Itching ...?

Hey all,

I found this forum after searching for a general support group. I'm 24 and have PSC and mildly active UC. For months now, I've been itching like crazy. Sometimes it's not so bad -- just a "regular" itch ... but I've noticed I get more itchy at night. Sometimes it literally wakes me up during the night -- and more frequently I'm itching during the day. I'm not overweight by any means, but I do snack a bit too much -- I'm working on cutting out excessive carbs and caffeine, etc. as I've noticed too many carbs make the itching worse.

Anyone have any suggestions for diet or medications that have worked for itching? My doctor put me on Hydroxyzine Hcl and it worked for a while, but then it seemed I grew immune to it rather quickly so I didn't have my prescription refilled. I want to avoid just constant increasing of drug dosage.

Thanks! :)

Hi Stacy-

My Dr. put me on Cholestyramine for the itching. I had tried two others before this one and this one works as long as I remember to take it. It's a powder and you mix it with a drink. It's orange flavor (at least mine is) and I mix it with a small glass of cranberry juice twice a day. But it can be mixed with any non-carbonated fluid. Unfortunately it does not 'dissolve' so it's kind of like drinking something with sand in it. But it does work. Ask your doc about it.

Hope this helps,

Sarah

Hi,

I think the current standard medication for treatment is Ursodiol. Ask your doctor about it. Hope this helps.

Colleen

Hi Stacy. I’m 26 and have been living with stage 4 PSC since college. The itching was so bad for me at some points that I would make myself bleed. I have a really excellent doctor who prescribed Rifampin for the itching. Hydroxyzine is good for minor itching, but its only an anxiety drug, so it relaxes you to keep u from itching. Rifampin is a drug used to treat tuberculosis (so u might get some crazy looks at the pharmacy) but it has been a miracle for me. I rarely itch for 3 years strong. It’s a little “outside the box” to take a TB medicine, but ask your doc about Rifampin.

Let me know if this works for you and best of luck.

Hi Stacy

Yes I was on Cholestryramine for a short while and it helped with in hours I was able to go off it when they replaced my blocked stent,,there were no side effects with this drug,,it tastes awe-full but soooo worth it,,,my specialist recommended I not get a liver biopsy because he is concerned about triggering a infection its not the best way of staging the disease properly he and the other specialist use how I am feeling and my blood work to determine the next step,,,,, I may be seeing the transplant team in Vancouver Canada this coming spring does anyone know what I should ask them??? any info would be appreciated thanks

cathy

TO: Joseph: I itch like crazy too and wake up a few nights a week itching sooo bad. My doctor prescribed neltronxe for itching...This drug is used for people going thru drug or alchol withdrawal. Unfortunately, I take an axiety medication for sleep so I notice the two are not working well together. He also prescribed Rifampin for me several months ago but I'm so afraid of the side effects. The montly blood work, the orange tears and so on, please tell me this really did work for you. I've done so much research on this drug and came up with nothing. Hoping you can shed some more light and maybe I will try taking it. I can't live like this anymore....thanks

Hey all -- thanks for your advice. I went to a new GI doctor recently and he prescribed me Rifampin -- but I, too, am worried about the side effects. Not to be superficial -- but my career is in Marketing (ironically) for a hospital and I never know when I'm going to need to be "in the spotlight" for various reasons -- I very well can't go walking around being orange and I'm a budget person who won't ruin clothes because I'm sweating orange. I've tried epsom salt and oatmeal baths -- they seem to help when the itching is really bad.

I have another question for you all. I've noticed in some discussions that people categorize their "stage" of the disease. I've never had this mentioned to me. Can anyone explain the different stages -- Stage 4 someone mentioned -- or where I could find this information? I know that when I had my last liver biopsy (probably 5 years ago now) I was ranked at a 3 on the 0 - 6 scar tissue scale. But I was also a 3 in 2001 and the doctors somehow forgot to mention that ...

Thanks for your input! I'm glad I found this group. I realize I'm literally teetering on the brink of a transplant / death each day (oddly enough it's good motivation to live each day to the fullest!) -- but it's comforting to know that there are others out there who truly understand what it feels like -- physically and emotionally.

Many prayers and blessings to all of you for a healthy 2012!

