Lisa
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Having hives and flushing, or diarrhea, etc, these are what we call breakouts. These reactions are such that show that you are indeed reacting and that you are on the edge of progressing into further, more dangerous activity. It indicates that you've got too much activity and that your antihistamines can't account for all the extra activity, your usual day of meds can't handle it all.
Let's make this practical: A cold/flu. Having a cold or flu will call the mast cells into action cause this is what they were designed to do- defend your body from invaders. Well, they're going to produce mediators. Well, your body is already over producing MC mediators on a daily basis so having a cold/flu will only add on to the overload. Therefore, you have to increase your meds to compensate for the higher mediator release/burden that is going on. What you normally take won't be sufficient to handle the extra MC activity, thus breakouts occurr.
Stressfull day at work: This scenario is typical in that the day may start out just fine, but you get to work and your boss tells you that you have a report to crank out for the emergency 3:15 meeting. This puts you into high gear to gather that information together and to have it written up, proofed and printed with 25 bound copies within 4 hours! It means giving order, running around checking on things, talking with people and going beserk and even skipping lunch! Your adrenaline kicks in and the other stress mediators do to and this in turn triggers your MCs and thus begins the flushing, hives diarrhea, etc. You have no choice but to up your meds in compensation!!
Extremes of temperatures/medical procedures: This is one of the major triggers for most of us for MCs are easily physcially activated! If you read some articles about the process of doing surgery on a masto patients when their spleen has gotten too big, this will teach you how sensitive the MC is to physical activity. These kinds of case studies comment on how the surgeons must precisely plan just exactly how they are going to remove the spleen on these patients for the very handling of the tissue will cause massive degranulation of mediators into the blood stream! This is why we can't go into saunas or hot houses, or jump into the snow like those polar bear people who do that kind of craziness. This is why we can't go running the Boston marathon or racing around the block for anything which causes our bodies to physically sweat has called in the mast cell into action. It physically aggitates the cell itself and this physical aggitation makes it open up and release it's mediators.
When this kind of situation happens, you must physically get yourself out of the situation which has offended your MCs - so, if you are too hot, you need either air conditioning, or a cold shower to bring down your body core temperature. If you are physically active and it's caused you to have breakouts, then you need to physically stop doing what you were doing, be it sit down and rest, or even take a nap. To compensate, you need to up your meds. This is the same for any kind of polen going on as well cause if you are already allergic to pollen and the such, then your MCs are going to be normally activated. So, during allergy season, you must compensate for this excess activity which is totally normal for your MCs to be doing, only in us, it's overkill! So this is why you compensate for the overkill!
Foods/drinks:
These are often choices you make to eat what is a known trigger. The best thing is to avoid it. But sometimes you don't realize it's going to cause trouble. If you are having a good day, then that chocolate may not be an issue. However, on a bad day that chocolate could be the last drop in the bucket and it then causes overflow and a huge mess. In this case the antihistamines are what helps to wipe up the mess, after the fact. On a bad day, the bucket is already borderline and any extra triggering is going to make the mess. If the day is good, then that extra piece of chocolate isn't going to be a big deal. This is like physical activity - on a good day, like in the winter, a walk around the block will be great, but in the summer heat, it will put you in the hospital! The extra medications may be what keeps you out of the hospital for you are compensating for the extra triggering that happened.
I hope this helps make more sense as to why one time we can do something, another time not, and how we work with the overloads and compensate for them in return.
Lisa
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