drrees | Caro, not that we know of. However, it is interesting to note that most of our patients do not smoke. |
| Diane | Dr's do you feel that anti depressants or anti anxiety medication would help? |
| patuk | or do you think they contibuted |
| drburkhart | Mary, After working with OLP patients for a number of years now, the one item that strikes me is that yes, many are as you say type A but also one can develop more in the coping skills area. |
| drsciubba | Diane--perhaps in terms ofd stress reduction, however, stress is only one of many modulating factors |
| patuk | ive been on valium low dse since the 60s |
| vixtor | with regard to smoking...my olp occurred when i QUIT smoking... |
| drrees | Diane, they won't help you lichen planus but you could talk with your doctor to learn if one would help you control stress. |
| Devera | I am currently taking Dapsone. Have you seen good results from its use? |
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| mary | I have been on Prozac a few years ago and am now on Effexor for hot flashes, but it hasn't helped, only the Temovate helps. |
| Darryl | I am a 58 year-old male. I have been diagnosed with OLP. Could it be a yeast infection caused by oral sex with a female? |
| drsciubba | Devera--Some people are helped with Dapsone |
| drrees | vixtor, interesting observation but certainly not a common one |
| drburkhart | Caro, I agree with Dr. Rees. In surveys that we do, it is striking that most are health conscious in general |
| drsciubba | No sexual connection here |
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| drsciubba | Are people leavbing because of the yeast question??? |
| pn | Besides Lovenox I u am oerscribed opiates for pain releif (thank god) can this make olp worse, need to leave shortly please comment |
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| drburkhart | Darryl, you can develop a yeast infection from someone else is you are susceptible in the first place. |
| drrees | Darryl, no a yeast infection won't cause olp. However, the treatments we use may predispose you to a secondary yeast infection. I im speaking of topical steroids and drugs such as Protopic. |
| Caro | Interesting feedback on the smoking issus. My OLP cropped up after 3 months on Nicorettes to stop smoking. Is there any research on that? |
| Verapaula | are synthetic nails bad for lp nails? |
| Diane | I was diagnosed with olp when I was going through menopause--any connection? |
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| Darryl | Why does "yeast infection" show up in the same discussion with OLP? Is there such a thing as an oral yeast infection? Could the diagnosis be confused? |
| drburkhart | Jim, I don't think so |
| drsciubba | I have not yet seen over-riding yeast infection with Protopic |
| vixtor | nicorette is what i used to quite smoking...interesting |
| Cindy | Dr S. unfortunately, I have to leave due to prior obligations(not the yeast quest) I will look forward to reading the script-thanks! |
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| drsciubba | Good luck Cindy |
| drburkhart | Caro, that is really interesting. |
| vixtor | do you think there is a connection between nicorette and OLP? |
| drrees | Caro, no research that I am aware of. However it is possible that the nicorettes caused a so called lichenoid drug reaction. That has not yet been reported but in theory any drug can cause the lichenoid reaction. |
| drsciubba | Diane--I don't know of a menopause connection with LP |
| ru | I am 82 and in perfect health except for the OLP and LP . Think I can make it to 102 with this OLP and LP. What are the ramifications for a long life with this bothersome stuff. |
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| drrees | Jim, unfortunately we have had two in the past two weeks. |
| Anna | I have been on actonel could the olp be a reaction |
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| drrees | Anna, please tell me what actonel is |
| drsciubba | Long life and bothersome stuff ?? Lp will not affect your long life ambitions provided it is reasonably well controlled with minimal treatment and absent systemic immunosuppression. |
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| drburkhart | Ru, I have been contacted by at least three or four people in your age group within the past few weeks. Most have had OLP for many years off and on. The important thing is to have it monitored and do what you can to minimize its affects such as with eating. |
| vixtor | what is "absent systemic immunosuppression...in english? |
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| drsciubba | As noted by Dr rees, any drug amy be producing a reaction. |
