eczema, exercise and activity, flare-up, food and nutrition, my journey

why eczema is so hard to solve

assemble challenge combine creativity
Photo by Pixabay on Pexels.com

Over the years I have gotten so much advice from well wishers about how to cure my eczema. While some of the suggestions may be useful, more often than not they aren’t, and it may not be because the advice is something I’ve already tried or something outlandish. It may be more so because advice about a single aspect in my life to change doesn’t do anything impactful, because eczema’s root cause can be anything but singular. I know some people are lucky: they remove the allergen (mold, gluten, soy, eggs, nightshades, dairy, dust), they decrease their stress, they exercise more, they find a supplement that really works, and bam, no more eczema.

Unfortunately, I am not one of those people. My root cause seems to be tied to many different aspects, from overuse of topical steroids, to unresolved emotional issues after familial deaths, to increasing sensitivity to foods (on top of food allergies I was born with), to increasing discomfort with specific exercises and a sensitivity to heat and sweating, etc. So being given a new product to try doesn’t really solve the other issues preventing me from quickly recovering from each flare.

What I do find interesting, is people that have learned to live with eczema (and/or topical steroid withdrawal) and the various lifestyle changes they have done to help keep their flares under control. I came across a post a while back called The Metaphysical Meaning of Eczema – Do People Get Under Your Skin, which I thought would just be talking about how my emotions cause my eczema, but I was pleasantly surprised to read the author’s inclusion of a whole host of other things she does in her life to help. Because yes, I am sensitive, both skin-wise and emotion-wise (I can now flare-up from heightened nervousness from public speaking, or due to misunderstanding over trivialities at the store) but, and I am indignant about this, my sensitivity didn’t cause my eczema, and it definitely didn’t cause my topical steroid withdrawal. It probably is the reason it takes me so long to heal (on top of the constant flow of changes in my life… e.g. getting married, moving 4 times, leaving my graduate program, buying a house, having a baby- all within the last 3 years). I have learned to be zen about skin-related sleep deprivation, about hives from foods I normally can consume, over having to adjust all forms of activity I enjoy, over forgiving myself for making “mistakes” that then provoked a flare, etc. I know I still have a ways to go to consistently help my emotions flow naturally and not build up stress, but I have made immense progress and my skin doesn’t always reflect that. Hence why I get up in arms when people try to reduce my condition down to me “just not doing x”.

Woof, okay so now that I’m done that rant, back to my initial idea around today’s topic. The point is, eczema can be a multifaceted b*tch of a condition, with varying twists and turns that dictate how it goes for different people. If you don’t believe me, try reading the experience of Daniel Boey in his book Behind Every Itch is a Back Story: The Struggles of Growing Up with Rash, or peruse any number of personal blogs out there these days about someone going through TSW.

My point is that while I am happy for people who find ways to rid themselves of eczema flares through a singular method, I find it frustrating when we see the gimmicks of “anyone can cure their eczema if they just do x!” and find it somewhat damaging to reduce all people with eczema into the same world because said singular solutions don’t work for everyone. I appreciate people that talk about the myriad of changes they have had to do, because it shows that the cause of eczema, as it is still unknown for the most part, requires different management for different people, hence why it is so hard to “solve”.

Note: Some of the above links are affiliate links. This means that if you click on one and purchase an item, I will receive a small affiliate commission (at no cost to you).

eczema, exercise and activity, flare-up, food and nutrition, my journey, women's health

eczema with a newborn

white bed spread near a human foot during night time
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For the first few days after having my little one, I was on such a high of nerves and adrenaline that I felt great!  I had been on antibiotics while in the hospital, and after getting home my skin started to feel really dry. I started taking some probiotics and focusing on drinking lots of water (I knew getting enough sleep was a lost cause), and keeping my stress down.

Initially, my skin was calm enough that I had no problem doing skin-to-skin contact with baby Fi, but around week 4 or so I started to experience more flare symptoms- sweating, itching, redness- whenever I had the baby lay on me for too long. I started to have to wear long sleeves when holding her to not get overheated. I’m not exactly sure when this happened, but it may have also correlated when the humidity increased, and the temperature with it.

I’m not sure if it was due to the antibiotics, the temperature, the lack of sleep, the terrible diet I had in the hospital (think chicken fingers and ice cream for multiple meals in a day), or the hormone fluctuations but my skin definitely became more sensitive post-pregnancy. Though estrogen has been considered one of the reasons women can flare-up worse during pregnancy (see my post about pregnancy and eczema), after pregnancy the estrogen drops so it’s unclear what would be provoking my symptoms (besides the above mentioned items).

Either way I’ve had to be more creative about adjusting to life with a newborn. The biggest aspect I’ve had to cultivate is endless patience mixed with quick stress-reduction habits. My lackadaisical approach to getting house and life stuff done has been somewhat of a saving grace because my little one has wreaked havoc on my schedule. I’m exhausted in the afternoons, I have no idea what it feels like to sleep more than 3 hours at a time anymore, I tend to eat a bit worse now (mostly eating too many carbs and too much) because I lack the self control to stay as dietarily balanced when I’m sleep deprived. It’s something I’ll have to work on in the coming months.

I find ways to not focus on my skin when it’s getting all sweaty from holding her and I have learned to wear light layers or wrap a small blanket between her and myself when breastfeeding to avoid irritating the more sensitive skin areas like my stomach.

There are some inherently awesome aspects to having a newborn when you have eczema (at least in my experience). For one, I tend not to think about myself as much so I am not as aware when I am itchy. She keeps me busy to such an extent that even when I’m immersing my hands in water (which is traditionally a huge irritant) to give her a bath, I barely notice. Also, lately my core temperature seems to be evening out even as my skin fluctuates (which means that the hot, sweaty skin nights and cold shivers have been decreasing). I actually enjoy the cold temperature more than I used to, and I don’t enjoy basking in the sun for quite as long.

