Tag: podcast

Interview #10: Kline

klineKline (and Loren, Kline’s mother)

Lake Tahoe, California

What doesn’t kill you makes you stronger!

1.When did you start using topical steroids? And why?

Kline started at 4 months old for baby eczema.

2. What was the name of the topical steroid?

Desonide and antibiotic compound.

3. Were you ever prescribed more potent steroids? 

His eczema kept spreading and getting worse What kinds? I think dermasmooth was the highest potency we used.

4. How did you find out about RSS?

Google.

5. What made you feel you had RSS?

He looked just like everyone else…red sleeve and all.

6. Were you diagnosed by a doctor? Did you have a supportive doctor?

We saw Dr. Rapaport at 6 weeks off topical steroids to confirm it. Yes, Dr. Rapaport and some homeopathic and chiropractor.

7. What were your first symptoms?

Full body flares.

8. Is your family supportive? Friends?

Yes.

9. Have you ever been to a hospital for this? Why?

No.

10. What has been the hardest part of this condition?

The length of the withdrawal and watching your baby suffer and not be able to help them or speed it up.

11. How long have you been in withdrawal? 

Started February 21, 2012, 4.5 years ago. Kline is still in withdrawal but living his life and much, much better…the itch and skin is managable but not perfect.

12. What do you use as comfort measures during this?

Popsicles, ice packs, lavender oil, EPROMs salt, Shea butter with essential oils, gauze and tape.

13. Are you employed? Has this affected your job status?

I had to take a night job because Kline couldn’t go to school.

14. Has this affected your Kline’s education? He had to redo kindergarten

15. Have you gone to therapy/wish to go to therapy because of this condition?

Yes, I think we all have PTSD and depression from this terrible life changing ordeal.

15. If there is one thing you could say to another sufferer, what would it be?

 

Take each moment by moment ..don’t get your hopes up on a time frame for healing, expect more flares to come. And ask for help! You are beautiful and strong and can do this!!!

Thank you so much, Loren, for taking the time for this interview!

The possible irreversible effects of antibiotics

We focus a lot on how chronic use of steroids can cause much damage to our body, inside and out. There are actually many drugs that can do this. One drug that most of us end up using (because of Red Skin Syndrome) is antibiotics. What many don’t know is that this drug can also cause much harm.

At first, some get very defensive on this subject because, if you are told you need antibiotics, you must need them for a reason. Many of us get staph on our skin and are immediately prescribed this drug to help. But we must take into consideration the pros and cons of this drug, not just on ourselves but others.

I think people see their own use of antibiotics as a solo consequence. That if they wish to use them as much as they want then they are the only ones who will suffer the consequences. However, that is not the case. If people begin to overuse this drug, it can change the microflora for the next generation. It is a domino effect that can change the world.

This is a very serious problem when it comes to newborns. One doctor, Martin Blaser, has been vital in this research and whom highlighted his immense concern for babies born from either C-seciton or from mothers who were given antibiotics during the pregnancy. These babies could have an insufficient amount of friendly guy flora, leaving them susceptible to health conditions and problems.

These health problems are often autoimmune related. Even just a one-time intravenous dose of antibiotics can alter our gut flora.

An unbalanced microbiota in the gut is also a contributing factor in autoimmunity. (13) Infection with certain microbial pathogens can trigger autoimmune reactions in joints and other organs. (14) The destruction of healthy gut flora can make the mucosal lining more susceptible to leakage, which some researchers believe is a precondition for developing autoimmunity. (15, 16) It is well-established that the balance of gut bacteria plays a key role in the formation of a proper immune response. (17, 18) A lack of healthy gut bacteria is associated with allergies, IBD, and general autoimmune reactions when this immune modulation goes awry.

Now, there are certain situations where we do need antibiotics. We can not always shy away from their services. But there are things we can do to help ourselves out.

Though antibiotics may be necessary in certain situations, it’s important to weigh the benefits of using them with the potential risks that may come from the permanent alteration of the gut flora. If antibiotics must be used (and there are certainly situations where this is the case), special care should be taken to not only restore their gut flora using probiotic foods and supplements, but to eat a diet that supports healthy gut microbiota with plenty of fermentable fibers from starch and the removal of food toxins.

For those instances where we can forgo oral antibiotics, there are other alternatives we can use to help us. You can find these alternatives here: Mark Sisson

We need to truly keep our minds open to these alternatives instead of jumping right into using antibiotics. Much like steroids, they can really hinder our health. And imagine using both at the same time for long periods of time. It can reek absolute havoc on our bodies.

