Back into the Society
- Again as a Physician -

I quitted my job as a doctor at 34 year-old and restarted at 44.

The recuperation needed much longer than I inteded to, but there finally came the end.
Even though I had almost completely relyed all of my daily life on my parents for the first 3 years and then severe symptoms had lasted endlessly, I had continuously refused receiving corticosteroids treatment !
So selfish patient was I.

When I had already been stuck in my house due to serious AD for 2 years, one of my friends said to me in our phone talk,

"I'm afraid you'll never be able to come back to normal social lyfe again."

His prediction did not come true. I definitely delighted it.
It was really a pleasurable fact for me, for my family and for the friends who had worried over me.
And for every AD patients who were not willing to rely on corticosteroids medication.

I had started to prepare for working 6 months before.
First, I wrote a letter to a delmatologist who had been my senior in my residency and began to visit her dermatologic clinic (I'll call it C clinic here) once a month to observe her practice.
At the beginning, I felt so tired, sleepy and also confused about certain progresses in dermatological practice such as new wound-covering tools, however, little by little I recovered my confidence as to be a dermatologist again.

My old workplace gave me some mysterious relief.
I realized I truely liked this work.
Seeing patients (especially dermatologic ones) would be my lifetime work.

I was not hasty.
I knew my body was still too weak to work fully every day.
Maybe 1 or 2 days a week would be suitable, as a parttime job.
Just when I was to start working at C clinic beyond observing, I was invited from the hospital I had wrote about in the last chapter (N hospital) to come.
So I decided to commute C clinic and N hospital, once a week each.

There were a few reasons I needed 2 different job places.
N hospital was fit for me to work steady as a general dermatologist.
However, I could not do any altenative therapeutical trials there.
I needed another place, too.

The directive doctor of C clinic treated AD patients with pure western medicine measures. But she was a torelant person, enough to permit me to try some other "unscientific" alternative practices there.

Moreover, nevertheless she was very academic, she had retired from a university hospital because of its commerciarism.
I wanted to help her, as well as to learn from her.

Now, it was quite hard for a weak one, me, to achieve these familiar but responsible job from morning to evening.
I sometimes took a nap during lunchtime and asked by a nurse, "Are you tired today, doctor?"
Yeah, but not today. I was tired every day.

However, I didn't feel much itch when I was working while the job strain kept the sympathetic nerve active.
In contrast, I felt icthy when I went back home and relaxed.
The itch lasted all night.

The next day of the job, after I saw off my daughter, I had to take a long nap to recover until noon.
It was somewhat strange that I could take a deep sleep in the morning, while I was insomniac at night.
(I supposed that was because more cortisols (inner antistress hormone) were secreted in the morning than at night.)

It had to be a good chance to switch my daily cycle over from reversed to ordinary; going to bed early and wake up in the morning without long nap.

However, as my daughter entered a junior high school, her busy schedule built another obstacle.
She came back home very late (at 19:00-20:00) every day, so we had to take late dinner afterwards and sleep late, too.
She also had to get up early because the junior high school was far.
Therefore, I could not take enough sleep at night still and had to supplement the insufficient rest during the daytime.

The evolutional electric technologies changed our life to stay up late at night.
This might be another factor (though it was not an allergen) of increasing allergies.
Sleep disorder or sleep loss would deprive us of enough body power as well as confuse our autonomic nervous, hormonal and immune systems.

In other aspects, my body including the skin got better.

I got up early every day, took a bath to smooth my skin, lay in bed eating breakfast for about 1 hour and went for work (or sleep to noon).
The hardness of morningtime had decreased.
When I woke up, I no longer rushed to take a bath. I sometimes even could pass the morning bathing.
I felt itches or wheals here and there during and after bathing and soon after getting off from bed, but the intensity had decreased.

Moreover, there was another change.
Since my childhood, I had long been less sweating and poor circulated, but now I was not.
As I moved my body, I perspired properly.
Now my body rarely had a trouble in peripheral coldness. I was sometimes even told that my hands were warm !
My autonomic nervous system had surely improved.

My skin looked better.
Redness and scaling of my neck, hand and so on had lessened with smaller scratch marks.
As my face kept clearness since more than 10 years before, now with a high-necked long-sleeved T-shirt covering my neck and arms, I was no more obviously looked atopic.
"I did it !" I clenched my fists with joy in my mind.

Actually, I was not willing to express the joy.
Because it amounted a confess that I had surely been ashamed of my outward appearance due to AD.
Nevertheless, I could not deny that I was happy to be in good looks.

