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Posts by Kyle Goleno:

Jill Biden has Mohs Surgery

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On January 11, 2023 Jill Biden (the First Lady) had Mohs Micrographic Surgery for Basal Cell Carcinoma.

This procedure is safe and a fairly common treatment option for certain Basal Cell Carcinomas.

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Drug Shortages

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Did you know that drug shortages are a common occurrence in the United States.  At any time of the year the FDA reports multiple medications that are out of stock.  This becomes troubling for people with specific diagnoses who require treatment that doesn’t have alternatives.

However, we are now in a crisis where the supply of an entire class of medications has been disrupted and millions of patients have/will be affected.  Local Anesthetics.

Dermatology practices like ours have been struggling to get local anesthetics like lidocaine.  These anesthetics are used for hundreds of procedures that are done in our offices each week.  We use lidocaine to biopsy lesions suspicious of cancer and to perform surgical procedures to remove malignant and nonmalignant, but sometimes critical, lesions.

This is frustrating for both our patients and our providers.  We are dependent on the suppliers of these medications to have them readily available for our use.  It’s surprising that our government hasn’t done much to prevent these drug shortages since the first FDA drug shortage report to congress in 2013.

Please consider sending your representative a letter regarding your concern.

National_Drug_Shortage_Patient_Letter

[Date]

 

Dear [Congressional Member]:

 

I am writing to you as your constituent to discuss an issue of great concern—the national drug shortage.  It is troubling that commonplace medications that are used in physicians’ offices every day are not available in the United States, and that their unavailability places America’s patients, including your constituents, at risk. 

 

The issue of drug shortages in the United States is an escalating problem that began nearly a decade ago when limited production capacity and lack of competition in the pharmaceutical industry led to a shortage of generic injectable medications, including lidocaine and lidocaine with epinephrine.  Since then, medical organizations, like the American Academy of Dermatology Association, have actively lobbied Congress and federal agencies, including the Federal Drug Administration, to address the concern.  I fear that those efforts have not fixed the problem.  Therefore, I am writing to you as a patient and your constituent to let you know how this shortage affects us. 

 

Lidocaine is a local anesthetic frequently used for common dermatologic procedures, and lidocaine with epinephrine is essential to control bleeding during these surgical procedures.  However, lidocaine with epinephrine is only available in limited quantities and in some cases has been on back order for months.  The impact on this shortage is most acutely felt among solo and small practitioners where the predominant outpatient care is provided. 

 

This is what the national shortage of lidocaine means to me and millions of other patients across the United States:

 

  1. A patient (especially one taking a blood thinner) may not be able to have a biopsy of a suspicious skin lesion simply because the risk of bleeding is too high.
  2. A patient’s skin cancer surgery may be delayed indefinitely simply because the physician cannot control the pain and bleeding inherent in the surgical procedure, which could lead to intraoperative complications.
  3. A physician may have to find unconventional alternatives to anesthetizing me, thus increasing the risks associated with my procedure.

 

Please put an end to our nation’s drug shortage by working with the pharmaceutical industry, federal agencies and our national medical organizations to rapidly identify feasible solutions to this national crisis.

 

Yours most sincerely:

 

[Patient Name and Contact Information]

 

Botox

Botox® Cosmetic is the most common nonsurgical anti-aging treatment. It is a safe and effective way to reduce or eliminate lines on the face caused by use of the facial muscles. With a few injections the areas treated can smooth out and give you a younger, relaxed look, with results lasting a few months and follow-up treatments often lasting longer, if you would like to learn about other cosmetic procedures then consider looking into microneedling.

According to Healthcare Business Today, Botox® Cosmetic is a natural purified protein that is injected into the targeted muscles of the face and blocks nerve impulses that cause contractions. The absence of muscle contractions prevents the skin from being bunched and creating lines. The protein does not travel elsewhere in the body, so there are no unwanted effects from a treatment. There is a potential of bruising from the injection, and one of our expert providers can discuss with you possible outcomes and rare side effects.

Within the first few days the treatment starts to take effect and the majority of patients see significant improvement at 7 – 10 days, and further improvement for up to a month. Results can last up to four months, however individual outcomes may vary.

Our practice has an excellent relationship with the makers and suppliers of Botox Cosmetic® and participate in the Brilliant distinctions® program, allowing patients to earn points for their treatments which can be used for special perks.

As with all cosmetic procedures it is best to consult with one of our providers on your specific concerns so that you receive the best treatment, or combination of treatments, for you. The cost of Botox® depends on a number of factors, including how much is used and will be discussed with you during your consult.
Call our office at (707) 643-5785 to get started.

FDA raises concerns: Are sunscreens actually safe?

Sunscreens have not required the same scientific studies to be done that medicines require.
Recent studies made by Wp Health Care News have been conducted that now show that when using lots of sunscreen, those chemicals are absorbed systemically and can be found in your blood stream. Additionally some of these chemicals may not be safe.

So… now the FDA is going to require that safety studies be done on sunscreens to make sure the chemicals that are absorbed are safe.

Until these studies are done, it is still recommended to use sunscreens to prevent UV damage to the skin which is a known cause of skin cancer.

If you are suffering with damaged skin then also have a look at this skin repair cream for damaged skin made by CHOLLEY as we have seen amazing results so far.

This often brings up the question about using natural sunscreens that don’t contain these chemicals. However, it is these chemicals that make sunscreens effective at preventing UV damage.

Are sunscreens Safe? FDA article

Napa Dermatology Office

Napa Dermatology Office

1700 Second St., Suite 220
Napa, CA 94559
Tel: (707) 252-2931
Fax: (707) 603-3895



FROM Lake County – SOUTH ON HWY 29

  • Take exit 18A for First Street toward Downtown Napa
  • Turn right onto 1st St
  • Once you go over the overpass, follow signs for Central Napa, going to the right onto California Blvd
  • Use any lane to turn left at the 1st cross street onto 2nd St
  • Go straight at the Jefferson light
  • Building is on the Left, just before Seminary Street.

FROM Vallejo – NORTH ON HWY 29

  • Take exit 18A for First Street toward Downtown Napa
  • Keep right at the fork, follow signs for Central Napa
  • At the light stay in the right lane to turn onto California Blvd
  • Use any lane to turn left at the 1st cross street onto 2nd St
  • Go straight at the Jefferson light
  • Building is on the Left, just before Seminary Street.

FROM Fairfield – I-80 W

  • Take I-80 W to CA-12 W.
  • Take exit 39B from I-80 W
  • Merge onto CA-12W
  • Use the right 2 lanes to take exit 39B for CA-12 W toward Napa/Sonoma
  • Continue to Napa County
  • Continue onto CA-12 W
  • Turn right onto CA-12 W/CA-29 N/State Hwy 12 W (signs for Napa/Sonoma)
  • Continue to follow CA-29 N
  • Take exit 18A for 1st St toward Downtown Napa
  • Turn right onto 1st St
  • Merge right onto California Blvd
  • Use any lane to turn left onto 2nd St
  • Destination will be on the left

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