Troubled by my choices

What’s is troubling you today? Is it your Hidradenitis Suppurativa?

Well, if it is you are not alone. I have been managing my HS through diet for the past 11 months. It has been going really well. There have been ups and downs and even some remission.

Mostly I have avoided having any foods or drinks that I know kick my HS off – not too much fruit, no gluten, only raw dairy – no milk, limited night shades and so it goes on. 

Remember how I told you I was just about resisting temptation? Well, along came Christmas.

I fell off the wagon. I ate three or four homemade mince pies. I ate some homemade tiramisu. I ate some homemade Eton mess. I ate some homemade Panna cotta. I know, I know, you get it. Lots of puddings. That’s not all. I drank some Baileys. I had some Cadbury’s chocolate. Do you know what? I thoroughly enjoyed all of it! 

So now I am suffering. I have had recurring sores and old tracts have opened up, causing me to have pain when I walk. Along came the familiar pattern of having to change dressings whenever I had to use the bathroom. Not only that, but I have had two more spots come up – both in completely new sites, where I have never had HS before. Ever wondered what you would do if it suddenly sprouted in your armpit? Well, here it is! There is nothing I can do, except be a little sad. I have tried to be positive; however, being grateful for the amazing technology of the dressings I use and the fact I get them all free can only carry me so far. I am grateful, but I also want to cry. Is it fair that I can’t enjoy a few desserts over Christmas? It wasn’t even like I had too much! 

I know I have the option to go back to the antibiotics. It gives me comfort that if I really cannot get it back under control using my diet (studies show that willpower is finite!), I have a Plan B. Part of me feels like it is selfish to try to manage the disease using diet, as it takes so much longer to heal. I feel sad that my pain and grumpiness affects my family, when it could so easily be rectified if I just took the drugs. We could all be happy. Temporarily.

That said, the results I have seen from eating a balanced, but carefully tailored way of eating have allowed me to live a pain-free life for nearly a year, with no side-effects, no risk of immunity to antibiotics, no need to constantly balance the good bacteria in my body with probiotics. Now, if I can just get there again….

So, what is next? Well, we will see.

I give my body, my mind and my willpower another week. If the pain starts to subside and the wounds begin to heal, I will hold off on the antibiotics. If the pain continues and my quality of life continues to diminish, there will be a (reluctant) call to the Dermatologist and I will take the medication that gave me life back in 2012. 

I feel I am able to make choices about how to manage my disease and just for today, that gives me the power to say no to a croissant! 

Whatever your choices are today, remember, you are trying your best – be kind to yourself.

My Paleo Success story!

I sent in my Paleo story to paleoplan.com and the lovely Neely Quinn sent me an email to say it had been published. Have a little read 🙂Screen Shot 2013-09-25 at 15.08.30

http://www.paleoplan.com/2013/09-24/paleo-success-story-losing-weight-healing-hidradenitis/

 

A fortnight post-Clindamycin and Rifampicin

It has been two weeks since my last antibiotic pill. I am in remission. I did feel absolutely fantastic….then my stomach went a little crazy.

It started Wednesday evening and followed the next day. I was working and was a little worried, but managed to control it all until I got home. Then it really was bad! I was feeling pretty weak by then, as I had just been drinking chicken soup (hardly chicken soup – just hot water with an organic stock cube, as we have no homemade stock due to freezer fail – see earlier posts). I managed a trip to the pharmacy with the wee one and purchased some Immodium and some super expensive probiotic. I then dealt with two more days of gastric distress and working really hard, trying to placate Inner Hypochondriac who had completely written me off as a terminal IBS sufferer.

