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scribbles from lucid dreaming (aka notes at 1am)

person uses pen on book
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Sometimes I have really weird thoughts and mental chats while I’m in and out of sleep. Here is the most recent collection of them.

Perhaps a professor

who undergoes research bouts

or collects sources to ribbon together

as fact of experience

to craft my own thoughts.

And derive the privilege to explore

the world outside clinical confines or

academic walls.

A touch of freedom

the taste of travel

wanderlust, I presume.

Reconnecting to the artsy

the book-infused

the sociological side of life.

 

The outdoors:

lightness of being from sunlight,

dappling a chimera city that I call

my “for now” home.

 

Strokes on my baby’s head, soft

her languid, lazily opened eyes driving into content sleep

Nostalgia or nosferato?

Blood sucking I am used to; blood is freely given.

Time is stolen.

Breastfeeding love despite sacrifice of time.

Excited to share the world.

 

Smell of burning firewood during campfire piles reminds of

familial community aching,

but absence filled by anecdotal and perceived noise.

 

Raising a baby alone by internet,

but wary of lapses in previous generation.

 

Wanderlust of mind and eyes.

Sunlight glow within:

“a love of things that grow”

“everything the light touches.”

all posts, community, women's health

on matrescence

selective focus photo of woman carrying baby
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This is a quick blurb from the women’s health field (a field I find endlessly fascinating).

If you follow news in the field of maternal health, you may have heard the term matrescence thrown around in the last year or so.

Often defined as the transition of a woman into motherhood, it has also been likened to going through adolescence again, mom-style, due to the fluctuation in hormones, the rapid changes in the body, the newly forming identity of oneself and one’s place in society, as well as changes in one’s day to day life. Alexandra Sacks, a psychiatrist, wrote a piece in the NY Times called The Birth of A Mother that covers a bit why this transition is so powerful, but often overlooked as society focuses on the baby and ignores how momentous of a change it is for the mother.

This lack of conversation around the realities of becoming a mother has been suspect in being one of the many factors that contributes to postpartum depression, as a mother may feel she is supposed to be estatic about her newborn baby, without expressing any negative emotions despite the magnitude of change her life has just undergone.

In effort to mitigate that mental divide, allowing mothers to express all their emotions, and to create recognition in society about the magnitude of change motherhood is, many companies, academic institutes, and individual professionals are researching and producing more information about this time, working to get the message across. Another huge player in the field is the clinical psychologist Aurélie Athan, whose focus is on reproductive psychology. She looks at both striving and struggling moms in order to normalize the transition to motherhood and continues to work to revive the term and meaning of matrescence. She has even worked on getting some of the first academic concentrations and graduate-level certificate programs created that focus on reproductive and maternal wellbeing because she recognizes the importance of getting health providers, activists, and others involved in the spread of awareness about matrescence.

So if you are a new mom wondering why you feel so off, so different, and how to deal with these feelings of ambivalence towards your new life, know that you are not alone and that you should definitely speak up about how you feel. It will help cultivate a culture of acceptance around our motherhood adolescence.

all posts, miscellaneous, the eczema body

healing skin, hormones, and hot nights

fire wallpaper
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It’s currently 3am and I’m awake despite the little one actually having been asleep since 830ish.

“Why on earth are you awake?”, you may be asking yourself, and rightly so.

Well let me tell you, internet reader. I am hot.

Now though the ambient temperature in the room feels cool, I know I set my thermostat a bit high (in my defense, with the skin disorder I’m usually always freezing, and the baby likes it warm too). However, I am not sweating. I’m just really warm. Warm enough to sleep in just a t-shirt and underwear, which I haven’t done since before my skin declared mutiny on my body (circa 20013?).

So as I’m over here pondering my existence in a semi-lucid state at 3 in the morning, the question that keeps popping up on the forefront of my mind is: this heat, what does this mean?

What does this mean? I’ve got a few theories.

