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情人節早上山大王睡得很沉 山大妞則六點半就醒了 今天山大王仍舊和媽咪待在家 這週五天只上了兩天課 連體育課最後一堂都沒法去上了 更不用說山大王班上也難得 有的情人節派對也去不成了 媽咪約了十點半帶山大王去看小兒科醫生 媽咪選的Dr. Shinmei診所搬了 從離家車程五分鐘的距離搬到15分鐘車程遠 山大王一直很不舒服 又是頭痛又是眼睛痛胃口也不好 看過醫生化驗鼻涕結果不是細菌造成感染 可能是病毒的感冒 所以也沒能開藥 媽咪在車上讓山大王又吃過退燒藥 然後去Fresh & Easy買菜 回到家山大王吃了剛買的草莓和草莓優格後就吐了一地 媽咪只好讓他躺沙發休息 清地板然後洗手煮雞湯麵等他醒來吃 還好山大王午睡睡得很沉 不過得接山大妞 媽咪還是得喚醒山大王吃點東西再去學校接山大妞 他醒來還是懶洋洋的沒胃口喝雞湯麵 不過他看到漢堡披薩速食店廣告倒是很想吃 媽咪見他這兩天都沒吃什麼 只好答應他接過妹妹就去Costco買片Pepperonis pizza 山大妞今天在學校吃得不錯 這兩天哥哥訂的午餐沒能吃 老師就轉送給山大妞吃了 山大妞喜歡吃Pasta和chicken nuggets 還有派對時也吃了許多水果 媽咪去接她時也才剛醒來 山大妞作了很多情人節心型勞作 好像上學一個月半來有很多進步 雖然長串的字山大妞還說得不是很清楚 但是Happy Birthday to you Annabella Thank you very much Water Come (on) 山大妞都很會說了 山大妞回家依舊很開心 繞著媽咪廚房和家居間走來走去 玩情人節老師送的小玩具 媽咪鹹酥雞剛炸好還沒完全放涼 山大妞就嚷著要吃 小妞妞怕燙就會要媽咪先吃 嚼一嚼再要媽咪直接嘴嘴親給她吃 小小年紀就學會French Kiss實在是媽咪的錯 山大妞好胃口吃過鹹酥雞,sushi,梨子,蘋果汁,一點雞湯麵還要 吃媽咪做的巧克力蛋糕 雖然每種都吃一點 但加起來也是很可觀 相對山大王病厭厭地 連媽咪做的鹹酥雞他吃到嘴裡又吞不下地吐出來 實在叫媽咪擔心 媽咪又讓山大王吃退燒藥三十分鐘後 山大妞不能吃的魚型起司餅乾 山大王倒是很有胃口地喀吃喀喫地下肚了
一早山大王難過地哭醒 哭說脖子痛眼睛痛 爸鼻量他有點燒 給他吃退燒藥讓他在家裡跟媽咪一起 今天就只有山大妞和爸鼻出門去上學 山大王吃了退燒藥後生龍活虎的在家玩 好像沒什麼不舒服 他和媽咪去Children Ochard把high chair賣掉 然後去對面的Armstrong garden看看噴泉就回家 到了晚上山大王又開始頭痛眼睛不舒服 媽咪又給他一點止痛藥 吃過媽咪烤的心型吐司夾草莓醬 山大王就在沙發上睡著了 山大妞在學校睡得不錯(12:40~2:30) 回到家小妞妞心情超好 媽咪忙著做她明天學校情人節派對要帶的12個心型起司吐司 山大妞也會說"heart shape" 在學校睡夠午睡山大妞晚上不急著睡 喝過ㄋㄟㄋㄟ還很開心地拿著小毛巾玩 媽咪給山大妞放熱水洗澡前 讓她坐在小朋友的馬桶上 上面加了一個baby如廁專用的軟墊子 山大妞很棒自己就噗噗好幾條小黃金了 還跟媽咪報告"噗噗"然後要求要拿衛生紙自己擦屁屁 便便後山大妞洗好澡玩過水 很舒服地入睡九點睡到一點 山大王睡到半夜又發高燒又要上廁所 山大妞一點起來又是要抱抱ㄋㄟㄋㄟ抓抓癢癢 爸鼻處理山大王退燒;媽咪處理山大妞 半個小時後大小兩隻才分別又入睡
山大王星期四回家後看完電視沒有胃口吃飯 爸鼻要他去睡覺 但山大王就是窩著沙發 媽咪生氣他不吃火鍋烏龍麵 過去摸摸懶洋洋山大王的額頭 覺得是發燒了 爸鼻抱他上樓睡覺後 果然沒多久就開始發高燒 半夜吃了退燒藥山大王早上精神還不錯 今天寒假前最後一天上學 媽咪要他自己向學校請假 因為山大王最近很愛我們讓他接電話 一整個早上山大王雖然還是有些發燒但都還不會太難受 下午要他午睡一下山大王也睡不著 但是他不舒服時還是主動要求吃退燒藥 等到傍晚早早吃過晚餐 山大王又從一條活龍變蚯蚓了 快八點時山大王高燒又開始飆漲 山大王吃過藥還是一直喊全身痛:眼睛和手及胸部 耳溫槍量出來都是104F度以上 最高到106.9F 吃過藥三十分鐘山大王還在高燒 媽咪在他額頭貼退燒貼 額頭溫度量出來是100F 爸鼻量山大王腋下體溫是101F 媽咪還要妹妹拍手給哥哥鼓勵 山大王見家人都圍他身邊關心他 好像精神就好很多 看一下Ask Dr. Sear網站高燒護理後 爸鼻和媽咪還是決定帶他去Urgent Care Bristal Park Urgent Care今晚九點就關門 爸鼻覺得自己向以前古早醫藥不發達時候 爸爸抱著孩子半夜去找醫生 媽咪和山大妞則在家等候爸鼻消息 找了一下看診醫院方向 山大王終於順利在Urgent care關門前看到醫生 在那山大王量舌下體溫是100F 醫生看看耳朵咽喉眼睛等 認為是病毒感冒 退燒藥已經發生效用 而耳溫槍量出來的嚇人高溫 醫生則覺得不準 勸告各位父母要帶孩子高燒找醫生前 先量"舌下體溫"再決定 結果是不準的耳溫嚇著爸鼻媽咪 如果媽咪爸鼻先量舌下體溫 大概就不需跑一趟吧 還好山大王逛urgent care 來來去去一個小時半 就可以安心回家過週末 也算跑個安心啦
過敏性皮膚炎亦稱異位性皮膚炎，好發肘部、膝部、膝後窩、四肢、全身等，常為對稱性發作，有搔癢症狀並起紅色斑疹、濕疹、蕁麻疹，常反覆發作，此病在飲食上也不宜食用易引起過敏的食物，如海鮮、辛辣類，在食療上建議過敏性體質的患者，可食用薏仁、紅豆、扁豆等具有健脾燥濕，腎虛者取黑豆、小米、小麥，鯉魚、木耳、芹菜、竹筍、絲瓜、慈姑、蜂蜜等，以上皆有健脾利虛的功用，以為日常食療所採用。 過敏兒童異位性皮膚炎的照顧 2007-08-10 Page:1/1 東元綜合醫院 兒童過敏氣喘科 陳君毅 醫師 一、定義 又稱過敏性皮膚炎，一種與遺傳及環境有關的慢性、反覆發作、發癢的皮膚炎。 二、臨床症狀及病程 各年齡層有不同影響部位，共同特徵是「癢」，皮膚乾躁。 嬰兒二個月發病後，濕疹樣變化先侵犯臉及身體伸側，週期性惡化及改善，一歲後逐漸移到軀幹，身體屈側易磨擦部位，可因搔抓造成流膿續發性細菌感染。二歲後會漸改善，大多5-6歲後好轉，少數可持續至大人，皮膚比一般人敏感，易因外來刺激而發癢、發炎。 