Please remember that I am not a health professional of any kind. My notes represent my own experience and reactions to the drugs in the past and present. Your reactions may be different.
Oh, and I am not paid by anyone to say either good or bad things about the drugs.
Aerius (Desloratadine) - evidently this is America's Clarinex. I use it, it seems to do the job, although for me the restriction of one a day means I have to take another antihistamine to finish the job.
Histazine or Zyllergy (cetirizine dihydrocholride) - sold in Israel, apparently not in the states. It does not seem to be exactly the same as zyrtec (cetirizine hydrocholride, just one, not di) nor xyzal (levocetirizine dihydrochloride). Whatever. Works fine enough for me.
Profiten or Zaditen (ketotifen) - now that I look it up, it says that it is mostly used for asthma prevention. So maybe you (and I) shouldn't be using it for atopic dermatitis. Dunno. I took it twice daily as part of my switching scheme and it seemed to work OK at the time. But I'll try to pay more attention if I ever take it again.
Mizollen (Mizolastine) - the pages I read claim it has less sedative effects, but as I never suffer from sedation from the regular antihistamines, I failed to appreciate the gesture. In fact it gave me gases and caused my mouth to taste weird. If I recall correctly, this seemed to be caused by the inactive ingredient that had something to do with lactose (although I am not lactose intolerant as far as I know). Stopped once I switched to a different drug. Oh, seems to be European only - couldn't find it in the states.
The real sedative antihistamines:
Phenergan (promethazine), as stated in the previous post, is an antihistamine that causes some sedation/calming. The sedation part is supposed to calm down the itchy and scratchy show. For me it just sent me on a wild ride of dizziness, nausea, and major major headaches (caused, as far as I could tell, by extremely high hearing sensitivity. Think Clark Kent in Smallville when he first discovers superhearing).
Otarex (Hydroxyzine hydrochloride) (Atarax in the states) - it is considered as the same family of drugs as phenergan.It's supposed to relieve that itchiness that drives you bananas. Well, it did. It also, in both distant and recent past attempts, gave me those same severe headaches, as well as memory lapses. It affected my ability to think clearly, and caused extreme drowsiness. For me at least it was NOT worth it.
The Headaches with a capital H lasted for a few weeks after stopping to take Otarex (and I only took it for a week). But after I stopped Phenergan they stopped within a day or two.
Saturday, September 29, 2007
The other allergy
In trying to get rid of the many side effects I had been suffering due to the massive infusion of drugs that I was on, Dr. R in my first checkup recommended stopping to take Phenergan. This drug is an antihistamine that also induces calm and so is expected to ease itchiness. By this point I was sleeping fine at nights
Dr. R was right in a sense. My nasty side effects all but went away. The massive headaches due to noise sensitivity completely disappeared and the worst of the nuasea, dizziness etc. was gone with the wind.
However Dr. R (dermatologist) dismissed my question about replacing the phenergan with another antihistamine. After all, I was getting aerius, wasn't I? That should be enough, said the doctor.
Enough for the itching, maybe. But within two days, I was sniffling and sneezing, my nose was running a marathon, and I was coughing up mucus like it was fifth grade and I was in a spitting contest. In other words, my allergic rhinitis had reared its ugly head, with a little bit of asthmatic mucus as a side dish. After all, before changing to otarex (later switched to phenergan) I was balanced on a two-antihistamines-a-day diet. So backing down to one was definitely not good.
The good news? Once I put the histazine back on, the runny nose ran in to hide and it's back to normal. Or as normal as it gets around here, anyway.
So there's my reverse warning from the last post. Your dermtologist may discount your other allergies. You have been warned.
Drug info in the following post.
Dr. R was right in a sense. My nasty side effects all but went away. The massive headaches due to noise sensitivity completely disappeared and the worst of the nuasea, dizziness etc. was gone with the wind.
However Dr. R (dermatologist) dismissed my question about replacing the phenergan with another antihistamine. After all, I was getting aerius, wasn't I? That should be enough, said the doctor.
Enough for the itching, maybe. But within two days, I was sniffling and sneezing, my nose was running a marathon, and I was coughing up mucus like it was fifth grade and I was in a spitting contest. In other words, my allergic rhinitis had reared its ugly head, with a little bit of asthmatic mucus as a side dish. After all, before changing to otarex (later switched to phenergan) I was balanced on a two-antihistamines-a-day diet. So backing down to one was definitely not good.
The good news? Once I put the histazine back on, the runny nose ran in to hide and it's back to normal. Or as normal as it gets around here, anyway.
