It's Official: I Have Cholinergic Urticaria

I have been officially diagnosed with cholinergic urticaria, though I've suspected for the last month that that was the case. The allergist, Dr. Bobbitt of Cincinnati, was as advertised: helpful, thorough, receptive to my thoughts, and confident in his diagnosis. I took the photos (posted a few days ago) with me and they seemed very helpful to him in making his diagnosis. Thankfully, the photos also spared me the agony of having to reproduce the hives for him in the office, and I would suggest others do the same if possible. Take real photos, not something you took with your cell-phone or something. He was so confident that it was cu that we completely skipped all the allergy testing.

He gave me prescriptions for zyrtec (10 mg/1 tablet per day) and hydroxyzine (25 mg/ as needed), and also said I should take 150 mg of Zantac twice a day and 10 mg of loratadine (claritin - 1 pill) once per day. Initially he wanted to prescribe Allegra but I told him that the samples of Allegra I received from my family doctor were pretty useless, so we settled on zyrtec instead. He seemed to suggest that 20 mg (2 tabs) of zyrtec would be best but that insurance normally doesn't cover more than 1 per day, so just to take 1 zyrtec and 1 claritin per day and see how it goes (zyrtec in the morning and claritin at night). He said that the zantac is useful in blocking H2 receptors, while zyrtec is good for only H1 receptors, so maybe that combination will prove effective. Worried that the zyrtec, claritin, and zantac might not be enough, I asked him about hydroxyzine, and while he agreed that it is a pretty powerful antihistamine, he was a bit concerned about the side-effects, mainly the drowsiness and the fact that it really has a detrimental effect on your ability to drive or perform tasks, almost as if you were under the influence of alcohol. He advised that it stays in your system for up to 24 hours and should only be used on an as-need basis.

So I'm hopeful, and relieved. Dr. Bobbitt seems commited to helping me through this, and wants me to stay in touch so that we can adjust the drugs (dosage/type) based on how I'm doing. He said that some of these cases can resolve themselves completely in a matter of months, and most are resolved within 2 years, which was music to my ears.

I'll give the meds a whirl and keep everyone updated. I go back to work tomorrow so hopefully my skin will behave! Stay cool.

Don't Want To Fall Asleep

It's 2:30 in the morning and I'm dead-tired, but going to sleep means waking up in 2 hours in the middle of a hives attack...great fun. I wonder if I stayed up all night and slept all day if I would still have attacks in my sleep? Crazy. It's really true that you don't know how good you have it until something is taken away. What I would give to just be able to go to sleep or walk to the mailbox on a sunny day without fear of my skin exploding. This has really been one of those "I took my life for granted" experiences. This is really starting to sound fatalistic, I guess. It's not like I'm dying or something. I really just need to suck it up and stop whining like a baby. This will pass eventually (right?). This post will probably make no sense to anyone, but hey, it's 2:30 in the morning. Cut me some slack. Tomorrow is a new day. Happy Easter to all!

Every night at around 4 AM

Yep, it's like clock-work now; i have an attack just about every night at around 3-4 am. Now I keep the blue ice block right next to the bed so that as soon as I am awoken by the attack I can slap it right onto my chest and try to cut it short. This despite having the AC running almost continuously. It is frustrating to be locked up in my apartment all day, every day, because Spring is my favorite time of the year (not a big winter guy), but all I can do is try to stay positive and have hope that the allergist on Wednesday will be able to give me ideas and some drugs that will help me re-enter my life and the world at-large.

Now Nightly Attacks

had another attack last night while drifting off to sleep. got to the freezer/ice quickly enough that i cut it off before it got really out of control. so maybe this will be a nightly thing now. I guess I'm now realizing how beneficial the antihistamines were for me, though I thought them useless. Either that or the suddenly warmer weather is simply aggrivating my condition. So I've got the AC ramped up so high that I'm either freezing at night or I'm breaking out in hives...can't find that happy middle-ground. Van't wait to get my hands on the meds. I'm hoping he'll hook me up with steroids like prednisone or something like atarax (hydroxyzine) in combination with zyrtec so we can put this thing to rest. I don't mind the drowsy side-effects at this point...I just want to resume my life.

