Response to intensive 3 months of prednisone treatment for AA

My response to three months of prednisone treatment for Alopecia areata. (As posted on Alopecia World website)



I am going to voice my opinion as brief as possible into three aspect Physiologically, Philosophically & Psychologically. I'm into veterinary medicine and we even use prednisone for animals but never longer than 7 days. However, I need more specification/ details in term of the dosage of prednisone and the route of administration. However, my response is based on the recommended prednisone dosage being used over this three months of treatment (given systemically).

The physiological aspect:

Side effects of Prednisone:
Major
1. Risk of developing diabetes
2. Weight gain (also increased risk of Cushing's syndrome- hyperadrenocortism)
3. Facial swelling / ascites/ edematous
4. Depression, euphoria, or behavioral changes
5. Fatigue or lethargic
6. Vision impairment
7. Ulcers / Mouth sores
8. Osteoporosis
9. Insomnia
10. Joints & abdominal pain
11. Cataracts
12. Anxiety
13. Blood vessels diseases

Minor
1. Rash
2. Diarrhea
3. Frequent urination

In short, I am strongly against the use of Prednisone for more than 7 days as recommended for the treatment of Alopecia areata and what more for 3 months. ( Again, very dosage dependent)

The philosophical aspect:
One must set priority right, naturally and normally in our body as designed by God. Hair is just a part of the body, when we are compromising the conditions of other major organs and vital organs and the IMMUNE SYSTEM in the sake of getting our hair back, I seriously urge people to re-examine their thoughts and decision. The compromises made would probably led to one the side effects mentioned above (Under recommendation, the use of prednisone is not more than 7 days or give and take 14 days). Three months is almost 12 folds higher. One must be compromising their quality of life and even their LIFE if agree to be subjected to the treatment regime. In short, it is philosophically unwise when one opt to regain a non-vital part of the body by compromising other vital organs and even LIFE itself!

The psychological aspect:It would be thrilling and exciting to have my hair back. It would be perfect and awesomely great if I can have my hair back just with a simple faith without compromising my quality of life and my loved ones around me. I have been living with AA for more than 20 years and with AU for more than 6 years. I would definitely sacrifice alot for my hair to grow back as long as my sacrifices are practical, logical and sensible (i.e the more people I help, the more hair I get...etc) In short, our psychology needs to grow through proper thoughts and knowledge together with practicality and wisdom.

AT THE END I STRONGLY OPPOSE TO THE ABOVE TREATMENT REGIME & WOULD NEVER RECOMMEND IT TO ANYONE EVEN IF THE TREATMENT CAN WORK 100% EFFECTIVELY.

I couldn't read all the response to this discussion but I have read that some are willing to take this kind of treatment regime and some are trying for more than a few weeks already. I would like to add that some are taking calcium supplements to prevent the side effects of having osteoporosis while treating alopecia with long-duration of prednisone. Let me remind everyone to remember the amount of burden one is putting on the kidney. Kidney has to work extra hard for drug elimination and calcium mineral. The liver has to work extra hard for drug metabolism. The heart has to work extra hard due to the increase of blood viscosity due to the effect of drug, calcium supplements together with the ongoing comprimising of liver and kidney.

AGAIN, I AM STRONGLY AGAINST THE USE OF PREDNISONE FOR MORE THAN ONE MONTH (INJECTABLE into the body system) /TWO MONTHS (ORALLY) FOR THE TREATMENT OF ALOPECIA AREATA. * Local subcutaneous injection on the scalp are still acceptable once every two months (three times = six months)

SOME MAY DISAGREE WITH ME BUT THIS IS TOTALLY MY OWN OPINION. NO INTENTION TO OFFEND ANYONE. THANK YOU.

Joshua

Easter Day reflection

Hi,

I know it's more than a week since Easter but nevertheless the Lord is still risen, aren't he? Here's some youtube reflection that I would like to share.

Hope everyone had a blessed Easter. Praise the Lord.

Joshua

At the cross...

Holy Thursday reflection

As the christian calendar marks today as the Holy Thursday with several significant occasions, it was the official starting of the passion of Christ when he was betrayed into the hands of those who wanted him to be killed.

