June 1, 2012

Poison Ivy

I'd had a rash on my arms for about a week, starting in one elbow-pit and spreading down that arm and over to the other arm. It was itchy and looked scary and blistery. When I realized it would be helpful to build consensus to persuade me to make a phone call, I asked Twitter how long I should wait for a rash to go away on its own before calling the doctor. Overall consensus: "How about calling now?" So I did.

And thank you, Twitterers, because the doctor said it's poison ivy, and because later that same day I could FEEL the rash PERCOLATING under my skin, but by then I probably wouldn't have been able to get an appointment. You are my spine when I need the loan of one. (And today the rash is EVEN WORSE. I had to go to the grocery store and I was worried I looked too diseased to be out in public.)

I picked up my prescription for prednisone today, but I am concerned about taking it. It says it can cause anxiety and rage---and on a GOOD day I am snappish and impatient and worrywartish. Not to mention how little help I need with my appetite, or with lying awake at night. Also, it says to take three tablets the first and second days, two tablets the third and fourth days, one tablet the fifth and sixth days, and half a tablet the seventh and eighth days---but there are no instructions about whether those multi-tablet doses are supposed to be taken all at once on their respective days, or spread out throughout the day. All the doctor said was not to take it before bed. Yes, I should call. But I will not call a doctor on the weekend unless a limb is severed or my heart is stopping or I have a UTI, so that's not a sensible suggestion. I guess I could call the pharmacist, but what if he says I should call my doctor? You can see the bind I'm in: someone MIGHT say that I SHOULD do something I don't want to do!

But the rash is definitely worsening: just now I felt itchy-tummed, and when I looked I found about six new tiny itchy bumps there. So I think I will start the prednisone tomorrow, even if it means I have to make a phone call first. And I will try to remember over the next eight days that if I feel like everyone is BEYOND BELIEF, it MAY be the medication. And if I can't seem to remember that, I hope YOU will. SWISTLE MAY BE TEMPORARILY CRAZY.

40 comments:

Anonymous said...

The pharmacist should be able to tell you how to take it, they won't ask you to call your doc. I've taken pred before for poison oak and also for auto-immune disease flare ups and if you're on a step down packet, it's usually a split dose during the day (3 and 3, 3 and 2, 2 and 2, etc.). On a short-term regimen of pred, you shouldn't have any side effects that are major, other than maybe feeling a little hungrier, and awake (hence, don't take a dose at bedtime). Good luck!

Anonymous said...

You seem crazy to me ALREADY that you have a rash which has the potential to keep spreading and you want to wait until tomorrow to take the prednisone.

Erin said...

I too am ragey and impatient by nature, and I don't find that prednisone makes this any worse. I actually can't recall ever having any abnormal symptoms at all, except for maybe a little extra-awakeness.

And if I remember correctly, you're supposed to take the doses one pill at a time, multiple times a day, but I could be wrong. Probably not a bad idea to check with the pharmacist.

JLP said...

My son took that prescription many times for poison ivy. You take all 3 at once and 2 at once.
I agree with anon about side effects and you might have the one they don't mention -when you feel kind of like you're stoned.

JLP said...

The anon at 8:30, not the second one.

d e v a n said...

I would definitely call the pharmacist! They will be able to tell you and they should be open on a weekend so it won't be like calling the doctor. ((hug))
Now, this comment may not go through because the picture (?!) I have to decipher is just a fuzzy blob.

HereWeGoAJen said...

I was coming to say that I always take those types of doses all at once, but I see that there are conflicting opinions already. So I have no idea!

Type (little) a said...

My prednisone packet had instructions on it. It was a blister pack.

I'll call the pharmacist for you.. LOL

Swistle said...

Anonymous 8:47- I know, right? But the only instruction I got was NOT to take it before bed.

Jenny said...

Okay - according to my nurse's drug guide one is to administer once-daily doses of prednisone in the morning to match body's normal cortisol secretion schedule. The guide also says to "instruct patient to take prednisone with food to decrease GI distress and to take once-daily dose in the morning".

Hope this helps!

Jennifer B said...

I would recommend taking the steroids as early in the morning as you can tolerate and all at once. If I take them anytime after 6 AM, I don't sleep. Medrol dose pack, a different steroid, is the one where you take pills at different times. Straight prednisone, all at once.

Swistle said...

Type (little) a- Do you remember what the packet instructions were---like, was it take the day's pills all at one time, or spread out throughout the day?

Swistle said...

Jenny- YES. So, take the day's dose all at once, in the morning, with food. That is the kind of instruction I can manage to follow!

