Time for desperate measures

Lees deze post in het Nederlands. This post is part of a series. Start reading here!

So, where were we? Oh, right, my skin has been misbehaving for years, I have tried a tremendous amount of creams and finally, in agreement with my physician, I drastically changed my diet three months ago. Now my skin is better moisturised, but my eczema is still really severe and my desperation even more so. Glad to have cleared that up… But yeah… damn… what now?

Back to the hospital once again. After a long journey, during which my dermatologist continued to be hopeful over and over again, in vain I might add, he finally caved and agreed we could not continue like this. So, he started suggesting other options.

I heard about it… nobody talks about these things in my world… but there are always… Options.

Though no one managed to develop a treatment method that actually cures eczema, symptom suppressing medication is available. Or to be more precise, immune suppressing medication. Because, in fact, eczema is nothing more than a side effect of an immune system that takes its job significantly more serious than necessary. But since the immune system is unbelievably complex, and because it influences processes all over your body, it’s hard to develop a drug that effectively suppresses eczema without it having dangerous side effects.

See, again with these stupid trade-offs…

For example, I have been taking antihistamines for a long time to keep my allergic reaction under control. Although this drug has very little side effects, the effect is way too superficial to really do anything against eczema. Of course, there are also less innocent drugs that work much deeper into the immune system, but these come with serious side effects. The most prescribed are Prednisone, Cyclosporine (Neoral®), Azathioprine (Imuran®), Mycophenolic acid (Myfortic® and Cellcept®) or Methotrexate.

My dermatologist gave me two options: Cyclosporine and Methotrexate. Cyclosporine is a drug that works quite fast, but you can only take it for a limited amount of time. Methotrexate takes a bit longer to be effective, but in theory I could take it as long as needed. Both medications are terrifyingly poisonous. To give you an idea, these are the most common side effects:

Cyclosporine: High blood pressure; fluid retention; headaches; muscle pain; increased risk of infections, which could lead to fever, flu, coughing, sore throat, severe shortness of breath and tinea; a light tremor in the hands; stomach and intestinal problems like, nausea, vomiting or diarrhea; risk of liver and/or kidney damage; increased hair growth, especially in the face; burning sensations of the skin; inflamed and bleeding gums.

Methotrexate (MTX): Upset stomach and intestinal problems, like nausea and vomiting, or diarrhea; gastrointestinal inflammation; headaches; rash; slight hair loss; increased risk of infections, like flu, UTI, pneumonia, tinea; disturbed blood supply; shortness of breath and coughing; risk of liver damage.

Shit… these are no Smarties…

You can imagine I was not jumping on the chance to take these. Choosing to take medication like this is a serious decision and I did not want to do it unless really necessary. So, I kept having doubts… for a Really Long Time. I had taken the flyers home months before and had read them numerous times. Again, and again, I decided that my symptoms were not serious enough, that I could wait it out, that my skin would probably improve in the summer, that my diet would hopefully be enough… and time after time, I sank away deeper and got more convinced that the time was right for desperate measures.

So, with a heavy heart, I called the hospital. My blood got tested, my urine inspected and my lungs photographed. Everything seemed in order, so I could start if I wanted to. After a lot of deliberation, I decided to choose Methotrexate. With a small voice, I asked my questions about side effects and interaction with my diet and other medication to the pharmacist. And with a big sigh and lots of hugs from my partners, I took the first dose.

Down it went…
On good luck.

Curious how this ends? Continue reading here!
Picture by Hanne Kause.