Saturday, July 30, 2011

Shaving and Saving your Skin

Well, I'm too young to remember women's lib, but I've heard the stories of bra burnings and not shaving legs and underarms. That legacy didn't last long and never seemed to penetrate mainstream culture. So, in North America women are expected to be "supported" and have smooth hairless legs and underarms. Some go as far as removing hair from their arms, but I can't say that thought has ever concerned me.

To some extent, I wonder if advertising has created this overarching need for women to have hairless skin. When I was young, I can't remember seeing this number of commercials for various hair removal systems - crystals, chemicals, wax, sugar, razors and I'm sure some I've yet to hear of.

At the end of the day, the need to be hair-free is there. I'm not going to try to argue against that. I have the same wish as every other woman to have happy, shiny legs. Unfortunately, as someone with sensitive and allergic atopic skin, shaving is not something my skin is happy about. So, I've talked to my dermatologists over the years about the best ways to go about it. I haven't found the perfect system; so, at some point I will have laser hair removal.

So, here's what I've learned and I practice these steps where applicable:

1. If you don't have to shave, don't. I can't say I was happy when my first dermatologist told me this, but it's true. I invest in really great opaque nylons which helps me to get around that in the winter months.

2. Find a method that works for you. My legs are far too sensitive to use a regular razor or sugaring. I haven't tried waxing or chemical removal systems and never will. So, the only thing that works for me is an electric razor. If you have the will and the funds, consider laser hair removal. Do not cheap out on this. Make sure you go to a trusted dermatologist who will discuss this option and explain it thoroughly.

3. Electric razors. If you use this system, keep it clean. Replace components as directed. People with atopic dermatitis are at risk for serious infections like Staph. These infections can be troublesome or lethal and keeping the tools you use on your skin immaculate can be a matter of life and death. You wouldn't get a mani-pedi from a place that doesn't sterilize their tools; so, you need to be vigilant when it comes to what you use on your body. If you have open areas, don't shave.

4. Prep your skin. Clean your legs with soap (remove oils, bacteria, etc) and soak your legs in warm water for a few minutes before shaving. It makes the process easier.

5. Shaving lotion/cream. I use Kiss My Face Shaving Lotion. Find one that works for you with as little ingredients as possible if you have allergic skin. Stay away from irritants like peppermint. That can be harder than it seems.

6. Shaving in the direction of hair growth. My first dermatologist advised that shaving in the direction that the hair grows is less aggravating for the skin. You won't get a close shave this way, but it if helps, then it's worth it.

7. The three Is - Ingrown hairs, Infection and Irritation. Avoiding ingrown hairs is key, because they can be a site of infection. Mayo Clinic has some great tips to prevent and treat ingrown hairs. Speak to your doctor about how to address sites of infection and irritation. I use a corticosteroid cream on my skin right after shaving and an antibiotic ointment in the event of minor infections.

8. Moisturize. This is something you should be doing anyway, but keeping your skin in optimal condition is very important if you're going to do something that irritates it, too.

9. Talk to your dermatologist. It may seem like a minor thing, but this about the health of your skin. Come up with a plan that works for you. Your doctor may have other options that work better.

Personally, my next step will involve permanent hair removal. Being brown, I have issues with hyperpigmentation and depigmentation; so, after a discussion with a dermatologist at AvantDerm, I am confident that the procedure can be performed there with little risk to my beloved pigmentation. I've done a lot of research since not everyone can perform this procedure on patients with dark skin. Once I begin that process, I'll post with the results. I expect some irritation in the short term; so, I'll have to see how I manage that.

Hope this helps and hope you enjoy your summer - hair-free or not!

Wednesday, July 20, 2011

Emergency

Health care in Canada is not a perfect system. I don't think it's possible to have one without some magical source of unlimited funds and an infallible system - two unlikely scenarios. However, when it comes to trip to Emerg, a great deal of it is free; so, I'm willing to put up with some issues. I am not willing to put up with others.

This post isn't about placing blame on any specific hospital, though I encourage anyone with a truly bad experience (use your best judgement and try to be objective) to write a formal complaint to the hospital in question.

This post is about experiences I've had and things I think I could have done better at the time. It's easy to look back and see what I should have done, but understandable that I felt I couldn't at the time. So, I think it's important that anyone with a condition that may require brief hospitalizations on a moment's notice have some foresight and plan for the possible scenarios.

You are not and often cannot be in your right mind and in complete control. Have a plan and someone to contact who knows what you expect of them. The reason I've developed this list is because while I have anaphylaxis, I show no external signs - facial swelling, hives or rashes. My asthma is also not triggered by anaphylactic reactions to food. This has led to unfortunate situations where doctors are confused about why I'm in the hospital at all or educated medical professionals have insisted I do not need to go to the hospital.

