http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001470/

A.D.A.M. Medical Encyclopedia.

Psoriasis

Plaque psoriasis

Last reviewed: November 22, 2011.

Psoriasis is a common skin condition that causes skin redness and irritation. Most people with psoriasis have thick, red skin with flaky, silver-white patches called scales.
See also: Guttate psoriasis

Causes, incidence, and risk factors

Psoriasis is very common. Anyone can get it,  but it most commonly begins between ages 15 and 35.
It is not contagious. You cannot spread it to others.
Psoriasis seems to be passed down through families. Doctors think it probably occurs when the body's immune system mistakes healthy cells for dangerous substances. See also: Inflammatory response
Usually, skin cells grow deep in the skin and rise to the surface about once a month. In persons with psoriasis, this process is too fast. Dead skin cells build up on the skin's surface.
The following may trigger an attack of psoriasis or make the condition more difficult to treat:

• Bacteria or viral infections, including strep throat and upper respiratory infections
• Dry air or dry skin
• Injury to the skin, including cuts, burns, and insect bites
• Some medicines, including antimalaria drugs, beta-blockers, and lithium
• Stress
• Too little sunlight
• Too much sunlight (sunburn)
• Too much alcohol

In general, psoriasis may be severe in people who have a weakened immune system. This may include persons who have:

• AIDS
• Autoimmune disorders (such as rheumatoid arthritis)
• Cancer chemotherapy

Some people with psoriasis may also have arthritis, a condition known as psoriatic arthritis.

Symptoms

Psoriasis can appear suddenly or slowly. Many times, it goes away and then comes back again and again.
Symptoms include:

• Irritated, red, flaky patches of skin
• Most often seen on the elbows, knees, and middle of the body
• Red patches may appear anywhere on the body, including the scalp

The skin may be:

• Itchy
• Dry and covered with silver, flaky skin (scales)
• Pink-red in color (like the color of salmon)
• Raised and thick

Other symptoms may include:

• Genital lesions in males
• Joint pain or aching
• Nail changes, including thick nails, yellow-brown nails, dents in the nail, and nail lifts off from the skin underneath
• Severe dandruff on the scalp

Psoriasis may affect any or all parts of the skin. There are five main types of psoriasis:

• Erythrodermic -- The skin redness is very intense and covers a large area.
• Guttate -- Small, pink-red spots appear on the skin.
• Inverse -- Skin redness and irritation occurs in the armpits, groin, and in between overlapping skin.
• Plaque -- Thick, red patches of skin are covered by flaky, silver-white scales. This is the most common type of psoriasis.
• Pustular -- White blisters are surrounded by red, irritated skin.

Signs and tests

Your doctor or nurse can usually diagnose this condition by looking at your skin.
Sometimes, a skin biopsy is done to rule out other possible conditions. If you have joint pain, your doctor may order x-rays.

Treatment

The goal of treatment is to control your symptoms and prevent infection.
Three treatment options are available:

• Skin lotions, ointments, creams, and shampoos. These are called topical treatments.
• Pills or injections that affect the body's immune response, not just the skin. There are called systemic, or body-wide, treatments. 
• Phototherapy, which uses light to treat psoriasis.

TOPICAL TREATMENTS
Most of the time, psoriasis is treated with medications that are placed directly on the skin or scalp. This may include:

• Cortisone creams and ointments
• Creams or ointments that contain coal tar or anthralin
• Creams to remove the scaling (usually salicylic acid or lactic acid)
• Dandruff shampoos (over-the-counter or prescription)
• Moisturizers
• Prescription medicines containing vitamin D or vitamin A (retinoids)

SYSTEMIC (BODY-WIDE) TREATMENTS
If you have very severe psoriasis, your doctor will likely recommend medicines that suppress the immune system's faulty response. These medicines include methotrexate or cyclosporine. Retinoids such as acitretin can also be used.
Newer drugs called biologics are used when other treatments do not work. Biologics approved for the treatment of psoriasis include:

• Adalimumab (Humira)
• Alefacept (Amevive)
• Etanercept (Enbrel)
• Infliximab (Remicade)
• Stelara

 PHOTOTHERAPY
Some people may choose to have phototherapy.