And overall I do think that my skin has been able to consistently heal slowly but surely. I feel as though I look more or less human again, what with the redness decreasing.  I think the hormones from breastfeeding are helping my skin heal to some extent; I know my hair has gotten shinier, which is an awesome boon.

alternative/holistic medicine, eczema, exercise and activity, flare-up, food and nutrition, my journey, NEA, pregnancy, relationships, skin biome, skin care, sugar, topical steroid withdrawal, topical steroids, topicals, women's health, wounds and infections

my deviation from the beaten path

gray pathway surrounded by green tress
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Today’s post is all about trying to convey what life with eczema is like for me. The first thing I need to stress is that my condition was not always this severe. I can remember a “before”, as my condition didn’t start affecting my skin globally until I was 21 or 22.

So how has eczema affected me?

  • insomnia – Some nights I was unable to sleep until 6am. More recently off and on I have difficulty sleeping from midnight to about 6am.
  • food paranoia – Given that I have legitimate food allergies to peanuts, pistachios and cashews, I know how to deal with food allergies that cause anaphylaxis. What I don’t know how to deal with is the thought that some common food might have developed into being the cause for the severity of my skin issues. Also sometimes I’ll eat something that is usually fine for consumption, and I’ll break out in hives in my mouth inexplicably and the next time I consume said food, it won’t happen.
  • many different diets – I have tried the gambit of elimination diets, auto-immune diets, vegetarianism, paleo diets, sugar-free diets, low-carb diets, detox diets, etc).
  • food-related social repercussion – You have no idea how frustrating it is to have people think I am “just being picky” when I am avoiding certain foods or diets. It’s usually when I’m avoiding gluten, dairy, or soy or other common American-diet staples. What I don’t understand is why people think I enjoy avoiding these foods… do they not know my undying love for pizza and ice cream?
  • intimacy issues – picture not being able to cuddle on the couch while watching a scary movie without covering myself in a blanket to make sure my skin doesn’t touch my husbands. Long drawn out hugs? Nope.
  • skin-to-skin with baby issues – I have adapted to the lifestyle of needing to put a barrier between me and my baby’s skin. When I feed her, I throw a cloth on or wear long sleeves before I put her head on my arms. When I have her in a carrier, I try to put a layer between her face and my chest, or else I know I’ll have to take her out earlier as my chest will start turning red, flushing, and itching.
  • exercise limitations – Up until my junior year of college I was doing many different sports and activities including soccer, track and field, long runs on my own, ultimate frisbee, generically running around like an idiot, etc. Post-eczema life, unless I can get a flare to calm down for months, cardio is a nightmare. Hell, at this point in time, just going for a long walk in the summer induces itching everywhere that takes at least 10 minutes in an air-conditioned building to relieve.
  • summer nightmare – See what I mentioned about walking above and now just add that to general life in the summer. I do well if I don’t move, and if I avoid direct sunlight. Though I also need sunlight for vitamin D (and in my previous life I loved the sun) so I’ll pop outside for a few minutes to bask in the sun’s warm embrace and then I’ll overheat and have to come inside. At least the itching only starts if I sweat.
  • pain (cracked skin) – During certain stages of a flare I dry out (especially at night or after washing my hands or other random times) and my skin will crack. The worst areas are my hands (which will fissure all over) and my ears, as well as sometimes under my eyes.
  • obsession – I spend so much time thinking about my skin and worrying over if I am doing something to make it worse, or not doing enough. It gets exhausting really.
  • career switching – I dropped out of my physical therapy doctorate program because I just couldn’t deal with my skin. I wasn’t sleeping, I was uncomfortable sitting (more on that in a bit), and I couldn’t stand being in an air-conditioned room (see below), or being touched or coming in contact with another’s skin, which made it incredibly difficult to practice the hands on aspects of PT. I am now still in a stage of making my own career, which while exciting, is stressful when I have to talk about it because it’s not a clear cut “oh, yeah, I do X” anymore.
  • fear of infections – As my skin barrier is compromised so often, the risk of infections, primarily Staph, is high. I spend a lot of time wondering if I am infected and worrying when I catch a cold or something that I have contracted Staph (again).
  • hand washing (pain/itching) – Imagine how many times you have to wash your hands or use hand sani when you are a PT student working in a clinic. Doing dishes is irritating enough. Sometimes even just taking a shower will irritate my skin.
  • cleaning frequency – Given that I shed skin faster than the average human, I spend a lot of time cleaning to try to not live in my own skin dust filth.
  • social situation aversion – When I am flaring, I have no desire to go out, not only because I worry about the stares I get for physical appearances, but also because it takes so much energy to deal with varying temperatures, varying foods, varying stressors, usually a lot of sitting, the inability to play/dance without itching, etc.
  • general discomfort (pain, itch, smell) – Eczema this severe is uncomfortable. The obvious is that it itches, and not like a “I have a random little itch” but more on the level of if a swam of mosquitoes bite you all over your body but instead of having angry welt-y bite marks externally, they are all inside your body and not visible to anyone. The pain comes from the cracking I mentioned above, as well as the pain of the self-inflicted wounds from scratching too hard. When I have a bad flare, I develop this scent that I call the burning rubber skin that I loathe.
  • depression and anxiety – It’s no surprise that aggressive and long lasting flares take an emotional toll. As I spend time in pain, itching, paranoid about foods I eat, avoiding people, and unable to exercise and play as I normally would, sometimes my moods take a nose dive.
  • money spent – From skin care lotions and moisturizers, general soaps, bath products (bleach, epsom salt, apple cider vinegar), natural house cleaning products, dry brushes, the rebounder, to the doctors’ visits, etc, this condition isn’t cheap.
  • doctor visits (dermatologists, endocrinologists, neurologists) – There is something very frustrating about seeing many doctors and still getting no relief. I have moved a few times in the last past 4 years and as a result have an even larger number of individual doctor visits under my belt. The general consensus? I am fine (as in no underlying crazy cause of my skin issues like cancer), but I have eczema. Oh and have I tried using steroids creams? -.-
  • hormone imbalances – Since I spent so much time inflamed, I usually have a highly elevated level of immune stuff, like my white blood cell count. When my skin first started going haywire, I also have high cortisol level, which made doctors think I had a hormonal imbalance and first order an MRI of my brain.
  • forever fielding questions – “Have you tried X??” “What’s wrong with your skin?” “Do you use lotion?”
  • excoriation disorder (dermatillomania) – Due to very often having flaky skin, I have developed a picking disorder where I spend inordinate amounts of time trying to remove dead skin from my body. It’s become partially therapeutic and partially me trying to exert control over my uncontrollable presentation.
  • scratching OCD – I scratch all the time. In my sleep, when I’m stressed, when I’m relaxing. I don’t even notice I’m doing it sometimes.
  • scarring – Go figure from all that scratching I’d have scars.
  • ring wearing/jewelry/piercings – I no longer wear my wedding band on my left hand because the ring finger on that side is usually swollen. I wear it on my right now. I also had to take out my belly button piercing, my nose piercing, and all ear piercings except tragus one because the skin started itching so badly around them all.
  • hot inflamed skin with cold chills/shivering – One of the worst stages of a flare is when my skin is constantly wet and weeping and heated, but I’m losing so much heat that I am internal freezing and will shiver uncontrollably.
  • winter is bad – It’s hard enough to regulate my body temperature without the weather outside being frigid.
  • sensitivity to pressure contact (sitting/laying down) – This made PT school very trying. Hell, going to a doctors office and laying on the table, or sitting on a chair for too long made my skin feel terrible and heat up and start itching. This is even through wearing long sleeves and pants.
  • nervousness = flares – Some nervousness is good for keeping our brains alert. Unfortunately, any little bit of social nervousness (like before a practical or talking to new people) would cause me to start to flare and itch.
  • wrinkly, swollen skin – Still not sure why this happens (maybe it’s a product of topical steroid withdrawal) but the skin around my joints especially, on the extensor side, starts to look like that of an elephant.
  • discoloration – From redness to drying out gray/white, I am a veritable human mood ring.