A few days later and I have some perspective. It turns our Inner Hypochondriac was wrong once again. In fact, everyone in the family had a dodgy tummy and we’d all had some sort of bug. On the plus side, I lost 5 pounds and I look fabulous 😉

The Hidradenitis is behaving itself. There have been no flares. I still haven’t got my cooking mojo back. It is exacerbated by working and no hob/freezer, but it doesn’t mean we’re not eating amazingly tasty food, it just means I’m not being as creative, which is a shame. I have been mainly eating salads and basic proteins – fish, chicken, duck and steak. Steak hasn’t made me flare, which is strange, as it used to. It may be the fact we are buying it from a local butcher and it could be less pumped full of antibiotics etc. Who knows? I am also eating plenty of raw milk cheese – Gruyère, Comté and recently Saint Félicien – very stinky! Before my dodgy tummy, I was also eating a little bit of my organic homemade bread, made from spelt flour. I let it do a double rise, before I cook it and it doesn’t make me flare. I know I really shouldn’t eat bread, but occasionally I have felt the urge to eat it and as my work has been pretty physical, I’m not about to get stressed out about what I should and shouldn’t be eating on top of being physically tired. It has been fine if I just have a small amount and needless to say, I only ever eat the bread I make.

So far, so good. Generally being kind to myself. Generally working really hard. Generally loving life 🙂

The truth about remission.

Once again…I’m back! Losing internet connection is a little bit like being on a desert island, isn’t it? Especially if you live abroad and don’t watch local TV. It doesn’t look like I missed much and despite the frustration at not being able to Google-up everything, I survived.

So much has happened in the past few weeks:

We moved house (the second time in under two months).

We had two lots of visitors.

I underwent a three-step interview/recruitment process. In French.

I got a job.

Bubba Bodros went into childcare.

However, despite all of those highly stressful little challenges, stopping my antibiotics last Monday was the change I feared the most. Especially as I was starting work the very same day I stopped my tablets. I wasn’t sure if it was work suicide to stop the tablets, but I crossed my fingers and stopped them anyway.

The result? I’m still in remission. It’s early stages though and I am being a little bit more careful with my diet. I have no medical knowledge, but I am assuming the effects of the antibiotics will hang around for a little longer before I experience any flares. From the Rifampicin and Clindamycin combo research that I looked at, it appeared that many people remained in remission for a while after their treatment, so it could just be temporary. But lets not get down about that! Lets evaluate the absolutely fantastic situation that I currently find myself in. Remission.

I read many comments of people asking what is remission. What does it look like? Is it when your lesions heal, but tracts remain? Is it when you just have one or two spots, but the general area has improved? Is it just improvement generally? Is it possible to achieve remission at all or are these people just exaggerating??

The online Oxford dictionary states that remission is a:

“temporary diminution of the severity of disease or pain”.

I didn’t like that one. I don’t want to hear that remission is only a ‘diminution of the severity’. I had a diminution of severity the week I started eating Paleo, but it sure as heck wasn’t remission! I carried on my search down a different vein. As I have always heard of remission in the context of cancer patients, I looked up a cancer definition of remission. It states:

“A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although cancer still may be in the body.”

I prefer that one. It was a much better description of what I thought full remission was, and what I wished for when I was in the full throes of a Hidradenitis Suppurativa flare. It was what I dreamed my diet would bring about, but a state I was unable to reach. It wasn’t the diet’s fault, I just think there were too many open sores to heal and I was still working out which foods caused me to flare.

Remission for my case is no open sores, no swelling and no pain. I can still feel tracts under my skin (perhaps just the scars from them) and have small bulges of scar tissue all around my groin. It is amazing! I hope to stay in remission by keeping away from trigger foods. it is all gravy so far!

To summarise, it would appear that when people say they are in remission , but still have some HS activity, they are right to state their case. However, for those of you seeking remission in the way that I understand it – no current symptoms at all, it really is possible, too.

Go see your derm, keep working at the diet, be positive and above all be kind to yourself 🙂

 

You say saccharose, I say sucralose.

So far – so good – the meal plan is working! It has been a success (with only one slip up –  a last-minute fresh pizza when the day ran away from us) and I feel good. My Hidradenitis Suppurativa is well and truly behaving itself. I am still taking my antibiotics and have the odd nap here and there, but mostly I’m much better. The doctor has prescribed some steroid cream for my feet and they have healed nicely.