I reached out to the allergy community on Twitter and got some great advice. So, without naming names, I'll share what I've compiled - in a handy list format, of course.


1. Have a plan. This means that you need to have a thorough discussion with your doctor about what you should have in your allergy kit. Your allergy kit may contain the following: EpiPen/Twinject/Anapen, acid inhibitor, diphenhydramine in tablet and liquid form (a.k.a. Benadryl), inhaler, dosage information and instructions if you are unable to communicate, as well as MedicAlert ID that you wear at all times. If you have a mobile phone, keep it charged. If you're leaving your home province, get travel insurance (even for a quick jaunt from Toronto to Montreal).
2. Know your reaction. As stated above, you may have atypical reactions. Whatever the case, your  friend should know what to expect. Since reactions can vary, make sure they understand that things can change. Basically, is there vomiting, facial swelling, hives, etc.? You need to know.
3. Prep a friend. Tell them what they need to know in the event you have a reaction.
4. Have your kit. No matter where I'm going, I take my kit and my wallet. The latter has my health card in it.
5. Know the location of the nearest hospital. If you're traveling, it's especially important that you know the emergency number for that area. 911 is not a universal number.
6. Call an ambulance. Anaphylaxis can be life-threatening and epinephrine only buys you time. That said, request it when you call for the ambulance, even if you've already taken it.
7. Stay in control. If you are unable to communicate with ER team, this is where you need that friend. I've had doctors tell me they didn't know what I wanted them to do or been discharged in the midst of a reaction. Don't be bullied. Know what you want and make sure they follow through. This will add stress to your stay, which is unfortunate, but no one in a vulnerable state should be made to feel like a nuisance.
8. Speak up about your needs. Well, you been doing that all along, but this is where you need to know what your body needs. You'll only learn this through experience (unfortunately) and speaking with your doctor. While you should be able to rely on the doctors and nurses, they don't know your reaction. So, you may find they're more concerned with giving you a salbutamol nebulizer than a diphenhydramine drip. Your doctor may have recommended that you take a course of oral steroids after a reaction; so, let the medical team know. Speak up.
9. Document. Again, this is where your friend comes in. In the event you are unable to do so, make sure your friend knows to take names if necessary. This shouldn't be done with the aim of getting a staff member in trouble, but issues with the system need to be addressed. Take down times and what was discussed.
10. If eating out, follow-up with the restaurant or the person who prepared the food. This should be done as soon as possible after the reaction to ensure that you obtain the correct information. In worse-case scenarios, you may find that you've developed a new food allergy.
11. Follow-up with your doctor. Reactions can reoccur within a few days after the initial reaction. You should be prepared.

That is my game-plan, with a couple of additions from the fantastic allergy community.

Hope it helps. Though, I really hope you never need to use it at all.

Friday, July 15, 2011

I'm So Torn (And Still Itchy).

So, one application of the Verdeso seems to take away the itchiness. Once again, not crazy about the bleached petroleum in the product, but it will get me to a stage where I can not scratch. So, I'm going to use it.

Here's hoping it will do its job before it makes me worse!

Thursday, July 14, 2011

I'm Itchy!

I've been completely negligent about posting due to my other duties/jobs/etc. This post will be brief. Basically, it's summer and I've spent far too much time in situations in which I shouldn't have (outdoor situations). Hence, the resulting flare-up and the itchiness! Ack. I can handle a rash, but when they're itchy ones...not so handleable (not a word).

So, I tried cortisone first. Not sure why I bother. No luck. My skin is clearly bored with that stuff.

Despite my allergy to petroleum, I have a foam emulsion called Verdeso from my dermatologist. I can get away with using it a couple of times before breaking out because of it.  My petroleum allergy has waned a bit and the medication in the foam likely counter-acts the reaction to some extent. I'm not crazy about using a petroleum product for various reasons, but I have to admit that I'm a bit desperate. So far one hand stopped being itchy after one application. I'm trying the other hand and my arm right now.

The other thing that I will certainly do is an Epsom salt and baking soda bath. It seems to help. Not too hot of course. I've read about the bleach solution bath (very weak, read this article and talk to your doctor before trying), but that's for bacterial infections. I know when I've got one and I don't have one. So, probably not that one.

Other than that, it's Reactine (the super stuff with pseudo-effedrine) in the morning and Benadryl at night. Hate taking so many drugs, but what can you do?

The lesson I've learned, again, is that everyone has limits and working outside for hours is certainly one of mine.

I'll post an update with whatever ends up working!