Infection: the unforgiving trigger

Two weeks of clear skin without incident. We’ve successfully tapered down and off of topical steroids and are sailing into our second week of maintenance mode using only Vanicream lotion and a daily bath. The only area “wrapped” each night is her hands, with tube socks, because they were such a problem area for over a year, and they also act as a barrier for unconscious itching when Z sleeps.

Grass pollen season is coming to a close, the weather is cooling down, preschool teachers are maintaining an allergen free environment and religiously following the eczema care plan, house is dust-mite unfriendly. Perfect laboratory conditions to test our post-NJH plan with the final trigger: infection.

It starts with one sneeze.. then oh no, did I hear 2 consecutive sneezes?

Getting sick before NJH would begin with itching and flares around the eyes and hands along with a detectable tightness in her breathing 3 days before I ever heard a sneeze. As the illness progressed, so did the intensity of itching and flare.
Z needed her Pro-Air twice this week but so far I haven’t seen itching. Her hands are looking great and only a bit of rubbing under her nose.

She’s better about using a tissue, but the inevitable sleeve wipe happens . She has one area on her cheek that looks like it might develop into a bigger problem, with some bumps. The skin is not red, but it’s definitely a different texture. This is most likely from the constant friction. We’re only one day into the meat of the cold but so far no major flares present.

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I need to stay calm and remember there is a process to this, we can expect a flare but we now have a plan .

So many years of not knowing how bad her skin would get, and how long can send me into a whirl of anxiety. The last cold she had in February left her in such a nightmare flare that she was prescribed oral steroids . After the cold ran its course, the skin was in such disrepair that she was at serious risk of getting a skin infection if she couldn’t heal.

I learned at NJH that oral steroids (like Prednisone) is the worst possible thing you can give to patients with atopic dermatitis. Oral steroids are very different from topical steroids. You will see tremendous relief in atopic symptoms and even some healing for the few days they are on oral steroids, but the rebound will be so severe, and for so long, that you’ll find yourself begging for another round in 3 weeks and be in the same vicious cycle for a long time.

We think that Z’s eczema inflamed so severely for the next 6 months, worse than we’ve ever seen it, in part due to the 3 day stint of oral steroids in February. It’s important to note that in children without atopic dermatitis, Prednisone and other oral steroids are generally very safe.

For now we watch and wait, staying calm with emollient on.

Following Day

….long night of furious itching. We applied Desonide to the face under the wet wrap. She had so much congestion and spent the night in half nightmares. Her eye swelled shut at one point from the congestion and she had puffy blue skin around the eyes when she woke.

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After a morning bath, wet wrap with Desonide under, skin on cheeks was somewhat better, with swelling everywhere going down except for the left eye:

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After much coaxing, we convinced her to do a nasal wash and we are seeing good progress on all fronts right before her nap, just 24 hrs later.

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our drawing of “Germificient”, the evil sister of Maleficient, who casts sick spells on princesses

 

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One response to “Infection: the unforgiving trigger

  1. Great that you were able to get it under control with being so diligent. Colds always hit Violet hard too and we’ve been in the same spot with oral steroids. She ended up on them in August before we went on vacation and the rebound at the end of our trip was a nightmare.

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