Chris Kresser: High Price of Antibiotics

 

 

Why are we seeing the body as parts instead of as a whole?

I feel Chris Kresser said it best:

“In conventional medicine, there’s a doctor for each different body part, and so if you have heart disease and you have eczema, you go see the cardiologist for heart disease, you see the dermatologist for eczema, maybe you see an immunologist if you have an autoimmune disease, and all of these things are being looked at as separate conditions. As a patient, it can be pretty bewildering to just have this idea that you have all of these kind of separate and disconnected things happening and not to have an idea that there might be a common root cause that’s driving all of these pathologies. Of course, what that means is if there is a common root cause, then there’s a possibility of intervening at that level and seeing an improvement across the board in all of these conditions instead of trying to address each of them in a kind of silo fashion with specific drugs and things for each condition.” (CHRIS KRESSER PODCAST)

Now a days, when something is wrong and it’s pinpointed to a certain part of the body, we are referred to a specialist. This doctors specifically sees patients with one particular problem or problem area. It’s absolutely wonderful to have doctors well versed in one particular area of study, but why is it that when we speak of one problem in our body, that it is never thought to be connected to us as a whole? We are one huge machine.

When doctors now speak about the gut, and how so many other issues in the body arise from our gut not functioning properly, it makes absolute sense! Where do we get our energy? Food. Where does the food go? Into our mouths and down into our stomach and intestines and colon to get digested. Where do we get our nutrients from? Digesting the food! If we are eating foods that are creating a major imbalance in our digestive system, then we aren’t getting the proper fuel we need to function, which in turn can disrupt a slew of organs in our body. It can affect our brain, our eyes, our motor function, our muscle growth, our hormone levels and moods, our bone density, our blood circulation, and for us sufferers, our skin!

My biggest concern with modern medicine is the fact that it masks these problems. I recently watched a commercial for a pharmaceutical medication for helping lower cholesterol. This 1 minute segment was horrifyingly riddleddddd with side effects, including DEATH. Why on earth do we accept this form of treatment? Because it’s easier than changing our diet? That is the craziest excuse out there! We would rather risk death than yielding from a 3x a week McDonalds run?

This is where our solution lies! I will never bash steroids, be it orally, injection, or topically, because they are truly important in the medical community. However, what I can not and will not stand for any longer is the chronic use of this drug as a first line treatment for conditions that NEED to be better evaluated first because, chances are, patients don’t even need the steroids!! If you’re going into anaphylactic shock, of course take a steroid!! But, if you have eczema and you go into a doctor’s office and the first thing they do is write you a prescription for a steroid without evaluating it further… absolutely wrong (in my opinion). That is fast food service. You are receiving the McDonald’s $1 value menu treatment, and that is what is hurting so many around the world from ACTUALLY getting better.

Now, are there conditions that sadly may need chronic bursts of steroids? Yes there are. BUT, we should be finding alternative ways to help maintain a better balance for these conditions than subject innocent patients to the severe consequences that taking steroids chronically has on the body.

If we start looking at our body as a whole, instead of our problems being directed by the area they are located, we may start to see some real change in our world. And when it comes to Red Skin Syndrome prevention, this is VITAL! Taking the time to find out what is truly wrong with your skin, which may be actually stemming from gut issues, can save you so much pain and suffering. I would much rather give up dairy, or wheat, or fast foods (or all three if needed!) if that meant living a life that wasn’t constantly bombarded with skin concerns and anxiety for having to deal with them on a daily basis.

Are we perfect? No. It’s not always easy to eat optimally every single day of our lives (goodness, Christmas is upon us!), but we can make an extremely conscious effort to do it everyday. It’s important to stick to the diet that works for you 100% of the time, but give yourself credit.

Find a doctor who is willing to work with you, as an individual human being, and who cares about finding out what will work for you. They will take the time to dissect you from the inside out to pinpoint what is causing you harm AND help you live your life to it’s highest potential. No one deserves fast food treatment, especially if it leads to something as devastating as Red Skin Syndrome.

 

Depression Reversal

Ever thought about our stomachs affecting our thoughts and emotions?

