Creating health and not just treating a chronic condition (like eczema)

adult and child hands holiding red heart, health care love and family concept

My last post on our own journey was quite a while back. A LOT has happened since then.

This has been a really eventful year but in a much better sense than it has been over the past few years. This is the year when we saw a glimpse of how eczema can simply fade away when the root cause is treated and the body heals. This is the year when I completed my nutrition and dietetics course but more importantly I also completed my Functional Medicine Health Coach certification from the Functional Medicine Coaching Academy.

All those who have been following my blog know that it has not been an easy road that has led me here. It has been a struggle to say the least not knowing for sure that the treatment and the offbeat path I was following for my  daughter’s eczema would even work or not. This was a treatment which would work from inside out by strengthening her immune and digestive systems by providing the right conditions for her body to heal. That our body has an innate power to heal itself given the right conditions is something that we probably have witnessed to some extent or other but rarely give much importance to.

The path that I chose takes a much longer time, effort and involvement. Because of this reason and also due to a lack of awareness is why we usually seek out conventional medicine as a “quick fix”. I had the same approach to our health till our daughter’s health got affected really badly. 

Don’t get me wrong, antibiotics and steroids and other drugs have saved millions of lives and they will continue to do so. But this same approach does not work well for chronic health conditions. The other problem is that we take our bodies and our health for granted at times due to our busy schedules. And then when things go wrong we usually end up looking for a quick and painless solution.

But I am digressing here.

Eczema and our lives now

First I would like to give an update about the treatment and our daughter’s eczema today. The Functional Medicine treatment that I had started exactly 2 years ago has now started showing some results. It has been a slow and gradual healing journey (which is not yet over) but then I guess it works only when it actually becomes a way of life. I have written various posts on what this treatment is all about earlier and you can check them out.

5 R framework

Functional Medicine treatment in our daughter’s case focussed on healing her gut and the issue of intestinal permeability primarily through dietary changes but also with the help of various supplements. We followed a 5 R framework- remove, replace, reinoculate, repair and rebalance. Over time this has helped her digestive and immune system to recover and become more strong and also balanced. Her skin has showed the results on the outside by becoming smooth and soft. For the first time in many years, we have been sleeping well as a family and through the night. As any parent with a child suffering from eczema will tell you, that is a luxury!

Of course, this does not mean that we can stop doing our work and that her skin condition can never become worse again. Her skin is her weak point in the immune system and may flare up when there is a trigger (in terms of food, toxins, stress etc) and she will always have to be careful. She is still on her immunosuppressive medication, Methotrexate but it is at half the dosage as earlier at 5 mg. Also I need to tell you that we have had a minor setback since coming back from our US trip this month. We spent about 2 months there during the kids’ summer break and even with lapses in her dietary restrictions (excluding gluten which does not suit her at all), her skin condition was at its best in a long time inspite of the sun exposure and other uncontrollable factors during traveling. But ever since after we came back her skin condition became a bit rough and itchy overall. What had changed for her was the environment and everyday stress and her body is taking some time to acclimatise and settle down.

This was a real eye opener for me. This incident showed that even when her diet had improved since being at home, changes in the external environment (read water and air pollution) had a big impact on her skin condition. I immediately ramped up her antioxidant levels to combat the external stressors through a combination of diet (cruciferous vegetables like broccoli, cabbage, cauliflower and other leafy greens like spinach) as well as supplements like vitamin C and cucurmin and Hist D Jr. The last one has ingredients like quercetin ( a natural antioxidant), NAC (an amino acid which is a precursor to one of the most important antioxidant in our body called glutathione) and vitamin C ( a natural immune booster, anti oxidant and histamine lowering vitamin). Her skin has subsequently improved quite a bit and is settling down. I am keeping a close watch on how she is over the next few weeks or so.

On a more personal note 

Over the past few years of dealing with my daughter’s health related problems I realised a couple of things. One, initially I learned all about eczema so that I could help my daughter but after a while I realised that I had a genuine interest in knowing how to create health and apply it to our lives. The other realisation was that I wanted to bring this information to help and guide others in moving towards their own health and life goals. One thing led to another and my quest for knowledge led me to the Functional Medicine Health Coaching course which has turned out to be the perfect fit for me.

