Poison Oak and Treatments

A few months ago after a 100 mile bike ride I had poison oak rash for the first time in my life. I've brushed into a plant either on the bike or on my 'brick' trail run. Luckily it was just a few blisters and it helped to just get me acquainted with this scourge. Two weeks ago I got another reintroduction, this time it was a pretty bad rash at too many places. I've never treated poison oak before so this was another good exercise of patience and skill.

If I had at least known I had touched poison oak or ivy, I might have limited the spread. I never quite figured out how and when I got it, so I didn't do any of the immediate steps below. (My wildest theory - from handling my tomato plants that keep getting eaten by dears.  Dears might be carrying plenty of urushiol from poison ivy or oak on their fur).

Poison Oak Treatment Plan:

1. Remove as soon as possible as much allergen as possible before rash
   - Use cold water right away to wash off and close pores to reduce skin penetration  (within first two hours)
   - Use alcohol pads to remove some more oil and dry out skin
   + Do not put on the same clothes without washing.
   
   Obviously you need to see a doctor if the rash is systemic and not just on skin!
   
2. Otherwise home treatment of rash is patience and
   - Either try to leave it alone and bear it for the next 2 weeks.  Try meditation ;)
   + Hot water treatment helps - itching is all but unbearable at first,
   keep under hot water until it feels better, and then you are out of histamine for 4-6 hours of relief
   + Drugs: antihistamines, take orally to control dosage.
    I am comfortable with alternating hot water and Diphenhydramine (Benadryl):
      Start just at night for first 3 days, and then twice daily 1x25mg.  See more below.
   - Avoid sprays and creams - it is too easy to overdo antihistamines
   - Avoid hydrocortisone - in a cream it was almost ineffective, worse keeps the skin moist
   - Maybe try calamine lotion - soothing and drying effects should help, especially if blisters are bad.
        Calamine worked well when I got chicken pox (at 25!), but I didn't try it this time.

Antihistamines, Pros and Cons

Overall, for poison oak, I'll stick to Diphenhydramine. Mainly since Diphenhydramine is an old, well tested antihistamine and has no known long term use side effects.  I still don't like drugs affecting the central nervous sytem and Diphenhydramine readily crosses the blood-brain barrier.  Potential drowsiness and concentration impact makes its use best left for just before going to bed or midday in the office ;)  Good news that after 3 days tolerance against its sedation effects is built up[1]

Cetirizine (Zyrtec) might be a better newer choice for other longer period antihistamine needs as it is less drowsy, single daily dose.  Some other antihistamines don't mix well with some antibiotics.

   * DUI potential.  Blood levels would be minimal at the standard Diphenhydramine dose, but definitely
   + Don't mix with alcohol!

   * Import restrictions.  Good to keep in mind it is strictly prescription in Russia as an opiate base, and banned in Zambia.  In my travel medkit I have some Diphen, and I didn't even think about it for the trip to Singapore and Indonesia.
  + Hopefully just a few tablets will not get me in trouble.  Don't keep much of this on you or at home.

   * Overdose: Finally and very sadly, an MIT friend succeeded at committing suicide with Benadryl.
     Please talk to somebody, even if you intent to just ask how much it takes. Hopefully, you will find many reasons to live instead!

Shark territory practice swim

On conquering our fears

Shark advice: know where, when and with whom you're getting in the water. If you feel safe about it, check out your fears at the beach. There is really no point in thinking about sharks while swimming in shark territory. Of course, it's easy to give advice out of the water.
Don't read this if you aren't afraid of sharks.

Sunday, October 11, Santa Cruz, Cowells Cove

While waiting for everyone to gather for our triathlon practice at Santa Cruz, somebody mentioned that last week there were two shark sightings a few miles south. Sharks don't scare me. I even joked with Lara, who had forgotten her earplugs, that on the positive side she'll better hear us screaming 'Shark!' :)

I've surfed where we are swimming today, and one of my favorite surfing spots is just a little further South. I know enough about sharks to not worry about it too much: we were not a river mouth, it is a cove; it is too shallow for a great white shark; it's a very popular surfing spot, and I don't think sharks have ever attacked here; really, it should be fine.
Fifteen minutes later, I realize I know too much.

It was a chilly morning and the water temperature was warmer than the air temperature. It was time to go in. After the usual initial shock of the cold water, swimming was feeling great. That is until thinking started getting in the way.

"Entering murky waters - that's shark's favorite hunting ground!"
"And we just had a sea lion passing... uh oh! "
Looking around I don't see any sharks, "yet".

"What time are sharks having breakfast?"
"It is well past dawn, so it isn't the usual dusk&dawn risk time..."

"Sea lions are OK - they bark but they don't bite, right?."
"Why are the sea lions barking?"
"Are they barking 'Shark! Shark!'?"

"I have just this soft wetsuit I am too vulnerable without the safety of a surfboard underbelly."
"That's illusory - sharks bite off the legs anyways, so it's really not any different."
"I'm sure the only sharks around here are in my head! Get them out!"

"What was that touching my foot?! "
Just the guy behind me - too much thinking has slowed me down.

"Oh well, I can't see anything anymore through my goggles, why worry anyways? "
"Just keep swimming..."

"Hmm, I can't see sharks, but they can smell me!"
"Nobody has been attacked here, neither surfers nor swimmers."
"You can always be the first!"

"Don't flail" (attracts sharks).
"Just make full powerful strokes, good..."

"Good I am not ahead of the pack."
"But they attack from behind, I shouldn't be last either!"
"Really it doesn't matter, they do come from below."
"Fine then, just swim! Breathe out, pull in, keep kicking..."

The guy on my right seems to be slowing down and is looking around.
He is an ex-lifeguard and isn't wearing a wetsuit.
I ask "Are you OK? Are you cold?" he said "No, water is just fine...".

"Hmm, I am not the only one thinking about darn sharks."
"We're farthest out to the right from the pack, and he does look juicy..."
"On second thought, sharks aren't out for humans,
they are out for seals and sea lions. And he's not that fat :)"

"Mark, without a wet suit you are better off!
I do look more like a sea lion in mine - I will be first!"
We chuckle, and keep swimming.
Swimming next to a buddy makes it all feel a lot safer and easier.
"What was that white thing by the buoy? Was that a dorsal fin?
"No, just Lu turning back."
We should ban white swim caps to not scare others..."
Actually, bright contrasting colors are known to attract sharks.
"Maybe I shouldn't be wearing a red swimcap!"

"Anyways, just turn around, stop thinking, and focus on swimming, dude!
Swim to the beach as fast as you can,
kick vigoruously at the end,
and run to the bike."

I've won many contests before (though programming contests ;)
and I do know how staying fully focused makes champions.
Sometimes our mind gets too much in the way.

Good this was just a practice. On race day, the main danger is from fellow triathlete's thrashing elbows. Next weekend, we are back at Santa Cruz for another practice. I should try to get sharks out of my mind. Now I do need to work on my technique at the lagoon back home. The jellyfish there don't scare me, really!