skin

Headache Tension Gone

Headache Tension Gone

No headache or head tension today so I’ll stick with the 60mg steroids.  Our neighbours came back off holiday and Karen commented how much better my face was looking, and I have to say it is.  Maybe by the time the family get back in less than 2 weeks time it will be very normal.  My chest and shoulders still look bad, but no itching!

I almost feel I don’t need to apply the steroid cream and Cetraben, it feels and looks so much better now, but I’ll continue to do so as the steroid cream promotes faster healing, and I still need that skin barrier assist of the Cetraben.  Just a tiny amount of soreness still on my face under my eyes on my cheekbones where I guess the skin is closest to the bone, but that’s it.

This is the 9th day of 60mg Prednisone  – 30mg seeemed to be only a holding pattern, maybe a *little* better, but not enough to really notice and it may have been months to see anything – and all this real improvement has happened during that period.  The amount I’m taking continues to worry me, but if it can clear most of this mess up in the rest of the 4 weeks at this dose, then good.

After this month I drop down to 55mg and then another appointment on the 13th September at 10:15 with Dr H.  Hopefully when she sees me it will be an impressive amount of change and the photographer will take some more photos for the medical staff records.  I’m okay with that as it’s a learning hospital and I see the advantages of documenting it all.  Maybe this site will be of use to them too.

Posted by Frank Haywood in Pemphigus, Personal
The Steroids Are Working

The Steroids Are Working

The increased dosage of Prednisolone agreed with Doctor H (30mg to 60mg) seems to be working.  My skin seems to be getting better every day and I think it was about Saturday 5th I noticed my face wasn’t so tender and sore to the touch.  This means I can now really work my electric razor in to get at the stubble without it making me wince, which then makes it easier to apply the creams afterwards.  I’m still a little way off using a wet razor though, but my new electric razor is pretty good I’m surprised to say and gives me a close shave.

Still missing my 1/4 inch designer stubble though.  *sigh*

Maybe I’ll be able to grow it back again in a month as at this age I’m at now (57) it quite suits me and also hides any imperfections, of which there have been a lot just recently.

Last night my face which has been purply red up to now seemed to be very calm and a pale pink. Still a little flaky but looking much better.  As you might expect, my scalp is also much clearer and my hair seems to be less tufty.  I think I might have lost a little bit of hair, but WTH, that comes with age anyway doesn’t it?  Still some flaking when I scratch my head, but nowhere near as bad as it was.  Amazing how quickly my body is respondng to the steroids.  I thought it might take much longer than this to see the kind of results I am, so yeah…  I’m pleased.

Something to look forward to as my skin gets better, and at the moment I need things to look forward to more than I’ve ever done.

Posted by Frank Haywood in Pemphigus, Personal
Weight 89kg

Weight 89kg

Second day running that I’m 89kg on the bathroom scales so that looks like it’s for real. No bouncing up and down with this, I went straight from 90kg to 89kg and it’s stayed there.  So first target of moving from 95kg to 90kg complete, and now into second target of 85kg.  I’m hoping to achieve that in the next couple of weeks before the family gets back from Australia, but I’d also be happy getting near it.

I’m NOT patting myself on the back here, but I’ve been on the steroids for 3 weeks now and I’ve not really been hungry in that time, and when I have I just grab a coffee or some water and carry on working.  Maybe it’s early days and it will get worse, or maybe it’s my pure bloody minded determination this time round.

When I took Prednisolone in April for a month I wasn’t really bothered about putting back on the weight I’d just lost as I saw it as a temporary thing.  I ate constantly and couldn’t rid myself of the hunger.  Now I’m a little bit more sure I need to drop the weight for good so that’s what I’m focussing on, and I’m eating different foods now, which I have no doubt has helped me. Not having the family here has helped a lot too as I’ve been eating when I’m hungry rather than at mealtimes.  I think the problem is that in the past I’ve eaten when I’m hungry – which I’ve always thought was the right way of doing things – and THEN sat down to eat a meal at dinner.  Sort of doubling up, and that’s where I think has been my downfall.  I can’t wait for the family to come back, but I’m gong to have to keep up this new lifestyle so it will be a minor upheaval I reckon and I’ll have to continue to do my own thing.

