connecting the dots

Connecting the dots

21 May 2011

I wish that House MD from the long-running TV show were my real doctor: he’d start with my stated problem, notice symptoms didn’t even know I had, investigate my lifestyle, diet, home environment and personal history, write out all the possible causes on a large blackboard, systematically evaluate each one and come up with the final brilliant insight that would pull all the data into a grand unified diagnosis. Source identified, problem solved. If only real-life medicine worked like that.

Treating symptoms is easy; finding root causes is hard. No wonder real-life medicine is symptom-oriented: red pill for blood pressure, blue pill for cholesterol, white pill for thyroid regulation. Drug prescribed, problem solved. With one-off or short-term problems, this approach is often good enough.

But for chronic issues, treating symptoms without addressing underlying causes is like a game of Whack-a-Mole: smash down those symptoms, and whatever is aggravating the system will just pop up in another place. Pharmaceuticals are miraculous creations, but they are blunt instruments that often cause problems as they solve others. A lifetime of prescription medications seems like an idea born of convenience rather than wisdom.

Do we resign ourselves to chronic disease as an inevitable progression of aging? Epidemiological data point to many chronic illnesses – hypertension, high cholesterol, obesity, allergies, type 2 diabetes – not as a consequence age but of industrialized diet and lifestyle. I believe if we do the hard work to address root causes, we can all have a chance at unmedicated good health.

Like many others, I have a nagging but chronic issue. Mine happens to be eczema; yours may be sciatica, or arthritis, or a cough that won’t go away. I see a dermatologist; you may see an orthopedist, a rheumatologist, an otolaryngologist, or maybe even a whole series of specialists. Specialized medicine is well suited for serious injuries or acute illnesses, but it’s often stumped by unspecified ailments such as chronic fatigue, irritable bowel, fibromyalgia or many others. Even with eczema, the symptom is specific – skin rash – but the causes are anything but.

Doctors are only part of the solution. In today’s managed-fee environment, even the most caring doctors cannot afford to spend too much time with any one patient. Since root causes may lurk far from the symptoms, many health mysteries are unlikely to be solved by a single specialist. I play lead investigator in my own health mystery; doctors are expert witnesses who provide valuable insight and experience.

But as House MD always knows, the answers are not just in the medical office. You need to look at all the factors that feed into your body’s systems – where you live, food you eat, products you use, how you spend your time – then put that together with doctors’ theories and work to connect the dots. It can be a tedious exercise of trial and error. Even my wonderful dermatologist in California – a bright, curious researcher at Stanford – thinks the search for why is more trouble than it’s worth. We found cortisone creams that work, he says, why not rely on those?

But I know that the drugs tax my system, and after nearly 40 years of use they are less effective than they were. My eczema problem has gotten more severe in the last decade while my body’s response to steroid creams has diminished. Call me crazy, but I see a trend here, and I don’t want to wait around for it to get worse. I’d rather find the source and control the problem.

I believe a persistent health issue is our bodies’ way of sending the message that we are making choices it doesn’t like. We all have an Achilles heel, a weak link in the system. You and I may have the same problem but exhibit completely unrelated symptoms: my rash may be your migraines, sore joints or indigestion. For decades my body’s messages were polite taps on the arm. This winter’s message was a slap in the face. I’m paying attention now.

The good news is I might have some suggestions that may help you with your own chronic issue. And you might have some suggestions that could help me. So please speak up if any of this connects with you, and I’ll share with you what I’ve tried and learned along the way. My case is far from closed, but the knowledge I’ve gained has given me hope.

This work is licensed under a Creative Commons Attribution 4.0 International License.

{ 23 comments… read them below or add one }

Jenn 22 May 2011 at 4:49 pm

I have enjoyed your posts here in California but this one made me want to leave a message. I feel for you and can identify as I feel like I have spent the last 12 years trying to help my son who started with severe eczema at 4 months. We have seen the best doctors at Stanford and have been on a path of every blood test, allergy shots at the highest dose for six years only to find in the last two months that he has severe sleep apnea. It has taken us so long to get to this diagnosis I hope that I will have a new kid after surgery. I just hope this is it for him. But as you point out one thing might lead to another. I would love to hear what is working for you. Hang in there.

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cg 24 May 2011 at 8:25 pm

hi jenn – that is so interesting. thanks for sharing your story. i’ve never heard of sleep apnea related to eczema – which is in many ways exactly the point i was trying to make. great detective work on your part. i hope the surgery resolves the issue for your son – seems like it should make a huge difference in all kinds of ways. poor little guy – he’s lucky to have such a great mom.

