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I am really sorry for not having written anything for a really long time now. The Health Coaching course has been an immensely enjoyable and fulfilling experience and I become a Certified Health Coach next month! I will write more on that next time. This post is about something else. I have written quite a while back on a comparison between 2 immunosuppressive medications that my daughter has been on earlier on. In this post, I want to write about one more immunosuppressive medication that my daughter has been on since the past couple of years and it is called methotrexate.
Before I go any further though, I would like to out some things in perspective. Since these medications are very powerful and potent drugs, these medications are the last line of treatment for Atopic Dermatitis. These medications are not given to any patient, child or adult, unless all other forms of treatment moisturisers, topical steroids, narrow band UVB, wet wrapping, oral steroids have failed to reduce suffering due to severe eczema or even bring it under control.
Also, I would like to mention that while we certainly had no choice in giving our daughter these medications, initially I did not know that there was anything other way that we could bring her very severe eczema under control. However, I am really happy to say that this is no longer the case and if you have been following my blog posts you will know what I am talking about her Functional Medicine treatment.
We have lowered her dosage and are looking at hopefully gradually continue to lower and finally discontinuing her medication in the near future. But I will cover that in my next post. A few things which are common to all these types of medication are as given below-.
Cyclosporine was our first introduction to immunosuppressive medications in Aiyana was already on oral steroids at that time to manage her very severe eczema which had escalated beyond control and she initially needed an a fast acting intervention like oral steroids. However, we had to come back to this medication once again in mid since azathioprine had a disastrous effect on her health.
She was on cyclosporine for another year till we switched over to the third immunosuppressive medication methotrexate in late Hence, regular blood tests need to be carried out to determine kidney function in particular and to monitor other health parameters.
Cyclosporin in the treatment of severe atopic dermatitis: She had already been on cyclosporine for a year and a half and the doctors wanted to get her off cyclosporine since it clearly had not been very effective in managing her eczema very well.
Azathioprine is another type of immunosuppressive medication which is used for many autoimmune conditions including atopic dermatitis. It was originally developed to prevent infections due to transplanted organs like the kidneys. It takes longer than cyclosporine to take effect and is not used for acute cases of eczema due to the time taken. Since one of the main side effects of azathioprine is bone marrow suppression , a blood test measuring an enzyme called TPMT anthiopurine methyltransferase.
Those with low levels of TPMT are unable to break down azathioprine in the normal way and are at high risk of dangerous bone marrow suppression. Hence, those with very low levels of TPMT are not given this medication. However, as we realised to our dismay, just getting the TPMT levels tested and taking a decision of giving azathioprine to someone may not work out as planned at all. And we also learned a HUGE lesson in terms of how things can go terribly wrong even when all known rules and protocol are followed.
Our daughter was one of the outliers who suffered from the disastrous side effects of azathioprine inspite of having completely normal and within range TPMT levels. Infact, it was this experience that led me to search extensively another form of intervention for her. Tests are done regularly to ensure liver, bone marrow and other organs are working properly.
Any symptoms like hair loss, flu like symptoms and any others should be looked into immediately. Methotrexate and our experience. Methotrexate was the third immunosuppressive medication that our daughter was prescribed in and she is still on this medication as of now.
This drug has worked for her pretty well and she is now on a reduced dosage. With a very good response to the Functional Medicine treatment which is now finally showing its impact after being on this treatment for almost 2 years.
Methotrexate is actually a drug used mainly for treating psoriasis and rheumatoid arthritis. Methotrexate belongs to a class of drugs known as antimetabolites and also works by suppressing the immune system. Methotrexate can also cause some serious side effects by affecting the bone marrow, liver or lungs and once again regular blood tests are a must to monitor the effects of this medication. While I have given above an account of our experiences with the various drugs, I would also like to point out the other side of the story- these drugs help save many lives.
These medications are also used in other conditions like severe eczema, rheumatoid arthritis and other conditions as well where the immune system is involved.
This is especially true when we really do not like the turn our life has taken. It is true when we want to find a better way of dealing with our problems but we do not have a choice right at that moment and so we go along with it.
But I know that I am doing the right thing for her at this moment and at the same time I also know that I am doing whatever it takes to hopefully enable her to lead a healthy life without depending on any medications.
But whether I succeed in this or not, I will always know that I never shied away for showing up for whatever life has to offer us.
This is what enables us to deal with eczema and its effect in our lives. This is also what makes life seem so enjoyable and memorable for all of us and is so much more than any difficult circumstances, illness and medication. I wish you and your family a year filled with good health and happiness. I completed 3 years of writing this blog in October last year and it has been an amazing experience for me. As always, I am reminded once again about how fortunate we are as a family in all that we have and how grateful I am for the love and support of my family and friends.