I enrolled with Functional Medicine Coaching Academy (FMCA) which is a US based organisation. FMCA is offering this course in collaboration with the main body for Functional Medicine, Institute of Functional Medicine (IFM)I  completed the course last month and I am proud to say that I am India’s first certified FM Health Coach!

Health-Coach-Certificate-Badge_web

“A Health Coach is someone who really listens to you, focusses on what is right with you, supports and guides you”.

As a Health Coach I will thus be providing customised guidance and support for various chronic health conditions on

nutrition and hydration

-exercise and movement

-sleep and relaxation

-social relationships and connections

-mindfulness and stress management

Functional Medicine Health coaching – a new beginning

I am in the process of setting up a clinic with Dr Amrita Talwar (my daughter’s dermatologist) in Mumbai. I will also be having my own practice at the address mentioned below-

Nourish. Heal. Connect

Lodha Supremus

Unit 804, 8th floor,

2 Senapati Bapat Marg, Opp Kamala Mills

Mumbai 400013

The setup for dealing with chronic conditions is quite different from that of dealing with conventional medicine due to the time and commitment required both from me and the person involved. I am in the process of setting up my practice with the help of latest technological platforms relevant to coaching which are suited to dealing with chronic conditions. I am also in the process of customising relevant dietary guidelines for Indian conditions and sensitivities. In case you are interested in reaching out to me for health coaching for any chronic health conditions, please feel free to write to me at

anindita@aninditarungta.com 

You can also reach out to me at

Twitter: @aninditarungta

Fb: @healthcoachinindia

As someone wise had said, “You have got a new story to write. And it looks nothing like your past”. 

This is definitely true for me and it is equally true for you! 

 

 

 

 

 

 

 

 

Thank you for your part in our journey

 

New Year's resolutions

Another year comes to an end and yet another one begins

I wish you and your family a year filled with good health and happiness. I completed 3 years of writing this blog in October last year and it has been an amazing experience for me. As always, I am reminded once again about how fortunate we are as a family in all that we have and how grateful I am for the love and support of my family and friends. We also remain grateful to the wonderful support shown by our doctors in being there for us every step of the way. So thank you all for simply being a part of our lives!

I feel honoured to be able to share with you our experiences in dealing with eczema and most importantly to be able to share with you our experiences of dealing with eczema with the help of Functional Medicine protocol. I  want to emphasize upon this last bit since most of you may not be aware that such an option/treatment exists. I have written about this in my earlier post- https://eczema-anindianperspective.com/2015/09/10/the-functional-medicine-and-gut-health-approach-to-managing-chronic-conditions-including-eczema/

We are now mostly familiar with the conventional medical treatments but have lost touch with many others some of which used to be a part of our own culture like ayurveda. In fact, Functional Medicine is similar to our ancient Ayurvedic tradition in many ways since it approaches the individual as a whole and does not just treat the symptoms. However, it differs in many ways since it incorporates the latest science and research, diagnostic testing, use of nutraceuticals amongst others.

Life is full of ups and downs; the trick is to enjoy the ups and have courage during the downs

Road to Eldorado

It has been a while since I have given an update on my daughter’s skin condition and treatment. Since I last wrote about the essential oils, there has been a lot of upheaval with regards to my daughter’s condition. Staph infection, caused by the bacteria Staphylococcus aureus is very common among those suffering from eczema. It is a very common bacteria residing on our skin and is invisible for all intents and purposes most of the times. But for those with eczema/sensitive skin it tends to create problems by causing infections. My daughter had recurring bouts of this infection starting in August last year. It notoriously difficult to get rid of once it gets entrenched. This led to a couple of rounds of antibiotics and oral steroids to control her skin condition which had deteriorated rapidly. These medications were  added on top of her immunosuppressive medication, Methotrexate, which also had to be increased to manager her eczema.

Thus, till about mid November last year, it was again a very trying time for us as a family. We had to deal with her eczema flare up which had actually became a constant feature since August and  it had also somewhat as a shock for us. This was because her eczema had been fairly under control for the past 10 months or so under the Functional Medicine treatment and her medication had been brought down gradually. As part of the treatment we got her Functional Medicine tests like Comprehensive Stool Analysis and Optimal Nutritional Evaluation done to determine her gut/microbiome health and her levels of vitamins, minerals, amino acids, antioxidants and other metabolic markers from the European Genova Diagnostics laboratories.