• Phototherapy is a medical treatment in which your skin is carefully exposed to ultraviolet light.
• Phototherapy may be given alone or after you take a drug that makes the skin sensitive to light.
• Phototherapy for psoriasis can be given as ultraviolet A (UVA) or ultraviolet B (UVB) light.

OTHER TREATMENTS
If you have an infection, your doctor will prescribe antibiotics.
AT HOME CARE
Follow these tips at home:

• Oatmeal baths may be soothing and may help to loosen scales. You can use over-the-counter oatmeal bath products. Or, you can mix 1 cup of oatmeal into a tub of warm water.
• Sunlight may help your symptoms go away. Be careful not to get sunburned.
• Relaxation and antistress techniques may be helpful. The link between stress and flares of psoriasis is not well understood, however.

Support Groups

See: Psoriasis support group

Expectations (prognosis)

Psoriasis is a life-long condition that can be controlled with treatment. It may go away for a long time and then return. With appropriate treatment, it usually does not affect your general physical health.

Complications

• Arthritis
• Pain
• Severe itching
• Secondary skin infections
• Side effects from medicines used to treat psoriasis
• Skin cancer from light therapy

Calling your health care provider

Call your health care provider if you have symptoms of psoriasis or if the skin irritation continues despite treatment.
Tell your doctor if you have joint pain or fever with your psoriasis attacks.
If you have symptoms of arthritis, talk to your dermatologist or rheumatologist.
Go to the emergency room or call the local emergency number (such as 911) if you have a severe outbreak that covers all or most of your body.

Prevention

There is no known way to prevent psoriasis. Keeping the skin clean and moist and avoiding your specific psoriasis triggers may help reduce the number of flare-ups.
Doctors recommend daily baths or showers for persons with psoriasis. Avoid scrubbing too hard, because this can irritate the skin and trigger an attack.

References

1. Gottlieb A, Korman NJ, Gordon KB, Feldman SR, Lebwohl M, Koo JY, et al. Guidelines for the management of psoriasis and psoriatic arthritis. Section 2. Psoriatic arthritis: overview and guidelines of care for treatment with an emphasis on biologics. J Am Acad Dermatol. 2008;58:851-864.
2. Menter A, Korman NJ, Elmets Ca, Feldman SR, Gelfand JM, Gordon KB, et al. American Academy of Dermatology guidelines of care for the management of psoriasis and psoriatic arthritis. Section 3. Guidelines of care for the management and treatment of psoriasis with topical therapies. J Am Acad Dermatol. 2009;60:643-659.
3. Menter A, Gottlieb A, Feldman SR, Voorhees ASV, Leonardi CL, Gordon KB, et al. Guidelines for the management of psoriasis and psoriatic arthritis. Section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics. J Am Acad Dermatol. 2008;5:826-850.
4. Stern RS. Psoralen and ultraviolet a light therapy for psoriasis. N Engl J Med. 2007;357(7):682-690.

Review Date: 11/22/2011.

Reviewed by: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Disclaimer

Copyright © 2012, A.D.A.M., Inc.

Meat chart

 http://www.foodsafety.gov/blog/meatinrefrig.html

I've decided that fathers are really needed in raising children.  Sometimes, in order to really understand what a child is going through, that child needs to spend time with Dad.  Although Dad may know the basic routine of an infant, he still can't provide the food supply. 

Well, to tell you about what happened.  We had been really worrying about Rocky Jack's sleeping schedule.  It seemed that he couldn't sleep for longer than an hour FOR ALMOST A WHOLE MONTH!  Anyway, I finally learned that I was feeding him too much during the day and at night.  I was on an every hour feeding frenzy that wasn't very fun.  THE PROBLEM was that I was comforting him TOO MUCH.  Whenever he fussed, I fed him.  I think that I started doing that for several reasons.  One is that the Korean people tend to do that with their children: that is, feed them whenever they are upset and I had finally accepted that as a somewhat reasonable solution.  Another reason is that I was so preoccupied with the move and myself and the move...did I mention the move? :) That I wasn't giving Little Rocky the attention that he needed. 

So two days ago I decided that I had had enough.  I decided that I was feeding him too much and decided to resist the temptation to feed him and watch the clock more carefully.  I now feed him every 2 or more hours and make sure that he stays up more at night so that he can sleep longer.  We still have some improvements to make in our routine, but I've decided that it was that decision to NOT feed him...to really care, that made all the difference.  Without Rocky assuring me that it was ok that he did not get fed when I had normally done so, I don't think that I could've gotten past the trial.