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Katherine 25 May 2011 at 10:08 pm

I’ve also read, researched, pondered, and worried about my son (we have 3 other kids to give some perspective). He’s one of those kids that is mildly symptomatic in multiple ways but nothing so severe that any doctor would think that there is an issue. What constitutes clinically relevant? Two standard devs below average? I’m worrying long before that. But what “treatments” would be considered “too much”? Is it developmental, and he just needs time to mature? How much does food play into parts of it? Gluten/casein free? Feingold diet (preservative/dye free)? Sleep apnea? OT? Feels overwhelming to think about. And so instead, I listen to my husband’s advice to just let him be himself.

Oh, and I’m sure you’ve checked out the website http://www.solveeczema.org developed by a mom who solved her baby’s eczema by eliminating all detergents from their home.

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cg 26 May 2011 at 6:42 am

i agree so much with you, and i so much more to say about diet and health. but figuring it out is very difficult, especially if your child is not a flexible eater.

i have seen the solveeczema site and am so in awe of parents that go to such superhuman lengths. i admire their conviction and determination. i think for most of us, it’s a matter of weighing the severity of the condition with the substantial effort it would take to improve it. it wasn’t until i went through a more severe episode that i was finally motivated to do some hard work on why.

thanks so much for sharing your thoughts – i’m working on more posts on the topic, but they’re slow going compared to the food posts. i have too much to say, and it’s hard to cull it down to a piece that isn’t yawn-inducing. =P

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eileen 26 October 2011 at 6:09 am

hi jenn,
i too have struggled with atopic dermatitis my whole life — and worry too about what 40+ years of steroid creams has done / is doing. i remember when i first heard “thinning of the skin” as a side-effect of the creams — i couldn’t imagine what that meant. at 55, i get it — and since skin thins on its own, i wish i hadn’t been contributing to it with medicines. but i have never found any alternatives — other than hypermoisturizing, wearing gloves, TRYING to resist the itch (i was grateful to hear a doctor explain once that it wasn’t that eczema sufferers had no self-control; but that the intensity of the itch was way worse than non-sufferers could imagine) and running my hands under cold water when it gets obnoxious. i had been using hothothot — which felt great, but, i learned, was actually WORSE for the skin. good to know. i’d love to hear what you’ve learned about your own symptoms and solutions. i don’t share any of your other physical maladies — my other range has always tended to be lung-oriented (allergies, asthma) but those seem to have gotten better with age. so glad to have found your website (through the great recipes) AND a conversation about our vexatious skin condition!!

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cg 18 January 2012 at 4:11 pm

hi eileen – i just realized i never responded! so sorry, my head has not been on straight the last few months.

unfortunately after all my elimination testing, i just cannot identify a particular dietary trigger.

my dermatologist has recommended another approach, which i’m currently trying. on the theory that bacteria on skin exacerbates the eczema and makes it harder to heal, i have been using purell hand sanitizer mixed with lotion after bathing. then cortisone as needed. but purell/lotion every day regardless of eczema. i can attest that the purell does seem to help the cortisone’s effectiveness (that ultimately helped me heal my awful outbreak last spring). i can’t say yet whether purell/lotion alone helps prevent flare-ups, but i’ll let you know if i have a breakthrough. i have learned that purell on my face – which my dermatologist says is has not been a problem for other patients – is too harsh, even diluted with lotion. so definitely test out a patch before you try it all over.

keep me posted, and i will do the same…and more promptly next time. thanks so much for taking the time to share here.

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eileen 26 October 2011 at 6:39 am

oops! meant to say *hi lilian*

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Pier Keegan 18 January 2012 at 3:49 pm

I came to your blog for the balsamic vinagrette recipe ( I can’t wait to make it) but as I surfed though your posts, I cam upon this. I sincerely hope your skin is better now. My husband has been dealing with eczema for his entire 59 years. He has tried everything, including many elimination diets. Nothing worked. Two years ago he found two things that have really helped – Vitamin B Complex and Zinc. He takes a B vitamin that is 100 mg of each type of B, and 50 mg of zinc. His skin is the best it has ever been, and it’s been two years now.

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cg 18 January 2012 at 3:54 pm

thank you, pier – i will try it! still suffering, and in fact today happens to be a particularly bad skin day. i am glad you found the site, and it was so kind of you to take the time to share. i’m very glad your husband has found a solution that works for him – you give me hope!

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Marissa 5 February 2012 at 10:53 am

I found this surfing through your blog, and I hope you don’t mind my sharing some suggestions.

I also suffer from eczema, but for the past several years, I’ve been able to keep it under control. Mine was particularly bothersome because I had it on my scalp, as well as down the back of my neck, back, my hands and forearms, and sometimes even my eyelids and lips. But the scalp part bothered me the most because short of shaving my head, I couldn’t get any kind of ointment to it, and I remember as a kid, I often scratched until it bled.