Deb/Stacy,

I was literally itching to the point of making myself bleed before my doctor prescribed (and I took) Rifampin. I personally have not had the effect of orange tears/sweat and I play soccer a couple times per week, so I would REALLY notice orange sweat on a white jersey (but my urine is definitely very much darker now). Everyone is different, so I can't know if you would have the orange tears/sweat or not. In my case, the possible costs/side effects outweighed the benefits because my itching was the definition of "unbearable".

All in all, I do highly recommend trying Rifampin and think you should at least see if it stops your itching and if you sweat/tear orange.

As for the stages, Stacy, I had a liver biopsy, they sent the samples to the Mayo Clinic and Mayo sent back a report calling it stage 4 PSC. From what I read, it's stage 0 through stage 4, but it's interesting that you had a 0 to 6 scale. Wonder if different hospitals/organizations have different scales?

Happy New Year to everyone!

Thanks, Joe.

I was told that the rating for scar tissue is 0 to 6 (in general, all types of scar tissue -- 4 meaning cirrosis). But I just read online that liver disease has 4 stages.

I may try the Rifampin I was prescribed as I'm getting to that "unbearable" stage with the itching. Maybe I'll try it over a weekend in case I start to turn orange!

Thanks for the information! :)

Hello Stacey,

Cholestyramine powder, orange flavor (Rx), mixed in water (yich!) helps. Sarna is a lotion that helps. It is OTC. Not every drug store carries it. A friend, who has had his liver transplant, took a shower at lunch time. It helped. He had severe itching. Benadryl OTC helps me. I only take it at night because it makes me real sleepy. Need to be alert during the day. If you scratch in your sleep, wear soft cotton gloves so you don’t scratch yourself bloody. Itching is a royal pain in the tosh! Another medication to remember to take, lotion to put on, etc. But, it’s better than scratching in public like you have fleas! God bless and good luck.

Hi Stacey and Joe,

I believe the rating scale you are discussing is about cirrhosis, not really PSC. Cirrhosis of the liver is ranked in fourths. Stage I is very mild, progressively getting worse in Stage II, Stage III and reaching its worst in End-stage IV. That is where I am. I appear relatively symptom free to most people, but PSC has really taken a toll on me since 2000. Someone with Stage II could be more symptomatic and in worse shape than a Stage IV. Go figure? Stages tell the amount of cirrhosis you have, not how bad your daily health is. Any stage is serious and you should be seeing a hepatologist for care. Hang in there.



Stacy said:

Thanks, Joe.

I was told that the rating for scar tissue is 0 to 6 (in general, all types of scar tissue -- 4 meaning cirrosis). But I just read online that liver disease has 4 stages.

I may try the Rifampin I was prescribed as I'm getting to that "unbearable" stage with the itching. Maybe I'll try it over a weekend in case I start to turn orange!

Thanks for the information! :)

What stage would I be at if I have lost about 20 lbs in the last 7 months weight continues to come off no matter what I eat. I was diagnosed thru MRI in November.

Hi Theresa,

Unfortunately I don't have an answer to your question. I'm still trying to figure out my stage. Hopefully your doctor can provide some insight.

I apologize to all for all my questions! Although I've been diagnosed for 4 years now -- I'm just not starting to be more open about having the disease -- not that I hide it from people, I just talk very "matter of fact" about it like it's ordinary to avoid pity stares and always being asked "how are you feeling".

I have found that this disease has a huge emotional burden and just wonder how all of you deal with it on a daily basis. I try to tell myself daily that "hey you're alive today -- make it great" -- but sometimes it's just frustrating beyond all reason and I've had my share of (private) emotional breakdowns.

One of my issues is that I have a rare form of folliculitis (inflamation of the hair follicles) -- so since about age 13 (2000) I've had random lesions and so forth on my arms and legs (very difficult to hide -- and people do stare on occasion). I had it under control for a while but it seems I get zit-like bumps on my skin which eventually turn into scabs. I was told by my doctor that due to the PSC my body's ability to heal is greatly reduced. So, while it may take a "normal" person a week for a cut to heal -- it will take me several months. Does anyone have any suggestions? I've tried neosporin and bandaids, lotions, creams, etc -- nothing seems to work consistently. I'm not sure if this is a normal issue with PSC -- but I had UC so bad that lesions were erupting on my skin and now they're just annoying. Plus the itching doesn't help as I find myself ripping open scabs during the night when I wake up itchy.

Thanks again for all your help and insight!