“There is a huge and growing everyday body of evidence connecting the health of the gut to the health of the brain. In fact, there’s a saying in functional medicine, fire in the gut, fire in the brain, which means that if you have inflammation, parasites, small intestinal bacterial overgrowth, fungal overgrowth, or dysbiosis in the gut, then that is going to produce an inflammatory response that in turn affects the brain and can cause inflammation and a whole bunch of other problems in the brain, and this is not a fringe theory at this point. It’s true that unfortunately not a lot of primary care doctors or even psychologists or psychiatrists are aware of this connection, but that doesn’t mean it isn’t well established in the scientific literature. It absolutely is. And in fact, it’s been known for almost a hundred years going back to some research that was done at Duke in the early 1930s and 1920s connecting the gut and the brain and even the skin in this axis—the gut–brain–skin axis, which I’ve written and spoken about before.”

This podcast goes into a lot of detail about how inflammation, anywhere in the body, can affect our minds (the frontal cortex).

Also, Kresser talks about the HPA axis, or the hypothalamic–pituitary–adrenal axis. If we’ve learned anything about topical steroid dependency, we know that overuse can lead to a suppression of the HPA axis. And then, add chronic, everyday stress to the situation, and you’ve got a system that is extremely overloaded.

The last big subject he touches on is deficiencies in the body that could be contributing to depression. If we are lacking in certain vitamins and aren’t using it optimally in the body (methylation issues) then it can be throwing our balance off.

I highly recommend this podcast if you wish to catch his more in depth explanations on depression and inflammation in the body. What we are eating and lacking in our diet could  the reason we are mentally suffering and struggling to get through certain situations.

Kresser Podcast on Anxiety

Different Atopics Podcast

Dr. Matthew Zirwas, an Ohio MD, gave a very poignant (albeit slightly arrogant) talk in Arizona this October about atopic dermatitis in adults and how he categorizes this condition in order to give the right treatment.

He starts off with saying he is able to fix 90% of his patients. About 1 out of 10 of his patients he just isn’t able to truly help. Perhaps they are those with Red Skin Syndrome?

He checks IgE levels to see just how atopic they are (and to help initiate compliance).

Overall, I don’t appreciate the way he spoke about patients (very condescending), and even stated he had no problem lying to patients to get compliance, but I do wish to write about his lecture because it had interesting points.

One of the first things he began to mention was how awful the mainstream treatment for atopic dermatitis is for patients, especially when it comes to topical steroids. Dr. Zirwas gave a scenario of what usually happened when he was a resident. His doctor would state,

“Here is your triamicilone ointment, use dove soap, wear cotton clothes, stay cool, don’t sweat too much, don’t shower too much, good luck.” And we should have said as they were walking out of the door, “you’re not going to get any better…”

He knew there needed to be a change. He wanted to help people actually get better. He said  that topical steroids actually make the skin barrier worse. It may seem to help the symptom in the short run but it’s not fixing the problem, it’s actually causing a problem. He uses the analogy of using prednisone on bacterial pneumonia. The patient will feel great 12 hours in, but then will die because the steroids will have allowed the infection to get worse.

“Topical Steroids is probably one of the worst imaginable things you could do. If you were going to say ‘What’s the worst thing you could do for atopic dermatitis, it would be topical steroids.”

Now, I am going to get a little scientific on you. He used A LOT of big words. The lecture was riddled with jargon.

Dr. Zirwas explained the role of filaggrin for our skin. It is what brings together cyto-skeletal proteins. So, he uses the analogy of a hollow brick or shell as your stratum corneum (the outer layer of skin), and the filaggrin is what hardens it so nothing harmful can get in. It then degrades it into amino acids (which is our natural moisturizing factor, acting as a retainer for moisture in the outer layer of skin). Furthermore, it is a source of urocanic acid (a UV absorber). For those of us who are deficient in filaggrin, we are susceptible to friction, dryness and scaling, and fissuring (cracking).

While explaining this, he concludes that we shouldn’t be calling our condition atopic dermatitis, but cutaneous barrier disfunction. The biggest problem is our broken skin barrier.

Normal skin is like a wet sponge, moist and flexible and hard to tear. Atopic skin is much like a dried out sponge that’s hard, dry, and cracks.

He moves on to the main topic of the lecture: his 4 categories and how to treat them.

When it comes to mild-to-moderate atopics, it’s usually just water and irritants penetrating into the skin. With severe atopics, it is usually proteins leaking into the skin. Finding out which proteins these are will help you understand which treatment will work.