In my early 20s I made a few changes to help ease my symptoms. First, I stopped using soap and shampoo with sulfates. Sulfates are foaming agents, but they’re also very harsh on your skin and hair. I ordered castile soap bars, which is soap made using only olive oil and the lye necessary for the chemical reaction. I used it not only on my skin but also for washing my hair. (In the old days they often used way too much lye, which gave soap a bad reputation.) Now I have access to sulfate-free shampoos but I still use the soap bars for my skin. Second, I noticed my eczema also acted up more when my skin got hot, and after showers was especially rough. I started to rinse off using water as cold as I could stand it, for at least a couple of minutes. I can have the shower as hot as I want, as long as I cool my skin off afterwards. The third change I made was to use unscented, hypo-allergenic lotion and facial moisturizer. I love the scented stuff but if I use it more than once in a while, I’ll regret it.

I used to get this problem where my lips would get an itching, burning sensation, and then swell up and crack open. The doctors prescribed antibiotics and some kind of anti-bacterial ointment, but it would take weeks to get better. Late one night, I woke with to the familiar itchy, burning, painful swollen sensation in my lips and somehow, found a post online from someone with the same issue who speculated that it was an eczema outbreak. I treated it the same way, washing my lips with the natural soap and then slathering on a natural cocoa butter based lip balm. By morning my lips returned to their normal size. Now any time my lips start itching I slather that lip balm on and it always takes care of it.

I get the occasional outbreak on the back of my hands in the wintertime, but I’ve never again had eczema bother me on my scalp, back, or eyelids. I know eczema can have many causes and is more of a group of symptoms, but I hope some of these suggestions work for you. I remember the torture of living through the outbreaks, and having those greasy steroid ointments slathered on, which only helped temporarily. I wouldn’t wish it on anybody!

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cg 5 February 2012 at 1:16 pm

marissa – you are such a doll to tell me about your experience! thank you so much. i have been super careful with shampoos for years – last year during my awful oubreak i eliminated shampoos and soaps entirely, substituting baking soda and apple cider vinegar. i definitely agree there are a number of skin-damaging agents in detergents (which these says includes almost everything we call “soap”) – sulfates, surfactants, etc. and those of us with eczema are particularly vulnerable.

but i will definitely try castile soap and the cold water method. i do use unscented and hypo-allergenic everything. and i adore cocoa butter.

thank you again for taking the time to share – i truly appreciate it, and i hope your experience can help others as well.

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Julie Kingsley 19 February 2012 at 9:18 am

I have had years of skin issues. About 4 years I went through (again) testing for allergies to chemicals. As it turned out I was allergic to 7 common chemicals but most significant was Formaldehyde , which is in EVERTHING! I have had to stop using all products, makeup, soap, laundry detergent, shampoos, and only use certain brands. I can say that I am not symptom free BUT I have minimal outbreaks. I know you mentioned that you were tested, but these tests need to be done about 5-7 years as our body chemistry changes. Formaldehyde is in flooring, wallpapers, paint, fabrics (it is used as a binding agent) so that is why I think that I still suffer from the outbreaks, buying something new for my home is not always the best thing for me! Hope this helps you out.

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cg 7 March 2012 at 10:15 am

hi julie – so great of you to share. thanks for the formaldehyde tip – identifying triggers is so hard, it’s helpful to hear what others have discovered. thank you!

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mm 27 February 2012 at 7:04 am

Hi cg. Your dermatologist’s reaction is fairly typical, and understandable, given how serious a case of infected ezcema can be. I do not wish to undermine the specialists, but every case is different, and you are correct in pointing out that you yourself are probably best placed to identify the cause of your symptoms. All of my 3 children suffered from eczema to varying degrees as babies; onset coincided with switching from breast to formula milk, or weaning to solids, so the culprit there was fairly obvious. I avoided cow’s milk for years, although the allergy specialist assured me that yoghurt and cheese were fine (and necessary for a growing child). I also avoided eggs (and chicken – same proteins, apparently) for a number of years. The eldest, who is now at college, suffered from severe eczema until he was about 5/6, and still suffers from dryish skin occasionally. I would just advise sufferers to not rule out excluding suspected trigger foods from their diet (based on dermatological tests, of course), and to persevere in trying to find the triggers, as you are doing.

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cg 9 March 2012 at 9:00 am

hi mm – great info, i agree dietary triggers are often at work with eczema. i am still thinking i’ll figure something out at some point. appreciate you sharing your experiences!

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Sara 5 July 2013 at 2:34 pm

Hi there cg!

I too found you looking at your balsamic vinaigrette recipe and cannot wait to try it! I just finished reducing 2 cups of vinegar so maybe I will use it for the dressing!