Stacy

The doctors were able to tell me what stage I had from a liver biopsy. This is an out patient procedure where they do a needle biopsy through the front right side of your abdomen. They extract a small sample of you liver and a pathologist examines it. They might be able to do the same with an MRI. I really don’t know about that. If you are losing weight that fast and cannot stop no matter what you eat or how much (and that happened to me last spring) you need your hepatologist to look into it. I went from 167 to 146. I have regained about 14 pounds, but started retaining fluids which I estimate at 7 pounds.

There are several causes for PSC weight loss. Be sure you are going to a hepatologist who has experience and knowledge about PSC. Many do not, because it is so rare. They refer to medical textbooks and professional journal articles. I was in an emergency room with liver failure and not one of the doctors knew anything about PSC. Another time I was hospitalized with c-diff infection of the bile ducts and the on duty gastroenterologist said his medical professor said he would never see a PSC case in his professional lifetime. That’s how rare this disease is. Don’t be afraid to get a second opinion if you think the doctor is winging it.



Theresa said:

What stage would I be at if I have lost about 20 lbs in the last 7 months weight continues to come off no matter what I eat. I was diagnosed thru MRI in November.

Stacey,
Do not feel shamed that you have PSC. My arms and hands are easily bruised and cut. It takes much longer to heal because of PSC. You have less red platelets to clot bleeding. (building block for new cell generation) normally form around a wound to help it heal, but with PSC that process is reduced. Washing washes the leukosites out of the wound further delaying healing. It is painful, both physically and emotionally.

I’m a teacher. When I learned I had PSC, I decided to go public and tell people about it so that they understood. I say it is a degenerative liver disease of unknown origin. I tell them it causes cirrhosis but is not caused by alcoholism. It has no known cure except a transplant. I have lived with it a long time and never get a high enough MELD score to qualify for a cadaver liver transplant. People are supportive and compassionate. I don’t ask for or want their sympathy. I just want them to be informed.

I force myself to be normal and active. Neighbors and friends notice the muscle wasting and fatigue in my eyes, but I don’t give up. I tell them if they want to do something positive go an sign up at the DMV to be an organ donor. I’m not above asking for help if I’m not strong enough to do a job in the yard. My doctor does not want me to drive any more because I have become so impared. People around me have offered to drive me places. Occasionally, I have taken them up on that offer. I do drive, but I stay local. My wife drives me if I need to go places further away.

Don’t be embarrassed or ashamed of your looks. You are a whole person. You are what you are. Like you said, be grateful for the day and let people see your enthusiasm for life. They respect courage in the face of adversity. As bad as this disease is, it can make you a stronger person, someone who is admired for you fortitude, so don’t let it get you down.
I went through the period of worrying about my fate. I could not get early death out of my head. I was angry that this disease happened to me. Then one day after months of that, I said “the hell with this. I’m going to stop my fearful thinking and stop feeling sorry for myself.”. Accept what is, but don’t give into it. My life and physical state got better immediately. For me, that’s the only way to go. Who cares what other people think. I don’t hide it, nor do I care if they pity me. I’m not looking for that. I don’t like it, but that is the way some people are. So what!. If you are living near a transplant hospital, ask your doctor for a referral there so they can answer questions about changes you are experiencing and what the future holds in store. Chance are they will dodge the latter. But, they will get to know you and get you enrolled in the transplant program when that time comes.

Cirrhosis stages are not all that important. I went to a PSCPartners conference and met others with PSC for the first time in my life. We were all falling asleep and eating like birds.it was funny in a sick humor kind of way. Finally, I felt I was not alone. www.pscpartners.org I met a young man with Stage II and he was in worse shape than me with Stage IV. I have a MELD score of 16. My PSC friend had a score of 8. Physically, we were in about the same shape. He got a live donor transplant 8 weeks ago and looks good. He immediately felt his energy come back. He has a normal appetite and he can now sleep without the need for sleeping pills.

I wish you the very best. Do not ignore the spiritual you and accept that your emotional ups and downs are normal with chronic diseases. I have them. I know it, but I try not to stay down in the valley of darkness too long. Find something to be grateful for each day. It tunes up your thinking. God bless you. I’ll keep,you in my prayers if that is all right with you.




Stacy said:

Hi Theresa,

Unfortunately I don’t have an answer to your question. I’m still trying to figure out my stage. Hopefully your doctor can provide some insight.

