Wednesday, January 22, 2014

How things are going + a few of my tactics for survival.

Well, it's been 24 days without steroids and I am feeling okay.  Better than I expected, actually. Compared to the last time I attempted TSW (about 1.5 years ago), this time seems so much easier for some reason.

I feel like moisturizing is imperative for me.  Last time, I went about TSW without moisturizer (as a few TSW-ers were touting the benefits) and it was absolute hell.  The dryness & cracking was absolutely unlivable.  This time, I don't care if moisturizing slows down my healing (as some people say it will).  I want to be able to get through every day as comfortably as possible!  I work two jobs and absolutely NEED to be able to look & feel the best that I possibly can everyday.  I was not able to work or do anything last time when I wasn't moisturizing.

My moisturizer(s) of choice: after a warm shower (twice a day), I slather my entire body in coconut oil and then seal it in with Aquaphor (however, I do not use Aquaphor on my arms, which I'll explain).  In the past, I tried many other moisturizers, but this seems to work best (and is the least irritating) for me.  It's REALLY greasy, though, and I have to wait about 20 minutes until I'm able to put clothes on over top of it (the clothes still get very greasy though :( .)

Occasionally, I'll retouch my skin with either coconut oil or jojoba oil when I feel my skin getting dry throughout the day (particularly my face & neck).  My arms are covered in bumps and moisturizing them actually seems to irritate them more, so I only use coconut oil on them twice a day (and definitely not Aquaphor).  It usually helps to open up the skin pores with a little bit of warm water even if I'm just touching up a small area of skin.

One other "moisturizer" that I think is helping me: after my evening shower, I wrap my head in a towel and leave it on my head until I fall asleep.  If possible, I try to keep the towel on my head all night as I sleep.  My hair stays wet for most of the night.  I feel like this extra wetness on my head helps me stay moisturized.  (I could be way off base here, but I honestly feel like it helps with the dryness).

I also sleep right next to a humidifier.  My hygrometer currently says that the humidity in the house is 16%!  That's really low and really dry!  A humidifier is absolutely necessary.

Help with the itch: I've been taking Atarax (aka Hydroxizine) 10mg multiple times throughout the day.  It's drowsy effects only catch me off guard occasionally nowadays, but it generally isn't making me feel sleepy anymore.  It doesn't take the itch away entirely, but it definitely takes the edge off (thank God)!  I don't really like the fact that I'm dependent on this drug, but.... gotta do what it takes!  I know that I absolutely cannot stand the itch if I don't take it.  So, I'm taking it and not worrying about it!

Here's two photos from today:

The bumpies and pimply-looking/rough texture is mostly gone at the current moment.  My chest is smooth-feeling but still flakey.

My hand looks... like a 90-year old woman's?


Tuesday, January 21, 2014

What's the cause, anyway? (A long tale with many uncertainties).

I have so many thoughts to share surrounding this whole ordeal with my skin.  Before I get into too much, however, I first want to talk about why my skin problems even exist in the first place.

So, what's the cause?  To put it plainly, I don't know exactly.  I have some ideas and theories, but I can't be totally sure of the exact cause.  Perhaps (and I tend to think) it was a combination of a lot of different things.

-LET'S START WITH CHILDHOOD AND GO FROM THERE-

As I mentioned before, I have had issues with my skin for my entire life.  Growing up, I had normal eczema--small patches of inflamed skin on various parts of my body.  Nothing too wild, mostly manageable.  There were a few times when it was so bothersome, that my childhood dermatologist prescribed some creams (we don't remember what they were, but we assume/know they must have been steroids).  I would use the creams for a couple days and magically my rash would be gone.  I never had to use the creams for more than 2 or 3 days.  And I probably used them once or twice a year, if that.  The rashes were very mild.

In high school, I saw a dermatologist on a semi-regular basis, but not for my eczema.  I had some issues with acne.  Again, nothing outrageous.  I never had need to take any of those strong drugs (like Acutane).

Throughout college, not once did I see a dermatologist.  I believe I applied over-the-counter Hydrocortisone 1% cream on occasion, but that was even pretty minimal.

My next eczema issue popped up about 4 years ago, after Christopher & I got married.  I had just moved to Philadelphia and started working at a coffee shop.  Due to the nature of working in the food industry, I spent at least an hour washing dishes everyday and--in between making espresso drinks & assembling sandwiches--washed my hands at least 60 times every day.  I ended up with some pretty terrible eczema on my hands.

Steroids to the rescue!  (Triamcinalone, to be exact.) It took about 2 weeks for my hands to heal & then I continued on by wearing dish gloves at work.  Fairly soon after that, I found another job and didn't have to worry about it anymore!  My hands were healed and I was fine!