三、異位性皮膚炎的治療 家長認知：了解病程會好好壞壞，不要氣餒，耐心做好生活照顧，避免惡化因素，並學會皮膚保養保濕及急性發作、續發感染的處理。 注意皮膚清潔保濕 (1)一天至少1次溫水澡，水中加入沐浴油，泡澡15-20分。 (2)頭皮濕疹可用無刺激性嬰兒洗髮精清洗。 (3)皮膚使用過敏專用肥皂、清潔液或酵素清洗，避免洗掉保護脂肪層。 (4)洗完澡幾分鐘內，水分未乾前擦上過敏皮膚專用潤膚劑(Moisturizers)。 (5)依嚴重度擦乳液、乳霜、油性品（凡士林或嬰兒油）等潤膚劑使皮膚保持水分，增加皮膚耐受性，一天除洗澡外應多擦幾次。 適當藥物的使用 (1)無症狀或輕微發癢時：服用一段時間可控制症狀 ． 服用抗過敏藥物，如Ketotifen (Zaditen)，可抑制過敏細胞，改善症狀，長期服用可同時改善呼吸道過敏症。 ． 口服第二代長效、非嗜睡抗組織胺，如Loratadine (Clarityne)，長期服用控制症狀。 (2)有症狀(皮膚發紅、發癢時) ． 口服第一代抗組織胺：短效、快速改善搔癢，但易引起嗜睡及口乾，可配合抗過敏藥物或第二型長效、非嗜睡抗組織胺服用。 ． 局部擦類固醇藥膏：針對皮膚發紅(發炎)處塗抹，對抗發炎 A.輕度濕疹，弱效局部類固醇擦拭，洗完澡水分未乾前擦拭效果最好。 B.嚴重濕疹，中至強效局部類固醇擦拭(連續不超過2星期)，臉及皮膚皺摺處仍擦弱效為主，避免皮膚變簿。 (3)續發性細菌感染：皮膚流黃色分泌物，臭味及形成痂皮 ． 局部：局部擦拭弱效類固醇加抗生素藥膏。 ． 廣泛：口服或注射抗生素。鼻腔也須塗抹抗生素10天，一天2次。 (4)口服類固醇：極嚴重有必要才使用，以短期為主，小心停藥後反彈現象。 避免環境中的惡化因素 (1)食物 ． 一歲以前：對牛奶、蛋及花生易過敏，餵食時應小心皮膚過敏症狀。 A.出生後盡量餵食母奶6個月以上，有困難可改餵牛奶蛋白部分水解的低過敏嬰兒奶粉(預防性)。 B.牛奶蛋白過敏有症狀者，須改餵治療性的“半元素牛奶”至1歲以上才可避免症狀，改餵豆奶一半有效。 C.副食品6個月大後才添加，蛋白及全蛋製品10個月大後添加。 ． 任何年齡食用易過敏食物小心皮膚症狀有否惡化，有則禁食一段時間。 A.易過敏食物：牛奶、蛋、花生、小麥、有殼海鮮、魚、有核水果等。 B.食物過敏的診斷：以吃後有否皮膚反應為主，抽血檢驗結果只做參考。 (2)衣著：穿純棉寬鬆內衣、衣褲，不穿緊身衣，材質粗，易磨擦的衣著。 (3)住家環境：尤其小孩臥房, 避免接觸空氣中散落寢具的塵滿、花粉、黴菌、貓狗皮屑等過敏原，會改善皮膚及呼吸道症狀。 ． 被套或寢具覆蓋物每週定期以60℃熱水清洗，床墊及寢具最好能用防塵蹣套套住。蓋被最好能以化學質料或蠶絲被為主。 ． 室內以吸塵器、溼抹布勤打掃擦拭，可使用冷暖氣機及空氣濾清器，濾網須勤清洗或更換，除濕機維持濕度50~65%。 ． 室內勿用地毯及厚重窗簾，可用百葉窗較易清洗。傢俱最好以木質或皮質、塑膠材質為主，拿掉不必要的裝飾擺設，不抱絨毛玩具。 ． 室內不養寵物，不放盆栽。室外寵物需定期洗澡。 (4)運動：避免流汗日曬過久，游泳完儘速沖掉身體消毒劑，擦上潤膚劑。 (5)注意天氣變化及避免流汗：夏天怕流汗, 冬天怕乾躁。 ＊夏天悶熱，室內用冷氣機減少流汗，流汗時用平滑毛巾擦汗。 ＊冬天乾躁，注意空氣中濕度，多擦潤膚劑。 (6)避免皮膚接觸其他刺激物，如有機溶劑、肥皂、香水、清潔劑。 (7)心情放輕鬆，避免情緒壓力使異位性皮膚炎惡化。 (8)指甲剪短，晚上睡覺考慮戴連指手套，避免搔抓引起感染。
Some forms of eczema can be triggered by substances that come in contact with the skin, such as soaps, cosmetics, clothing, detergents, jewelry, or sweat. Environmental allergens (substances that cause allergic reactions) may also cause outbreaks of eczema. Changes in the weather, or even psychological stress for some people lead to outbreaks of eczema. What are the symptoms of eczema? Eczema most commonly causes dry, reddened skin that itches or burns, although the appearance of eczema varies from person to person and varies according to the specific type of eczema. Intense itching is generally the first symptom in most persons with eczema. Sometimes, eczema may lead to blisters and oozing lesions, but eczema can also result in dry and scaly skin. Repeated scratching may lead to thickened, crusty skin. While any region of the body may be affected by eczema, in children and adults, eczema typically occurs on the face, neck, and the insides of the elbows, knees, and ankles. In infants, eczema typically occurs on the forehead, cheeks, forearms, legs, scalp, and neck. What are the different types of eczema? Atopic dermatitis is the