I can remember other instances with Annabelle that Rocky was a vital part in changing schedules or routines..  I truly love my husband and probably don't treasure him as much as I should.

Jet Lag

 http://www.deliciousbaby.com/travel/family-travel-tips/jet-lag-and-babies-toddlers-and-kids/

I thought that this Website was very informative and relieving to hear the expected night time awakenings were at the child's usual meal times (which happened with Annabelle).  I also think that it is essential to allow them to get up at night if they need to.   That way they can get rid of some energy and then gently put them back to bed.

http://www.travelwithyourkids.com/once-there/what-you-can-do-about-jet-lag

This was a great website that really stressed that time cures all.  I think that it's also important not to expect your children nor yourself to be normal after a long flight and different time zones.

Right now I'm on day 2 and a half and I truly am getting so little sleep.  It seems like if one kid wakes up the the other decides that it's time to wake up.  Also, Annabelle doesn't always go to sleep when she's tired, but rather picks up her pace so she doesn't pass out.  Today, she had little sleep that was very interrupted, so we thought that she would sleep better at night.  Boy were we wrong.  She did go to sleep well initially, but after only an hour or two she woke up in a horrible whine.  She did that several times.  Rocky Jack's schedule was also messed up, but because he usually wakes up more, it didn't seem as bad.

www.lonelyplanet.com/thorntree/thread.jspa?threadID=2114617

February 10, 2012

So it's almost been a month since we've been home and I can now say that it took the kids a good five days to back to schedule.  Once they were on schedule, it was then my turn ( I was soooo exhausted).  It took me two weeks to get the buzzing out of my head and to be able to sleep through the night when I was supposed to.  Even though the kids could sleep, even though I was extremely exhausted I struggled to sleep at night.  I'm so glad that we stayed with Rocky's folks so they could help us out emotionally and physically during that hard time.  I'm glad that I wasn't too stubborn to ask for help when I needed it.

Sat. Mar 3, 2012

I've decided that changing time zones affects our bladders along with our sleep schedule.  Annabelle used to wake up with little urine in her diaper, but now it's bursting, even after two months of returning.  I think that she'd be ready to potty train otherwise.   I can tell that my bladder had to make an adjustment, too.  I don't fully feel like my body has adjusted to this new schedule.

Mon, May 28, 2012

I think that our children are finally on track.  Jack is finally sleeping the way he should and Annabelle doesn't have such wet diapers at night.  Halleluiah.   

What are the advantages and disadvantages of sleep masks?

Ok, so here is the first website that I found that involved sleep apnea and eye masks improving sleep overall: 
 http://www.bestsleepapneatreatments.com/blog/general/advantages-of-eye-masks-and-sleeping-masks/

I thought that this was one of the best quotes: 

"Most people have discovered that utilizing sleep masks for sleep have aided them to get rid of the bags beneath their eyes, make their skin appear fresh and knew, as well as even help their acne clear up."

Wow, and all these years, I should've bought a sleep mask to help me clear my acne!  No, I'm sure if we get the sleep we need, our bodies have time to repair themselves better.  

This articles also says that sleep masks may eliminate snoring!  I think that that sounds great!

I've tried the masks and although it does take time getting used to and sometimes it gets misplaced in the sheets and under the pillows, I find that it works great and helps me sleep longer than before.

What causes this flatulance?

Enough said, here is what I found from the Mayo Clinic....

Gas and gas pains

 http://www.mayoclinic.com/health/gas-and-gas-pains/DS00080/DSECTION=causes 

So, how is gas formed?
"Gas forms when bacteria in your colon ferment carbohydrates that aren't digested in your small intestine."


It was comforting to discover that "It's considered normal to pass gas as flatus between 10 to 20 times a day."  Who's willing to count to see if they truly are "normal" passersby?

So, according to the site, I (hum) one could swallow too much air, eat too much fiber, be lactose intolerant (or have some other food allergy) and therefore be the recipient of the therefore said gas. Who knows which is the culprit.  When I have time I'll have to do some experiments to eliminate the possibilities.

