Debilitating Hand P Threatens Livelihood
Hi Ed: Found your site today as I searched
for answers/info on P. I was diagnosed earlier this year with
P. My problems are P on both hands and sometimes in the crotch
(difficult to explain to a date).
Your site has been a welcome comic relief for me as I'm sure it is for a lot of others with this damned condition. I plan to visit it more often. Keep up the great work, as I believe humor does help and is important in any therapy. -Mark P.
Ed's Response: Whew, Mark! Your P might not add up to big numbers geographically (i.e., percent of skin affected) but it's probably hitting you harder than most flakers with five times the coverage. Hmmm. Hands and crotch. For a guy, that's about three-quarters of our sexual apparatus. No fun.
I am affected on hands and crotch as well, butknock on woodso far the days my hand P has been nearly disabling have been few and far between. At the momentknock on wood againmy P in both places is better than it has been in over a year. I believe I can attribute this to the Methotrexate therapy, which I'm four months into, now. I wonder if MTX is one of those chemotherapies your derm has mentioned as a "down the road" option?
Before MTX, my best-bet therapy for hand P was overnight occlusion of a group 1 corticosteroid (usually Diprolene or Temovate) using food handler's gloves taped tight at the wrists. Four successive nights of this occlusion, at most, would quiet raging hand lesions, meaning cracks would also heal. Occlusion was so reliable I could actually schedule it (i.e., write notes to myself to lay in supplies and do it) weeks in advance of important business trips or speaking engagements. I think one reason it did work so well for me was because I did not overuse it. When I wasn't making professional appearances, and the cracks weren't debilitatingly painful, I usually tackled the hands with topicals and no occlusion, which is to say I let the lesions run their course with only moderate intervention.
You did not mention psoriatic arthritis as a part of your hand problem, so I am assuming it isn't ... which is good, because PA is something the occlusion therapy never improved for me. Fortunately, PA in my fingers has been a johnny-come-lately problem for me and the MTX has worked well on it, too. Your case makes me realize how much I have to be thankful for.
For some inspiring sympathy, check out In Strindberg's Shadow from the Archives. Johan August S. was a famous flaker whose hand P was also debilitating. If the portrayal of him by Max von Sydow in the movie "Wolf at the Door" is factual, Strindberg was hospitalized to obtain the same kind of occlusion we accomplish at home these days.
An MBA and an MCSE certification (Microsoft Certified Systems Engineer) is a potent and potentially lucrative combo in our day and age, Mr. P., and I don't blame you one bit for being dismayed about a physical condition that can keep you from realizing that potential. I don't knowbecause I don't possess either of those credentialsbut aren't you a likely candidate for a good telecommuting livelihood? Perhaps I overestimate the availability of this kind of work. It has, after all, taken me three decades to "grow" my current situation (see Aren't You In Hiding, Ed? in this month's mail).
Let us know how the job hunt goes, Mark ... and if your derm was thinking MTX when she mentioned chemotherapy. If she was, check out the Archives here for several exchanges about Methotrexate and a journal from my 1st twelve weeks on this therapy. I'll be thinking about you! -Ed