We also remain grateful to the wonderful support shown by our doctors in being there for us every step of the way. We are now mostly familiar with the conventional medical treatments but have lost touch with many others some of which used to be a part of our own culture like ayurveda.
In fact, Functional Medicine is similar to our ancient Ayurvedic tradition in many ways since it approaches the individual as a whole and does not just treat the symptoms.
However, it differs in many ways since it incorporates the latest science and research, diagnostic testing, use of nutraceuticals amongst others. Life is full of ups and downs; the trick is to enjoy the ups and have courage during the downs. Staph infection, caused by the bacteria Staphylococcus aureus is very common among those suffering from eczema.
It is a very common bacteria residing on our skin and is invisible for all intents and purposes most of the times. My daughter had recurring bouts of this infection starting in August last year. It notoriously difficult to get rid of once it gets entrenched.
This led to a couple of rounds of antibiotics and oral steroids to control her skin condition which had deteriorated rapidly. Thus, till about mid November last year, it was again a very trying time for us as a family. This was because her eczema had been fairly under control for the past 10 months or so under the Functional Medicine treatment and her medication had been brought down gradually.
While the stool test did show some improvement from the earlier test done in January last year, the urine test was a bit of a disappointment but at the same time shed some light on her flare up. The urine metabolite test showed a huge amount of oxidative stress. Oxidative stress is akin to the process of combustion in our cells which use oxygen that we breathe in and food as fuel to provide our body with energy.
Infact this is the process of ageing that we all face over the course of our lives. However, once we figured this out and boosted her supply of antioxidants with foods and supplements, her skin condition improved gradually. I increased her intake of natural antioxidants like strawberries, blueberries, blackberries, raspberries, spinach, Brussel sprouts, broccoli, beetroot and other colourful fruits and vegetables in various forms such as soups, smoothies, side and main dishes. Under the guidance of our Functional Medicine practitioner her intake of antioxidants like Vitamin A, C and D as supplements were also increased.
For the past year or so, I have been dabbling in and increasing my knowledge of traditional and natural interventions using local herbs and spices to manage eczema and other minor health issues.
Over the past 6 months or so I had introduced a Curcumin supplement in a highly bio absorbable form. It is the main active ingredient in our local spice called turmeric used regularly in most of the Indian dishes, but for therapeutic needs one needs to consume much more than we can usually do from food alone.
Curcumin is a super antioxidant and is highly anti-inflammatory at the same time. Tulsi is a very important herb available locally and is used extensively in our Ayurvedic treatments.
It is an adaptogenic herb and is thus very good for stress management, has antibacterial properties and increases the activity of antioxidant enzymes amongst a host of other benefits. Neem is again a common and popular local herb which is extremely beneficial for improving skin health and boosts immune and liver function. Guduchi is an adaptogenic herb, boosts the immune system and improves liver function amongst other things and is again beneficial for the skin.
Then there are a few other herbs like berberine and burdock root that I use internally as well according to traditional Chinese medicine to enhance liver detoxification amongst other things. I intend to write about such herbal and natural interventions in a separate post later this year. I also intend to pursue a course in herbal treatments to take advantage of the vast natural resources that our country has in creating health and which we seem to have lost touch with.
Therapeutic grade essential oils continue to be the mainstay of our fight against staph infection. Hopefully, once again over a period of time I will be able to phase out her medications with the help of her doctors.
My course is an exhaustive one and encompasses diverse topics like positive psychology, coaching process, motivational interviewing and functional nutrition, Functional Medicine structure and operating system like the GOTOIT, Timeline and Matrix; mind body techniques and various relevant systems and technologies. As a part of my curriculum practicum I have already started counselling a few clients with various health issues on diet, lifestyle changes amongst others.
I am really looking forward to completing this course and setting up a clinic in Mumbai. Alone we can do so little, together we can do so much. I always knew that it is difficult to tackle problems including health related alone, but I realised how critical a support system really is during our darkest days. Our support system of family, friends and health professionals acted as a kind of a well knit community and enabled us to pull through. It is time for me to give something back now using my experience and knowledge.
I am excited and look forward to this new chapter in my life. Eczema has been a great teacher. Infact my whole family has. My daughter has learned what it means to be strong during very tough times and also how to deal with the many challenges she has faced in her young life.
As a family we have learned the importance of showing our love for our daughter and being supportive; being there for her no matter what. Personally, eczema has taught me what patience is all about and that often there is a silver lining behind the grey cloud on the horizon. Of course, we have learned many other lessons as well, but these to my mind are the most important ones. In the quest to learn more about this chronic condition which has been our constant companion for almost a decade now, I have learned a lot.
I have been writing about it in my blog for almost three years now.