I did have a little flare earlier in the week. I was a little shocked (and reminded of the horror of this disease) and experienced some pain for the first time in what seems an age. I couldn’t work out what had happened (it wasn’t the pizza, which was later on in the week and incidentally didn’t cause any reaction), so had to do a little rethink about my food consumption this week.

I saw a friend do this the other day – he asked his girlfriend what she had eaten yesterday and the day before. As she sat thinking really hard, I asked him why he had asked her that. He told me it was a remedy for hiccups. Thinking so hard made them stop. This isn’t relevant, but apparently it works and everyday can be a school day, right?

Anyway, I had to think about what I’d eaten, which was fairly easy, as I written it all over Facebook and this blog. A was a little baffled, as it had all been whole foods and not much fruit. Then I had a thought. My supplements. Uh-oh. Rookie error. Checked my French probiotics and – bam! There it was! Saccharose. In my probiotics. All white, innocent and promising to heal my little tum tum, when actually the devious little beggars were running around my insides causing chaos! Now, I had taken a little peek at the ingredients and honestly? I thought saccharose was a sweetener. Straight up. Totally confused it with sucralose. I just thought to myself that I’d forgo a little chemical toxicity to get the benefits of the probiotic. Silly, silly me. Luckily, I had only started taking them the day before and since I’ve stopped, little flare/leak has totally healed.

There have been no sh*t storms this week – a few minor issues, like our upcoming holiday to the UK being delayed because the car is still in the garage, but on the whole a good week. Also, I have concluded that pure sugar= instant flare, but fresh pizza=no flare. I’m sure that I would have to explore this further and whilst I’m not about to go out and eat a ton of gluten/dairy/nightshade laden foods, I am happy that the odd slip with certain foods may not be the be all and end all for my HS.

Meal plan recipe tonight is the wild prawns on the BBQ – yummy!

 

 

Dressing up for Hidradenitis Suppurativa

For those who have Hidradenitis Suppurativa (HS) or Acne Inversa, as it is also known, changing dressings is a daily or even hourly ritual. When HS is diagnosed, the patient’s disease is often given a stage of development, based on the Hurley scale of pain.

If you have early stages, you may have a limited knowledge of which dressings are available to you and may find this post useful – a novices guide to what’s available. However, those who have had surgery, incision and drainage and other more intensive procedures to remove glands and entire affected areas will probably have a far superior knowledge of this topic than I. Voila!

Getting dressed-up took on a whole new meaning....

Getting dressed-up took on a whole new meaning….

Micropore and gauze pads

I started trying to find different dressings when regular plasters were no longer big enough. I had the idea of using Micropore and gauze to cover the wounds and started off by buying 7.5 x 7.5 cm squares and regular Micropore. I would clean the affected area (in my case my groin, bikini line, entire genital and perianal area) with tea tree oil and warm water. Occasionally, I would apply organic Calendula oil or organic coconut oil to the spots before covering them with the dressings. The combination of healing qualities and soothing silkiness of the oil gave some relief to those tender areas.

I was amazed at the difference in quality of life such a small change had made. By covering the HS with the gauze, I could walk longer distances without getting sore. I still had to use sanitary towels, but felt the whole mess was a lot more manageable. After initially purchasing them myself, my doctor gave me a prescription for the dressings, including a larger 10 x 10 gauze pad and multiple boxes of Micropore. The larger gauze was much more effective, as I was beginning to need more coverage. Despite being happier, I was determined to find more ways to cover the suppurating wounds.

Mepilex Transfer 

My GP offered me a new dressing  – Mepilex Transfer, a silicone pad that adheres to the skin, but only really gently. As well as absorbing the exudate away from the skin and through to the other side, it provides a spongy and cushion-like layer against your delicate skin.

