Hives again part 2

Yesterday, after stopping my clindamycin and taking the first dose of prednisone 60 mg, I had high hopes the hives would subside. However, the apparent improvement on my chest was short-lived. Last night, despite my Benadryl (both before bedtime and at 330am), I found it hard to sleep. I itched everywhere. That same itch that prevented me from sleeping good. I got up at 530 am to subject my arms to hot water treatment. I had a few hours of relief after that, although my legs kept itching. My skin was sensitive everywhere even to cotton clothes. When I got up this morning, my neck and my face were red again. I took a hot shower to "scratch" my skin without traumatizing. It dawned on me that I could possibly be allergic to prednisone as ell. Good thing I blogged about my first bad case, wherein I was also just treated with cephalexin and prednisone when I developed very itchy rashes. I could rule out it was not cephalexin that caused it because I had no history of allergy to cephalexin, and that a second treatment course of cephalexin without the prednisone actually led to resolution of the swelling I had in my arms that time. The remainder of my skin healing depended on keeping it moist and applying vaseline petroleum jelly for barrier.

So, now I am thinking, after discontinuing my clindamycin yesterday, maybe I should hold off on the prednisone for now and see if I get better without it. I will continue with Benadryl instead. Type here

Hives again

Rarely a year comes without me suffering from some form of skin allergy manifestation. Usually it is something environmental, and would happen anytime from spring to fall. This time it is winter, and the only culprits I can pinpoint were possibly (1) the colossal shrimps I got from WalMart and ate for supper on that night the rashes appeared or (2) the clindamycin which I had been taking since 1/1/11. That was the second time I ate that brand/type of shrimps. The only other things I ate that supper were fruit cocktail (canned, plus fresh apples and kiwis, with the dressing made with condensed milk, cream cheese and mayonnaise -- nothing suspicious and nothing new to me), and a Knorr brand fetuccine alfredo which I cooked with bacon. I doubt that the pasta and the flavoring that came with it caused my hives. No new soaps or shampoos or perfume that would correlate with the appearance of this rash.

1/11/11 first night of rash on torso

So, since 1/11/11 (10 days after my first dose of clundamycin), I have had the hives, which has rapidly spread now all over my skin that you will only see pinpoints of normal skin amidst the red skin. I feel tight and, of course, itchy, although the itch this time is nothing compared to my itch that happened in 2008. It was not that itchy so I could sleep okay. In fact, with Benadryl's help, I can sleep very well.

1/14/11 fourth  day of rash on torso

I am just worried that the hives keep getting worse even after 3 days already, despite taking benadryl and zyrtec. I decided to visit my PCP for a prednisone prescription perhaps, and I did get that prescription. The doctor thinks it is the clindamycin that caused it. Now, if this subsides by Monday, probably I can proceed with my CAT scan on Tuesday, and my follow up appointment with the surgeon on Wednesday for a possible FNAB.

1/14/11 rash on my left arm

It's a good thing my allergies manifest only on the skin and not on the airways.

US Immigration: Medical Examination - What do they look for?

I thought I'd post it here for quick reference when someone asks me what do medical examiners actually look for when they are examining immigrants/aliens prior to going to the USA for immigration purposes.

Below is a set of guidelines that tells the medical examiners specifically what to look for:
http://www.cdc.gov/ncidod/dq/pdf/ti-alien.pdf

If you are planning to immigrate and are having medical exam, having a high BP is not a reason for you to be banned from immigrating to the US, although the doctors will feel safer to "clear" you if you are being managed appropriately, taking your medications, and your BP is controlled. That way, even if you suddenly suffer from a stroke on your first day upon setting a foot on the US soils, the medical examiner will not be apprehended for "clearing" you.

However, the major concerns are:
1. Communicable diseases - Tuberculosis is easily transmittable. However, if just diagnosed, based usually on x-ray (presents as nodule at the apex), then you will be required to have treatment for 9 mos, but they can clear you, I believe, as early as after two weeks upon starting treatment, but you have to continue treatments.
2. STDs - HIV, AIDS, syphilis, gonorrhea, etc. Of course, there is no treatment yet for HIV or AIDS so don't bother if you have this. With other treatable STDs, have them treated first.
3. Mental or Psychological issues - No to drug abuse! Psychological problems that will pose threat to the public safety or yours (e.g. suicidal, homicidal tendencies), or will be a burden (I believe mental retardation used to be a factor to prevent one from coming to the US since this will be of so much burden to the government, but I did not find that anymore in the guidelines, probably it is now acceptable unless there is homicidal/suicidal/violent tendency).

