Sunday, May 5, 2013

The results are in... Part II: No, really!

I'm sorry I cut you off with the last post before revealing anything. I'm very wordy in print.

If you skipped the last post just because you saw there was a Part II and guessed the surprise ending, you are a perceptive but terrible person. I bet you peek at the endings of books too.

We've tried Cetaphil, Cetaphil Anti-Itch Lotion, Burt's Bees, Cerave, normal Aveeno lotion, and Aveeno Eczema Therapy cream on Diana. We've tried coconut oil, sunflower oil and even emu oil. (I still want to know how they extract oil from emus.) We've tried Vaseline and Aquaphor. We've tried 1% and 2.5% hydrocortisone, as well as "moderate" and "strong" topical steroids, whose names I don't remember. This list seems short, so I know I'm forgetting some, but basically, we've tried everything we can think of. I've changed our laundry soap and household cleaners multiple times, as well as all my soaps and cosmetics. Mostly, we've had two and a half years of red rashes from allergic reactions to new soaps or moisturizers. The only thing that seems to help a little is Aveeno Eczema Therapy Cream, but since it has some alcohol in it, we can't use it where there are scabs on Diana's skin. When her skin got bad a couple of weeks ago, that was basically all over her body.

The allergy clinic gave me the results of Diana's blood panel over the phone. Hallelujah! Hooray!

And they were as follows:

Diana had a strong reaction to: cats, dogs, and peanuts.
She had a moderate reaction to cow's milk and egg whites.
She had a low reaction (which may not manifest as a sensitivity at all) to soy and tree nuts.

My first reaction was relief. Thank goodness! We had some idea of what we were dealing with, and there was scientific evidence to back it up. I've always suspected cow's milk and egg whites, but couldn't get a strong correlation between those and her eczema during our elimination diet. My second reaction was: "Rats." Only partly because we have a dog in the house. My motivation might have been a little selfish. I don't like being told "I told you so." People always ask, "Could she be allergic to the dog?" and it drives me nuts. Usually they do it gently, as if they're breaking bad news to me. As if I hadn't considered she might be allergic to the giant walking allergen in our house? Or as if I was so emotionally attached to the big dumb (but sweet and loving!) dog that I would have any kind of pang of conscience over throwing her out if I knew it affected my daughter's health? We've never had any concrete evidence that Diana's eczema was related to the dog. So I feared that the first reaction I would get would be "Well, I told you so," and I knew that the question immediately following it would be "What are you going to do with the dog?" And I really don't know. We're still talking about it.

So now we know that Diana is allergic to something she's exposed to in our house 24 hours a day. Something that is leaving extra hair everywhere because it's shedding season. You know what that means, don't you?

Nothing.

That's right. In terms of her eczema, it means basically nothing.

Really, though, we knew that. We've traveled away from the house with variable effects on Diana's skin. We were between dogs for a while and her skin was still bad. It turns out, allergies and the causes for eczema can be entirely different. Here's a very stream-of-consciousness transcript of a talk by Dr. Harvey Leo of St. Joseph Medical Hospital on that topic. Eczema like Diana's is a combination of genetic susceptibility and environmental factors. Even if we got rid of our dog (and here are some interesting stories from dog-allergic families whose eczema didn't clear up after getting rid of dogs), Diana would still have eczema. She has an allergic response to the dog, an immune system response, that would probably manifest as itchy eyes, runny nose, etc. when she touches the dog or rubs her face in her fur: something we've already seen and know how to treat. But her dog allergy and her eczema are separate things. Also- surprise!- a study by researchers at the University of Cincinnati found that children with eczema may actually benefit from living with a dog! (Technical abstract here, summary news article here.)

We'll be meeting with the allergist again this week to talk about what her results mean. For the sake of thoroughness, we'll probably try having the dog stay elsewhere for a while. She's a nice dog, but I have too much on my plate to be really emotionally attached to her, so I would have no problem being a dog-free family. But unless it will positively affect Diana, I don't see a reason to get rid of the dog when there is only a correlation between Diana having eczema and our family owning a dog. The nurse at the allergy clinic suggested that the doctor might ask us to try another elimination diet (goody) with cow's milk and then egg whites to see if that affects Diana. Since our first elimination diet didn't reveal anything, I'm guessing we won't see much improvement in Diana's skin. I suppose in reality we'll probably just end up waiting this one out until Diana grows out of her eczema. There are so many factors I wonder if we'll ever find them all. I hate eczema.

(On that note, can I take a moment to vent that I am always the one taking the blame for Diana's eczema?? Of course it doesn't matter really, but I've had so many people ask about her skin, because that's the first thing strangers ALWAYS say to me, and then comment, "Well, you're so fair-skinned, it probably runs in your family..." FALSE! NO! Not me! I'm even mixed, for Pete's sake! You can take your disapproving stares to my tan-but-completely-Caucasian husband! Oh, genetics are a hilarious and nonsensical game.)

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