  1. My skin has shown an unprecedented amount of healing lately. I have soft skin on my face, stomach, back, and thighs. Perhaps I have done the majority of my topical steroid withdrawal pemance and am finally seeing the results, aka having skin of normal thickness and elasticity and with the ability to retain heat and moisture.  Maybe. Or, maybe,
  2. I have finally hit the point where, despite still breastfeeding (which can delay this), my hormones are kicking back in, and I am soon to rejoin the ranks of menstruating-aged women. In which case, hormones could be the culprit for my heated sleep body. Or, perhaps,
  3. My circadian rhythm is so butchered from having to wake up at all manner of times during the night shift for the last 7 months (more if you count pregnancy months too) that my body doesn’t know what to do with un-externally regulated sleep interruptions, and so in a desperate attempt to keep its new status quo, it’s driving me awake via continued thermoregulation fluctuations. Maybe that’s it.

Or maybe it’s some culmination of the three of those things because as is often the case with complex systems like humans, we don’t always have a simple solution.

At any rate, I’m enjoying the fact that my little one is getting so much sleep, and that I’m getting some silky smooth patches of skin. I’m not stressed and as I am awake I am making sure to hydrate, so I’m sure in time I’ll learn to sleep again. So c’est la vie et bonne nuit (that’s life and good night).

all posts, treatments, women's health

things that suck, literally

nature grass black outdoors
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I haven’t fallen off the face of the earth, I just no longer subscribe to the spacetime continuum on it. But you’ve heard enough of my excuses about why I’m so untimely and inconsistent with posting, so let’s just skip that rerun.

Today’s topic is things that suck. But literally suck, as in suction, not in that they are uncool. The latter is way too arbitrarily subjective for me.

Anyway, so I’ve been pondering about my skin health, especially that of my feet. As a whole my skin has improved immensely; so much so that going outside in 20 degree weather does  not reduce me to being a miserable shivering mess any longer. I feel like each day, despite my diet not being on point and my sleep amounts being wonky, my skin is developing a more human luster again. Obviously this is exciting beyond proportions, however, my feet in particular still look horrendous and itch aggressively at times. Many areas, especially where the foot skin meets the plantar skin surface (bottom of the foot), there is a tough thickened layer of scarred skin, much like a callous but not so strong and mostly still flaky. From staring at it collectively for hours (and talking with my sister, who is good at thinking about skin care), I have come to the conclusion that I sorely lack blood flow in those areas, and so the trick now is figuring how to remedy that. I’ve been trying massage techniques as part of a bedtime routine and maybe it’s working, but at any rate I started envisioning a new “quick fix” direction: leeches!

Here me out. Leeches are small and single purpose-y: they bite to latch to human skin, secrete a light numbing type chemical, and then they start sucking and drawing blood to satiate themselves, and when they are done their fat content selves detach and they fall off. Well, what if they were applied to those thickened eczema spots, like on my feet? Could their ability to draw blood work in my favor to get the needed blood flow to that area to promote better healing? Would it reduce the thick skin build-up?

I then got curious if any medical practitioners have tried using leeches for eczema and recorded their findings. Turns out the answer is yes, but so far only in India (or that I could find). The study I did find had no control group (so no way to control for placebo effects or to compare in general) but they did find that leeches helped the eczema spots. Honestly I’m not sure why though. The study mentioned the leeches’ secretion having a microbial effect and the penetration of the epidermis and dermis layers of the skin, as well as the increased bloodflow the leeches provoked, so maybe I was on to something there.

The next thing that sucks isn’t a thing at all, but my baby. As a breastfed baby, my little one practices her sucking multiple times a day (I don’t pump honestly because I’m not good at it, so it feels like it takes forever just to get a low yield), meaning my schedule is worked around her needs. While I don’t mind this, it has caused me to wonder how I could have a career, as there are not many jobs I could take her along with me in this day and age (or at least not that I know of).

In short, I started coursework to become a postpartum doula. It will probably take me a few years to finish it all, mostly because you need to spend 5 hours minimum with 4 separate families and Fiona isn’t ready for that duration of separation yet, plus I don’t have any families lined up. That and also Fiona has developed complete object permanence, and so we are drastically having to readjust her sleeping routine again.

In other news, I have also started a role as a research writer for a site called PPDJourney, which features stories from moms about their experiences with postpartum depression. I’ll be doing monthly pieces on things that relate to maternal mental health.

Also I may be possibly developing a course with my favorite herbalist group, but I’ll keep that under wraps until it becomes more concrete.