most common of the many types of eczema, and sometimes people use the two terms interchangeably. But there are many terms used to describe specific forms of eczema, that may have very similar symptoms to atopic dermatitis. These are listed and briefly described below. Atopic dermatitis Atopic dermatitis is a chronic skin disease characterized by itchy, inflamed skin. Atopic dermatitis is believed to be caused by an abnormal function of the body’s immune system. The condition tends to come and go, depending upon exposures to triggers or causative factors. The most common form of eczema, atopic dermatitis affects about 10% of infants and 3% of adults in the U.S. When the disease starts in infancy it is sometimes termed infantile eczema. Atopic dermatitis tends to run in families, and people who develop the condition often have a family history of allergic conditions such as asthma or hay fever. For more, please read the Atopic Dermatitis article. Contact eczema Contact eczema (contact dermatitis) is a localized reaction that includes redness, itching, and burning where the skin has come into contact with an allergen (an allergy-causing substance) or with an irritant such as an acid, a cleaning agent, or other chemical. Other examples of contact eczema include reactions to laundry detergents, nickel (present in jewelry), cosmetics, fabrics, clothing, and perfume. The condition is sometimes referred to as allergic contact eczema (allergic contact dermatitis). Skin reactions to poison ivy and poison sumac are examples of allergic contact eczema. People who have a history of allergies have an increased risk for developing contact eczema. Seborrheic eczema Seborrheic eczema (seborrheic dermatitis) is a form of skin inflammation of unknown cause. The signs and symptoms of seborrheic eczema include yellowish, oily, scaly patches of skin on the scalp, face, and occasionally other parts of the body. Dandruff and “cradle cap” in infants are examples of seborrheic eczema. Seborrheic dermatitis is not necessarily associated with itching. This condition tends to run in families. Emotional stress, oily skin, infrequent shampooing, and weather conditions may all increase a person’s risk of developing seborrheic eczema. Nummular eczema Nummular eczema (nummular dermatitis) is characterized by coin-shaped patches of irritated skin, most commonly located on the arms, back, buttocks, and lower legs, that may be crusted, scaling, and extremely itchy. This form of eczema is relatively uncommon and occurs most frequently in elderly men. Nummular eczema is usually a chronic condition. A personal or family history of atopic