Anyhow, I saw this article and my husband suffers from both eczema and psoriasis. He tried the western medical route with only cortisone helping, but it can be so harmful and the benefits were not long lasting.

So a family member of his took him to an herbal “doctor” and acupuncturist. I am not sure of his medical license but it is posted in the shop. He was able to pinpoint my husband’s “allergies” and said when he eats seafood of any type, as well as lamb his liver has to work extra hard and this is the reason for his breaking out.

He suggested some herbal supplements and when my husband followed the suggestions, took the supplements regularly, and avoided the foods mentioned his skin cleared up completely!

I am not endorsing this particular man, just wanting to share the info so you can check it out for yourself.

I wish you luck in dealing with your skin, and thank you for sharing your recipes and other articles!

All the best,

Sara

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cg 8 July 2013 at 3:49 pm

hi sara – thanks so much for the note! very glad your husband was able to get to the root of his skin problems. i’ve concluded that my trigger is external (irritant) not internal (food). but i can’t live in a bubble…managing my skin better now with a lot of daily purell. though my mom found a great acupuncturist, so i am going to give it a try as well. worth a shot!

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Nora H 17 February 2014 at 12:36 am

Hi Jen: I too suffer from eczema. Have had varying degrees of severity all my life. I finally found a product that has helped tremendously. I only use household cleaning and personal products from Melaleuca.com. Finally, my clothes are not causing me rashes ( detergents and soaps for sensitive skin are a joke in my case) and my hands are not raw and bleeding.
I also think we need more vitamin B and D. Mine runs low. If you have not had yours checked, you might want to consider it. Thanks for sharing. Looking forward to reading more. And love the recipes too. mmmm

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cg 21 February 2014 at 4:04 pm

hi nora h – thank you so much for taking the time to share! i too have problems with chemicals in products and am extremely careful about what i use. at one point i was really down to vinegar, water, baking soda and tea tree oil. but now i do allow for a limited number of commercial products, also because the commercial market has come along with better alternatives. i think my vitamin levels are ok, but that is a great tip.

i really appreciate your note – sorry it took me a while to reply, it’s been a crazy couple of weeks.

cheers,
lilian

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J 16 July 2014 at 7:45 am

Hello All
I have a mild case of eczema in the summer on one ankle. After checking with PeoplesPharmacy.com I began drinking oolong tea and it cleared up in a week. This web site if run by pharmacists who share information on home remedies for all kinds of problems. They also provide information on issues relating to drugs, herbs, home remedies, vitamins and related health topics, and how to be an informed patient.
Love this blog, thanks and good luck.

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cg 20 July 2014 at 8:29 am

hi j – oolong tea – very interesting! thanks for the tip, i appreciate you sharing back!

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Linda 29 August 2014 at 8:37 pm

Hi CJ,

I don’t have eczema, but I do have Seborrheic Dermatitis. Nothing as horrible as yours, but it does make red, itchy, scaly patches on my face (front and center, sheesh), but I’m 67, so at least not a really young woman worried about what people think(it’s amazing what losing your estrogen does for becoming outspoken!). I have found that Eucerin’s Daily Cleansing Oil (Not positive that’s exactly it, but I’m in the living room and it’s in the bathroom) and their Calming Lotion, all scentless, have helped a lot. I share your search for help from other resources for my problems. I have chronic pain from Spinal Stenosis, and complete lack of cartilage in my right hip. Because I’m obese, a lot of people think I did it to myself, and, therefore, look at me with disdain ……Hello!, I am pretty good at eating a reasonable diet, but if you can’t walk, stand or even move without excruciating pain, it’s hard to exercise. I think everyone, including the jerk doctor, think I use my walker for attention!! Sorry, I got on a roll, and couldn’t stop. I tend to have a logical mind, and it drives me crazy that there’s not a logical way out of things. If you could just find something that works, the bad stuff would go away. I’ve been in pain for going on 30 years, and I’ve found that it has left me angry and bitter. My kids are all grown and have not only flown the nest, but California, too. I used to look forward to “The Golden Years” but, surprise, I’m not able to travel to visit them and my grandchildren – they barely know me. I’m just a picture and a voice. I long to hug and kiss them. Please forgive the rant. I love your blog, and always look forward to the emails arriving in my mailbox. Love your recipes, and share them with friends at the drop of a hat. I don’t know why it took so long for this post to hit my inbox. Keep the faith. Love your stories, too!

xo Linda

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cg 30 August 2014 at 4:53 pm

hi linda – thank you so much for sharing your story! i am laughing at your estrogen comment – i must have started out with none…who knows what i’ll be like later!

i am so sympathetic to your lack of mobility. chronic pain is a terrible thing to endure, and 30 years would make anyone irritable. keep sending love out to your children and grandchildren, they will feel it despite the distance. i am sending you a big hug from here. XO

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