And since people love me and will forever want to help, here is a list of what I have already tried:

  • topical steroids (for a good 20 years as this was the main accepted solution to eczema for decades)
  • topical medicines that are not steroids (Elidel/protopic, etc)
  • oral steroids
  • lotions/moisturizers (cetaphil, cera ve, aquaphor, dove eczema line, exederm, burt’s bees, obscurely-named-other-ones, etc)
  • going moisturizer free (actually does help with the red/weeping stage)
  • ocean water
  • chlorinated pools
  • naturopathy
  • acupuncture (including herbs, cupping, and massage)
  • diet (gluten free, soy free, dairy free, vegetarian, sugar free)
  • phototherapy (clinically done in light boxes, and just being in the sun)
  • antihistamines
  • sleep aid pills
  • yoga, meditation, and deep breathing
  • coconut and sunflower oil
  • bleach, epsom, and apple cider vinegar baths
  • antibiotics
  • collagen powder (edible)
  • collagen cream
  • wound care
  • probiotics

Update: I have not tried any biologics because I have been pregnant and am now nursing.

Despite all the shit that comes with eczema, there have been some silver linings in my experience including:

  • Having to deal with eczema year round has made me live much more seasonally. In the warmer months I try to take advantage of being able to walk outside for hours and garden to get vitamin D and get exposed to bacteria in the soil (and as stress relievers). In the colder months I turn to herbal teas and nourishing soups, and bundle up well to go on walks to get fresh air. I pay a lot more attention to what can grow when, and try to eat accordingly (like lighter foods in the summertime).
  • Having dealt with the difficulties of eczema for so long, in juxtaposition pregnancy wasn’t half bad (though to be fair my belly was small and I didn’t have morning sickness… but discomfort with sleeping? Aversions to certain foods? Tired randomly? Feeling generally uncomfortable? Yep, I was used to that all already).
  • In effort to control my flares, I am constantly open to trying new things (though my wallet isn’t!).
  • When I first came up to visit Jake, before we were dating, we had an honest conversation about eczema and I told him how bad it gets for me, and he still wanted to be with me. To this day, I’ve never had insecurity about my skin around him.
  • I have learned to really appreciate the good days. As a result, I’m generally even happier of a person.
exercise and activity, my journey

yoga for the atopically inclined

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This is a post I initially wrote after talking about the different alternative medicines and their content. I never ended up posting it because I had the baby and promptly forgot I wrote it. But without further ado, here is a post that focuses a bit more on the physical aspects of one of those holistic practices; yoga.

Though I love exercising, I am no stranger to avoiding heavy aerobically-intense exercise because of the nasty skin side effects that occur during a flare (the flushing sensations, the heating skin, the sweating/wetness in flexor surfaces, the rashes, and the insatiable itching). One of the times I got the best reprieve from my flares and related skin symptoms was February of 2016 when I was doing a 200-hour yoga teacher training. I took anywhere from 1-3 classes, 5-7 days of the week in rooms with high temperatures and lots of humidity. As I breathed through new poses and slowly worked my muscles and  focused on breathing and meditation, I felt stronger and better day by day. I won’t say my eczema went away because it didn’t, but the movements and concentration on my breathing did help my skin improve a lot, and in February no less (usually the winter months are worse for my skin).  At the same time, practicing that much yoga naturally made me want to eat cleaner because I felt heavy if I tried to practice after eating unhealthy foods (so at the time I tried out the Whole 30 Diet).