Mepilex transfer....the cushiony option

Mepilex Transfer….the cushiony option

Patch of pure perfection..

Patch of pure perfection..

My prescriptions in France are mostly reimbursable at 100%, but I still tried to be economical with the Mepilex knowing it was pretty pricey (around 26 euro/22 pounds/34 dollars for a pack of 16). I cut it up to cover my awkward and hard to reach HS sites and then strapped the whole area up with gauze and Micropore.

It was fantastic! I was so amazed at the technology of the whole thing. Where the gauze had worked by reducing the chaffing, this almost stopped it altogether. The exudate was concentrated in each area and looking at the Mepilex afterwards helped identify how many areas were weeping, or had healed. With Mepilex underneath the gauze, the dressing stayed in place over the wound and I did not get the same eye-watering shooting pain that I normally would just from taking a seat. It was no miracle cure, but boy, it was way better than just a pad in your underwear!

So I stopped there, right? No. I was still faced with the issue of having to change the pads every time I used the bathroom and was still looking for a waterproof option. I am not blessed with the strongest of bladders and just the thought of not being able to go pee makes me need to go again! Also the thought of using public toilets, whilst balancing over a seat, holding dressings away from your skin and then reapplying them or new ones, all with a 2-year-old clinging to my legs wasn’t inspiring me to leave the house!
I Googled away until I found this wound care sheet and other wound care information (the latter is for medical staff). It gave me a good place to start, especially as I was not seeing a dermatologist. Even if I was, it would have been good to have this info to take with me and demand stuff! I sent off some emails to the dressings companies, but they usually deal with dermatologists directly, so I set about pestering my lovely doctor and homeopath for some more prescriptions.
Duoderm – extra thin and bordered (Granuflex)
Bordering on comfort...

Bordering on comfort…

Sneaky peek at the hydrocolloid...

Sneaky peek at the hydrocolloid…

A-peel-able glimpse at the cushion finish.

A-peel-able glimpse at the cushion finish.

I mentioned on a previous post that I had intended to get Duoderm extra thin, thinking it would be a good waterproofing option. I wanted something I could leave on all day, without having to worry about changing it whilst I was out with the little one. Instead I ended up with Duoderm border, as featured above! It was a bit of a disaster, as I applied it with no knowledge of how it would work. It stuck firmly to my skin and the absorbent cushion layer was not what I was looking for on the whole waterproofing front. I had to take it off prematurely and it was all very painful!!

 I eventually got my Duoderm ET and after a rough start with the hydrocolloid dressings I decided that I needed to have a plan.
Extra thin and extra sticky

Extra thin and extra sticky

Wash the wounds and clean them before bed. Apply cut out Duoderm extra thin. Hold and mould against skin until it is firmly adhered. Leave in place for 24 hours and peel off after a soak in the bath or in the shower.

It worked, but alas, it rubbed/stuck together when applied on both sides of my groin/backside/top thigh area. This meant long walks with it were out, but it was perfect for long car journeys where using the rest room meant a quick in and out, with no awkwardness (other than hovering over a toilet seat – or the traditional hole in the ground!). The hydrocolloid absorbed the exudate and there was no chaffing from my clothes. If my HS had been elsewhere, I think both the Duoderm products would have been perfect for everyday cover.

Still undeterred, I spoke to the Pharmacist in my best French (probably more like primary school French, but I tried) and she showed me Hypafix. This was what I had been looking for all along – a thin layer of adhesive that I would be able to place over the Mepilex. It was 11 euro, and only 2 euro reimbursable, but heck, with all the free dressings I had had up until now, I was willing to pay out for this!

Deceptively papery...

I stick it where the sun don’t shine…

Hypafix

This stuff is a thin sheet of film. Trust me – under all that paper there really is just a layer of cling-film type stuff, that adheres beautifully to the skin. You cut it to size. Peel one side up to the red line, to expose the film. Stick it over your Mepilex patch, making sure you’ve got a good couple of centimetres around the dressing (if you can manage it – I couldn’t always due to the main offenders being on my bikini line and there ain’t much flat skin around there!) Peel the paper back and voila! A fully waterproof cover for your dressings. Now, I still had a few issues with keeping it stick to the skin, but mainly because my HS is all down below and pretty awkward to keep covered. However, it worked and I felt vindicated in my solo search for the waterproofing option!