I apologize to all for all my questions! Although I’ve been diagnosed for 4 years now – I’m just not starting to be more open about having the disease – not that I hide it from people, I just talk very “matter of fact” about it like it’s ordinary to avoid pity stares and always being asked “how are you feeling”.

I have found that this disease has a huge emotional burden and just wonder how all of you deal with it on a daily basis. I try to tell myself daily that “hey you’re alive today – make it great” – but sometimes it’s just frustrating beyond all reason and I’ve had my share of (private) emotional breakdowns.

One of my issues is that I have a rare form of folliculitis (inflamation of the hair follicles) – so since about age 13 (2000) I’ve had random lesions and so forth on my arms and legs (very difficult to hide – and people do stare on occasion). I had it under control for a while but it seems I get zit-like bumps on my skin which eventually turn into scabs. I was told by my doctor that due to the PSC my body’s ability to heal is greatly reduced. So, while it may take a “normal” person a week for a cut to heal – it will take me several months. Does anyone have any suggestions? I’ve tried neosporin and bandaids, lotions, creams, etc – nothing seems to work consistently. I’m not sure if this is a normal issue with PSC – but I had UC so bad that lesions were erupting on my skin and now they’re just annoying. Plus the itching doesn’t help as I find myself ripping open scabs during the night when I wake up itchy.

Thanks again for all your help and insight!

Stacy

Cover a cut with a Nexcare clear plastic bandage. It is the toughest bandage I have found. It won’t was off or peel from oily skin. Change it after a week. I heal a cut this way in about 10 days. Nexcare bandages are a little hard to find. Thy several pharmacies. Around me, Osco Drug has them.

I was on Rifampin for a while. It did not make a big difference to me. I had mild itching. The doctor changed me to Cholestyramine powder. It has few side effects and is non-addictive. It stopped my itching.

Paul Hain said:

Hi Stacey and Joe,

I believe the rating scale you are discussing is about cirrhosis, not really PSC. Cirrhosis of the liver is ranked in fourths. Stage I is very mild, progressively getting worse in Stage II, Stage III and reaching its worst in End-stage IV. That is where I am. I appear relatively symptom free to most people, but PSC has really taken a toll on me since 2000. Someone with Stage II could be more symptomatic and in worse shape than a Stage IV. Go figure? Stages tell the amount of cirrhosis you have, not how bad your daily health is. Any stage is serious and you should be seeing a hepatologist for care. Hang in there.



Stacy said:

Thanks, Joe.

I was told that the rating for scar tissue is 0 to 6 (in general, all types of scar tissue -- 4 meaning cirrosis). But I just read online that liver disease has 4 stages.

I may try the Rifampin I was prescribed as I'm getting to that "unbearable" stage with the itching. Maybe I'll try it over a weekend in case I start to turn orange!

Thanks for the information! :)

Hi Paul,

Thanks so much for your kind and inspiring words. I appreciate your insight and positive outlook on life. I'm known for being the overly positive person so I like to keep that going. I have my meltdowns in private! haha

Thanks also for your prayers -- I'll keep you in mine. :)

Best wishes to you and prayers for improved health.

Stacy

Hey all,

Another question for you -- I'm on a roll with these, huh? :)

After my cuts and wounds heal (arms and legs) ... I'm left with discoloration of my skin. Spots of my legs literally look like I have lepracy. Has anyone found anything that works to lighten skin tone -- or does no one else have this problem? I've tried creams, lotions, gels, pills -- everything. Even baking soda. I can't find anything that works. I used the ProActiv skin lightening lotion for a while ... but it's not strong enough to cover such a big area -- it's made just for someone's face.

Thanks! :) I appreciate you all sharing your information and experiences with me.

Stacy

My discoloration was white on a white guy. The wounds healed, but my normal color never returned. It is much more important for a woman than a man to get those blochies cleared up. I understand your concern. Maybe, a dermatologist could help.



Keep being positive about life and yourself as PSC presents more issues. I have had PSC for 12 years. It’s nothing new to me. There is no such thing as a stupid or silly question. Bloggers on this site are knowledgeable and helpful, so ask whatever.

Anyone with a serious, chronic disease that says they are never depressed are lying or they don’t recognize it for what it is. You are in good territory if you can have more up than down days.

Peace. Confidence.



Paul