As I tried to recover from the particular cold, damp prolonged and lingering last bit of the Northeast winter weather, I decided I wanted to make use of my teacher training and research the best exercises to promote blood flow, skin healing, and stress reduction. My goal? To help my own skin maintenance (and the skin of anyone else who wishes to try this routine). So first I’ll give a brief explanation of some the theories behind how yoga can help eczema. Then later in the post I’ll show a few poses that have been said to be most beneficial to add to a yoga practice (and mostly ones that a beginner could do) to help the skin.

From my teacher training I learned that in yoga, there are 7 major chakras, or energy cluster points, that line up with the spinal column where nadis, or channels intersect. These channels carry prana or our life force energy. Of the 7 chakras, each corresponding to a respective spot on our spinal column, the 3rd chakra, Manipura is said to be unbalanced when we see skin conditions like eczema. Manipura is located in the solar plexus and corresponds to physical body parts such as the detox organs (liver, spleen, etc). When this chakra is unbalanced, as in it is underactive, people may feel a lack of control or a tendency to withdrawal from social situations.  Poses said to help invigorate this chakra include core strengthening poses such as those that entail isometric contractions, and breathing focus. This can include poses that entail twists (because they engage the core muscles to be able to do the poses well, and are said to help with detoxing).

So first off, does yoga truly help eczema? Well, some studies have show that it helps reduce inflammation after moderate to strenuous exercise. Others indicate it helps with the glycation process (mentioned in my post about sugar’s effects on eczema), by increasing the muscles’ glucose uptake, and therefore reducing blood sugar levels.

Yoga also entails a lot of focus on breathing (which can be beneficial for both getting you to distract your mind away from the itch and improving circulation of O2). It also often includes a meditative component, and meditation has also been seen to help eczema. It can be useful for reducing stress levels and improving sleep as well.

In general all of those effects would help alleviate a lot of the issues that eczema comes with, and personally I got more into yoga because it was one activity that didn’t induce worser flares for me. Plus getting a good night’s sleep is huge, since we do so much healing when we are catching some z’s.

Here is my take on poses for eczema, though most of these poses are somewhat “general” because they are known to help symptoms of eczema (such as inflammation, bad circulation, stress), aka they benefit the skin generally. Then again, there is no “cure” for eczema in isolation, so getting up and moving and in this case doing yoga will most likely help with eczema too.

Here are specific poses I found listed on various websites that were said to help the skin (with photos of me demonstrating! Note: I won’t demo the twists as I am over 8 months pregnant at the moment).

Livestrong.com suggests a lot of inversions (or poses with the head below the heart) including:

  • Legs Up a Wall (beginner friendly. I only stayed here for a few seconds to take this picture before getting off my back because it’s not the most comfortable when 38 weeks pregnant).

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  • Camel Pose (can be modified to be more beginner friendly. Note: keeping your hips pushing forward so they are lined over your knees. Also note that I am not reaching for my ankles because I am too pregnant to keep good form attempting that so I’m just reaching my arms downwards).

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  • Wheel (needs a level of back/hip flexor mobility… wouldn’t suggest it for pure beginners and I will update myself doing it when eventually).

From healthline.com we have asanas for beginners to yoga with the intent to decrease stress (in this case for psoriasis, but stress is stress):

  • Child’s Pose (my big toes are touching and my knees are out wide as the mat, and I am sinking my hips down and back while reaching my arms forward. Though I am limited to how far I can stretch downwards by the baby).

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  • Salutation Seal (never knew it was called this, but essentially you sit cross-legged, keep your back nice and tall, and bring your hands to your chest like you are praying).

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And lastly, a few from HolisticVanity who brings up poses to help with inflammation:

  • Seated Twist (again I’ll get around to adding this photo)
  • Revolved Chair (ditto this one)
  • Warrior 1  (note that my lower back has a lot of curvature here, which is not ideal. The baby is pulled me forward and it’s hard to compensate, but generally you want to reduce some of that low back curving to make sure you are setting yourself up for the best alignment to continue the safest practice).

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  • Chair (note: I have my feet hips width distance apart to accommodate the baby, but normally the feet are together will a little space between the heels. Also I need to relax my shoulders down more and pull my ribs in to have better form, but my ribs are also flared out because I’m 38 weeks pregnant!!).

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alternative/holistic medicine, distraction, eczema, exercise and activity, food and nutrition, my journey, pregnancy, skin care, women's health

back after a hiatus

quote calligraphy under cup of lemon tea
Photo by Studio 7042 on Pexels.com

I essentially disappeared off the face of the earth almost two months ago. Things got a little chaotic what with prepping for the baby, the baby shower, having the baby, and then learning about life post-pregnancy.

And in tandem with all that was going on, to be honest I was thinking of discontinuing this blog. My reason was I didn’t think I could continue to come up with content about living life with eczema if didn’t somehow entail my career being related to eczema- but I have since reconsidered and am back with a plethora of thoughts, stories, and research on this condition that I’ll be sharing over time.

I’ve got a lot of fun things in store including:

  • what it’s like to deal with eczema when you have a newborn
  • antibiotics and eczema
  • why it’s hard to know what factors cause or alleviate eczema (aka why humans are not perfect subjects)
  • my love of the sun (but does it love me back?)
  • challenges to try including 30 days yoga (getting moving, tackling isometric holds, and getting that tissue stretch in)
  • rebounding for lymph drainage
  • addiction to picking my skin- how to break it
  • herbs and herbalism… when you want a break from reactionary allopathic medicine and just want to grow some greens
  • Prime Physique Nutrition’s Conquerer Eczema Academy
  • and more!

