Annie Lowry
speaker
54 appearances
1 recordings
1 series
first heard Nov 2024
last heard Nov 2024
Annie Lowry’s voice in public audio — every appearance, attributed to the second.
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That person might, you know, have some other infestation. I'm going to start scratching to get this off of myself because scratching is in part a self-protective mechanism, right? We want to get irritants off of the body and that's in part why we scratch.
Yes. So histamine is an amazing chemical that does many, many, many things in our body. And it's part of our immune response. It leads to swelling so the body can come in to heal. And the scratching is meant to get, you know, whatever irritant was there off. And the itch-scratch cycle ends when the body heals.
So I think that that's all part of a natural and proper cycle that's part of our body being amazing at sensing what's around it and then healing it. But we have some itch that's caused by substances other than histamine. We've only started to understand that kind of itch recently. Similarly, we didn't really understand, science did not understand chronic itch very well until recently.
And we're in a period, I'd say in the last 20 years, of just tremendous scientific advancement in our understanding of itch.
I think the patients that he often sees, and he does a lot of things. He, you know, studies itch as a doctor who does medical research, and I believe that he also sees patients. I've talked to other dermatologists who've told me not to itch, who've, you know, tried to hand me cold packs and try to get my hands off of my body.
and explained the itch scratch cycle and sort of said, OK, we might not be able to treat your underlying itch, but at least we can break the itch scratch cycle and stop that kind of secondary itch that's coming on top of it. And when I talked to him, he sees people that are so miserable and they know they know that scratching is not going to help them. But at some point it's reflexive.
And I think that he felt like it was cruel to tell people to stop doing this thing. That is deeply irresistible and often the only source of relief that you might be getting, even if it's leading to a problem down the road.
So short of having like a nice ice cold bath for somebody to sit in, telling somebody with no other answers at that moment to stop scratching themselves might feel a little bit rude. But I would say that all of the dermatologists I've ever seen have been very, very sympathetic and supportive. itches is something that they deal with on a daily basis is enormously common. And they mean well.
I'm certainly not trying to get on dermatologist's case for that.
Absolutely. So I have a poorly understood degenerative disease called primary biliary cholangitis. It's autoimmune in nature. It seems to be partially genetically, you know, you perhaps have a genetic predisposition, but then perhaps environmentally triggered. They don't really know why people get it. Right now, I believe that it's roughly 80,000 people in the United States total who have it.
About 9 in 10 of those people are women, and the disease is most common in adult women, somewhat 40 and older. And it is a disease in which the body mistakenly attacks some of the cells in your bile ducts, in the lining of your bile ducts. It causes them to inflame. It hurts your liver's ability to secrete bile into your digestive system, into your body.
And ultimately, if the disease is allowed to progress, will slowly progress towards cirrhosis. Disease used to be considered or was often considered fatal. They found a drug, an actually really old drug that dissolves gallstones, works really well to slow its progression. And so, yeah, so that's the condition that I had.
I was diagnosed with it during my second pregnancy, though I clearly had it in my first pregnancy. And I was young, although not unheard of, young to get it. And my OBGYNs had never had a patient with it. It took a while to get to a hepatologist who recognized it.
But it, like a lot of liver and kidney conditions, for reasons that are not understood at all, causes really, really bad itching that does not respond to antihistamines and does not respond to steroids.
When scientists said that itching is a disease in and of itself, what they meant was was that chronic itching changes the body's own circuitry in a way that begets more chronic itching, that implies that itching is not just a side effect, it's a body process in and of itself.
And so instead of just being a symptom, instead of being something where if you fix the underlying issue, you might fix the itch, itch itself can kind of rewire the body and can be treated as a condition unto itself. And a lot of dermatologists see itch that way. It's often a symptom, often a side effect, but sometimes it's really its own thing in the body.
It's a great question, and I think that the answer is multilayered. So one is that doctors didn't understand itch, even just that basic histaminergic itch, very well until recently. There's not a lot of drugs to treat itch, and there didn't seem to be a lot of money in treating itch. there's a lot of money in treating pain, right?
An upsetting amount of money that has led to a tremendous social crisis due to our treatment of pain. But it is also true that, you know, there's a lot of chronic pain and we have a lot of ways to treat it. And, you know, I think there's now a lot more emphasis on non-opiate medications to treat pain while also acknowledging that a appropriate opiate medications to treat pain.
So there just wasn't a lot of optionality for treating itch. It wasn't the sort of thing that medical centers were going to make a lot of money by treating people with chronic itch because they didn't have options to give them. I also think that there's a social aspect. Pain is so awful. And I would never say that there's something ennobling about pain.
But I think that there's a certain amount of social respect to people who are going through it. And itching, you kind of sound like a Muppet, right? I do think that itching, it's just a little bit disrespected. You look like a dog with fleas. It's embarrassing to scratch yourself in public. It's inappropriate to scratch yourself in public. I think people just kind of don't take it very seriously.
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