Lastly, yes I know the cover picture is a slug, not leech, but in the immortal words of Rick the Hormone Monster “What’d ya gonna do?”

 

REFERENCES

Shankar KMP, Rao SD, and Gopalakrishnaiah V. A clinical trial for evaluation of leech application in the management of Vicarcikā(Eczema). Anc Sci Life. 2014 Apr-Jun; 33(4): 236–241.

all posts, eczema hacks, miscellaneous

sleep training and skin drying, a midwinter’s tale

cat sleeping
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The little one is beginning to have a routine emerge. So far she fights all forms of sleep training and instead functions on a growing stable sets of principles.

  • Bedtime is 9pm.
  • Midnight to 2am is the start range for the late-night meal.
  • 5am-6am is the start range for the early morning meal, but a second attempt at sleeping afterwards will be successful.
  • 6am-8:30am is the relaxed independent wake-up time range where self play is initiated until boredom or some confined position occurs and it’s time to wake up mom.

At the moment, I don’t really mind this schedule, save for experiencing the skin drying out feeling each time I wake up. The apartment has central heating, which equates to forced air from ceiling vents, which feels great but does tend to dry me out especially as I’m up three times each “night” period. I have a moisturizer by my bed (which I’m starting to think every non-moisturizer withdrawing person should do) so every time I get back in it I reapply to all my problem spots (feet and hands primarily, but also knees and elbows).

It’s annoying because we’ve officially hit that time of year where there’s a consistent wetness in the air outside, and temperatures vary from 40 to 14 Fahrenheit. As a result, my skin gets damp and itchy, I’m constantly bundling up to stay warm, and I can’t keep moisturize on my skin to save my life.

But back to Fiona. Last night she fell asleep at 7pm instead of 9pm (which was a feat in itself and aided by the fact that she hadn’t napped since the morning). What was the result? Feedings at 9pm and 3am, and we’ll see where the terminal night feed lands, but I’d guess it will be around 5am now.

I think it’s fascinating that she has her own internal clock developing. She has never been a great sleeper but she is slowly adding hours in like with a late morning nap she eventually takes that lasts from 2 to 3.5 hours. At first I was really frazzled that she didn’t do what all the books and sites say, which was to settle down around 6pm and be asleep by 6:30/7pm consistently, but then I realized it wasn’t helping either of us that I was getting stressed out when no amount of routining could successfully have her asleep before 8pm each night. She also got so inconsolable with our few day stints of attempts to sleep train her, and it would carry on into the next day. When I finally stopped trying to get her on the “normal” schedule, she got happier, so I got happier, so she slept longer, so I slept longer, and my skin started to heal more- winter dryness and all.

That had been a hugely frustrating part of this new baby life. There are so many external pressures to have a baby that conforms to the general standards that society has deemed the norm, that when yours doesn’t, it can be so mentally taxing.

For example, so many of the pediatricians I saw told me Fiona was too small, therefore not eating enough. The newest pediatrician pulled up the growth curve and showed that Fiona was tracking perfectly for a baby in the 5 percentile (aka she is growing consistently, but is a small baby as far as “norms” go). But instead of understanding that for the first 6 or so months, I lived in fear that I wasn’t feeding her enough, but also knowing that I was on the most hypoallergenic diet I could be (no dairy, soy, gluten, eggs, rice, oats, corn) and that breastfeeding reduced her risk of getting eczema. It was a vicious mental gymnastic I had to contend with, with every comment about how small she was, or every assumption that when she cried that she was hungry, really sucker punching me in the gut. It amped my stress levels up so much and so it is little wonder I had stagnant skin healing for months (on top of fluctuations in my amounts of sleep).

But now, though some of the old thoughts still rear their ugly heads, I have found more peace with the situation, especially as I see Fiona make developmental milestones. And subsequently new calmness is helping my lizard skin slowly regain its shine, even if this north east winter is trying its darnest to dry me out.

all posts, eczema hacks, the eczema body, women's health

will my baby have eczema?

smiling baby lying on white mat
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A while back I wrote a post about what it’s like to have eczema and be pregnant, followed by another post after my little one was born all about living life with eczema and a baby. But today’s topic isn’t about the mom, but rather, about the baby and the baby’s risk of inheriting eczema from his/her parents.