dermatitis, asthma, or allergies increases the risk of developing the condition. Neurodermatitis Neurodermatitis, also known as lichen simplex chronicus, is a chronic skin inflammation caused by a scratch-itch cycle that begins with a localized itch (such as an insect bite) that becomes intensely irritated when scratched. Women are more commonly affected by neurodermatitis than men, and the condition is most frequent in people aged 20-50. This form of eczema results in scaly patches of skin on the head, lower legs, wrists, or forearms. Over time, the skin can become thickened and leathery. Stress can exacerbate the symptoms of neurodermatitis. Stasis dermatitis Stasis dermatitis is a skin irritation on the lower legs, generally related to the circulatory problem known as venous insufficiency, in which the function of the valves within the veins has been compromised. Stasis dermatitis occurs almost exclusively in middle-aged and elderly people, with approximately 6-7% of the population over age 50 being affected by the condition. The risk of developing stasis dermatitis increases with advancing age. Symptoms include itching and/or reddish-brown discoloration of the skin on one or both legs. Progression of the condition can lead to the blistering, oozing skin lesions seen with other forms of eczema, and ulcers may develop in affected areas. The chronic circulatory problems lead to an increase in fluid buildup (edema) in the legs. Stasis dermatitis has also been referred to as varicose eczema. Dyshidrotic eczema Dyshidrotic eczema (dyshidrotic dermatitis) is an irritation of the skin on the palms of hands and soles of the feet characterized by clear, deep blisters that itch and burn. The cause of dyshidrotic eczema is unknown. Dyshidrotic eczema is also known as vesicular palmoplantar dermatitis, dyshidrosis or pompholyx. This form of eczema occurs in up to 20% of people with hand eczema and is more common during the spring and summer months and in warmer climates. Males and females are equally affected, and the condition can occur in people of any age. How is eczema diagnosed? To diagnose eczema, doctors rely on a thorough physical examination of the skin as well as the patient’s account of the history of the condition. In particular, the doctor will ask when the condition appeared, if the condition is associated with any changes in environment or contact with certain materials, and whether it is aggravated in any specific situations. Eczema may have a similar appearance to other diseases of the skin, so the diagnosis is not always simple. In some cases, a biopsy of the skin may be taken in order to rule out