While the stool test did show some improvement from the earlier test done in January last year, the urine test was a bit of a disappointment but at the same time shed some light on her flare up. The urine metabolite test showed a huge amount of oxidative stress. Oxidative stress is akin to the process of combustion in our cells which use oxygen that we breathe in and food as fuel to provide our body with energy. However, in the process of creating energy, some byproducts in the form of extremely volatile free radicals are created which are usually neutralized by our body’s natural antioxidants. But when our body becomes overwhelmed by oxidative stress and/or there are not enough antioxidants to combat oxidative stress, problems occur. Infact this is the process of ageing that we all face over the course of our lives.

However, once we figured this out and boosted her supply of antioxidants with foods and supplements, her skin condition improved gradually. I increased her intake of natural antioxidants like strawberries, blueberries, blackberries, raspberries, spinach, Brussel sprouts, broccoli, beetroot and other colourful fruits and vegetables in various forms such as soups, smoothies, side and main dishes. Under the guidance of our Functional Medicine practitioner her intake of antioxidants like Vitamin A, C and D as supplements were also increased.

Other natural and traditional interventions

herbal medicine in capsules.

For the past year or so, I have been dabbling in and increasing my knowledge of traditional and natural interventions using local herbs and spices to manage eczema and other minor health issues. Over the past 6 months or so I had introduced a Curcumin supplement in a highly bio absorbable form. It is the main active ingredient in our local spice called turmeric used regularly in most of the Indian dishes, but for therapeutic needs one needs to consume much more than we can usually do from food alone. Curcumin is a super antioxidant and is highly anti-inflammatory at the same time. I use the Indian brand Cure Garden Daily Defense  and I increased the dosage to combat her oxidative stress.

The other supplement that I had added at the same time is a popular herb called Tulsi (or holy basil) from the brand Organic India Tulsi. Tulsi is a very important herb available locally and is used extensively in our Ayurvedic treatments. It is an adaptogenic herb and is thus very good for stress management, has antibacterial properties and increases the activity of antioxidant enzymes amongst a host of other benefits.

The other 2 local herbs that I introduced were neem from Himalaya Herbals (or Margosa) and Guduchi. Neem is again a common and popular local herb which is extremely beneficial for improving skin health and boosts immune and liver function. Guduchi is an adaptogenic herb, boosts the immune system and improves liver function amongst other things and is again beneficial for the skin. Then there are a few other herbs like berberine and burdock root that I use internally as well according to traditional Chinese medicine to enhance liver detoxification amongst other things. I intend to write about such herbal and natural interventions in a separate post later this year. I also intend to pursue a course in herbal treatments to take advantage of the vast natural resources that our country has in creating health and which we seem to have lost touch with.

Therapeutic grade essential oils continue to be the mainstay of our fight against staph infection. Lavender, tea tree, geranium and other essential oils from the brand Eden Garden are the ones that I use diluted with coconut oil as a carrier oil for applying locally. I have already written about this in greater details in my last blog post a while back – https://eczema-anindianperspective.com/2016/05/27/essential-oils-for-managing-eczema/.

Hopefully, once again over a period of time I will be able to phase out her medications with the help of her doctors. We have a long way to go yet and the road ahead may yet be a winding one but I know that we are pretty much prepared for our journey.

Reclaiming optimal health 

optimal wellness in wood type

You may be aware from my earlier posts that I am a certified Health Coach from the US based Dr Sears Wellness Institute. However, I have not mentioned earlier that I am currently pursuing a one year course with the Functional Medicine Coaching Academy (FMCA) which is offering this course in collaboration with the Institute of Functional Medicine (IFM). My daughter’s ongoing treatment is with the help of a UK based IFM certified practitioner, Pete Williams. My course is an exhaustive one and encompasses diverse topics like positive psychology, coaching process, motivational interviewing and functional nutrition, Functional Medicine structure and operating system like the GOTOIT, Timeline and Matrix; mind body techniques and various relevant systems and technologies.

fmca-coaching-center-ifm

As a part of my curriculum practicum I have already started counselling a few clients with various health issues on diet, lifestyle changes amongst others. I am really looking forward to completing this course and setting up a clinic in Mumbai. This clinic will be in conjunction with my daughter’s dermatologist and the coauthor of my book “ I have eczema…so what?”, Dr Amrita Talwar later this year. I hope to bring my personal experience of dealing with my daughter’s autoimmune condition with dietary, lifestyle and other changes to the table apart from all the knowledge that I would have gathered in my course as a certified Health Coach.