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| jolojo | This is my 1st time in this chat room and find it interesting that everyone is still looking for what might have caused this condition. I must sign off but will go through the script later. Thanks to all of the Dr's for their time and to others for their input |
| drsciubba | In the absence of drugs that may be needed to control LP tha also reduce the capabilites of the immune system to do what it does. \ |
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| drrees | jolojo, sometimes we can identify the cause. That is always good since we may be able to eliminate it. |
| patuk | ru has certainly cheered me up |
| drburkhart | jologo, please contact us anytime. We are here all the time and try to answer questions at any point. We will also help to find someone who knows about olp treatment when needed. |
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| buckeye | I've wondered about menopause, too, as that is about the time I first noticed it.......however, I was also under alot of stress with my job at the same time. So I credit the problem to stress. It's just odd that it doesn't go away after the stressful time is over. |
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| vixtor | yes...why is that...that it doesn't go away after the stressful incident is over? |
| drsciubba | It's important to separte CAUSE and modifier relationships such as stress |
| Anna | actonel is given for osteoporosis I don't have the active ingredient handy Phophates?/ |
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| drrees | buckeye, the maority of our female patients are past the age of menopause. We did a study a few years ago in an effort to find a relationship but were unable to do so. |
| htwheels | Are their any OTC drurgs to avoid with me having errosive lichen planus? |
| patuk | itoo have noticed my olp is worde at times odf stress |
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| Diane | Dr's, are most of your pt's over the age of 40? |
| drsciubba | Actonel is a bisphosphonate; it is in the same general family of osteoporosis management drugs as Fosamax, etc |
| drrees | Anna, thanks. We don't have the bisphonates on our list but as I mentioned earlier, any drug may cause a lichenoid reaction. |
| pro.parachatgroup.com | [2009] touser Everyone -- we have about 20 minutes to go. In the next 15 minutes, please conclude any open conversations. The room will remain open for about 5 minutes after the session for the exchange of emails. Transcript will be on the website by tommorrow morning. I will alert you at 10minutes and 5 minutes before signoff. |
| Verapaula | psychological stress is always the reason for a sudden Olp disease |
| Caro | How contageous is OLP? |
| drsciubba | Verapula: No |
| drsciubba | LP is not contaghious |
| drrees | Caro, there is no evidence that it is contagious |
| drburkhart | Buckeye, many women develop OLP in mid-life. When you think about it, that is a time when many life changes occur. Especially, with the generations now. Most women work, take care of children and parents as well. Life is stressful in general. Even eating disorders are occurring at an alarming rate in this age group. |
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| Devera | Does the use of Advil seem to have an effect? (Or other anti-inflamatories?) |
| patuk | are there any conections to surgery |
| ru | Can you estimate how many people in the USA have OLP and LP. I am curious. In numbers there is a bit of comfort........ |
| drsciubba | Advil can adversely impact LP |
| patuk | had a bypass this flared up 2years after |
| drburkhart | OLP IS NOT CONTAGIOUS. I don't know how many people have contacted us thinking that it is. |
| buckeye | are there any mints/breathe mints that help alleviate the discomfort of OLP? |
| drrees | ru, some studies suggest about 1-2% but that is probably a little high. It is relatively uncommon but not rare. |
| drsciubba | Frequency stats are wide-ranging--with some studies quoted as high as 1.5% of the population |
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| Verapaula | Is there higer percentage of olp in USA than Europe |
| ru | Do you know of any support groups in AZ. |
| Diane | Dr's I used Tylenol PM to help me sleep and found that it seemed to help my symptoms-was it the benadryl? |
| drrees | patuk, there should be no relation with your surgery. However, medications you may take to control your heart condition may be a factor. |
| drsciubba | In some countries OLp may be a bit more common and may be related to other factors such as hepatitis C |
| drburkhart | Ru, no I don't, but you sound interesting enough to start one! |
| patuk | think they have checked those |
| drrees | Diane, chances are that the meds just made you sleep wall and dulled the discomfort. |
