World Mental Health Day - October 10, 2011

There isn't a lot of advice I can give regarding mental health. It's not like giving advice about how to eat at a restaurant or find natural treatments. However, the reason I talk about it frequently is because it's often seen as part of an atopic-allergic-depression triad. Basically, allergic and atopic individuals often suffer from depression as well. While, it's not difficult to understand why this is the case, there is no medical consensus on whether depression is caused by the effects of being allergic/atopic or if there is some deeper correlation.

Presently, it doesn't really matter whether it's an effect or another symptom. The fact is that it happens and while there is a lot discussion about how to physically protect and treat allergic/atopic individuals, there is very little said on how to mentally help them. Depression isn't always about being suicidal, but it can still be very debilitating in its silence.

If you are an atopic and/or allergic person or if you are the parent of one, please think about how this might impact you or the person you care for. If it does, talk to your family doctor. Just as you would request an allergist, immunologist or dermatologist, ask to consult with a psychiatrist or certified therapist.

For more information, please speak with your family doctor or contact your local mental health organisation. In Canada:
Mental Health Commission of Canada
Canadian Mental Health Association 
Health Canada - Mental Health

It Gets Better

This blog was sparked by an aggravating incident I had with someone in a work context. I have never met this woman and hope never to do so, but the exchange left me upset and bewildered. She was under the impression that I never left the house because I was far too sick to do so; so, I needed other people to take over for me. She kept repeating that I was too sick and couldn't leave the house. Since I had to leave my house for my job, it was a bizarre statement to make.

I don't have the specifics on why she was under that impression. I clarified my condition for her as it pertained to my work at the time. I would have liked to tell her that her suggestions and tone were inappropriate, but frankly, I was too shocked. I haven't been spoken to like that in years.

Honestly, my asthma, eczema and allergies can make things tough if I have to be outside for long periods of times. And, as I've mentioned in a previous post, smoking and misused chemicals seriously aggravate my condition. However, these aren't common occurrences. I don't view my conditions as disabilities. I seriously dislike being pitied and I have to hold back a groan when someone calls me a "survivor". I wasn't marooned on a deserted island.

So, this all got me thinking and I think there's a lot to be learned from the "It Gets Better" campaign developed by the LGBT community. I'm in my 30s and while I unfortunately still have to deal with ignorant people, it doesn't happen often. My skin can never be perfect, I can't eat anything I want and I have to be honest about being allergic to pets and cigarette smoke when people invite me over, but most people don't care.

Things as a child were far more difficult. Frankly, children can be evil, little jerks willing to pounce on any perceived difference with which they're not familiar - race, disease, health conditions, homosexuality and the list goes on. So, while I don't think it's a bad idea to start educating all children about conditions like eczema, food allergies, asthma (and you can add a whole host of conditions to that list), at the end of the day, the message is that it gets better.

My intention isn't to compare atopic and allergic conditions to homosexuality directly. The latter is not a health condition. I also don't want to make it seem like children with allergies and atopic conditions don't have a difficult time simply growing up. They do and they need emotional support.

As a child, your concerns are pretty limited to "Why can't I eat that birthday cake?", "I hate feeling different" and "I wish I could stop being itchy so I could sleep". As you grow up, those concerns accumulate. "Will I have real friends who don't tease me because I'm allergic?" "Will someone want to date me even though I have scars?"

And the answers are that you can't eat the birthday cake because it will kill you (but grocery store cake is kind of gross anyway), being different is far better than being a clone and yes, someone wonderful will want to date you and won't care one whit about your scars.

No one knew I had those questions growing up. And, I had to learn those lessons by myself. But, I learned them. And, I hope that more allergic and atopic adults start speaking out so the following generations know that yes, it gets better.

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!

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.

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!

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!

Variety

I've been thinking about this a bit lately. When I first discovered non-dairy products, I went a little crazy on the soy. While soy still makes up part of my diet, I've definitely worked hard to find alternatives.