But  in the meantime I’ll give a general status update on my life.

I had the baby! We named her Fiona and she was born June 18th. She’s now 5 weeks old and her favorite thing to do is sleep on top of me.

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During the labor I was on antibiotics and postpartum I have been trying to keep my diet clean to stave off candida overgrowth, and have also been taking probiotic pills daily. I’ll talk more about that in my antibiotics post.

My current skin condition is interesting to say the least. Skin color-wise I was almost back to normal after Fiona’s birth, and appearance-wise too, though I still have wrinkly skin, and that got a bit worse after the birth. Lately my skin has been dry- but not the dry like ashy-so-put-on-some-lotion, and not the dry like I-am-a-snake-with-the-way-I-shed-so-much, but instead I’m at this weird dry where I have tough and rough skin that feels like I have developed an immature exoskeleton. It’s worse on my hands and feet, and then my legs and parts of my arms. I’ve somehow managed to keep it relatively at bay on my face and neck (which is so important because I’ve noticed when the skin gets bad there, my emotional health drops the quickest). I hate to admit it, but I have definitely been scratching and picking at this new annoying exoskeleton, which hasn’t been the best for appearance (or skin barrier) because I now have a lot of scabs and scar marks. I definitely need to work on not picking my skin. I am extremely thankful that my chest has been relatively unaffected, as I am breastfeeding Fiona and it would be exponential harder (and I would be more worried about her getting an infection from my skin) if I was flared there.

Anyway, that’s more or less the basics of where I’m at now. Stay tuned over the next few weeks for posts about the content I mentioned above!

eczema, exercise and activity, pondering

exercise is medicine for bones, but also for skin?

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A few years ago when I was living in Maryland, I was volunteering with the Montgomery County Bone Builders program. It was a group that offered community classes to adults aged 55+ to help build bone density and reduce osteopenia risk via group weight lifting. Needless to say, I enjoyed it immensely. Well, the other day I came across some notes I took from a continuing education course I took while volunteering, on exercise as medicine. As usual, I started thinking about what I had learned but now with the framework eczema. And thus I will now gift you all with my self ramblings. Not all of the bone building notes are relevant to eczema but whatever random thoughts I did have I’ll put in lavender.

 

2016 – Seminar

“Exercise is Medicine: The explosion of information today” presented by Professor Karen Thomas (a professor of exercise physiology at Montgomery College)

Exercise as Medicine – “Move”

NIH study at Brigham’s and Women’s Hospital stated that done right, there is no higher injury rate than college-aged person even when lifting heavy weight at few reps for people in nursing homes

Strength Training – use it or lose it (every day a person lies flat, as when ill, they lose 4% fitness) – So those days of relative immobilization from large flares are drastically messing up our health! 

–       muscles have 3 types of fibers:

o   ongoing = type I, slow endurance

o   strong = type II, fast

o   fibers that can go either way

–       lose strength fibers with age – body reabsorbs unused fibers and one can never get them back – It would be interesting to see if there are any correlations of increased (or decreased) incidents of eczema with lost muscle strength fibers with age

–       when exercising want to work all major muscles but especially rhomboids for older adults  

o   arms down at side, thumbs pointed out (rhomboids engaged) = can’t slouch – Finding ways to keep optimal “no slouching” positions are important also for allowing a more consistent flow of our fluids (lymph, blood, etc). 

–       some “old age” symptoms are actually just a product of lack of strength

–       need strong core (but also flexible) to protect everything else (e.g. low back) – A strong core is also important for blood flow and healthy digestion, which are crucial parts to helping our skin heal 

–       need to train people how to move in all directions (train to do activities of daily living) – Good to get lymph moving! 

humans gain muscles at same rate no matter age (so long as fibers not lost)

–       large mental component (which ties into a lot of studies in psychology about how ageism affects people’s memories and abilities… in short, if you think you can’t do something, you make it so you can’t do it)  – The mentality behind skin issues has been highly studied. Meditation, distraction, etc are all seen to help with itch sensation reports

low back pain often caused by muscle weakness

–       leg strength – e.g. squats (we also looked at how people can cheat when going to sit or get up from a chair, as by rocking themselves forward to get up or letting themselves just fall onto the chair rather than engaging their leg muscles)

Bone Density (need enough Ca2+, vitamin D and movement) – similar things we need for skin health

(bone replaces entirely every 3 years)  – skin replaces entirely every 30 days for the average person, or so my doctor told me

–       to get Ca2+ into bone, need negative charge in bone

–       bone bending/moving makes static electric charge that pulls Ca2+ into bone if vitamin D enzyme present – it would be interesting to the study the chemical reactions/absorption rates of products on the skin, moisture, etc during exercise. That and if the collagen levels in the skin change with exercise. And also what is happening chemically with the skin cells when they are inflamed and when they die/new ones are created. Looks like I need to get into skin physiology soon.

–       body parts you move, strengthen – if moving the skin helped strengthen it… that could explain why massages tends to be good for us (besides the stress component? I wonder if they have studies on the affects of massage on skin as it ages.