| Kitty | Dr. Ciubba: How does one make an appointment wiith you or an oral med. specialist at Hopkins? |
| drsciubba | Call 410 955 2083 |
| Verapaula | after each general anesthesia(3 in total) there was a very ilness of olp |
| drsciubba | Coincidence |
| Darryl | Why is yeast infection mentioned in OLP discussions. Are symptoms similar? |
| drburkhart | Just to let you know, Kitty. We have sent patients to Dr. Sciubba and we always hear good things. |
| drsciubba | Also the stress connection amy be at work here--I assume there was a procedure associated with the anesthesia |
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| Diane | Dr's, can you recommend a specialist in the Pittsburgh, Pa. area? |
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| drburkhart | Darryl, patients who have OLP sometimes develop candida because of the topical steroids that are used sometimes. Also there is a chance of candida when dryness occurs in the mouth. |
| Kitty | Thank you so much doctors for all your help. |
| drrees | Darryl, symptoms can be similar. Also yeast infections may occur because of the medications we use to treat olp . Sometimes that confuses the issue because then you need to be treating two things at the same time. |
| ru | Do you know of anyone in Az that you could put me in contact with without offending confidentiality |
| pro.parachatgroup.com | [2009] touser Everyone -- 10 minutes to signoff time. |
| Verapaula | it was a suffering time olp for me after each operation and I took many bucalsone |
| drburkhart | ru, contact me by email and I will talk to you. |
| Anna | Is there any Dr you can recomment in the kingston Ontario region |
| ru | I would not like to put an ad in the papers as ,in these times,it might not be a good idea. |
| patuk | thank you for your help hope to join you next time |
| drburkhart | Everyone, Dr. Rees and I are changing our email addresses soon. The new email is on the site, right Art? |
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| drrees | Several of you have asked about the name of someone in your area for you to see. If you will contact Dr. Burkhart by e-mail she and I will try to find someone for you who is relatively close to where you life. |
| drburkhart | Yes, we would be happy to help. |
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| Verapaula | now i feel better with 'aloe vera' good effect! |
| nofa | Thanks for the info. I'll check back another time. |
| pro.parachatgroup.com | [2009] touser Everyone -- 5 minutes to signoff time. Thanks to Drs. Rees and Burkhart of Baylor, and to our special guest, Dr. Sciubba. The room will be open until 35 after the hour. Please log off before then. Thanks to everyone! And the new emails are on the site! |
| ............................ nofa left............. | |
| vixtor | Dr. Gobetty at Michigan has always indicated to me that OLP doesn't turn into cancer |
| drsciubba | I very much enjoyed this--if I could only type better!! |
| Verapaula | thanks dr. |
| ru | Thank you drburkhart. Will contact you as soon as my time permits. Yhank you Dr drees. |
| Diane | Thank you Dr's --and thank you for this web site--it's good to know I am not alone |
| Anna | Thank you for this chat , i will reed the transcript tomorrow |
| drburkhart | Dr. Scuibba, thatnk you so much for joining us. You have added so much! |
| Caro | Amen |
| vixtor | ditto on that |
| drrees | vixtor, I hope she is right. |
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| drburkhart | If anyone has any questions for Dr. Scuibba. email me and I will forward them to him. |
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| drrees | Thanks Jim, your comments were much appreciated. |
| drsciubba | Any time Terry |
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| drburkhart | I think that the room is left open for a few min to exchange emails if you want to do this or for comments. |
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| drsciubba | Cindy--Do you hasve any more questions? |
| drrees | Nancy, thanks for arranging this and thank you Art. I am going to sign off now for another appointment. |
| Caro | Is there any way to dialog with others in this support group? |
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| drburkhart | Thanks Terry-talk to you soon. |
| Cindy | Dr S, just wanted to know if it is "safe" to have an erosive area stay such a lengthy time period |
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| drburkhart | Cindy, I think that Dr. S. has gone. Be sure that you stay under the care of someone and that the area is monitored |
| drburkhart | email us everyone with any comments or questions. We will see you next session! |
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| .............. Log stopped at Wed Nov 03 10:32:36 PST 2004 ........... |