As a clinician to treat skin diseases, obvious skin diseases on myself autobmatically meant my incurability about them.
While I had been a young dermatologist, in one morning my eyelids had been much edematous with red scales when I had woken up. I had felt so depressive to see my patients that day.
In other time, I heard an AD patient I had treated saying, "That doctor also must be atopic, isn't she?"
It was not my fault, I knew it, but I could not help feeling ashamed of myself.

Dermatologists with beautiful skin were just lucky not to have their own skin diseases originally. It never meant they had cured their skin diseases.
However, people wanted to believe that doctors could cure any disease.
So dermatologists were expected to appear in front of their patients with perfect ideal skin.
Dermatological patients came to see their doctors to get some new beautiful skin instead of their present ill skin. They might be disappointed to see their doctors' ugly skin then.
Therefore, it was an undeniable fact that "one with beautiful skin would be a winner !".

I really felt it was heavy to have a disease.
The heaviness would never leave until the disease terminated.

I would talk about several general symptoms I wrote in chapter 6: "Unexpected Complaints".

First, postural hypotension.
I was about to conquer it.

Since I felt much less pain and twinge when I went out of bed, I could stand up and move more easily and act more.
Accordingly, the blood circulation balance would have improved and the hypotension symptoms faded away.
I didn't have most of symptoms any more, such as heaviness of my head and body when and after I stood up, fainting sense, mental irritation and stuffy nose.

Irritating bowel syndrome was also going soso.

I sometimes could eat, or wanted to eat cold foods or beverages.
Although there still were convulsive motions of digestive tracts with belches every day, no more severe constipation tormented me.

(After I started to work regularly, my bowel movements improved much.
Then 2 years have passed, now smaller belches occurred less frequently expect while I was tired due to tight schedules and I could have natural intestinal excretions of moderate hardness once in 1-3 days.)

I could perform more stamina.

Walking to commute, cycling for shopping and training chiropractic operations...I used my muscles in daily tasks now.
I also tried to continue habitual short-time muscle training once a week.

But I had anxiety about enjoying sports yet.
Though I could do a short exercise, tiredness and sudden itch prevented me to continue.
I was sad my body became dull, not endurable to hard exercises.

All too soon, I reached to middle age while just being busy with AD.
I noticed my aging several years before, by feeling a pain at my left knee when I got recovered to walk out after a long bedridden time.
Indeed, bodies would be rust away in idleness.
I should also take care of myself to avoid other diseases, such as metabolic ones.

Sure enough, obesity became another problem for me.
My body weight began to increase steadily after I restarted to work, according to the change of eating customs.
It was an adverse effect of the comeback.

As I went out frequently, I was shocked too much temptations to stimuate our appetite everywhere in town in Japan.
Sweet tasty foods full of fat and sugar overflowed here and there with so attractive commercialism.
To get along others, we also sometimes had to eat what we did not necessary want to eat.
As my daughter became older, she had her own choice, so I felt more difficulty to control her daily foods suitably.
I often could not overcome the sweet temptations after I worked all day long and got tired, .
And our dinner time was dragged into later at night after I came home when my job was finished...

Lots of factors took us into unwholesome eating habits leading to overweight.
I knew it was really a luxury worry who lived in a country with no starvation.
Despite my foolishness, I could not think and act as a saint.

I tried to choose foods of "magowa yasashii (*see below)" in Japanese.
Still, I also l preferred meat, dairy, fat and sweets and all our family member of course had each different tastes although within the same family.
And as I confessed, I rarely cooked after I restarted to work.
Because cooking severely damaged my hands and deprived me of much power for any other activities.

Though I lived with such numerous excuses, I still believed the value of my knowledges and thoughts.
I believed I could eat better than when I had been ignorant and careless.

* "magowa yasashii" indicated Japanese traditional food materials for good health by their first letter of words.
Mame = beans, goma = sesame, wakame = one of seaweeds, yasai = vegetables, sakana = fishes, shiitake = one of mushrooms and imo = potatoes kinds.
A recent shrewd advertisement added meats to it in their own way, saying "magoniwa yasashii" (meat is niku in Japanese).
Oh, we could not be too careful today to know the truth.

And I added a sequel of my previous unrefined rices story in chapter 10.
It ended after 4 years.

The reasons were...
First, unrefined rice was easily polluted by molds and small insects while being stocked.
Second, I noticed I felt my stomach full not because they were full of nutrition, but because of dyspepsia. (As unrefined foods had more structures including some bran or germs or so, they tended to be the cause of an indigestion as well as an allergy.)
And finally, my family consistently claimed more tasty white rice.