So there's my reverse warning from the last post. Your dermtologist may discount your other allergies. You have been warned.
Drug info in the following post.
Saturday, September 15, 2007
The right doctors: worth more than their weight in gold
Dr. G told me he was the wrong doctor, but I didn't really listen. He's an allergist, and in fact the only doctor I was seeing regularly. He told me I needed a dermatologist. I found one but was inconsistent in my visits. In fact I found three or four dermatologists and did not persist in more than two or three visits to each. And then I went to a different allergist, because Dr. G wasn't doing anything about my atopic (he kept telling me I needed to see a dermatologist!)
Boy, was I wrong.
With atopic dermatitis, you've got two major factors at play. You've got your allergies, and they play a major part. But you can't just bank on the allergies. As Dr. H (dermatologist) once told me - but it didn't sink in - even if I were in a bubble, ate just lettuce and drank just water, I'd still have atopic dermatitis. In other words, allergies are a contributing factor - possibly a critical one - but not the sole cause. And when push comes to shove, and treating the allergies fails to solve the problem, you need a dermatologist.
I found this out the hard way. By the time I saw a dermatologist, it was in the hospital. Learn from my mistakes. Don't wait.
P.S. The reverse is also true. Don't put all your trust in a dermatologist without ever seeing an allergist; allergies may have a major effect on your atopic.
Boy, was I wrong.
With atopic dermatitis, you've got two major factors at play. You've got your allergies, and they play a major part. But you can't just bank on the allergies. As Dr. H (dermatologist) once told me - but it didn't sink in - even if I were in a bubble, ate just lettuce and drank just water, I'd still have atopic dermatitis. In other words, allergies are a contributing factor - possibly a critical one - but not the sole cause. And when push comes to shove, and treating the allergies fails to solve the problem, you need a dermatologist.
I found this out the hard way. By the time I saw a dermatologist, it was in the hospital. Learn from my mistakes. Don't wait.
P.S. The reverse is also true. Don't put all your trust in a dermatologist without ever seeing an allergist; allergies may have a major effect on your atopic.
Thursday, September 6, 2007
Crème de la Crème
One thing that did not come as a surprise to me at the hospital was the insistence on moisturizing. I had been taking baths and putting creams on my skin for ages. However, the precise nature of these was slightly different than I was used to, especially regarding the creams.
The treatment began with very cortisone-heavy creams. However, as the days passed and my skin cleared up, these were gradually decreased - lower dosages, smaller areas, etc. The main treatment, they explained, will be the immuno-suppressants... and that I gotta keep up the moisture.
So, which creams? Up until now I had been using Vanicream for years. In the hospital they used Eucerin, but not the store-brand one. They mix it up with... olive oil. Precise measurements to follow soon. They recommended I keep using it, and I intend to for now. It leaves the skin feeling quite smooth.
Oh, one more thing. They recommend keeping the creams refrigerated. The idea, as I understand it, is that when you put on the cold cream it has a further soothing effect. Just don't keep it too cold.
And how should you spread the cream? With the palms of your hands, not your fingers. From top to bottom, in the direction of the hair growth, to avoid folliculitis (inflammation of the hair roots).
Baths will come in a separate post.
Edit: with cortisones you're supposed to spread a thin layer, but with the moisturizers, don't be stingy. Other than cost, there's practically no reason not to apply liberally. Just don't forget to use the fragrance-free, paraben-free, everything-free version.
The treatment began with very cortisone-heavy creams. However, as the days passed and my skin cleared up, these were gradually decreased - lower dosages, smaller areas, etc. The main treatment, they explained, will be the immuno-suppressants... and that I gotta keep up the moisture.
So, which creams? Up until now I had been using Vanicream for years. In the hospital they used Eucerin, but not the store-brand one. They mix it up with... olive oil. Precise measurements to follow soon. They recommended I keep using it, and I intend to for now. It leaves the skin feeling quite smooth.
Oh, one more thing. They recommend keeping the creams refrigerated. The idea, as I understand it, is that when you put on the cold cream it has a further soothing effect. Just don't keep it too cold.
And how should you spread the cream? With the palms of your hands, not your fingers. From top to bottom, in the direction of the hair growth, to avoid folliculitis (inflammation of the hair roots).
Baths will come in a separate post.
Edit: with cortisones you're supposed to spread a thin layer, but with the moisturizers, don't be stingy. Other than cost, there's practically no reason not to apply liberally. Just don't forget to use the fragrance-free, paraben-free, everything-free version.