It’s a bit hard when you like minced beef and onion pie and chips fro the chipy, and cake and ice cream, not to do that any more.  Or at least greatly reduce it.  No pie for 4 weeks and hardly any chips.  I still let myself have a small apple pie and a bit of ice cream every other day though.

I’ve been mostly eating things like porridge in the mornings, changed from larger sliced white to smaller whole bread slices and limited my consumption of that to no more than 4/day, but usually just a couple of slices.  Luckily for me, I REALLY like baked beans which it turns out don’t have as many calories as you think. So I can help myself to two smaller slices of wholemeal bread toasted and buttered with beans on and I feel really full up afterwards – and I’ve enjoyed the meal.  It was a nurse at my local GP advised me to switch to wholemeal as it takes longer to digest and fills you more.  She also advised me to eat boiled potaoes instead of mash – which I’ve always preferred anyway – and to leave the skins on for extra roughage.  So I’ve been doing that, scrubbing them and boiling them and they’re great.  I haven’t quite worked out how many to put in the pot yet and so tend to do too many, but I then chill any that’s left and occasionally take a bite from the fridge.

I’ve also prepared myself for some “grazing/snacky” food and been eating diced apples, bananas and I have a honeydew melon to slice up.  Also more tomatoes, cucumber, that kind of thing.  But I’ve not been overdoing it on the snacky front, I’ve been pretty damn good really.  I’d be very annoyed with myself if my calorie input went up because of grazing food.  Yeah I’m a bit determined, have I said?

Going for my daily brisk walk in a bit as it helps pump my metabolism up.  Then I’ll shower and go through my daily new cleansing ritual of steroid cream (betamethasone valerate and clioquinal) and Cetraben on my skin.  I like the Cetraben – it’s got paraffin in it and stings for a few moments but then feels great and seems to calm my skin right down.  In fact I’d really like to only use the Cetraben as I can just slather it on as a barrier protection for my skin until it heals.  The steroid cream takes ages to apply and rub in as I have to be careful not to over do it.

It’s early days of taking the immunosuppressant – Mycophenolate MoFetil (MMF) 500mg – just 5 days so far and it takes 4 months to get working properly, but when it does in say a months time I’ll have to avoid the sun or cover up as MMF can cause skin cancers as melanin production (your suntan) is controlled by the immune system.  I’m probably fine at the moment, but it’s on my mind as it’s just gone sunny outside while typing this.

No sign of the upper arm trembles I experienced a couple of days ago, so I was probably correct in my thought that my body was either adjusting to the higher dose of steroids as they settled in, or it was an emotional thing.  Yeah I’ve been a bit emotional about it all.  It will pass I know.

Posted by Frank Haywood in Diet, Personal
New Drugs Regime

New Drugs Regime

Today I took my first step onto the new drugs regime, moving from 30mg of steroids (Prednisolone) up to 60mg.  I’ve been taking the 30mg for 2 weeks and all that dose seems to do is keep me in a holding pattern, so I’m hoping this double the dose will actually start to do things to help.  In a month it gets reduced to 55mg and then reviewed in clinic.

I also started taking the Mycophenolate Mofetil (MMF) of 500mg once per day initially.  This is an immunosuppressant that is normally given to transplant patients so that their bodies don’t reject the transplanted organ.  It works by suppressing the immune system, and at the moment that’s what needs to happen to me to get my skin back to normal again instead of the angry red sheet of patchy flaky open wound horribleness that it is.

Next Friday I up the dose of MMF to twice daily, then the week after to 2 in the morning and 1 in the evening, and then finally and thereafter – 2 morning and 2 evening at a total daily dose of 2000mg.