Christ knew what was going to happen to him and felt the intense burden and heartache that he had on his shoulder when he prayed to Heavenly Father in Gethsemane. If we were to go back to that particularly time, knowing that he is Christ...what would be our reaction? Run away or fight for him? It was not for us to decide.

Let us all, christians (and non-christians) reflect on the beginning of this historical event that transcended across our physical realm of time and matter.

Let us reflect on the creator of heaven and earth that call us his friends on this special night:

WHAT A FRIEND WE HAVE IN JESUS



Now, let us focus our spirit and mind on Christ who loved us so much...

TURN YOUR EYES UPON JESUS

*This series of blog is specially dedicated to people of all faiths (including atheist, agnostics), as all us learn about each others' different faith and so at the end of the day, we respect other people's choice without being judgemental and narrow-minded.

*However, this blog is not for discussion or debate forum for inter-faith matters.

* I just wanted people to know what Christianity is all about, just as how much I am learning about others' faith and thus respecting their belief.

* Hope all is greatly inspired and to christians, hope you find strength in your faith again.

Joshua

Wouldn't the T-lymphocytes around the hair follicle die?

Hello,

I receive a question that what if the excessive T-lymphocytes around the hair follicles of a patient with Alopecia areata dies or will they live forever?

We're alive today because our body is alive, our tissues are alive and so does our cells (We're living organism because we're composed of living cells)

Yes, eventually all cells have to die however the life span of each type of cell varies. (Normally our red blood cells live about 120 days, they lost their membrane integrity due to wear and tear, and eventually destroyed by the spleen.)

T-lymphocytes also have its life-span. In human, the T-lymphocytes (Special/ specific Soldier) can survive between 3 to 6 months (The more wear and tear, the shorter the life-span) and B-Lymphocytes can survive between 1 to 2 months).

In my previous blog, I talked on the functions of T-lymphocytyes (the Cytotoxic and Helper cells), I was merely talking about effector Lymphocytes (Special/ specific Soldier). The second type of lymphocytes by function is memory Lymphocytes (Special/ specific Messenger). Memory lymphocytes stayed in the periphery tissues and blood circulation for an extended period, responding quicker upon the same specific exposure of antigen by providing instant information to the effector Lymphocytes (In this case, we're talking about the self-antigen of the hair-follicle).

Memory lymphocytes (T & B cells) live somewhere between 3 months to 5 years with 1% of the memory lymphocytes living up to 20 years (Vaccination that we get annually? or once every five years i.e. hepatitis A, B as booster?...much related to memory lymphocytes).

With the word memory alone, the dysfunctional T-lymphocytes found around the hair follicle or an Alopecia areata patient, kept on producing a specific dysfunctional response against the hair follicle.

Theoratically, (Memory Cells with the time element) we can now basically explain why some Alopecia areata patients:

1. Experience little regrowth but then fall off again...

2. Have a very long duration of disease...

3. Believed to be of genetic basis...

More details...(Wait for the next blog or post me a question)

Joshua

A letter response to Jon's ex-school

Hi everyone, I am brought to the attention that a highschool kid with alopecia areata has quit school due to the school/ district authority refused to allow him to wear a head gear even with official writing from dermatologists.

Below is my written response to the school's authority (sent on early February 2009) based on the kid's mom letter/discussion on an alopecia forum.

__________________________________________________________________________

5^th February 2009

Our Ref. No.: aasc/asia/oletter/01FEB09-01

Mrs. A., Principal
West Seneca East Senior High School

UNITED STATES

Mrs. A.,

Hello. It is brought to my attention (from a letter written by Sharon Lesakowski- attached for our reference) that a student has quit your school due to the school authority’s refusal to allow him to wear a head covering even though he is diagnosed with alopecia areata (Hairloss due to a medical condition).

The excuse given by the school authority is almost absurd, laughable and mostly unprofessional as per the context given by Mr. Wiley, Assistant Superintendent on a return phone call to Sharon Lesakowski that Jonathan’s way of dealing with his affliction (wearing a bandana) was not acceptable.