Suburban Correspondent said...

I hope you're feeling better soon! It's a shame you have to wait to take the medication. My friend's son had poison ivy all over his genitals (we can't figure it out either); it was very painful.

Gretchen said...

Just checking - you're not putting any cream w/benadryl in it on the rash, are you? That stuff + broken skin will create a horrible, spreading, bubbly rash. It's my PSA for all rashes after doing that to myself.

Type (little) a said...

Oh it was something like 6 pills the first day, 2 before breakfast, 2 at midday, 2 with dinner, and it tapered off. So day 2 was 2 breakfast, 2 lunch, 1 dinner, Day 3 was maybe 2 breakfast, 1 lunch, 1 dinner, Day 4 was 1 each time, etc, etc.

I took it for pneumonia, my husband took it for a sinus infection, and my client took it for a back injury. Same dosing.

Type (little) a said...

Though I just read the above comment from the drug guide and now WHO KNOWS???

My diagnosis: Call the pharmacist.

Swistle said...

Gretchen- WHAT. Yes, I AM putting a benadryl cream on it! It says on the tube "temporarily relives pain and itching associated with poison ivy" and "dries the oozing and weeping of poison ivy." And I mentioned to the doctor that I was using it, when she asked if I was putting anything on it, and she didn't say anything about stopping. But I ran and washed my arms just now, just in case! I don't know WHAT to think now! Except that I'd better start that prednisone tomorrow so I don't have to make any more Risky Medical Decisions!

Kenner said...

My mom is the queen of awful poison oak reactions (and just happens to be visiting right now, so I asked her!) She said you take them all at once, and that it will make you high as a kite/euphoric (which is why they say not to take it at night). BUT, she also said that it doesn't necessarily last a full 24 hours, so at night it kind of wears off a bit. So SHE would probably take MOST of the dose in the morning, and maybe save a small portion of it for the evening (but you could always try it all in the morning for a day, and then adjust it the next day!)

Alice said...

oh dear. these comments are not especially illuminating, are they. i was hoping they would be, because i really want you to start taking the meds NOW and stop the spreading! poor swistle!

Slim said...

The Caladryl/benedryl won't make your rash spread, but it will make it ooze.

If you have washed your arm thoroughly with cool water, so there's no oil left to spread, do the hot water treatment: spray hot water -- as hot as you can stand -- on the rash. At first it will feel much itchier, but then the itch will subside. Then apply whatever you're using on your rash. The combo should get you through the night, and then you can start your pills in the morning. It's the weekend. Paul call stay between you and the children.

Alexicographer said...

Ooh, fellow sufferer here (not currently, but don't worry, it's sure to be just around the corner for me), and I am sorry. Poison ivy basically looks like / is a chemical burn (for me) with lots of oozing and broken skin so I wouldn't necessarily join @Gretchen in blaming the benadryl for that; I don't use benadryl (because I find it doesn't help with the itching) and I still experience those symptoms.

The one thing I have found that helps with the itching is a product called apinol, which you can buy at (among other places) Amazon. It is a godsend and well worth rush shipping if you are suffering. It is a product made from pine oils, so if you have allergies to those or object to smelling like a pine tree you may not like it, but I for one am happy to smell like a pine tree (hey, there are worse things) in exchange for some relief. The other thing that helps (me) is blasting the area in REALLY hot water (like in the shower) but the one time I truly needed prednisone in connection with poison ivy (I developed hives), it was after doing that a lot so I now try to limit myself and clearly shouldn't be recommending it. What am I thinking?

And if you know you have been exposed but haven't broken out yet, or are just breaking out but fear it may get worse, a product called Tecnu works well to wash the oil out -- but it sounds like you're well past that stage. I'll also note that the usual advice of covering up with clothing is when I get the WORST cases, presumably because the oil saturates them and stays on them and infects me, versus just touching my skin and not sticking as much, so I'm just sayin', if I run around au naturel all summer long, that's why, but in all seriousness I try to stick to (e.g.) shorts rather than pants if I'm going to be in an ivy-infested zone.

Christina said...

I get hives semi often and have to take prednisone for them. I take the pills all at once.
I haven't noticed any of the rage, etc. side effects and I'm a depression/anxiety mess. I have noticed that it affects my eye sight, it feels like my Rx isn't strong enough while I'm on it. Not sure if that's just me, or what. It's the only significant thing about it I can remember.

For poison ivy I usually just do cortisone and oatmeal baths. You must be in major, major agony for them to Rx a steroid!! Good luck!