The inspiration for this post comes from the eczema community on instagram. Many ladies have been asking about this topic, so I figured I would try to search for an answer. I apologize if it isn’t the clearest of posts. It’s a culmination of a bunch of witching hour moments over a few days, when Fiona decided that midnight, 1am, 2am, 3am, etc are equally important times to wake up each day.

Most of us know that there is a genetic component to eczema but what does that actually mean? There are a few different ideas being studied about where genes come into play with this condition that are lumped under the “outside-inside model” which look at skin barrier dysfunction (as opposed to the “inside-outside model”, which is about the gut health). Some examples of the outside-inside model, which I’ll go over individually, include:

  • FLG (a gene, that makes the protein filaggrin). I mentioned this protein in an older post, talking about how there were treatments for eczema being developed that made use of it. The gist was that a loss-of-function in the specific gene results in less filaggrin being made, and filaggrin is an essential player in keeping the skin barrier intact.
  • Tmem79/Matt (colloquially known the Matted mutant gene, so named because in mice it results in their fur having a matted look). Researchers found that mice that had this mutant MATT gene also had skin barrier issues and dermatitis issues, and that humans had a similar gene, with a common single nucleotide polymorphisms (or SNP). When there is a misstep (or a mistake) in humans’ SNP, there are significant atopic dermatitis associations.
  • Th2 (a cytokine, or a protein that impacts cell signaling). Th stands for T helper cells, and they help with host defense, but also impact inflammation. Some, like Th2 are know for being (pro)inflammatory, while Th1 is known to be anti-inflammatory. I mentioned this a little when talking about pregnancy and eczema. Research from 2015 showed there are many different Th types, that all may have their own impact on inflammation.
  • interleukin-1 (a protein from a family of inflammatory and regulatory cytokines). Many studies are still showing that breastfeeding reduces your child’s risk of eczema, because of some components (interleukin-beta specifically) in the breast milk that the child consumes. One such study went so far as to say that breastfeeding halves the risk for children between 0 and 3 years of age (and no you don’t have to breastfeed for 3 years for that to be the case!). The way interleukins work is that they are released when there is bacteria or immunological disturbances. The interleukins show up and affect cells like capillary endothelial ones, making them release chemicals and attract monocytes (large white blood cells that help kill bacteria). The problem with these is that certain types can be associated with Th2 (like IL-22 which is made by Th-22), or they can be known to be associated with inflammatory diseases like IL-17.

Then there has been a lot of research investigating if and how probiotics can help prevent eczema for babies too (even Gerber makes probiotic-included products now). In particular, Lactobacillus rhamnosus was seen to have mixed results, with some studies showing it reduced genetic susceptibility to eczema (meaning it somehow calms the baby’s risk of having eczema) for children with thirty-three eczema susceptibility SNPs. On the flip side, other studies said Lactobacillus rhamnosus had no effect on reducing the child’s risk of eczema.

To be honest, I am still a bit skeptical of the studies done that show no effect because, from what I can tell, they have the parents give the babies probiotics for say 6 months, and then continue to see if there is a benefit at some later date like 2 years of age. If a modern western diet (high carb, especially in refined sugars) can alter an adult’s gut microbiome fairly rapidly, why would the probiotics a baby takes at 6 months still be helping the gut at 2 years (the biome diversity would have changed due to diet by then, and the gut must stay healthy for it to help the skin)? Wouldn’t one expect the gut microbiome diversity to change and said “good” gut bacteria to not be able to survive the environment anymore?

So essentially I am still thinking, as the studies show no negative effects of taking probiotics, after talking with your baby’s pediatrician of course, what would be the harm in giving your baby probiotics? That and making sure to keep your baby on a diet that creates a gut environment more conducive to good bacteria flourishing.

Also note, I wasn’t able to access the whole study so I’m not sure how the probiotics were administered unfortunately. On a tangent, that’s always a frustrating point to me. I don’t think studies should cost the public to access because we should want to encourage people furthering their health in any way possible. I understand scientists need go make money too but I do wish there was another way besides charging subscriptions to databases of research. 