other skin diseases that may be producing signs and symptoms similar to eczema. If a doctor suspects that a patient has allergic contact dermatitis, allergy tests, possibly including a skin “patch test,” may be carried out in an attempt to identify the specific trigger of the condition. There are no laboratory or blood tests that can be used to establish the diagnosis of eczema. What is the treatment for eczema? The goals for the treatment of eczema are to prevent itching, inflammation, and worsening of the condition. Treatment of eczema may involve both lifestyle changes and the use of medications. Treatment is always based upon an individual’s age, overall health status, and the type and severity of the condition. Keeping the skin well hydrated through the application of creams (with a low water and high oil content) as well as avoiding overbathing is an important step in treatment. Lifestyle modifications to avoid triggers for the condition are also recommended. Corticosteroid creams are sometimes prescribed to decrease the inflammatory reaction in the skin. These may be mild-, medium-, or high-potency corticosteroid creams, depending upon the severity of the symptoms. If itching is severe, oral antihistamines may be prescribed. To control itching, the sedative type antihistamine drugs (e.g. diphenhydramine, hydroxyzine, and cyproheptadine) appear to be most effective. In some cases, a short course of oral corticosteroids (such as prednisone) is prescribed to control an acute outbreak of eczema, although their long-term use is discouraged in the treatment of this non life-threatening condition because of unpleasant and potentially harmful side effects. The oral immunosuppressant drug cyclosporine has also been used to treat some cases of eczema. Ultraviolet light therapy (phototherapy) is another treatment option for some people with eczema. Finally, two topical (cream) medications have been approved by the U.S. FDA for the treatment of eczema, tacrolimus (Protopic) and pimecrolimus (Elidel). These drugs belong to a class of immune suppressant drugs known as calcineurin inhibitors. In 2006, the FDA issued a warning about the use of these drugs, citing studies in animals that showed a possible association between use of these drugs and the development of certain types of cancer. It is recommended that these drugs only be used as second-line therapy for cases that are unresponsive to other forms of treatment, and that their use be limited to short time periods, and the minimum time periods needed to control symptoms. Use of these drugs should also be limited in people who have compromised immune systems.