To continue my research, I looked up which foods cause the most problems.  Here's what website I found:

 http://www.soulfoodandsoutherncooking.com/foods-that-cause-gas.html
The list is directly pasted from the site along with the following paragraph...

List of Foods That Will Cause Gas

• Apples
• Artichokes
• Asparagus
• Beans
• Broccoli
• Brussel Sprouts
• Cabbage
• Cheese
• Corn
• Fruit Drinks
• Ice Cream
• Milk and Milk Products
• Onions
• Pasta
• Peaches
• Pears
• Potatoes
• Prunes
• Soft Drinks
• Whole Wheat

Foods that contain fiber, starches and sugars will give most people unwanted problems.

• Starch Foods - Starchy foods such as potatoes and pasta are also to be avoided.
• Fiber Foods - food fiber comes in two forms soluble and insoluble fiber. Avoid eating a lot of soluable fiber as this type of food causes much gas.
• Sugar Foods - not all foods that contain sugar will give you gas. The most common sugars that cause gas are fructose, lactose, raffinose and sorbitol.

My question now is: How do I poop without FIBER!?  

*Foods That Cause Excessive Gas*

http://www.everydayhealth.com/digestive-health/foods-that-cause-excessive-gas.aspx

Ok, this site might not quite answer that question, but I especially loved how it explained how the colon takes care of our foods and how gas is the leftover between waste and energy.  What makes me wonder is if I (someone) should worry about the small intestine cause if gas due to lactose and the inability to break it down.  It's pretty hard for me to stay away from milk products, I admit.  Ice cream, cheese, morning cereal meals would really be hard to eliminate in my diet.  On the other hand, maybe my family would appreciate the sacrifice.

Now the real question comes:  How do I relieve this airy substance?

I found a great website that encourages the same thing the dietician in the clinic I went to with Annabelle's pregnancy:  EXERCISE!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!   

Does Exercise Really Relieve Gas and Help with Flatulence?

http://fatblastzone.com/inthezone/does-exercise-help-with-flatulence-and-relieve-gas/

I would have to agree that when I exercise, my body feels better all together, I even sleep better at night. The only thing is being consistent, which can be one of the hardest things to do! I know that if I exercise after I eat, as the article suggests then I feel so much better.

So if you 're down and blue about all the troubled foods you consume, then don't sit and pout, but get up and about and enjoy those morsels of cheese and milk, fruit and fiber!

How can I help Annabelle (21 months) give her toys away before we move?

My biggest question is whether we should involve Annabelle in the process of giving away her toys or not.  I'm just afraid that if she comes with us when we deliver the toys that she we make a huge scene and won't want to give them away.  I have a strong impression to leave Annabelle at home and to take the toys to the friends house without her.  I don't want to necessarily "go behind her back" though.  I'm not sure if just a chat will help her say "good bye" to her toys.

More than anything, I just want this move to be as smooth of a transition as possible. 

Here are some websites that talked about helping children give away their toys:

http://kidshealth.org/parent/question/emotions/donating.html

Although this article isn't long, I like how it talk about preparing your child by talking to them.  I really think that we'll have to tell Annabelle that we'll have to give a lot of her toys away.

 http://tipsfororganizing.com/getting-rid-of-kids%E2%80%99-toys/ 

It's true that kids should be involved in the organization process.  They are the ones who bond to their toys (although sometimes I do too!)  I like the suggestion of putting the toys up to see if the kids will miss their toys.  The only bad thing is the possibility of causing a clutter area of unwanted things.

We'll just see how this goes!

February 10, 2012

Ok, so here is my report on the matter:  I decided to warn Annabelle a few days in advance that we would be moving and that we wouldn't be able to take some of her toys.  That day that I took the toys over, I think I even mentioned it a few times.  I decided it best to leave the kids with Rocky while I took the toys over to our friends, Tomoko and Hi-ya.  I think that this was wise because Annabelle didn't really miss them.  There were so many things going on that I don't think that she really missed them.  I am glad that I saved some recognizable toys for her, though.  I didn't really use them for the plane trip.  Well, really she doesn't really play with them now either because she has so many "new" (hand-me-down) things. She really likes the fact that we saved her bath toys, though.  Anyway, I guess if I could do this all again, I would actually leave a few more of her toys....and a LOT more of my clothes, but that would have to be another blog topic.