Alone we can do so little, together we can do so much

I always knew that it is difficult to tackle problems including health related alone, but I realised how critical a support system really is during our darkest days. Our support system of family, friends and health professionals acted as a kind of a well knit community and enabled us to pull through. It is time for me to give something back now using my experience and knowledge. I look forward to doing my bit in building a community focussed on creating optimal health at a time when chronic conditions are rising exponentially and conventional treatments are falling short . As Dr Mark Hyman (Chairman, IFM Board of Directors and Director of the Cleveland Clinic Center for Functional Medicine) has said “The power of community to create health is far greater than any physician, clinic or hospital”. I am excited and look forward to this new chapter in my life.

As a wise person had once said ” Optimal health is a journey taken one step, one habit, and one day at a time“.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Our new eczema diet and a heart full of gratitude

It has been some time since I have put up a post. There have been a couple of developments at my end due to which I have been a bit tied up. The first and the most important one is that the combination of the new immunosuppressive medication, Methotrexate, and her new diet seem to be working for my daughter. I will be writing more on this particular diet later in this post.

The second one is that the support group for eczema that I started a few months back has been slowly gathering steam at a pace that I am comfortable with.

And last but not the least, I also want to express my gratitude and share with you this time the amazing team of doctors in Mumbai behind Aiyana’s medical treatment over the years all of whom have helped us in their own ways to deal with her severe eczema.

Diet and its impact on various disorders

diet

I had been reading about how diet affects one’s body in various ways and is especially important when dealing with autoimmune disorders and chronic conditions like eczema. Doctors do not really recommend any dietary changes unless allergy tests prove to be positive for various foods. However, I found that there more than a few genuine cases where people suffering from severe autoimmune and other disorders like Hashimoto, Lupus, Postural Tachycardia Syndrome, Irritable Bowel Syndrome as well as eczema have found relief from the symptoms due to dietary changes and have managed to go off medication completely over time.

It took me more than 6 months to come to this point of view after reading about the life altering experiences of these people and then figure out a diet which I was willing to try out on my daughter. The life stories of some of the people who influenced my decision to try out diet as an option for my daughter are captured in their blogs whose links are as given below-

http://deliciouslyella.com/philosophy/about/– This blog is by Ella who has Postural Tachycardia Syndrome, a relatively rare and painful illness with no known cure and she managed to go off her medications completely after about 18 months of changing her diet

http://www.naturallysassy.co.uk/about– This blog is by Saskia, a ballet dancer with chronic eczema since childhood and who has completely gotten rid of her eczema by altering her diet

http://www.choosingraw.com/about/– This blog is by Gena who has battled with anorexia, Irritable Bowel Syndrome and who now successfully uses a mix of raw and cooked vegan diet to keep herself healthy

http://www.amymyersmd.com/about/my-story/– The last link belongs to a website by Dr Amy Myers, a doctor of functional medicine suffering from Hashimoto’s ( a chronic and painful condition of the thyroid gland with no known cure) who has brought her severe thyroid condition under control after changing her diet/nutrition and life through meditation, yoga, supplements amongst others.

(Functional medicine integrates traditional Western medical practices with what is sometimes considered “alternative” or “integrative” medicine, creating a focus on prevention through nutrition, diet, and exercise; use of the latest laboratory testing and other diagnostic techniques; and prescribed combinations of drugs and/or botanical medicines, supplements, therapeutic diets, detoxification programs, or stress-management techniques.)

Source: https://www.functionalmedicine.org/

The Eczema Diet

Eczema-Diet-2nd-Ed-Front-Cover-192x300

In my post https://eczema-anindianperspective.com/2014/09/23/products-and-resources-which-help-to-manage-eczema/, I had very briefly mentioned that I was planning to start my daughter on a diet for eczema based on the book “The Eczema Diet” by the Australian nutritionist, Ms Karen Fischer. Her daughter had severe eczema as well when she was a 2-year-old and with changes in her diet, Karen managed to control the eczema successfully. She has since written this book based on her own experience with her daughter and the feedback over the years from her patients who have successfully brought their eczema under control using this diet.