-AND THEN THE REAL PROBLEM STARTED... WITH SKINNY JEANS-

About a year later, it was fall and skinny jeans were really "the thing" to wear.  So I jumped on the bandwagon (late, of course).  I looked cute in my new jeans (obviously...), but I noticed that my legs became a little bit irritated from the tight clothes rubbing against my skin all day, everyday.  But, in the name of fashion, I continued wearing them despite the discomfort.  I'd put some moisturizer on my legs every morning before dressing but, by the end of the day when I took them off, my legs were super itchy and flakey.  I continued wearing skinny jeans (and irritating my legs) almost every day for more than a year.

Why didn't I stop wearing skinny jeans?  Why didn't I do something more than simply moisturize once in the morning?  I look back on it now and feel utterly stupid.  I didn't take it seriously.  I tolerated the discomfort (like I always do) and ignored it.  By that point, my legs were pretty ripped up.  Every time I'd pull my pants down to use the bathroom, I would scratch at my legs for minutes, doing even more damage!  I didn't even wear shorts very often that summer because my legs looked absolutely awful.

-ARE CATS ANOTHER COMPLICATION?-

It was around this time period that we had this amazing thing happen in our lives--a pregnant stray cat showed up at our doorstep and we ended up having 5 kittens born in our home!!  It was the most wonderful time--I can't imagine anything more exciting (besides a human baby, perhaps)!  Before this even came about, we had already been living with a cat for over a year (his name's Random & he's the sweetest cat on earth).  Despite my childhood cat allergies, I managed just fine with one cat.  And then I managed just fine with 7 cats.  I would experience a stuffy nose/sneeze-fest about once a month but, really, had no other symptoms.  Fine.  Just fine.  The same story continued on for the next 6 months as the kittens grew and we found homes for each of them.

But my skin continued to get worse.  Was it simply because I let my legs get so bad from the skinny jeans?  Was the rest of my skin just starting to catch up with my legs and get weaker over time?  Was the cat dander starting to inundate my broken skin as it got worse and worse?

-THEN MOLD ENTERS THE STORY-

Or was my skin exasperated by the mold in the basement of our apartment?!  Yes, lots of mold. We lived on the first floor of a house and did our laundry in the basement all the time.  We never noticed the mold.... were we blind?!  It had always smelled musty since the day we moved in on July 15, 2009.  But we didn't notice it until my skin had a huge reaction one evening.

One night, right before my brother & sister-in-law were coming to town to visit, I was in and out of the basement all night.  I did about 4 loads of laundry that night.  I was running upstairs and downstairs all evening--unknowingly exposing myself to mold every time I went down there to switch the loads from washer to dryer.  The mold spores were probably swirling all around the basement with the vibrations of the machines all night and I was walking right through it with broken skin on my legs.  I had no idea it was even there (it wasn't for another few days that we finally discovered the horrendous mold).

-MY WHOLE BODY BREAKS OUT-

I went to bed that evening in my clean sheets, but my body was convulsing with itchiness all over.  I could barely sleep all night and ended up taking a hot shower in the middle of the night to try to calm my skin.  It helped ease the itch, but the next morning, I woke up and my skin was visibly irritated and inflamed in spots all over my body--my legs, my neck, my face, my arms.  I had never, NEVER experienced anything like it before.

And so I went to an Urgent Care doctor and they prescribed a 2-week dose of oral Prednisone.  During this period, we had found the mold, contacted our landlord and he promised to get rid of it (and he did).  We left town the following week for vacation and had a glorious time--my skin felt amazing on Prednisone.  We went mountain biking (very intense) and I experienced no symptoms at all.  I made it through our vacation quite comfortably until the very last day.  I took my last (and smallest) dose of Prednisone before we left our vacation spot to come home. The whole drive home, I became increasingly more itchy.  My rashes were already coming back with a vengeance.

By the time we arrived home that evening, my arms were already torn apart again.  To add to it, our apartment was COVERED in fur from the cats (we had someone watching them, but didn't ask them to vacuum).  I barely slept that whole night.  Itch, itch, itch.

The next day, I made an appointment with a dermatologist.  They, of course, prescribed topical steroids (Triamcinalone, again).  Yup.  Cleared the rash completely.

I used the steroids for 2 weeks, as instructed, but this time, I couldn't stop using it.  If I stopped using it for more than a day, the rashes would suddenly come back.  The rashes were so uncomfortable, so I kept using the cream for weeks and months afterwards.