Training – legs further apart during exercise means less likely to fall b/c wider base of support. Want head over base of support

–       Tai Chi and dancing are good for balance – and good low impact activities for people undergoing a flare to present the sweating-to-itching issue

–       Teach people how to get off the floor via balance and motor ability so they can help themselves – mobility is an important factor for skin health too. you can develop a lot of scar tissue (especially if you spend all day scratching the sh*t out of yourself) so setting yourself up for more general body mobility will help your skin. This is also why massage is known to help people with eczema I believe, because you get the blood flow stimulation and help cleanse out irritants/chemicals. Though also I’ve been wondering about the “new” organ that scientists discovered… the interstitium, and where that will come into play with skin health and chronic skin conditions. I’ll do a separate post on the interstitium later on.

–       Challenge self by doing one sided exercises (like one arm pushups, etc) to work core

ROM (range of motion) – need to be able to move joints as far as they are supposed to move that way no compensation in other joints – again mobility. Also with theories like sanomechanics, where when a joint is loaded, the pressure is hydrostatically spread to other joints. The end result is a floating skeleton, or a balance of all the joints allowing for protection from damage. Apparently the concept is novel, but the application of how to achieve it feels a lot like a cross between meditation, yoga/tai chi/other flow types routines, and good postural alignment. But what sanomechanics made me wonder for years, was if we can accept the concept of joints “communicating” (for lack of a better way to describe it), and keeping one another in balance, why isn’t the idea that the skin behaves similarly or in combination with such “communication” not a theory? I’ll work on fleshing out more about what I mean by that later (maybe in the same post I do about interstitium).

–       so need to learn body’s ROM (different for each person)

PSYCHOLOGICAL – effects on nervous system and brain

–       painkillers mimic endorphins (but one can’t OD on self made endorphins)

–       endorphins mask pain (so good for arthritis) – And potentially itching, given some pathways of itching and pain being similar (post coming soon on this too!)

–       moving increase lubrication of joints and produces endorphins but won’t fix arthritis – but creation of endorphins may help also distract from the itchy sensations!

–       exercise wakes up brain (thalamus) – think smarter and faster (cognitive abilities)

o   elderly can think as well as younger kids but as slower rates

o   consistent exercise maintains cognitive speed

o   exercise prevents dementia (or slows it in those already afflicted, b/c more O2 to brain decreases plaque – especially in regular dementia)

The more you exercise, the less likely you will die from anything – exercise is dose related

–       150 minutes physical activity a week for adults at minimum (so 25 minutes 6 days a week, or 5 days minimum) – I’d say this is an important mark to meet in general, especially when you have a skin flare too!

–       more benefits for longer durations of exercise b/c chemical reactions ongoing – I’m curious if that would be the case with eczema flares, or is it more dependent on the activity level (low/high impact, low/high heart rate, perspiration rates, etc)?

–       want to work at intensity hard enough that one can’t have a conversation  – I tend to do body weight/weight lifting rather than pure aerobic type exercises to avoid sweating. though I will take long walks in my hilly neighborhood, which sometimes winds me (though I am 34 weeks pregnant now)

–       want to be a little sore so just exercise until tired – Would being sore help distract from flare symptoms?

eczema, exercise and activity, food and nutrition, my journey, pregnancy, women's health

pregnancy and eczema

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Today I decided to dig a bit more into the world of eczema for us pregnant folk.

I started by watching a podcast done by Abby Lai (of Prime Physique Nutrition) in which she talked with Dr. Peter Lio (he’s done a few National Eczema Association webinars). Link to Abby’s podcast is here.

The major points were:

  • It’s not really understood why but about 1/2 of pregnant women have worsened symptoms and 1/2 have bettered symptoms. Dr. Lio likened it to how some women get nausea during pregnancy.
  • You can have a flare in one pregnancy, but not in the next. Also you can have changes in skin between trimesters.
  • Dr. Lio mentioned a few itching conditions that can occur during pregnancy such as cholestasis (when liver and gall bladder slow down their bile flow which causes a terrible itch), atopic eruption of pregnancy, PUPPP (or pruritic urticarial papules and plaques of pregnancy which usually occurs during the 3rd trimester).

He and Abby then talked about treatments used during pregnancy including such as:

  • how topical steroids are okay but not most potent ones. The goal is to keep body surface area that you apply the topical steroids to relatively low (so not WHOLE body), because topical steroids go in blood if they are used long enough or over large surface areas.
  • light/phototherapy
  • Benadryl and other anti-histamines
  • wet wraps, icing, moisturizers (see my post on products I’ve tried here)
  • anti-itch creams in small amounts (such as camphor and menthol)
  • natural oils like coconut and sunflower seed oil (if not allergic)
  • dilute bleach baths (he also mentioned a recent paper shows it’s anti-inflammatory and anti-itch directly, as well as being antibacterial)
  • topical vitamin B 12 (water soluble) – pink magic

The takeaway advice he gave was don’t be afraid to use medicine so long as you have a doctor helping you.

 

I was having trouble finding full access studies but I did stumble across a PDF from the National Eczema Association about getting pregnancy, skin tips during pregnancy, and after pregnancy advice. It also talked about the likelihood of the baby getting eczema and things to hopefully prevent it.

The same study also mentioned that avoiding soap can also help decrease the disruption to the skin barrier.

In regards to when the mothers are postpartum, there can be challenges with breastfeeding if the mother develops eczema around the area. In that case, the study said low to moderate potency topical steroids can be used so long as they are washed off before the next breastfeeding.