This diet is practical and comprehensive with information on products and backed by research; it has menus and recipes for babies, children and adults. It also has non diet information like skin care products and general recommendations for eczema. The objective of this diet is to temporarily take out all the eczema unfriendly foods from the diet and add all foods which are highly nutritious and eczema safe.

There are 2 stages to this diet- Stage 1 and Stage 2 .

Stage 1 is primarily to heal the gut by avoiding foods with any kind of artificial chemicals and limiting naturally occurring eczema unfriendly chemicals (like MSG or salicylates) ; allergens (eggs, wheat or dairy products); anti nutrients (phytic acid, sugar, processed foods) and acid forming and other foods which increase itchiness (oranges, corn, tomato, dairy, grapes, dried fruits). This diet thus helps restore the acid alkaline balance in the body.

Stage 2 is an extension of the first stage where the food groups are gradually expanded by adding back different food groups in moderation ( no processed foods, artificial colourings, preservatives etc) depending on the improvement in the skin condition. The diet also has recommendations on supplements like vitamins, probiotic, glycine, flaxseed (Omega 3) amongst others which are very important in helping the body cope with eczema since the child might not be consuming adequate quantities of the same from food.

I started this diet for my daughter after going through it thoroughly and arranging for most of the eczema safe ingredients as there are quite a few changes in ingredients that we usually use at home. Infact, it took me almost a month to assimilate all the information, answer the different questionnaires and make notes and list down the essential foods and recipes as a part of my preparation before starting this diet.  It’s been about 2 months since I have started this diet for my daughter.

Since it is pretty restrictive in the first stage, I took my time to prepare my daughter mentally for what was to come in the following months by telling her about the diet. I also made her read excerpts from the book about other children who have benefited from this diet and have seen their eczema either disappear almost completely or finally come under control. Only when I was sure that she was ready for this change and that I had prepared adequately for this diet did I finally start the diet for her.

The recipes and menu

recipes

Over the past couple of months I have tried out various recipes from this book as well as developed and modified some recipes from this book using eczema safe ingredients. This is to ensure that Aiyana not only followed this diet completely with no exceptions but also had a wide variety of options to keep her from feeling deprived of all the store-bought and other foods that we are all so used to having nowadays. The good part about doing all this apart from the health benefits for my daughter is that my entire family now has much less processed foods, negligible amount of junk foods, healthier organic and fresh foods, homemade preparations of bakery and other  foods with no sugar and preservatives.

This has not been easy especially since I have had to cut out sugar, dairy, wheat, eggs and all processed foods, all spices ( apart from garlic and salt) out of her diet and give her a  very limited variety of fruits and vegetables. These last couple of months I have extremely been busy with this diet trying out the book’s recipes and new recipes almost on a daily basis since I have had to modify some of them to suit her needs and our Indian palette. This has been made more difficult since the recipes in the book are for meant to suit an European palette while we are used to our Indian spices and foods. What has helped me is my past experience with gluten-free cooking for my daughter in 2012 ( I have covered my experience in the post- “Eczema and diet” ) and my determination to ensure that I find a way to manage my daughter’s health in a more natural way in the long run.

The book can now be purchased both as a paperback and kindle version online at amazon.in.

When there’s a will there is a way

 inspire-31What encourages me is that Aiyana’s skin condition has improved in the last couple of months. Here I should also add that we had to start her new immunosuppressive medication around the same time as the diet and that the new medicine also takes 3 to 4 weeks to show results. But with my experience of giving her the third immunosuppressive medication (Cyclsosporine, Azathioprine, Methotrexate) I can say with conviction that the only medicine which has truly worked for her and made her skin completely smooth and normal all over has been oral steroid in high doses. The other medications have either just about helped keep her eczema under control (Cyclosporine) or brought about bone marrow suppression (Azathioprine); I have covered the effects of Azathioprine and our traumatic experience in my earlier post “…the tough get going (Part 2)“.

Hence, I am really happy to see that after starting her on this diet her face is totally clear of any rashes and has finally got back that healthy glow that had disappeared under the effect of all the strong medicines being given to her. I am willing to continue the hard work required to carry on with this diet and keep her motivated to follow the same for the next few months at least. I will keep you posted on further developments about my daughter’s skin condition in relation to this diet in my future posts.

