Monday, October 11, 2010

Erythema Nodosum

What's Erythema Nodosum (EN), you ask?  It's basically slightly reddish, very tender nodules, occurring just under the skin, usually occurring on the lower legs.  I've got them.  This is new to me, and is occurring at a time overlapping some other new and troubling symptoms, specifically, intermittent mild to severe abdominal pain with nausea and fatigue.  I've spent many couchant days with Wellington, just hurting and trying to feel better.  I've had several days when sudden onset of pain and/or nausea hit me just before or at work.  

The most recent episode occurred in the office last Wednesday around 1:45pm.  My belly was wrenched with cramping pain, so I headed right to the rest room, hoping for relief.  I broke out in a cold, dripping sweat while a terrible nausea came over me, all the while, still doubled over in pain.  I had a meeting scheduled with my boss for 2pm, but ended up having to reschedule it, due to my unavailability.  I had to text him about my emergency.  I was stuck in that stall for about an hour before I felt stable enough to get my purse to leave work and drive home.  My pain continued for several hours until it slowly began to dissipate to a milder version that would continue for about two more days.  The heating pad on my belly helped with the discomfort as I watched episodes of Dr. G: Medical Examiner and Mystery Diagnosis, my newest favorite sick day shows.

There are several causes indicated for the occurrence of EN, including various infections and Inflammatory Bowel Diseases like Ulcerative Colitis or Crohn's Disease.  The last visit to the doctor for the abdominal pain was on Aug. 27th with a new gastroenterologist, who suggested I try stopping the daily probiotics, in case my guts have too many bacteria in them.  I have been off the probiotics since late August now, yet I still continue to have the episodes.  All blood and urine tests done thus far have been "normal" so I'm not sure what is behind all this.  I just know the abdominal pains and EN are linked.  It's too coincidental for these to occur for independent reasons, right?

I have had a few days of a mild sore throat in mid-August, before all of this started, but I find it hard to believe that I could have had strep, a common cause of EN.  Strep also doesn't explain the abdominal stuff going on.  

At any rate, my research on this is definitely continuing until I can at least determine my next plan of action.  With the way my last few doctor visits went, I feel like I need to present them with plausible ideas.  The lack of thoroughness is very disheartening to me.  My dermatologist was actually the one who diagnosed the EN, with just a quick glance and touch.  He prescribed a topical steroid that I've been applying religiously since my diagnosis on Sep. 24th.  He also gave me no reason to dig deeper for an underlying cause, which makes me a bit sad.  Thus far, all the info I've dug up on EN has been on my own.  He didn't even write the name down - I had to find it based on something that sounded like what he said, which I remembered as "ereth-- something".  

On the bright side, last Saturday and Sunday were a breath of fresh air.  I felt lots better than I had been lately, even as recently as Friday.  I got outside, did some walking, and enjoyed some quality time with Don.  I don't want to speak too soon, but today is going pretty well so far, too.  However, both Don and I noticed that I've been having sick time on Wednesdays lately.  We are wondering if there is something in the air or water in my work building (the water is not great, but we have a filter for drinking water which I use), or if there is some other thing in my routine, perhaps, that is contributing to my deterioration after a couple of days of the work week.  

Over the next few weeks, I'm going to see if I can find out what helps.  The first thing I'm trying is not taking my morning vitamins and supplements, since I noticed that I forgot to take them both Saturday and Sunday.  I skipped them purposely this morning, to see if I can make it to Wednesday a little more easily this week.  If that doesn't work, perhaps I'll try avoiding drinking the building's water and bring in my own.  If that doesn't help, maybe I can try to get more sleep, like I definitely did last weekend.  

I'm thinking something in my genetic makeup or somewhere in my body is at odds with something I'm exposing to it.  Maybe I can narrow it down and avoid it.  Wish me luck!