Monday, September 3, 2007
Things that were, and things yet to come
Phew. I haven't been very active lately, but there were some good reasons for that. So, I am going to tell you a little bit about what has been going on. I'm also going to mention a lot of things that will receive my fullest attention in separate posts. I want to do this right, so I will devote a post to any topic that seems relevant and not go into too many details here. So to avoid repeating myself a lot, I'll write "TBE" - to be explained - wherever I want to write more later. [Edit (6.4.08): these TBE's are now links to the relevant posts, wherever I actually wrote them.]
Around the last time I posted, my situation was already pretty severe, and it was getting worse by the day. I somehow managed to function although I was barely sleeping at nights, scratching constantly and so on.
My situation can be likened to the proverbial boiling frog. For nearly two years my situation was going from bad to worse, with only temporary remissions brought upon by use of cortisones in different formats. I will write a separate post about all the warning signs I missed, should have seen, or didn't know existed... TBE#1. But for now suffice it to say that by the beginning of August, I was near the boiling point.
In hindsight, my situation was actually dangerous (TBE [6.4.08 - due to infections and sleepless nights]). To make a long story short, I came to an appointment with an allergist. As I was waiting for him to show up, the nurses told me in no uncertain terms that they think I should go to the emergency room - a statement which managed to dull the surprise when the allergist took one look at me and said I needed hospitalization. Most importantly he said this should be seeing a dermatologist - that he as an allergist couldn't do enough for me (TBE).
So the very next morning I showed up in the Rambam hospital in Haifa, which evidently hosts one of Israel's best skin departments (if not the best one). I came to the upstairs clinic first, and met with the department head. He was also very clear on the fact that I needed to be hospitalized, and so I was admitted to the hospital.
I spent the following ten days there, and received all-around treatment that has turned my skin upside down, inside-out and altogether amazingly healthy. To me the best part of this was that I received no systemic cortisones but rather a combination of other treatments (TBE), the most important of which being an immuno-suppressive (TBE). Within two days of being there my skin was nearly entirely cleared up. I was still itching, though, and not sleeping at nights; this improved later on (TBE). Finally I was discharged home, and I will continue some of the treatments at home while others are over (TBE...).
With so many things yet to be explained, I want to wrap up this post now with a note of cautious optimism. Right now, my skin is in a wonderful condition, and I intend to do everything in my power to help it stay this way. To this end, and also to help other people be healthier, I plan to post a series of short posts on specific topics that I encountered immediately before and during the hospitalization. I hope that I can follow through with these ambitions.
Around the last time I posted, my situation was already pretty severe, and it was getting worse by the day. I somehow managed to function although I was barely sleeping at nights, scratching constantly and so on.
My situation can be likened to the proverbial boiling frog. For nearly two years my situation was going from bad to worse, with only temporary remissions brought upon by use of cortisones in different formats. I will write a separate post about all the warning signs I missed, should have seen, or didn't know existed... TBE#1. But for now suffice it to say that by the beginning of August, I was near the boiling point.
In hindsight, my situation was actually dangerous (TBE [6.4.08 - due to infections and sleepless nights]). To make a long story short, I came to an appointment with an allergist. As I was waiting for him to show up, the nurses told me in no uncertain terms that they think I should go to the emergency room - a statement which managed to dull the surprise when the allergist took one look at me and said I needed hospitalization. Most importantly he said this should be seeing a dermatologist - that he as an allergist couldn't do enough for me (TBE).
So the very next morning I showed up in the Rambam hospital in Haifa, which evidently hosts one of Israel's best skin departments (if not the best one). I came to the upstairs clinic first, and met with the department head. He was also very clear on the fact that I needed to be hospitalized, and so I was admitted to the hospital.
I spent the following ten days there, and received all-around treatment that has turned my skin upside down, inside-out and altogether amazingly healthy. To me the best part of this was that I received no systemic cortisones but rather a combination of other treatments (TBE), the most important of which being an immuno-suppressive (TBE). Within two days of being there my skin was nearly entirely cleared up. I was still itching, though, and not sleeping at nights; this improved later on (TBE). Finally I was discharged home, and I will continue some of the treatments at home while others are over (TBE...).
With so many things yet to be explained, I want to wrap up this post now with a note of cautious optimism. Right now, my skin is in a wonderful condition, and I intend to do everything in my power to help it stay this way. To this end, and also to help other people be healthier, I plan to post a series of short posts on specific topics that I encountered immediately before and during the hospitalization. I hope that I can follow through with these ambitions.
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