...just took a walk to get the mail (about 100 yards) and on the way back started breaking out. this is ridiculous! got back and rushed to the freezer to get an ice block which is now firmly pressed against my chest...full-blown attack averted. sunny day. 80 degrees. is it possible i also now have solar urticaria? the doctor's appointment can't come soon enough. i need some serious steroids. this is no way to live.

Had an attack last night

Had another attack last night, which surprised me as I had the AC running and the air temp was relatively cool. Seems like this happens every 3 nights or so. Perhaps I should expect more of it over the next several days as I am without the antihistamines in my bloodstream. This sucks! Guess I'll have to turn the temp down even lower tonight so that this place is an icebox.

Here Are The Photos

Below are a few photos taken as I had an attack this past weekend. Note that this was an hour after taking 2 alavert and was triggered simply by sweeping leaves off a patio. The first photo is a close-up of my back, the second photo is full back shot, and the third is a frontal shot. These are the areas where the hives are mostly concentrated.

I have scheduled an appointment to see Dr. Bobbitt in Kenwood next Wednesday, but the catch is that I can't take any antihistamines for the next 7 days so as not to skew the test results (ugh!). So I have taken these next 7 days off of work because I know that without the antihistamines I would be in absolute misery. Just going to spend the next week indoors with the AC on and trying to rest. It's amazing and frustrating how this has pretty much brought my life, and my ability to make a living, to a standstill.

Been Over 6 Weeks

Well, it's been over 6 weeks since all this started for me (started about mid-Feb.) , and probably more like 7, so I guess this can now officially be called a "chronic" condition, though I've been assuming that for the last several weeks. Guess I'm in this for the long haul. Today I had a bad attack while over at my parents' house, and I had a camera loaded and ready to shoot, so sometime in the next week I'll be posting the photos. The attack was brought on simply by sweeping some leaves off a patio for about 5 minutes, and I think the severity of it really surprised my family and fiance. My mom was on the phone immediately with a friend of her's who sees an allergist in town regularly, and she said the guy is very thorough and quite outstanding, so I plan on calling his office tomorrow to schedule and appointment. I'm not expecting much in the way of results, but maybe he can at least try some steroids on me or something...I feel pretty powerless right now, and with my wedding coming up in June, I just need some powerful drugs and pronto. Have not gotten ahold of the Reactine yet, but if and when I do, and if and when I use it, I will update results here.

Taking 4 Alevert a Day

Loratadine (Alevert) has not been helpful in its recommended dosage of 10 mg per day (one 24-hour tablet), so I have gradually stepped it up to 4 per day. I would not recommend this for most people, but I seem to have a high tolerance for its side-effects (mainly drowsiness when taken in such high dosages). So I now take 2 at around 10 AM and 2 more around noon, and it now seems to be helping to decrease the CU episodes and the severity of each a little bit, though I do start to drag a little starting at around 4 PM. Still not satisfied, though, as the attacks keep coming, and if I were exerting myself at all I'm sure they would be just as explosive. Getting ready to try Reactine (ZYRTEC) (ceretizine), and am anxious to see if there is an even greate improvement. Ceretizine seems to be the antihistamine of choice for many CU sufferers, though it remains to be seen how it will effect me.

This the first post of my Hives Blog. This is intended to be both a diary of my daily hives attacks, as well as a possible resource for others who suffer from it. I have not seen an allergy specialist yet, but from doing ample web research on my own I've come to the conclusion that I have developed a type of chronic hives called cholinergic urticaria. This appeared as a problem out of the blue about 6 weeks ago, and I'm doing my best to try to find a remedy so that I can avoid costly doctor's visits, lab tests, etc.

I read on a website that one way to test for CU (cholinergic urticaria) is to submerge the patient in hot water and wait to see if they break out in hives as their body temperature rises. Today I decided to test that on my body, so I took a warm shower, and slowly increased the temperature of the water until it was very hot. Several minutes went buy with no reaction, so I was about to give up on that experiment when, sure enough, I started feeling that intense itch all over, and the hives appeared. I shut off the water and cooled before things could really get out of hand because a full-blown attack is almost unbearable, and I saw no need in pushing it. Perhaps I will try again sometime and extend the shower to see if, as others have suggested, the histamine stores will eventually be depleted (for hours or up to a day). Further updates and photos to come.