Part of the reason is that I'm always a bit worried that I'll develop a new allergy and I want to make sure that I do as much as possible to prevent that. So, I switch up my meals and try new things whenever I can. That can be tricky, but I've found little ways of getting around some of my allergies and sensitivities.

One thing that I've recently discovered is that while I can't eat instant oatmeal or even oatmeal cooked for a few minutes on the stove, I can eat baked oatmeal. It takes about 40 minutes at about 425 F, but it is totally worth it. I add about 10 ml of maple syrup (the real, pure stuff), 10 ml of brown sugar to about 125 ml of oatmeal and one cup of soy milk or almond milk. I've used rice milk and the consistency didn't quite do it for me, but if that's what you can use, it was still good. I'd probably cut the amount back though. I've also put a bit of agave syrup and cut back on the other sugars as well. Not as amazing, but still good. It makes the real stuff a treat. (I think you can see why I can never run a food allergy recipe site!)

And a quick explanation, I do have a nut allergy, but not to all of them. Almonds and I get along fine.

Essentially, trial and error are my friends in the kitchen. I have a good awareness of my allergies/sensitivities and I'm able to work around those safely. I experiment mostly with whole foods since there are generally no hidden ingredients.

However, this comes easily to me. I've grown up in a Indian household in Canada. My parents immigrated here decades ago and integrated well into society. So, my mother is just as likely to cook curries as she is an awesome Thanksgiving feast or lasagna. I've watched both of my parents experiment with new foods and tastes in the kitchen and I recognize that not everyone "knows" how to do this.

I think there are some great options out there.

1. Cookbooks. While I'm not vegan (I just prefer vegetables), some of the books I love the most are the Veganomicon (Isa Chandra Moskowitz and Terry Hope Romero) and the series of cookbooks from Fresh Restaurants in Toronto. If nothing else, they will inspire you and I think that's one of the most important qualities in a cookbook. If the recipe calls for nuts and you can't have them, experiment! I once came up with an odd but yummy replacement when a recipe called for feta in a salad. You should definitely take notes, since I've never been able to recreate what on earth I did.

2. Look for a good nutritionist, especially if you've been newly diagnosed or your allergies have changed. This field has grown and changed since I went to one a couple of decades ago and a good nutritionist can really help you out of a food variety slump. You may not take all of their advice, but like a cookbook, they can be inspiring and help you think about your abilities, not your disabilities.

3. Pretty grocery stores and markets. There is nothing I love more than walking around a Whole Foods Market or a great weekend farmer's market with some cash to spare and not a clue in the world what I want to do for dinner. But, then I see some gorgeous corn or a beautiful cut of fish and I start putting things together. Even better, I see a vegetable that I've always wanted to try (but never have) and start working around that. I've no idea how it will work, and sometimes it doesn't, but either way I've got something to work on and improve.

4. Have flavour on hand! I can't stress this enough. I have friends (who will remain nameless) who own nothing beyond pre-ground pepper and salt! To a Canadian-Indian girl this is unthinkable! Don't buy the cheap stuff that's included with the spice rack from WalMart or wherever. If you want the containers, fine, but toss the stuff when you get home - it's old and bland. Try growing fresh herbs. They're pretty easy and you can buy them (already grown) from grocery and home gardening stores. Or, buy the ones in the grocery store that look pretty. They often cost more, but you can actually tell the difference. Keep them in a cool, dark place. They may look pretty on the shelf, but oxygen and light are not their friends. And, of course, experiment!! Flavour applies to a lot of herbs, spices, sauces, etc. Soy sauce, balsamic vinegar with a bit of lemon to brighten things up (in just the right mix) are amazing on some sauteed vegetables and spaghettini.

In conclusion, I can't say that I eat beautifully and wonderfully all the time. I'm definitely the girl who'll eat lime & salt popcorn for dinner if she's exhausted enough. But, I love food and having food allergies has really made me appreciate all the lovely things I can eat in the world. So, I'm determined to keep on changing it up and looking for more things that I've never tried before!