It then takes around another 3 months after that (4 months altogether from today) to reach full efficiency.  While that’s all going on I’ll still be taking (hopefully) reduced doses of steroids and hoping that the MMF takes over and can stop my immune system from attacking my skin.  Everybody is different and it’s a case of “suck it and see” to find out what works for them, and that’s where I am for the next few months.

Once my immune system is being well and truly suppressed then apart from my skin clearing up, then of course I’ll also be very susceptible to infection.  I have to avoid the bad stuff like hepatitis, TB, and all the nasties that small children get such as chicken pox and so on.  Normally my system is immune to those things now, but not if it’s turned off.

I’ve talked to my wife about handling this if her or the kids bring stuff home (all at 4 different places, school, college, work) and how I can live here at home without being put at risk.  “Man cave!” she said.  That means maybe us doing some work in the garage and turning it into a room for me where I can be away from any possible risk.  I’m good with that apart from the cost.  I guess I could do it myself although me and DIY don’t mix.  And I guess I need to do it sooner rather than later while I can at least be okay (happy) with going to DIY stores and mixing with the great unwashed public.  It’s all normal commonplace stuff like going out and handling money that I have to be concerned about now.

And at this moment in time, I’m not sure what will happen if I do catch something silly like a cold.  Would it be enough to finish me off?  Will I end up hospitalised in ICU?  It’s possible I guess.  Another question to be asked at my next appointment.

At any rate, I also have to have my annual flu jab, which I’ve been doing routinely for a few years now as I always seemed to get flu every single year and I don’t know why I didn’t start doing it earlier.  It’s dead virus so it’s safe for me to have.  Anyone can go get a flu jab from their local pharmacy now, and it’s cheap – under a tenner in the UK – so you just should and save yourself from some misery later.  It works!

Also I found out that there’s a pneumonia jab, which I didn’t even know existed.  When you’re weakened by something else, good old pneumonia will step in and quickly finish you off.  So yeah, dead virus again and I’ll take some of that if it’s available to me.  Maybe it’s not available to the general public and only given to cases like mine?  I’ll find out.

And of course both of these jabs then raise another question I’ll need answering.  If your immune system produces antibodies to the dead virus to protect you… and your immune system is off or greatly reduced… then does it actually produce the antibodies?  Have I missed something here?  Maybe my suppressed system will just be that.  Suppressed and not actually off altogether.  I need to ask.

Posted by Frank Haywood in Pemphigus, Personal
And Yet Another GP

And Yet Another GP

Today I saw another GP, this time he actually used to specialise in dermatology, so some knowledge here about what my condition might possibly be.  We had a good long chat and he said the rash could have been triggered by a virus and asked me if I’d had a virus around that time in November / December and I showed him the wart that I’d been trying to freeze off with a kit I’d bought from the local pharmacy between the thumb and forefinger of my left hand.

“Yep, it could be that. I’ll freeze it off for you now,” and so he did.  It stung a bit, but you know, it’s worth it if it’s actively causing the rash.  I’m getting a bit desperate as the rash is still spreading slowly and implacably.  It’s in my face too now.

He prescribed 30mg of Prednisolone steroid with a tapering off off by 5mg every few days after the first week, and discussed the dangers of using steroids but that he really thought they’d help in a case like this.  I was a little wary, but extremely happy this was getting some attention now.  I’ve since been researching the use of steroids and see that yes, they’re very potent and VERY dangerous for long term use, and that this was quite a high dose and should start to shift things.  Of course I found out that it didn’t, but it did seem to completely arrest any further development while I was talking them right down to 5mg, but then when I tapered and stopped after about 3-4 weeks, the slow progression started up again.

That information was filed away in my brain for later use.

He told me to come back in two weeks and that he’d refer me to the local hospital, which he did.

Great! Progress!

Posted by Frank Haywood in Pemphigus, Personal