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Anon talks to DrB about Weeks 4 to 6 with The Eczema Solution and Twitter
Continuing The Combined Approach self-help programme with Twitter: Weeks 4 to 6
Using the self-help programme by reading The Eczema Solution by Sue Armstrong Brown Anon has been reporting back on his progress regularly as @EczemaBeat on Twitter. Here he brings us up to date with his use of all three levels of The Combined Approach, from week 4 to week 6...
DrB: How do you think the last three weeks have gone?
Anon: Overall, great - healing more and more - but week 4 was a tough week with lots of external factors threatening to knock me off course! There were days when I only did the bare minimum: I counted scratching episodes but wasn't putting any effort into replacement behaviours. Weeks 5 and 6 have been much better. A real breakthrough came for me when I started averaging under 80 scratchings a day - I even had one day with only 19 clicks!
DrB: The improvement in your skin is obvious to you, but what do others say?
Anon: People definitely notice - my family know why and comment about how my skin looks so clear now and how they barely ever see me scratch. I had a day in week 5 when I had to give presentations to people, and before, I'd have been terrified that my face would be affected, so that the audience would spend all the time wondering about why my skin looked bad, rather than listening to me, which in turn would affect the quality of my presentation. No such issues this time - fantastic!
DrB: How is Twitter helping?
Anon: The discipline of checking in and reporting progress on Twitter every day has really kept me on track, especially when things got difficult. On a bad day it's tempting not to bother for a while, and not register episodes of scratching - because I know the score will be higher than I want it to be. Twitter gives me both routine and support: both help me not give in to temptation! But it's also a good feeling sharing the good days on Twitter. That is as important as being able to share the bad ones!
DrB: Let's take a snap-shot of where you are right now, with the six metrics we use in clinic. The first three are to do with scratching - so, how often are you scratching now, how much is due to itch, and when is most scratching happenning?
Anon: Scratching frequency is way down now - often as low as 50 to 75 a day - and almost 100% due to itch, apart from scratching first thing and last thing each day, and when reading - then it's still habit, not itch!
DrB: And with 0 as no eczema at all and 10 as the worst it ever gets, what do you score your skin now? Also, where is it? And how much is new, and how much is the old, chronic stuff?
Anon: I'd say my eczema score now is 0.5 on the 0 to 10 scale - almost all gone! Some still on my right hand, bits only inside my elbows, behind my knees and on my right ankle - 80% is old; only my hand eczema is new.
DrB: Right - that's all going well then! Take us through the three levels of the treatment programme. Level 1 - which is the most important level long-term - your moisturisers, and Level 2, your topical steroids.
Anon: Certainly less moisturising needed now! Twice daily is usually enough: no real need mid-afternoon. I need to find a reliable moisturiser for my hands that I can keep in my pocket. Suggestions welcome! Topical steroids twice daily on flare-up, right hand - once daily other parts, plus continuing now beyond the look good points for hidden healing!
DrB: Those are the two levels needed for acute eczema: for chronic eczema we need Level 3, habit reversal. How is that going for you now?
Anon: Habit reversal can seem less important now, since healing is almost complete and scratching frequency has come right down. Sometimes it has been hard to sustain - but am terrified of slipping back though, so not giving up! De-stressing by working out, plus using meditation, and the focus tips, are all really key for me.
DrB: Sounds good. Now, your next stage of the programme - in clinic we call it follow-up - is covered in chapters 7 and 8 of The Eczema Solution: understanding the healing curve, and how to remain on track in the future by anticipating flare-ups, and knowing how to zap them.
Anon: Yes, I have read the chapters and am primed and ready! Emollients and soap substitutes are on-going, important prevention against skin dryness - and therefore flare-ups - these are my first line of defence. Then, for a flare-up, prompt use of correct strength topical steroids, and continuing beyond the look good point for the hidden healing. Habit reversal less important from now on, as I anticipate danger periods and ensure I have a stockpile of steroids to deploy, as detailed in chapter 7.
DrB: Great! From now on, vigilance is the name of the game. As you have said, fundamental is the prevention of skin dryness. Next, know your triggers and avoid those that can be avoided - do not chance fate! Finally get good at recognizing the earliest signs of a flare-up and be ready to zap the relapse - in just days Levels 1 and 2 will work - no more clicking, no more habit reversal required. As the next few months pass, if you handle triggers as you can, and you zap relapses promptly and thoroughly, you can reasonably expect to get less and less trouble, as your skin thoroughly recovers. Now you can discover life without eczema!
Anon: Yes, indeed. I just hadn't been aware how much my eczema influenced what I did or didn't do in my life. Like avoiding meetings which would have been beneficial because I was embarrassed about my appearance. Or not concentrating on games with my kids because I was too busy scratching. I also hated the passive, out of control feeling of being at the mercy of my eczema - it really stressed me out to wake up in the morning and find that my skin had flared up and was inevitably going to make my life miserable for much of the day. Now I have plans and know how to minimise the effects and that alone is a hugely positive development. Also - having seen the effect the programme has had on a problem that I thought would just be a fact of life for ever, I now feel loads more positive about the possibility of achieving other long term goals - fitness, better diet - and I can see how one would feed into the other so they all start to mutually reinforce. This makes me feel very optimistic about life in general!
Follow Anon on Twitter at https://twitter.com/EczemaBeat