 

(NEW) The National Eczema Association posted a new article May 2018 called Oh baby! Eczema from pregnancy to menopause that goes into more detail about why women may experience more incidences of eczema during pregnancy. It mentions how a researcher at the University of California-San Francisco (Dr. Jenny Murase) found that when a woman is pregnant, her body shifts from Th1-dominant to Th2-dominant immunity in order to protect the fetus (because Th1 attacks foreign material that get into our cells, aka it would attack the fetus since they have half of the father’s cells). Th2-dominant immunity means the mom’s body attacks allergens and whatnot that are flowing around outside her cells, protecting the fetus, but not helping when it comes to eczema. The blog post said that the shift from Th1 to Th2 is driven by the surge of estrogen. Perhaps that is also why women generally have higher rates of eczema than men? Unfortunately I couldn’t find the study that the NEA article cited so I can’t follow up with more, though I did find an abstract from Dr. Murase et al, that mentioned how psoriasis tends to improve during pregnancy correlating with those higher estrogen levels… so maybe one of the immunity-linked causes of eczema and psoriasis are opposite in origin?

My personal experience with being pregnant while having eczema has been that I have to be more mindful about how I treat my eczema relative to general lifestyle changes too. For example, no longer can I go and drink tons of kombucha (due to varying alcohol content and the light risk of bacteria), enjoy whatever random herbs I feel will help me heal, go jump into a hot yoga class unprepared (because getting dizzy affects another being besides myself), eat whatever fish I want whenever (I am a tuna fan and enjoy sushi when not pregnant), run and jump into a hot springs all willy nilly, etc. I have to be more mindful about sharing my body and not just jumping into whatever new protocol or thing I want to try out to help my skin. I can’t decide to just go on a particularly aggressive dietary change that involves caloric restrictions or drastic nutritional adjustments.

That being said, being pregnant has also had a lot of changes that might be helping my skin. In my first trimester I was very sugar and meat adverse, so I ended up eating a lot more veggies. Now in my third trimester I tend to crave veggies as a way to keep my guts feeling good, and to keep indigestion at bay. I also eat smaller meals more frequently, and don’t really accidentally binge eat big meals mindlessly, which is great because it means my body isn’t overtaxed in digestion (more time to heal the skin!). Pregnancy has me feeling a bit more tired (and much like with a flare, also avoiding high intensity activities), so I tend to stick to lower impact, longer duration activities like going for walks for miles or remembering to get in 100 modified push-ups a day.

Anyway, I’ll stop there and leave you with a current photo of me. I’m about 31 weeks pregnant now and you can see my arms and hands in particular are especially topically-challenged.

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Note: Some of the above links are affiliate links. This means that if you click on one and purchase an item, I will receive a small affiliate commission (at no cost to you).

distraction, eczema, exercise and activity, skin biome, storytime

digging down deep

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Here’s little bit of writing for fun that I came up with during a bout of insomnia this week.


My mama always said you need to dig deep to really find yourself. What I didn’t realize was that she meant it literally.

The first warm weekend in New England, I found myself at Home Depot, my eyes scanning along the garden shelves looking for that perfect plant to take home with me. I had finally coaxed myself out into the sunlight and had witnessed what the winter had done to my yard, and knew it was time to help it heal. It didn’t take long for some hardy flower types to catch my eye and I quickly placed a bunch in my cart and wheeled them to the register. On the way I paused to think if I should buy gardening gloves, but then decided again it.

Soon I was at home, kneeling on the lawn scraping away layers of rock and gravel and old stiff mulch from my beds. As I gardened bare-handed I realized the dirt was getting everywhere, in my tiny cuts, stuck along the dry skin flakes, immersing my hands in their loamy fertileness. Though it was nothing like soaking in a warm bath, I felt comforted by the sun beaming down and the dirt encasing my hands. It felt natural and right, even though my hands were no less dry than any other day.

Later that afternoon as I washed the dirt off with soap, I realized my hands were cracking less and less itchy post-wash, unlike my usual discomfort from water and soap encounters. Though I still applied moisturizer, the effects of my gardening had already reduced some of the more persistent symptoms of my stagnant eczema, and I felt good. Obviously it was no cure, but the benefits of getting down and dirty with the dirt seemed to be somewhat relieving from the usual eczema grind.

It was nice to know that my non-flares hands were still down in their under the scrapes and wrinkles and redness and flakes, even if I had to dig down in the dirt to get to re-meet them.

 

eczema, exercise and activity, my journey, topical steroid withdrawal

elephant skin

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My skin is going through what I believe to be another topical steroid withdrawal. My reasoning? I have excessive wrinkling on the extensor surfaces of my skin (I call this stage of skin my “elephant” phase, and I’m not alone; see the study here), and I was on a moderately potent steroid ointment for most of my body and a lower potent one for my face/crooks of elbows and knees when I found out I was pregnant. What finding out I was pregnant meant for my skin was that, because the more potent one was not necessarily safe for a growing baby, I was taken off of it earlier than planned and told to use just the lower potency one all over my body instead. Unfortunately my thicker skin areas were used to the higher one so the response was less than ideal and I ended up still flaring a lot as I did my low potency taper. I gradually phased out using the lower one despite some discomfort because having to use topical steroids over such a large surface area of skin does increase the risk of it being absorbed into the bloodstream, making it more likely to affect my baby.

So in a nutshell I had a fairly quick taper and now am cold turkey off all topical steroids again. The result has been interesting. This winter has dragged on which means I have been starved for vitamin D, more sluggish from being trapped indoors, and cold. Whenever I have a withdrawal, my skin is hotter to the touch because it is acting as an impaired barrier and letting my core temperature heat go. The result? I am a grouchy popsicle of a human.

Luckily, we have finally seen a break in the northeast chill, and I was able to enjoy the weekend basking in the sun and walking for miles. Hopefully getting outside and playing more will help me get my skin back to its old equilibrium before the baby comes.

