"Treat the disease, you win some, you lose some. Treat the patient, you always win."
~Patch Adams~

Monday, September 2, 2013

Scars and hormone absorption!

This comes under the heading of "until it happens to you"............

As I have detailed in the blog a number of times, I use bioidentical progesterone cream 4 times daily.  I put 1/4 teaspoon on my forearm (where the skin is thin and the blood vessels are near the surface for maximum absorption) and then I rub my forearms together to rub the cream into my body.  I've done it this way for nearly 7 years, and it has worked very well.  I know some practitioners have their patients rub the cream into their abdomens or inner thighs, but even in slender people (which I am not!) there are layers of fat, and the hormone deposits into the fat, thus reducing absorption into the system.

When I fell at the gym in early August, I realized that my normal way of dosing my progesterone would no longer work.  I called Dr. Carr's office as soon as I got home from the ER, and was told that an acceptable alternate site was into the upper inner arms (which didn't work at first as my right upper inner arm was very badly bruised and sore, and I couldn't reach my upper left arm because of the injury/splint/sling.)  Another acceptable site was up around the base of my neck/collarbone, where again, the skin is thin and the hormone will more readily absorb.  I used either my neck, or had one of my friends rub the cream all up and down the inner part of my left arm for about 7-10 days after the injury.

I returned to the surgeon 5 days post operatively, he removed the sling, the bandages and told me I could now get the operative site wet (which was music to my ears, so much easier to shower and wash my hair!).  The stitches came out 12 days post operatively, and I am now 24 days post surgery.  The scar, as you can see, looks great........I am using Vitamin E oil on it about 4 times a day.  I have a long way to go with rehabbing the arm to regain function; the middle, ring and little fingers are working well, the index finger is about 50% functional, but the thumb is still of great concern.  I'm slowly regaining some mobility in the wrist, it is no longer "painful" per se, but aches like crazy later in the day.  During the surgery, the doctor removed the existing plate in the arm, repaired the fracture, and put in a larger plate (titanium, no, I will not set off the detectors at the airport!).  I can easily feel the plate beneath the skin, and jokes have been made about how I am all set for Halloween as long as I want to be a zombie.

However, the long scar/scar tissue, and the plate in my arm means that the absorption of progesterone in that arm will be forever compromised!  I now have to rub my progesterone up and down the length of my left arm (which is still a bit of a challenge because my right arm/hand are still limited in motion, but I'm getting there).  It's a little inconvenient, as the weather gets cooler and I start wearing longer sleeves, it will take more effort to get my progesterone dosed 4 times daily.  I'm sure I will work it out.

Bottom line, if you are taking any hormone transdermally, and suffer an injury/surgery to the area where you normally dose your hormone, you must talk to your health care practitioner about alternate sites for applying the cream!  In my case, it's a double whammy of both a metal plate very close to the surface of the skin, along with significant scar tissue, but even the scar tissue alone would likely cause a compromise of the hormone absorption.  As it is, I have a hard time keeping up my level of progesterone, as stress makes you burn through hormones faster-------and this whole injury thing has been stressful in a huge way!