-WHEN I FIRST LEARNED ABOUT RED SKIN SYNDROME-

A few months later, I came across "Red Skin Syndrome" (otherwise known as "topical steroid withdrawal") on the internet.  I saw pictures of people who had used steroids longterm and who were now paying a huge consequence for it (taking 1-2 years for their skin to heal from the steroid damage).  Even though my steroid usage had been pretty minimal up until that point (and I couldn't be sure that I actually had Red Skin Syndrome), I knew that the steroids were not actually "healing" me.  They were simply masking my symptoms.  So I decided not to use them anymore.

Well.... that led to a HUGE EXPLOSION a few days later.  It was an ENTIRE BODY RASH EXPLOSION, to be exact.  Unimaginable skin rash covering me from head to toe.  Completely red.  Completely raw.  Every inch of my body.

Did I have "Red Skin Syndrome" at this point?  Was my skin already addicted to steroids? I don't know the answer to that.  I do know, however, that I had a "rebound effect" from stopping steroids.

I lived for about 2 months completely covered in rashes.  I continued going to work for a portion of that time and then I was completely bedridden for a period of about 3 weeks.  And that's when my mom contacted Dr. Rappaport (one of the few dermatologists in the entire country who acknowledges that Red Skin Syndrome is real!) and asked if there were any like-minded dermatologists in Philadelphia.  He gave us the name of a doctor and we went to see him that very day.

-DIAGNOSIS: NOT RED SKIN-

Well, my skin WAS red.  Very red, in fact.  But, the dermatologist said that I was not suffering from "Topical Steroid Withdrawal."  It was purely atopic dermatitis that I was experiencing.

So?  One shot of Kenalog and a few bottles of Triamcinalone... and he sent me home.

And, boy, did I LOVE the relief that the steroids brought me.  By that very evening, my rashes were already starting to feel less irritated.  And, within a few days, the redness was starting to fade little by little.  GOD, THANK YOU.

-BUT HOW LONG AM I GOING TO KEEP USING STEROIDS?-

It's been about a year & a half since I was told that I do not have Red Skin and I have been using steroids ever since that time.  If I hadn't learned about Red Skin Syndrome, I'd probably be slogging my body with them every night without a worry in the world.  Instead, I've been trying to use steroids as minimally as possible during this time.  I saw the awful stuff that people have had to endure with topical steroid withdrawal.  I have tried to be so cautious with my own usage because I knew the side effects.  I'd try to go without them as often as I could (usually only lasted between 3-5 days).  My rash would, of course, come back every time.  But I kept trying to wean.

The odd thing is that, ever since I went back on steroids, the eczema is affecting mostly my face, neck & arms.  I NEVER had eczema on my face or neck before.   My legs (which were my original problem with the leggings) are almost completely clear.


-WHERE I'M AT NOW. AND WHAT'S DIFFERENT THIS TIME?-

Now, I'm finally at the point where I believe "If my skin wasn't addicted to steroids that first time.... then it almost certainly is addicted at this point!" (1.5 years of usage later).  And I still believe that the steroids are not a "cure" and are only masking my symptoms.  So, I'm steroid-free once again.  And soooooooo not comfortable.

But, what's different?  Well, to start, we're living in a new, completely renovated house (as of three weeks ago) and it's completely mold free.  Second, our cats are "on vacation" and staying with Christopher's family for the time being.  This is the most awful thing in the world, emotionally, but if cats play ANY part in my skin, they are not currently a factor.  Also, I no longer wear skinny jeans (just leggings that don't irritate my skin in the slightest)!

-HAVE I CONSIDERED ANY OTHER CAUSES?-

Some people reading this might wonder if I've skipped over any other potential reasons for my problem.  I haven't done absolutely everything possible, but... I've seen allergists, I've gotten extensive blood testing done, I've tried every diet on the face of the earth, I've done liver cleanses and colonics, gotten room ionizers, shower filters, drinking water filters....  I've done a lot and have seen no positive effects from any of it yet.

This doesn't mean that my skin problems don't have another cause.  I just don't know what it is yet, if there is!  I'm definitely open to the possibility of some unforeseen something causing this.

But, in the meantime, I do not want to use steroids any longer (did I mention that I break out into cold sores now when I use steroids?) for a variety of reasons.

I'm going to see a new dermatologist next Tuesday.  Hoping, of course, that they will be able to shed some light on, well, anything.  At the very least, I'm hoping that they will accept where I'm at and what I'm doing (with the steroid withdrawal).  I'm not expecting a whole lot, quite honestly.  But it would be nice to have a doctor by my side as I try this out!