Mepitel

The Pharmacist also recommended Mepitel, which my obliging doctor was happy to prescribe. it is a sticky meshing dressing and is to be used under another dressing. Again, I think this would be perfect for HS in other areas other than the groin, where the dressings do not need to be changed every bathroom break. Like the other dressings, it can be left in place for a long time and seriously reduces chaffing and promotes healing.

A sticky mesh...

A sticky mesh…

I hear that Medihoney is a really good dressing, too, but along with many others, I have yet to try it. It’s a wonderful world of technology out there and if you have the means, or a lovely doctor/dermatologist, you can get your hands on some super dressings to make the whole sticky mess a lot more comfortable.  Allez! Go try them!

I am currently dressing free, due to the antibiotics I am on. It is a relief, but only a temporary fix, so I may have to start strapping up my HS once the course is finished. Or not, if I manage to stick to the AI diet…wish me luck!

Serocytol immunosuppressant therapy and Hidradenitis Suppurativa.

I’ve been back to see my Homeopath. I’ve been prescribed a second batch of Serocytols, a Swiss homeopathic immunosuppressant treatment. It is a natural remedy made using blood from immunised horses, who are apparently very well cared for on the Serolab farm. Serum therapy, as it is known, has been around for over a century and was initially used to treat diphtheria and tetanus patients. The development of Serocytol came from this in the 1930’s.

It has no side effects, but I have yet to see any improvement from taking it thus far. I have had a three-month treatment and am about to embark on another three months. It costs me just under 120 euro (about 156 dollars/102 pound sterling) for the three months and I take it orally in a tincture. If you haven’t already read about why I’m taking Serocytol, here’s a little recap.

A good friend of ours, a lovely French man lived in the UK and married an English woman. She had Rheumatoid arthritis. She was young and had tried different treatments. He persuaded her to go and see his family homeopath back in France (in France it is common to have a homeopath treat you as regularly as a General Practitioner). She was prescribed Serocytol and took it for three months with no results. She was further persuaded to take it for another three months and noticed improvements. About 6 months later, she took another 3-month course and she is cured.

Horsing around with Homeopathics...

Horsing around with Homeopathics…

I did some Googling, but was not very successful – you can bet that most of the research is in French, as it is a Swiss drug, and I didn’t Google it up in Français. Anyway, I like to think I am pretty open-minded and whilst the treatment is expensive, it has no known side effects (apart from burning a small hole in your pocket). Meh…I’m willing to give it ago. Also, I wanted to write about the success (or failure) of the Serocytol therapy, you know, just in case it is the cure-all for this nasty little disease!

I started the treatment at the same time as I started my AI diet, so it was lucky enough to be credited for some good results at first. However, when I fell of my AI wagon (with a few bumps appearing shortly after), I knew that it was really my strict diet that had given me respite. Despite all that, I’m not a quitter and where would be the sense in starting a treatment, if I wasn’t to give it its best shot? So, mug or not, I am going to order a second batch.

The Homeopath has already tried me on about 8 other different homeopathic remedies and this time, he has prescribed another three on top of the Serocytols. He’s a persistent man and I thank him for that, because if I were a homeopath faced with a disease as complicated and diverse as Hidradenitis Suppurativa, I would have just thrown in the towel!

I am reimbursed by the French state for all homeopathic treatments (apart from the Serocytols), including most of the consultation fee, which is only 36 euro anyway. So, it’s off to the pharmacy I go today (for my freebie homeopathic granules and probiotics). Serocytol will have to wait until next payday, but fortunately HS is very patient and I know it’ll stick around until then. 🙂