Nighttime presents its own problems. Though I am less stressed about losing sleep nowadays (having a remote job helps), I do find that physically sleeping is still a trigger. The last few days I have had hives that appear on my back when I am in bed (but not in the same part of my back each day which would have made me think it was my sheets or  lotion). I also tend to get heat rash-like symptoms on whatever side of my body I am laying on, or even if I roll over to lay on my back for a bit. I haven’t figured out why that is, but it’s extremely irritating and usually affects my IT band area on my legs the most. And naturally since I am awake weird hours, I notice how my skin dries out as the night goes on (but I am usually too tired to actually get up and re-apply another coat of lotion/moisturizer).

My methods of combatting this withdrawal flare are the following:

  1. keeping calm. I have been extraordinarily unfazed by my skin this time round. I am not worried it will never heal, and I am not worried when I miss sleep (I just try to take more cat naps later on or go to bed the next day at crazily early times like 5pm).
  2. diluted bleach baths. I tend to take one many once every one or two weeks just to make sure I keep the potential infections at bay. I usually know when I have had bad scratching bouts or see signs of what I think may be early infections, and I decide when to do these baths by those feelings.
  3. sugar reduction. Yes, despite being a sugar-lover, I am trying to cut down on added sugars. I don’t even put sugar in my oatmeal anymore (instead I cut up a fresh green apple into it or add berries if I have them). I let myself have one treat on Saturday and Sunday, but I make it so I have to work for it (like walk 2 miles to get the treat, then walk back).
  4. finding a good product for the skin presentation. Lately I’m hooked on Exederm’s daily care moisturizer. It doesn’t stop me from still drying out and flaking but it also usually doesn’t burn or cause excessive itching (except sometimes at night, but my skin is an unpredictable animal at night).
  5. living the “motion is lotion” motto. I have been trying to increase my NEAT (non-exercise activity thermogenesis) meaning I have been trying to reduce the time I am a sedentary lump. The warming weather is helping (I will happily walk anywhere in my town even if it is a 1-3 mile walk one way), and I have been doing a 100 push-up challenge every night before bed (I do modified pushups as my belly has been getting bigger!). I also started incorporating more hip workouts and squats/lunges to keep my legs in shape as this baby grows. All in all, “I like to move it, move it”.
  6. showers first thing. When I get up from bed (which sometimes is a struggle in itself), I get into the shower to start my day. One, I find it therapeutic, the feeling of water. Two, it helps me soften the skin and wash off some of the dead skin so that the lotion/moisturizer can be better absorbed. Three, it bases me in a routine.

All in all I feel like I am handling this withdrawal much better than previous ones. My skin has more or less remained skin-colored this time (instead of reddening everywhere). I’ll give updates if it starts to subside or if it gets worse in time.

Oh and here is a photo of what I mean when I say I have elephant skin (this is my right knee):

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distraction, eczema, exercise and activity, flare-up

babysitting with eczema

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So many searches come up with how to be a caretaker for a person or child with eczema, but I haven’t heard from, or found research more about the challenges and options for when the caretaker is the one with eczema.

This week I am watching my baby cousin. He’s about 7 months old now and his mom leaves him with me starting around 7am until anywhere from 6-8pm. It’s my first time watching an infant and though he is a delight, today required some adjustments to my routine as I overslept. Normally, when I have a rough night, I can sleep from 6-8am and catch up on some of the lost time. And then the first  thing I do when I get out of bed is take a warm shower and then apply lotion (as it helps my skin absorb it better when I shower first. Also for those interested, I am currently using Exederm lotion as my go-to).

Today however, I failed to get up before my cousin had to leave so instead I just rolled out of bed and got the baby, dry flaky skin and all. As I haven’t had enough time to zip off to take my usual shower, because I obviously can’t leave him alone for long periods of time (and I am not familiar enough with his nap schedule to know if I have enough time to shower during one), the day has come down to being a lot of a mind over matter deal about my skin. Yes I still itch, and my hands especially are quite dry, but mostly I’ve focused on the mini wheat, and by doing so I have been able to ignore my own normal tweaks and discomforts. There’s actually a fair amount of studies that show that being able to have a distraction helps decrease the itch sensation due to how itching is perceived via the brain (but more on that in a post coming soon about addiction to scratching).

Though I understand the necessity of taking care of oneself physically and mentally, before others (such as with the oxygen masks on airplanes), I do recognize when handling my skin is less than urgent. Yes, I am dry and theoretically could desperately use some more lotion, but I feel well enough that I can handle waiting to do my usual routine until tonight. That being said, after changing his diaper I did have to wash and soap my hands thoroughly which caused some cracking so I did apply lotion then. The rest of my body is holding up well enough in the meantime.

Plus the advantages of babysitting an infant are that they keep you up and moving. I probably feel relatively good because I haven’t stopped moving around with him, adding validity to the “motion is lotion” mantra. Although sweat-inducing physical activity has been seen as eczema-provoking, overall it seems there still hasn’t been enough research done to figure out what kinds of exercise are the best for people suffering from eczema. Research for moderate, non-sweat-inducing activity helping eczema has been fairly supported by organizations like the National Eczema Association, which encourages trying low-intensity activities such as yoga, tai chi, pilates, walking, and gardening. I’d love to take my cousin out for a walk but it’s currently 45F and down pouring so I’ll settle for doing some squats with the extra baby weight. 🙂

I think one of the most important things when you have a flop day in terms of your care of a chronic (non-fatal) disease is to not get too stressed out. As we all say, life happens, and so sometimes it’s best to just roll with the punches and let that bad day pass on by. So long as it doesn’t become a habit of mis-care to yourself, you’ll most likely be okay.

And so, all in all though I look like a ragamuffin and clearly didn’t take proper care of my skin today, I am not upset and I know I’ll survive one less than ideal day.

Are there any other caretakers (parents, guardians, babysitters, senior home workers, etc) who suffer from eczema and have had to forgo their usual skin care every now and then in order to take care of someone else?