Of course, vaccination requirements must also be met as part of preventive measures of the government, especially for minor immigrants.

For a full set of information, check out http://www.cdc.gov/ncidod/dq/panel_1991.htm


Now, if you are already in the US and is currently applying for permanent residency, you will probably need another medical exam (or not; I believe it depends on how long you had the last medical exam done by panel physician), here is the link to the guidelines that medical examiners use to examine the applicant:
http://www.cdc.gov/ncidod/dq/pdf/ti-civil.pdf

DEFINITION of TERMS in my simple words:
Panel physicians are the medical examiners in the Philippines designated by US embassy to conduct your medical screening prior to immigration
Civil surgeons are the medical examiners in the US designated by US embassy to conduct your medical screening prior to approval of your application for permanent residency or citizenship(?)

Contact Allergic Dermatitis that turned into a NIGHTMARE!!!

Are you like me, who, after having immigrated to the US, have encountered a lot of new things to which you react (i.e., allergic to)?

During my first year in the US, it was the year of exposure to new trees, new bacterial/viral strains, etc. That first exposure made my immune system create a counter-attack force for future re-exposures...

On my second year I had a brief episode of urticaria, which lasted 3 days. I could only think of having eaten Chinese food as a culprit. I used Benadryl and Aveeno oatmeal baths to help soothe the itching.

On the third year, I suffered another episode of urticaria for almost two weeks. Aveeno oatmeal did not help much to soothe. I was glad it was over by the end of the second week.

Fourth year here, I seemed to have succeeded avoiding re-exposure to whatever triggered my urticaria (I avoided gardening).

This year I attempted gardening during the first nice weekend of spring, and suffered from a new type of allergy that led to the nightmare depicted on the photo. As of this posting, the whole event is now on its 5th week. Yap! That's how long I have been suffering from this predicament.

As I mentioned in my previous post, I was suffering from dishydrotic eczema and was on prednisone treatment. I was at the last days of my prednisone taper when my allergic dermatitis started.

See my slide presentation for the series of events explaining the whole thing. I will keep updating this slide show as I progress.



UPDATE:
The flare-ups of my skin inflammation apparently was caused by my alternating use of petroleum jelly then lotions (which I would dare use once I felt my skin was getting better). Upon my derma's suggestion, I stopped all lotions or special soap for sensitive skin and stick to petroleum jelly, soak for at least 15 minutes in shower or tub (to engorge my skin cells and close the cracks), then slather a thick layer of the petroleum jelly to trap the moisture. Also, he prescribed desonide lotion which I had to apply to affected areas twice a day. I did that, and the desonide use had immediate effect on inhibiting the itching and inflammation of my arms/hands, and with showers twice a day at least, using the (self-prescribed) hot water treatment (counter-intuitive, the treatment regimen was effective for me. I believe that the increased rush of inflammatory chemicals like histamine, bradykinins, interleukins, etc. overload the receptors so that after the initial sensation like that of being scratched when in fact it was heated water, comes pain, then relief from itchiness for at least 4 hours (so finally I would get at least 4 hrs of straight sleep). Increased sleep boosts health and immune system. Less irritation (use only petroleum jelly) and more hydration of my skin (showers soaks)...finally my skin was back to normal after 6 months. When I mean back to normal, there is no longer that thin layer of skin with fast turnover, which was very very prone to losing moisture.

Well, during the first few months when I thought I would never get my pre-morbid skin, I was getting depressed because not only could I not wear tank tops/shorts without being so self-conscious, I also was not sure if there was ever an end to that suffering. I also felt so vulnerable since my skin was not intact and I was working at the ER (skin is the biggest organ of defense, so I felt defenseless). I even recorded songs for my hubby (although I did not tell him then that those were in case my skin issue would lead to my early demise eventually).

Now, I am happy with my skin, even if I still suffer from itchiness and cracks every time I go on duty at the hospital and have to wash my hands often.