Sunday, May 15, 2011

Delayed Pressure Urticaria (DPU)

A couple Saturdays ago, I attended a great party at some friends' place. I had a great time and met lots of great people, but my body had some major bitching about the experience. The bottoms of my feet are apparently averse to long periods of standing around - especially in cute, party shoes (even though they were made by Söfft®).

I have been dealing with tender soles since that point during the party when I decided my feet had had too much and I took the shoes off. Unfortunately, the damage had already been done by then, and my feet were in so much pain that standing or touching anything with the bottoms of my feet was unbelievably painful. I had to kind of grin and bear it for the sake of preserving whatever amiability I could muster for the party and other guests. "Regular" foot pain is pretty bad, but coupled with swollen, tender, hived soles, it gets pretty ridiculous! I don't know if I can explain the feeling enough to someone who doesn't deal with this.

My skin is apparently very sensitive to many things, including: chemicals, sun or heat, cold, and various kinds of touch. I'd been officially diagnosed with dermatographia, which means that my skin hives up just from a scratch. (Paper cuts really itch a lot, sometimes before I realize I've gotten the cut.) This was long before the Fibromyalgia started.

Since the FMS diagnosis, however, I've noticed that kneeling in the garden to plant my native plugs caused me to have red, tender knees even a day or two after the hour or less of kneeling occurred. It looks really stupid as red ovals on the areas of pressure (I wouldn't wear a skirt or shorts in public if I can help it), but if they are touched, the areas are very tender and painful. Kneeling after the hive wheals have appeared is not possible without intense pain.

I've now learned that this is yet another category of urticaria/hives of which I have to be aware. Any part of my body that bears weight for a few minutes can break out in a thick hivey patch that can last for days, especially if not allowed to rest. This is called "Delayed Pressure Urticaria" or DPU. It's delayed because the damage is not apparent immediately upon the first touch - it takes time in order for the reaction to occur.

The delay is the especially tricky part of this condition. Unlike touching a hot pan, the painful feedback is not immediate, therefore the damage occurs for some time before the patient is reminded that there may be something happening. Minutes or even hours may go by, depending on the body part and amount of pressure being applied, before even noticing pain, which seems to take much longer to relieve than to acquire. By then, it's much too late to stop the process.

So here I am, almost two weeks after the triggering DPU incident, still suffering with tender feet, even before standing up from bed in the morning. No matter what shoes I wear to work, my feet are just not liking them. Any walking seems to cause an increase in symptoms, preventing my speedy recovery. All I can do now is try to rest as much as possible between necessary standing, walking, shoe-wearing, etc. to try to ease back into the normal, everyday level of chronic pain in my feet. (Isn't it great to have to wish for normal chronic pain levels? I'll take what I can get.)

Do you have DPU? Is there anything you do that helps? Please comment on this post and let me know!