But I digress. So what is the takeaway for all those future mamas worrying about passing eczema on to their children? Do they have cause for concern? Perhaps. The way I see it (noting I could be interpreting this incorrectly) is for:

  • filaggrin: If the loss of function filaggrin gene is passed on, the child would probably have an increased risk.
  • Th2: the Th1/Th2 dominance seems to be more dependent on estrogen than genetics (though I could be wrong) so my guess would be that having a girl would make her more susceptible in that case (again I definitely could be wrong).
  • MATT gene: The atopic dermatitis shows up is because of that misstep (mistake) in the common SNP of the gene. As a result I think the answer is yes, it probably is a risk for one’s children, because missteps (I believe) would be passed down since they are mutations.
  • interleukins: I believe the pro-inflammatory ones that are problematic are a product more so of consistent stressors on the body (both from invaders like bacteria, and from literal stress). If the baby/child is relatively healthy and isn’t too stressed out, in tandem maybe with the mom breastfeeding her baby (so long as she is able to, aka isn’t on chemotherapy or radiation or something), then I do think the risk of eczema from this perspective, is decreased.

But the real question now is how do all these components balance out in an individual, in a baby? Does having a loss of function filaggrin gene guarantee a lifetime of eczema? Or does it just make you more susceptible but you are fine if you don’t have the MATT gene’s SNP misstep (or one of the other 33 SNPs mentioned that are related to eczema susceptibility)? It would be interesting to see a study done that investigates all these components together, so we could know which are still present when you have people with severe eczema, topical steroid withdrawal systems, etc. As for the initial question, sure, there are genetic components that you pass down to your baby, but it seems like not all the heavy hitters are genetic so your baby may still be fine.

One more thing to leave you with: the American Academy of Dermatology made a post a while back saying a few ways to reduce your baby’s chance of eczema (minus genetics naturally), which included:

  • having a dog at home before the child’s 1st birthday
  • moisturizing a newborn’s skin
  • not eliminating a bunch of things in your diet
  • eating a health diet while pregnant, and
  • breastfeeding (and having a healthy diet during it too)

All in all, know this: if you do have a baby and he/she has eczema, the research body is growing in the field and more understanding of what causes eczema are coming to light, which means better ways to treat it will follow.

REFERENCES

Bauer SM. Atopic Eczema: Genetic Associations and Potential Links to Development Exposures. International Journal of Toxicology. 2017 Mar 30: 36(3): 187-198.

Cabana MD, McKean M, Caughey AB, Fong L, Lynch S, Wong A, Leong R, Boushey HA, Hilton JF. Early Probiotic Supplementation for Eczema and Asthma Prevention: A Randomized Controlled Trial. Pediatrics. 2017 Sep; 140(3).

“Can anything prevent my child from getting eczema?” America Academy of Dermatology, https://www.aad.org/public/diseases/eczema/prevent-my-child-from-getting-eczema. Accessed 9 Jan 2019.

Hofmann A, Kiecker F, Zuberbier T. A systematic review of the role of interleukin-17 and the interleukin-20 family in inflammatory allergic skin diseases. Current Opinion in Allergy and Clinical Immunology. 2016 Oct; 16(5): 451-457.

“Interleukin 1.” R&D Systems 1999, https://www.rndsystems.com/resources/articles/interleukin-1. Accessed 18 Dec 2018.

Jepsen AA, Chawes BL, Carson CG, Schoos A-MM, Thysen AH, Waage J, Brix S, Bisgaard H. High breast milk IL-beta level is associated with reduced risk of childhood eczema. Clinical & Experimental Allergy. 2016 Jun 2; 46(10): 1344-1354.

McLean WHI. Filaggrin failure – from ichthyosis vulgaris to atopic eczema and beyond. Britist Journal of Dermatology. 2016 Sept 26; 175(52): 4-7.

Morgan AR, Han DY, Wickens K, Barthow C, Mitchell EA, Stanley TV, Dekker J, Crane J, Ferguson LR. Differential modification of genetic susceptibility to childhood eczema by two probiotics. 2014 Aug 21; 44(10): 1255-1265.