 A heart full of gratitude

thank you

As the year comes to an end, I stop to count my blessings for all the good things in my life and my heart is filled with gratitude for all those doctors who have been with us in my family’s difficult journey in the past few years. In this post I would like to thank the amazing set of doctors behind Aiyana in her fight against eczema. I have briefly mentioned them in my earlier posts as well but have never mentioned their names which I do now with their consent.

 

 

Dr Shashi Merchant is Aiyana’s pediatrician from Breach Candy Hospital, Mumbai, and has known her since birth and held her as a newborn baby. She has been a pillar of strength and is unwavering in her support and care for my daughter. She gave us hope when we needed it the most in the darkest of moments when Aiyana was fighting for her life in the hospital last year. We are all lucky to have had her on our side in this journey.

Dr Amrita Talwar is Aiyana’s main dermatologist for the past 4 to 5 years now and has done much more and beyond than required as her role as a doctor. Without her help and guidance about the myriad aspects of dealing with eczema (including the essential but non medical ones) life would have been significantly more difficult for us. I have her to thank for encouraging me to write about our experience and starting this blog and for pushing me and helping me to start the Eczema Support Group.

Dr Manish Shah is a leading senior pediatric dermatologist and is the dermatologist whom we consult regarding her immunosuppressive medications and narrow band UVB treatment. He gives us advice when required and gives us much-needed guidance about giving these strong medications as well as dealing with and minimising the harsh side effects. We are very grateful to have him as Aiyana’s consultant dermatologist.

Dr Mahesh Balsekar is another well-known pediatrician in South Mumbai with Breach Candy Hospital. He is the one who diagnosed and admitted Aiyana to the hospital in time last year (Dr Merchant was on holiday at that time) which ultimately saved her life. Dr Balsekar thus gave her and the doctors at Breach Candy Hospital a chance of fighting her life threatening infection. My heart swells with gratitude for Dr Balsekar for keeping our family intact and saving my daughter’s life.

We are also grateful to the entire pediatric division of Breach Candy Hospital, haemotolgists Dr Antia and Dr Agarwal and the entire support staff at the hospital for playing a very important role in our daughter’s stay at the hospital last year.

A new year, a new beginning

new year

And so another year ends and a new one is about to begin soon. May the new year be filled with joy, laughter and good health. But may you also find the strength to overcome whatever obstacles lie in your path and remember to enjoy every precious moment with your friends and family.

From my family to yours

A Happy 2015! 

 

Our first encounter with Atopic Dermatitis in 2007

Eczema- an Indian perspective

My daughter, Aiyana was a chubby 1 year old child when we first realised that her skin was not exactly what is called “baby soft” that we usually read or hear about. Her baby skin was  quite rough in texture that somehow never quite felt smooth to touch. This was the first time we had heard of  this skin condition  which is called Atopic Dermatitis (or Eczema as it is commonly known)since till then we were not aware of this skin condition.

Aiyana when she was 1 year old

We also came to know that certain foods tend to trigger inflammation of skin for children with eczema. Through trial and error  we came to know that our daughter was allergic to eggs, dairy and though we did not give her any tree nuts (hazelnut, walnut, peanut, cashew etc) we avoided all of these all the same. This dietary restriction did help in alleviating her skin texture…

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Our first encounter with Atopic Dermatitis in 2007

My daughter, Aiyana was a chubby 1 year old child when we first realised that her skin was not exactly what is called “baby soft” that we usually read or hear about. Her baby skin was  quite rough in texture that somehow never quite felt smooth to touch. This was the first time we had heard of  this skin condition  which is called Atopic Dermatitis (or Eczema as it is commonly known) since till then we were not aware of this skin condition.

Aiyana when she was 1 year old

We also came to know that certain foods tend to trigger inflammation of skin for children with eczema. Through trial and error  we came to know that our daughter was allergic to eggs, dairy and though we did not give her any tree nuts (hazelnut, walnut, peanut, cashew etc) we avoided all of these all the same. This dietary restriction did help in alleviating her skin texture but it never went away completely. We were able to manage to keep her eczema under control since it was still mild and responded well to local treatments and moisturizers.  And so we managed for about 4 years without any major skin related issues apart  from once in 2008.

All was under control till about a couple of years ago when her skin condition took a turn for the worse and it has not gone back to normal ever since. But through all our trials and tribulations and struggles with eczema our darling daughter who is now seven years old has shown amazing fortitude and her smile has rarely dimmed.