Free advice and a shot of attitude for what ails you
Dear Know-It-All, Scratching my dry, itchy skin round the clock is driving me nuts. I’ve been checked, cultured and biopsied by an HIV-knowledgeable dermatologist who found no infection and said it was “just HIV.” I want to scream. Help! —Bitch of an Itch
DEAR BITCH, Knowledgeable is good, but this nurse is better. “Just HIV” is the typical doctor default when they run out of tests. And that’s when I step in. Dry skin? No problem. These four steps should help stop the itchin’ and bitchin’:
1. Chug-a-lug. Pretend you’re Liza at Studio—but stick to healthful fluids like juices and spring water. Remember this simple formula: Divide your body weight (pounds) in half, and then down that many ounces daily (160 lbs/2=80 oz=10 cups). And lattes and liquor don’t count—caffeine and alcohol dehydrate.
2. Steam up the windows. Buy a humidifier—and make sure you treat the water every time to prevent the growth of all airborne nasties. This is especially useful if you live in a dry climate or have a heating or cooling system that sucks moisture out of the air.
3. Suck up fatty acids. The double whammy of poor digestion and malabsorption creates a fatty-acid deficiency in many HIVers, which contributes mightily to parched skin. Improving digestion with pancreatic enzymes (a multi-enzyme formula containing lipase, the fat digester; take one to three with each meal) and glutamine (to improve absorption; needs vary, but 5 to 10 grams a day are not unheard of) can help get food’s fatty acids into the body. Another tip: Flaxseed oil (one to three capsules with every meal) will also help provide fatty acids to your skin.
4. Become a bathing beauty. Check the labels of your soap, lotion and other bath products for these no-no’s: lanolin and other preservatives (cause allergies), alcohol, glycerine, sodium laurel sulfate, propylene glycol and talc. Stick to mild body cleansers—unscented and hypoallergenic. Try a colloidal oatmeal formula like Aveeno. Or use soap only under the arms and in the crotch/anal area, avoiding the legs, arms or torso.
Avoid very hot water—it reddens and dries the skin, washing away natural oils that hold in skin juices. Add oil to your bath (avocado or sunflower are divine). Remember Cindy, Naomi and Christy’s mantra: Moisturize, moisturize, moisturize. Slather on lots of lotion before bed.
Look for products that contain lactic acid or ammonium lactate. They dissolve old skin cells, help new ones bind together, and penetrate better. There are numerous over-the-counter offerings such as AmLactin. POZ’s own Stephen Gendin recommends Eucerin (see "The Seven-Year Itch"). I see many steamy, itch-free nights ahead.
Dear Nurse, Eating is hell because of a new sore spot in my mouth. My doc says any number of different infections or conditions could be the culprit, but my appointment is two weeks away. What can I do to keep from starving till then? —Tongue in Cheek
DEAR TONGUE, Starving is not an option. Turn the volume down on your imagination and up on common sense. First, run from all that crunchy, salty bar food—pretzels, chips, tortillas, etc. Before you put anything in your mouth, put it through my trusty CHAPPS test. Is it...Carbonated? Hot? Acidic? Pickled? Peppery? Spicy?
Take mama’s pasta and marinara sauce, for example. Pasta is soft, right? But if those acidic tomatoes don’t get you, the spicy oregano will. Better to pick your foods the way Cher picks her men: soft and smooth. Put these items on your list: Oatmeal, creamy soups, scrambled eggs, soft fruits, canned fruits (nonacidic), mashed potatoes or bananas and macaroni and cheese, and the exciting cottage cheese (but beware these last two if you’re lactose intolerant).
Dig out the food processor you got as a house-warming gift. Do-it-yourself spin cycles can turn almost any combo of foods into a tasty, nutritious drink. Hot tip: Use a straw to avoid the sore spot.
Also, lube up foods by adding gravies or sauces to meats, grains or veggies may help them slide down. Dunk toast, crackers, cookies or bread in warm (not hot!) tea or soup.
Here’s the inside scoop: baby food. The yuppie baby-boom revolutionized the industry. Now you can dine like little Lourdes herself on “Spring vegetables and pasta” or “Country chicken and sweet potatoes.”
Ask your friendly pharmacist to point you toward over-the-counter products that contain benzocaine, like gels Ambesol and Zilactin, or Chloraseptic, a wash or spray. Tetracaine-containing products like Cepacol Viractin, a gel, are also good, as are Amoscan, a powder you mix with H2O and rinse, and the gel Gyloxide.
Last but not least, swallowing pills with soft foods can help the meds go down, but talk to your physician. Some regimens demand an empty stomach and have other food restrictions you need to make a note of. To paraphrase the sage Auntie Mame, life’s a banquet, and only fools starve. So don’t be a fool, Tongue. Bon appetit.
This column offers self-help for nagging health problems. Send your own complaints to Nurse Know-It-All at 349 W. 12th St., New York, NY 10014, or e-mail at firstname.lastname@example.org. Lark Lands and other experts supplied the answers; POZ editors the attitude.