Raphael I, Nalawade S, Eagar TN, Forsthuber TG. T cell subsets and their signature cytokines in autoimmune and inflammatory diseases. Cytokine. 2015 July; 74(1): 5-17.

Saunders SP, Goh CSM, Brown SJ, Palmer CNA, Porter RM, Cole C, Campbell LE, Gierlinski M, Barton GJ, Schneider G, Balmain A, Prescott AR, Weidinger S, Baurecht H, Kabesch M, Gieger C, Lee Y, Tavendale R, Mukhopadhyay S, Turner SW, Madhok VB, Sullivan FM, Relton C, Burn J, Meggitt S, Smith CH, Allen MA, Barker JNWN, Reynolds NJ, Cordell HJ, Irvine AD, McLean WHI, Sandilands A, Fallon PG. Tmem79/Matt is the matted mouse gene and is a predisposing gene for atopic dermatitis in huma subjects. J Allergy Clin Immunol. 2013 Nov; 132 (5): 1121-1129.

all posts, miscellaneous

memory blast from the past (the “invincible” days)

close up of pictures
Photo by Leah Kelley on Pexels.com

When you’re young you fly on this invisible tether, unaware of the fleeting nature of your adventure, how you will not always be there, balanced confidently but precariously.

I often think back on my journey living with severe eczema and immediately I remember the onset of the first cascade of knocked-me-off-my-feet-and-never-found-solid-ground-again topical steroid withdrawal symptoms and think that was where it all began. But it’s just not true. Even when I was young (under 14), active and energetic, there were moments when eczema was already blossoming under the surface.

I remember hiking the presidential range with my uncle, his girlfriend (now wife), his cousin, an uncle-esque family friend, and my sister. When we reached the last cabin closest to Mount Washington, I recall the cold as a storm rolled in and remembered vividly when I washed my face in a cold bathroom in the morning with chilly water, I felt the creep of a growing itch under my skin.

Nowadays I know that there can be many triggers for eczema including temperature changes, but then, eczema was a weird seasonal rash that showed up only on the insides of my elbows, not on my face. I think my thoughts at the time were something along the lines of “oh, I must have eaten something that was contaminated lightly with peanut fragments”, because in my head, face itching had to be a sign of an allergic reaction.

It’s also non-humorously funny to look back and realize I was already becoming paranoid of food allergies (and sensitivities) as the culprit to my skin woes.

I also recall having (and to some extent still have) the belief that because I possessed any abdominal fat, therein lied the reason I had eczema. It wasn’t yet possible to accept that I wasn’t infinitely healthy and majestic, that my body wasn’t perfect, that I had my own personal dis-ease I would have to reckon with that would change my whole game plan. It was easier to think that I was just eating too much and therefore making myself less than perfect.

It’s interesting because I can still so easily transport back into that mindset and remember how vital I felt, how alive, how healthy. I didn’t feel disappointment that my body had betrayed me yet.

Now don’t get me wrong, I can still get optimistic about my skin’s healing progress and feel I have come a huge way along the path of recovery. But my confidence of almost immortality that I had once before, is not there.

Part of that makes perfect sense. I have grown up and matured, and since realized essential concepts like that my body is no longer growing up, that I have to maintain health by eating right and moving and controlling stress or I will grow outwards in a horizontal direction. I get that. But there is also this, I think what I used to call “the Peter Pan effect” that I recognize is gone. It was akin to the moment I turned 12 and had to firmly accept the idea that I was never getting into Hogwarts, not because it was fictional, but because I had aged out of my chance. I adjusted to change of aging in asymmetry, non-smooth block jumps.

I think that’s the hard part of it all. You have to accept that time moves forward and one day you are on the other end of the growth curve, in what I now like to call the maturation phase, giving in to the adage of us ripening well like rare vintage wines. But it is hard to accept that where you were once full of epiphyseal (growth) plates, you now have the potential for osteoporosis; where hyaline cartilage once ran amok, we now see arthritis. I don’t know, I think sometimes the reality of aging, even if it is done amazingly, is still a bitter reminder that our lives are meaningful because they end, and so it’s important to accept the ride and always strive for better and better days, even if there are road bumps, like severe eczema in my 20s; here’s looking to flawless skin in my 30s!