This may not be a perfect analogy but it is good enough to reflect a medically illiterate faux pas. It provides an impression that as if the school will penalize a student for flashing gang signs where as the student is actually deaf and communicating in sign language. In this case, it is a student being penalized for promoting gang image where as the student is actually suffering alopecia and requires a head covering to protect his scalp. I believe that you are aware or at least read about alopecia areata. Even though alopecia areata is not a life-threatening or infectious disease itself, covering the hairless area especially the scalp is more than just a psychological comfort to the alopecia patient. Technically, Jonathan’s option of wearing a bandana has physiological reasons behind it. The physiological aspects, a bandana:

1. Keep the head warm during winter.

2. Keep the head (skin) from over exposed with UV during summer.

3. Keep the sweat from going into the eyes due to the loss of eyebrows and eyelashes.

As long as the attire does not offend others in the school, a bandana (with no offensive symbols or design) is not a violation a dress code or district policy given a medically certified condition as what Jonathan has. The school’s policy in Jonathan’s case (his rights) is itself a violation of the United States Constitution’s Bills of Right. In addition, the school’s policy discriminate alopecia patients (in general) of the right to protect their scalp with a bandana. About 2% of the human population and up to 5 million peoples in the United States are affected by alopecia areata (Sources by National Alopecia Areata Foundation, NAAF and National Institute of Arthritis, Musculo skeletal and Skin diseases, NIAMS).

As an education institution, the school has failed to provide a comfortable environment where knowledge is to be imparted without partiality and favour, in this case to Jonathan (for wearing a bandana to protect his head). As an alopecia patient myself, I felt insulted and discriminated by the excuse given by the school authority. Equating bandana wearing in general to promote gang image itself is an unacceptable reason and an insult to community of alopecia patients and patients suffering hair loss due to secondary effect (like hormonal problems, burnt victims, cancer patients).

Personally, I hope that the school authority and responsible personnel to provide a full public apology to Jonathan and his family, nothing short of a personal apology and also issue a public apology via local media. I strongly believe that being in the education profession, one should be courageous enough to admit and apologize for the mistake done whether by moral obligation or work ethics.

I am also affected by alopecia areata and have lost all my hair on my scalp. If I were to come to your school to seek education and I chose not to wear anything to cover up my baldness, would I later be “accused” or “penalized” for promoting the skinhead gang because I appeared bald at school? Therefore, I urge the school’s policies/ school district policies in particular the out-dated attire policy to be reviewed immediately in line with proper sensitivity to the medically unwell and needy patients, upholding the Bill of Rights as enshrined in the United States Constitution and finally to function as a school to provide education and conducive environment for students to receive education to avoid unacceptable mistakes like Jonathan’s situation in the future. All kind of responses is most welcome. Thank you.

Yours sincerely,

_________________

A Note of about hair follicle (Alopecia areata patients)

A NOTE ABOUT THE HAIR FOLLICLE:

Hair follicles are extremely tough and robust. They are able to take multiple insults and despite being disrupted by the immune cells, the hair follicle are capable to regenerate given the right conditions (subject of research), even after many years of insults/punishment.

The fact about hair follicle mentioned above has been a driving force for the search of a cure for Alopecia areata and it is also an explanation why some patients will have their hair back after many years of being afflicted by Alopecia areata.

So, do not be discouraged and keep your head high!

Joshua

My previous series of blog about Alopecia:

1. Explaining Alopcia areata and the immune system.

2. Understanding the Lymphocytes found around the hair follicle.

3. Alopecia areata as auto-immune condition.

...etc.

Should Alopecia areata patients strengthen their immune system?

Basically, the ultimate cure for Alopecia Areata would be to "tell" or "inform" the T-lymphocytes of our body (Specifically those who are targeting our hair follicles) that the "social security number" of hair follicle tissues are of our own body and NOT foreign.

So, should we strengthen our immune system?

Yes, the T-lymphocytes still plays a great role in our well being and defense mechanism against specific bacteria, viruses and prevent rapid proliferation of mutated cells (cancerous).

Therefore, systemic steroidal treatments are not encouraged to treat Alopecia Areata in long term, as it would "weaken" the ENTIRE Immune System. Its like, SHUTTING off the COUNTRY's entire police force because a few police made a mistake and arrested THE COUNTRY's own citizens as illegal immigrants.

Joshua