Mary said...

I have taken prednisone twice, both for allergic hive breakouts. I know I'm in the minority, but I love how it makes me feel. It helps that it makes the hives feel better immediately, but also, more energy and it kills my appetite. I am also an anxious and kind of cranky person, so take it for what it's worth.

Also, ibuprofen helps a ton with itching.

Doing My Best said...

Oh, Swistle! I'm so sorry!! This sounds really awful =(!

Aimee @ Smiling Mama said...

Ugh, prednisone is the worst but also the best. It will clear things up but really does have bad side effects. I believe you are meant to take them all at once. They are bringing you down slowly to lessen the neg effects of going off cold turkey -- good luck!'n

Jessica said...

Good luck, Swistle!! I hope you feel better soon:)

Anonymous said...

I always took the prednisone all at once in the morning. (for sinus infections). No side effects except making me feel like a badass that could work all day and then come home and clean all the things and handle the CRAP out of any situation. If I were to ever have a drug problem, prednisone would be my vice of choice.

Anonymous said...

I know this one! You can either take it spread out throughout the day, or you can take it all at once. I prefer all at once so you don't forget a dose. If you find it upsets your tummy the first day, spread it out for the rest of the course.

The bonus I find with pred is lots of energy, you could power through a project you've been dreading! (I cleaned my mom's hoarders-style office while on it... Tessa

phancymama said...

I just got prednisone for bronchitis/sinus, and the doc had me take two all at once for three days. And in the morning. The only side effect was a ton of energy--I got lots and lots done and loved it. Good luck, and I second taking ibuprofen until the morning!

Slim said...

Finally, do you know where you picked it up? I think my latest batch may have come from our dog, and as I recall, you have outside cats, right?

Someone needs to bathe them. And, unfortunately, you're the crazy one right now.

JG said...

Hi! Long time reader that doesn't like to leave comments! Years agoa I had poison ivy really bad. I did some research and found this stuff called ZANFEL that the loggers use. It really helped clear up the oozing and numbed the spots for a bit after using it. The tube is expensive and not all pharmacies carry it, but so totally worth it. Also if the itching gets too bad, wrap a blue ice in a towel and numb those nerve endings.

Good luck!

Groovymarlin said...

Hi Swistle! I've taken prednisone for rashes many times. The nurse advice matched what my doc always told me - take all the pills at once each day, with food. Also, I never noticed any rage or anxiety, but they definitely increased my appetite.

Anonymous said...

DON"T wait to take the prednisone, and never hesitate to ask the pharmacist about your medication...especially if they have not consulted you on it when dispensing it in the first place. Usually they like to show what they know and a Pred dos-pak is standard for poison oak so it's a common question. They also all have their different favorites as far as OTC remdies but most of the ones I worked with over the years say OTC Benadryl and Hydrocortisone 1% cream. Happy healing!

Gretchen said...

Oooh, sorry, but I think the caladryl package says do not use on broken skin. They are serious! Plain calamine is fine if that's what you're using. There's an old timey powder remedy called Domoboro powder you might find at a pharmacy. Helps dry up the rash. I think you mix it with water & apply w/compresses. Good luck, I had scars for awhile!

Gretchen said...

YMMV, but my experience with the benadryl cream was bad enough I warn everybody! I didn't have poison ivy, don't know what it was but it started small, I'd apply the caladryl, it would feel better, then spread and feel worse. So I warn people about it! If it specifically says poison ivy and doesn't have the broken skin warning, it's probably fine.

Jen in MI said...

My hubby was on prednisone for over a year for sarcoidosis. He actually liked it when he started taking it because he had crazy energy! The "honey do list" got done!

Anonymous said...

Maybe this has been said- I didn't read all the comments, but I'm a doctor and can tell you that you should take the multiple pills at the same time. So you take 3 pills the first two days, 2 tablets the next 2 days etc. Hope that helps.

Rose said...

Coming from a RN and someone who takes steroids every. single. day., for the last 2 years, take prednisone all at one time. Insomnia and increased hunger are the worst side effects I have experienced (except for fat pads, hello lipo!). Another type of steroid very similar to prednisone, methylprednisolone, comes in blister packs and should be taken in divided doses. Hope you feel better!

Jenny said...

Short-term pred shouldn't have much in the way of side effects, though. It's the long-term doses (like, over months) that cause rage, weight gain, night sweats, insomnia, etc. My husband took prednisone for ages for his Crohn's disease and had all of that, but I've taken it short-term for other things and had nothing.

I'm so sorry about the poison ivy!