***Update (1/22/14)***: one thing that I forgot to include in the story.... a couple months after my first attempt at TSW we found out that our cat had somehow gotten fleas!  I now wonder how much this played a part in my attempts to heal the first time around!





Sunday, January 19, 2014

First video entry.



Not the most informative of videos--just a chance for me to talk a little bit about my experiences thus far.  I found talking to the camera to be very cathartic.  I'll try to be a little more informative next time.  There was a lot that I left out!

Flakes & dry skin.

Since stopping steroids at the beginning of the new year, I've basically been forced to take 2 showers every day--one in the morning and one before bed.  I've always been a shower-in-the-morning type of person, so when the evening hours roll around, it's sometimes difficult to convince myself that I *absolutely must* take another shower.  I usually feel somewhat lazy at this point in the evening and just the thought of showering seems tiresome, but I'm coming to learn the consequences that I'll encounter the next morning if I don't follow through.....

I'll wake up the following morning, sit up and witness a blizzard of skin flakes falling onto my lap....

And then I'll proceed to the bathroom mirror to see this awful sight....

And then I'll want to cry the whole morning away.

Last night I thought about taking a shower a few times throughout the course of the evening, but I kept procrastinating until I finally fell asleep without doing it.  And now I'm sitting here telling myself that I can never let this happen again.

The necessity of the evening shower is this: I need to moisturize before bedtime.  But I can't simply put moisturizer onto my awfully dry skin.  The very second that you put something moist & creamy onto severely dry skin, you experience intense burning followed by hours of itching.  Showering must proceed moisturizing.  The skin must be softened and the pores opened for the moisturizer to be comfortably (and painlessly) applied.

Showering and moisturizing in the evening will not make the next morning an absolute cakewalk.  But it will make it a little more tolerable.

Tonight I'll take my second shower, most definitely.

Saturday, January 18, 2014

Snippet of photos over time.

To continue my introduction, I wanted to start with some photos which show a brief overview of my skin over the course of the past couple years.  This is, by no means, a complete representation of what my skin has gone through.  It's just a brief glance...










In the midst of using steroids.  Still not completely clear, but much better.

4 days of not using steroids and it already looks like this.


This last photo was taken just a few days ago.  Haven't used steroids since Dec. 30.

Have enough yet?  Looking at these photos is so exhausting for me now.  Although there's only a dozen photos here, this tells the daily story of a 2 year journey that is still continuing on.  There were very few "good days" mixed in here--I could perhaps count them all on one hand. 


Friday, January 17, 2014

To start.

I could have started this blog two years ago.  And perhaps I should have.  Perhaps I would have been healed by now, if I had.

Although 2 years ago wasn't the actual beginning of my journey with skin issues, it was the time when things first started spiraling out of control for me.  I've had difficulties with my skin for my entire life, however that was the definitive turning point in which my problems began to shift from "minor annoyance" to "huge problem."

But who could have foreseen this?  How could I have possibly known that this would stretch on for so long?  That the redness, the constant irritation and inflammation would still be going today?  That--for every second of every day--my body and mind would be plagued with an unstoppable and unquenchable itch?

From my viewpoint, this has been going on for far too long.  I have suffered so long and so hard.  When I think about how incredibly long each and every day feels like in the midst of suffering, I can hardly believe that I've endured this for over two years now.  That's at least 730 days of nonstop itchiness.   How can a person even tolerate something so wretched for so long?  Yet here I stand.  Because I'm alive and I have no choice in the matter.  This is the hand that I've been dealt.  Until it passes, I will continue to wage these heavy waters.

Very few people will ever know exactly what I've endured or what these skin problems actually feel like, physically (and emotionally).  In fact, I have a feeling that whenever this finally passes--someday soon or someday far away--that I'm going to downplay the suffering that I'm currently experiencing.  That I won't even be able to imagine what these current pains feel like anymore.  And that's okay, I think.  The ignorance is probably even going to be an enormous blessing, by that point.

But, for now, I'm starting to need an outlet to vent.  An outlet to write down my thoughts and feelings surrounding this entire experience.  I might think of it as a diary or journal on somedays.  Or use it to document photos on other days.  Or it could even be a medical or dietary record place.  Only time will tell, I suppose.

To close this introduction, I'm a person who prays and believes that God works through all things for good.  I believe that--and have already seen--many precious things will come out of this difficult journey.  Sure, I have gotten depressed along the way--and I surely will again--but let my hope prevail.  Let my faith stand firm.

...we also glory in our sufferings, because we know that suffering produces perseverance; perseverance, character; and character, hope. And hope does not put us to shame, because God’s love has been poured out into our hearts through the Holy Spirit, who has been given to us.  --Romans 5:3-5