Saturday, May 30, 2009

My life with poison ivy

This morning I convinced myself that my repeated bouts with poison ivy is the result of childhood re-enactments of the heroics of the Justice League of America where I was ALWAYS assigned the role of the villainess, yup, you guessed it, Poison Ivy.

The first time I remember an allergic reaction to poison ivy was on a family camping trip to Lewey Lake in the Adirondacks. I don't have any idea how I got it or what it felt like. But I do remember taking repeated showers and using Lava soap to scrub my body. I have poison ivy again and it itches like crazy. And one of the sets of rashes has become infected. And in my effort to treat the infection, I've given myself ANOTHER allergic reaction, this time to a topical antibiotic. After a trip to the ER I'm now on three different types of medication to treat the infection and have a divot in my right arm where the infection is the worse.

Poison ivy is an allergic reaction to a plant oil called urshiol found in the omnipresent and chameleon-like poison ivy plant. Poison ivy plants can have anywhere from 3-9 leaves (not just three), change color, can be bushlike or ivy like or a ground cover. It grows in marshy areas, woody areas and on beaches. Those of us who are allergic aren't even safe from DEAD PLANTS because urushiol is found in the leaves, the stems, the stalk and the roots and is potent even if the plant is technically dead. Urushiol is also found in poison oak and poison sumac. I wish I were a botanist or had a photographic memory. Because, while I know that anything with the word "poison" in its name should be avoided, I can't seem to remember what poison ivy looks like.

Urushiol is slowly absorbed into the skin and the allergic reaction starts once the urushiol has really settled in - usually 12-48 hours after exposure. That's right as much as 48 hours later! My brother-in-law introduced me to called Tecnu, an anti-poison ivy wash that. If used within 8 hours of exposure Tecnu can significantly reduce the allergic reaction. From the smell of the stuff I imagine Tecnu uses petroleum mixed with soap to wash the oil off. I'm afraid to let my cats near me after I've washed with the stuff because it smells so much like gasoline. There is also a Tecnu Extreme that has microbeads in it that abrade the skin and feels wonderful if you are even the slightest bit itchy.

The key to Tecnu's effectiveness is knowing when you've been exposed so you can wash right away. Tecnu's window of effectiveness is within 8 hours of exposure. BUT, the allergic reaction usually begins in 12-24 hours. So, once those itchy red bumps and blisters appear, you are simply left to cope. Which is what usually happens to me. (If you want to know what the rash looks like, visit the online "Poison Ivy Skin Rash Hall of Fame".)

However, even if you can't stop the skin reaction, you can prevent yourself from getting re-exposed by washing EVERYTHING that might have come in contact with the oil at the time of exposure. During this last bought I washed every piece of clothing I had, threw away a pair of shoes and a washcloth, washed sheets, comforters and futon covers, and doused my gardening tools liberally with alcohol. Urushiol seems to NEVER go away. So, if I touched something that got the oil on it - or something that touched something that got the oil on it - it could set off a different and separate reaction.

I've read figures that say between 15% and 85% of the population is allergic to urushiol. If the higher figure is true then I really should buy stock in some of the companies that make poison ivy itch relief agents. In my experience:
  • 24 allergy tabs with antihistamines work pretty well. On my current bout with the urushiol allergy I'm finding that the 24-hour tabs take about 2 hours to kick in. Which leaves me in excruciating agony for 2 hours. Why excruciating? Because you aren't supposed to itch the blisters or the rash. Not because you can infect other people with the rash (poison ivy isn't contagious), but because breaking the rash can lead to an infection which can lead to blood poisoning.

  • Cortaid 10 as a topical anti-itch agent stinks. Cort-aid doesn't dry quickly enough and maybe staves off the itching for only an hour or two. The wetter the rash stays the worse it feels.

  • Calamine lotion or a product like Ivarrest is satisfying because the entire rash can be visibly covered. This makes me feel like I'm doing SOMETHING to soothe the discomfort. I'm not sure it really helps with the itch and in fact is pretty messy. Particularly if the allergic reaction is in an awkward place. My current allergy is on the underside of both arms AND on one complete side of my torso. It is hard to wait for calamine to dry before putting my arms down. As a result, most of my clothing is covered in lotion and needs to be washed all over again.

  • Covering with lotion is okay. Covering the rash or the blisters with band-aids is terrible. Remember, the goal is to dry out the rash and let it "breathe." If a blister breaks, loosely cover it with gauze fixed with surgical tape.

  • Drying out the rash with alcohol washes is recommended. I'm afraid of the ouchiness and have never done this.

  • Hot showers are heavenly, as are warm oatmeal baths (like with an Aveeno brand oatmeal product. Something about the wet heat provides itching relief. But, be careful of the scope of the heat and the length of the shower or soak. Why? Because sweating makes the itchiness worse. There is a fine line between a blissfully comforting hot shower or bath and a gale of sweat-induced body shaking itches.

  • When the rash is really bad or doesn't go away after 12 days or is in sensitive parts, one can go to the doctor to get steroid shots and pills and prescription creams to address the problem. By Monday, June 1st, I'll have been to the doctor three times for this horrible itchy episode. Sigh.

The takeaway is this. Poison ivy stinks. And I'm a dope for repeatedly getting into it. I'm now six hours into my latest round of treatment. Antihistamines (to stop the itching), prednisone (for itching and swelling), and Bactrim (to kill the agents causing the infections). My infected arm is covered in a 4x4 gauze pad fastened with paper tape. And my arm, right now, doesn't hurt. It is a beautiful day and I shouldn't go outside because of sun sensitivity due to the meds AND the problem with sweating and itching. I'm not supposed to drink alcohol either because of the possible drug reactions.

The good news is the medicine is working and I'm not yearning to peel my skin off to make the itching stop. My kittens are sitting beside me snoozing. And there is a bowl of fat-free, sugar-free pudding mixed with sugar-free cool whip waiting for me on the counter. I have the names of three tree companies I can call to inquire about poison ivy removal services so I can feel like I'm really taking action to protect myself. And I've just arrived at the startling murder part of the story in the latest mystery I've plucked from BMG's considerable collection of paperback mysteries. So, I'll stay inside, regretting getting into this mess in the first place, and relax.

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