Well, we took our son to see the dermatologist today since it has been 2 weeks since he started the Propranolol treatment. We were told that the ulceration looks ok and it doesn't seem to be infected. Nevertheless, we were prescribed Metronidazole (same as Metrogel) to apply twice daily to the wound just in case. We were also instructed to apply good amount of vaseline to the ulcerated area ever 4 hours or so. We were strongly advised against washing the area as per VBF wound treatment instructions when I asked about a prescription for sterile water (the over-the-counter saline solution just didn't work and I hate sterilizing water because it takes so long and I still question myself if it is really sterile). So we were not given a prescription for this and were told to just let water drip over it during baths and that will be enough. And lastly, we were told to continue with the Lidocaine (we'll see about that).
We were instructed to start taking Propranolol again at 1mg/kg/d and in couple days increase it to ~1.4/mg/kg/d but not more than that (he was at 2mg/kg/d before). She kept insisting that Propranolol will cause ulcerations at higher dose and at lower doses (1-1.5) will actually help to heal. However, at lower doses, especially at 1mg/kg/d, it will be difficult to stop the growth of the hemangioma (sort of like catch 22). Actually, since our son starting taking lower dose for one day and didn't take any the following two days, the hemangioma has rebounded. It has gotten more red and elevated.
Anyways, I did call Dr. Mark Nagy's office today who is listed on this website and is located in Buffalo and was able to get an appointment for this coming Thursday. By the way, I read the story of Chloe Simone Grant on this website, whose operating doctor was Dr. Nagy. Can you please tell me if the parents are active on this website? I'd really like to get in touch with them and see what they have to say. By the way any experience/information regarding Dr. Nagy will be very appreciated (you can send a pm or reply to the post).
Overall, my son is doing much better. I think my wife and I are getting the hang of it. Attending the wound has not been as stressful, thankfully, (I hope we are doing it right), and he has not been too cranky.
Take care. I'll keep you posted.