My intention for more natural foods did not fit today's lifestyle and backfired.
It was really tough to live healthy.

In fact, these lessened care about my foods never worsened my AD.
How about other worsening factors? Like stress?
About physical stressors and/or mental stressors.
Many AD patients aggravated their symptoms due to social stressors.
I had been worried of it, but I was quite OK.

To conquer business physical stresses, I was careful to take much sleep and avoid excess work.

Mental stresses did not annoy me unexpectedly, I always felt them suitable.
Though any people told and did anything to me, I saw them calmly just saying oops in my mind, with no anger.
This was the first feeling in my life.
Maybe, this hard decade grew me up quite considerate.
And as I was just happy to be able to work in contact with other people, I was away from grumbles.

I seldom needed medications.
No oral antihistamines or antiallergics.
Just to my dry hands skin (and feet one in winter), I applied moisturizers (petroleum or vitamin A ointments) frequently. I needed none in other areas.

Especially the abdominal sides of fingers and the dorsal side of wrists often got dry and itchy.
I thought it might because I had to wash my hands many times in my work and I washed my body by my hands, avoiding a hard towel.
I had no another choice.

My feet eczema was exacerbated awfully in that winter.
It was so tough that I could not bear without applying topical corticosteroids (betamethasone valerate 0.12% ointment) 2 times.
Those were the single episode I used corticosteroids after I went through the critical deterioration of AD since I was a 31-year-old lady.

Other treatments for my AD were chiropractic once in 1-2 months and frequent NAET(Nambudripad's allergy elimination technique) I talked about in the last chapter that they diagnosed my allergic conditions about foods and so on.
Though NAET needed plenty of sessions and difficult to assess (some people labeled it as a hoax), after many twists and turns, it seemed to contribute certain improvement of my skin, intestinal and bladder conditions.

Now, the first winter for me to work again, severe dryness of the skin rather tormented me.
Every morning it was really hard getting up out of bed for work.
In fact, my skin was worse than anyone I treat in my dermatologic clinic (laugh).
But I could continue.
I started my work by 2 times a week, then after 6 months' warm up 3 times a week, but I never missed my work except once when my daughter got ill.
Sometimes I also could go to dermatologic annual meetings for study.

In the first working year, when I came back home after working, then and there itch spell broke out which often defeated me preventing from any housework to do and I just went to bed to rest.
Gradually, I could do more housekeeping.

From the morning to the evening, I was almost free from strong itch.
The itch was almost small, for example a place scratched during the night felt achy in the morning, 1 or 2 wheals appeared occasionally or dry areas were felt itchy when I got relaxed.
Those itches could be expelled by several scratch.

After the dinner before bed time, severe itch came to my arms, legs and trunk every day.
When I was in bed, all over my body except the face and head were full of itch.
I scratched and scratched for 30 to 60 minutes until I fell asleep.
However, I got awake within 2 hours with itch again.
I was awake more than 3 times a night, when somehow I also felt a need to urinate, which made me more insomniac.
Itchy areas were touched as multiple wheals but in the morning they were gone.
Sometimes I felt a desire to scream because of too much itch !
In some nights, I actually screamed in a small voice (not to wake up my family).
For all that, I could wake up in the morning fairly refreshed.

I was still in some torment.
However, I was much happier and content than the past decade.

As I daily went to hospital, I began checking my blood test again.
At the point after 1.5 year since I restarted to work, my blood data was as below.
IgE : 1800 IU/ml (normal range;170>), eosinophils : 5.2% (0.0-8.0), LDH : 213 IU/l (120-240)
All of those scores were reduced.
I had never dreamed of the day when the eosinophils score once critically raised got back into within normal limit like this.
Those objective scores proved that my AD surely had improved.
(The counts somewhat increased again in winter, but maintained better scores than the past days.)

Slowly and gradually, my skin had been changing more moisturized, smoother, less red toward normal skin.
Now, after 2 years since I restarted to work, as dryness and wrinkles of my neck skin fairly reduced and my wrist skin also improved, I was not bothered much to hide them from my patients' eyes.
Scales fallen on the floor of my house also so reduced in quantum and size (to less than 1mm) that frequent cleaning was not needed any more.

I should make more efforts to cure myself.
Because I would not have enough power to cure others provided I was deeply sick.
And, continuously seeking a way to cure severe AD patients or serious allergic patients without relying on topical corticosteroids, I myself wanted to be a proof who had recovered from a definitely severe AD.

......Thirteen years and eight months have passed since the aggravation.

to next chapter : WORKING
to previous chapter : BACK TO NORMAL SKIN COLOR

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