Main Goal: 1) Improve Skin Barrier and 2) Reduce protein exposure

The 1st Category, which everyone fits in, is barrier disfunction. This means lichenification, xerotic, usually worse in winter, and dull red. Treatment: physiological moisturizers (Ceramid based moisturizers). He feels these are effective because they penetrate the stratum corneum (outer skin layer), into the keratinocytes, into the golgi, and helps create natural skin moisture.

Ceramide based products, like EpiCerum, take time. Dr. Zirwas says no one will see results overnight. They need at least a week for results.

Here is where I get a bit off with his method, but it’s his way…

He mixes clobetasol steroid solution in with the creams for patients. He tells them to take the 50mg solution and pour it into a tub of new CeraVe (found at your local drug store) and use that for a month, 2x a day. That is a super potent steroid. Why give someone THAT potent of a steroid, regardless that it is diluted? His reasoning is that he feels the physiological cream makes the steroid less harmful to the skin barrier. Is there scientific evidence for this? I have no idea. I wish there was. And I am not sure if he has them do it for more than a month. If it’s just a month, I can kind of calm down about it, but if he puts his patients on this for a while, then it worries me.

The rest of the treatment for your barrier is: Shower at least 2 times a day and put a physiological moisturizer on right after – use a shower filter – double rinse your laundry or use vinegar in the mix – and use DryerMax dyer balls. 

He also went into talking about how he feels ointments are not the best choice for topical steroids. His logic is that steroids are looking for the most oily environment. The more oil in our vehicle of choice (like an ointment), the less likely the steroid with leave and penetrate into the skin. So he sees it as ointment is the worst, then cream, then lotion, then solution is the best. I can see his logic in this, but I don’t know of any scientific research backing this. I know ointments are more occlusive, so I would think, no matter what, the steroid would penetrate.

Category 2: Airborne -type

Aesthetically, men have what Dr. Zirwas calls an ‘inverse t-shirt’ pattern. Everything under his shirt is fine, but all the rest of his skin exposed to the outside is not. And women usually have facial dermatitis. Also, these patients usually have asthma and bad itching at night time.

He feels these are the hardest to treat. The problems are protein ‘allergies’, such as dust mites, pollen, ragweed, etc. These allergins are protease, which means they cause itch and worsening of the condition. These are the TH2 and TH17 triggers (which, when imbalanced, cause issues).

His Treatment: Mattress and pillow case covers (keeps the dust mite poop down) – washing at least twice a day, women washing their face as much as they can (and then putting on physiological moisturizers)

Category 3: malassezia driven

It affects the head and neck area. Usually they have eczema as children, but then into adulthood, it gets bad on their face.

This is his favorite type to treat since it’s easiest to him.

His Treatment: Itraconazole (check LFTs — which is liver function) 100mg 2x a day for 2 months, and ??? on weekends 100mg a day (literally could not understand what he said) – or- Ketoconazole (always check LFTs). He feels the former drug is safer than the latter, and feels orals must be used, not anti fungal creams.

Category 4: staph driven

It usually looks like moist atopic dermatitis with fissuring, crusting, and scabbing. Fairly bad eczema but it explodes/flares

He says he doesn’t swab (which made me angry) because he feels most of the time it isn’t MRSA so he doesn’t need to check. Well, I had MRSA on my skin in Month 8 of my withdrawal. If he hadn’t swabbed me, then I would still have had MRSA.

He says there hasn’t been a decent research article written about this. He also touched on antibiotic resistance and how we will be screwed possibly down the road.

His treatment: Keflix, Doxycycline or Bactrim for 4 weeks – Rifampin for 1 week in the beginning paired with one of three above (says it’s for decolonization) – Bleach bath once a week with clean towels, PJs, and sheets – Antibacterial washes (he likes Dial moisturizing antibacterial body wash) – avoid ointments (since he said most are contaminated with bacteria) – Neosporin 1 week per month on nostrils

Also, another reason for staph- driven dermatitis is decreased cathelicidin production. That means Vit-D production. You need to take LARGE doses, about 4,000 units a day. He says a study says it’s safe to take that much. No idea where that study is, but you can try and find it.

After explaining all of the different categories, he goes into some of the other treatments he gives on top of these if the patients are really bad. Things like immunosuppressants (Cellcept, Cyclosporin, Methotrexate). He says he barely prescribes these things since he can usually get things under control with his normal treatments.

Overall, it was informative. His method of treatment interests me, but not so much the compound steroid with CeraVe. I wonder how these patients would fair without the use of the steroids and just the other elements of his treatment.