Help, I've got a type-I hypersensitivity to studying
April 11, 2015 11:14 PM   Subscribe

I've been studying full-time (and then some) for board exams. I am enjoying this study period and I think my schedule is pretty balanced and healthy, but the rest of my body doesn't agree. I'm breaking out in hives and feel like I'm an overall inflammed state (think general urticaria, hives, ulcers, 熱氣). Help me push through these next few weeks.

I am so happy to be studying; it's fun to finally see more of the "big picture" and make connections between the discrete facts I've been (blah) memorizing the past two years. I wake up every day and have no problem getting started. I don't feel "burned out" in the sense of feeling like I'm mentally out of gas, despite the fact that I have been studying pretty much all day every day. However, I am concerned that my body is reacting to my study schedule by breaking out in hives and such.

Here are the breaks / wellness activities I have built in to my study plan:

I scheduled in one "break day" per week, where I basically sleep in, do fun things (watch documentaries, check Metafilter, draw, yoga, call my family) and don't look at anything boards-related. I drink lots and lots of water and tea while studying. My diet (which is good) has not really changed, although on some days my starch intake has been a little higher than my norm (which isn't terribly high to begin with)-- like, I'll buy soup at the cafeteria and take an extra packet of croutons or something. I feel like studying has made me generally crave carbs. My exercise has not changed; I exercise 6 times a week for 30 minutes to 1 hour at a time. I also walk outside for about a total of 1 hour a day. I am sleeping enough (6-7 hours; my usual), but on some days I wake up earlier than I intend to and can't fall back asleep.

I can't rule out environmental triggers (so feel free to suggest any possibilities, although I haven't changed any lotions, shampoos, laundry detergent, clothing, jewelry; it's not seasonal allergies, either), but I'm pretty sure that this general urticaric/pro-inflammatory state is the way my body is responding to this study schedule. Should I be eliminating something from or adding something to my diet? Would oatmeal baths help? Even more water? Strictly no sugar? Claritin? Anything?

I can't reduce the number of hours I'm studying if I intend to stay on schedule. I only have a few more weeks left, so I can probably suck it up until the exam is over, but I don't want to hit a wall in my final week (or at all) for this relatively high-stakes exam. Thanks for your suggestions.
posted by gemutlichkeit to Health & Fitness (16 answers total) 3 users marked this as a favorite
Where are you studying? If studying has you spending lots more time in a new place, perhaps something about the place is the culprit. Could be dust, mold, the shampoo they use to clean the chairs, etc.
Alternatively if you study at home, have you changed your own cleaning habits (esp. Important if you react to dust or mold).

Either way, if you think this is temporary, then personally I would just use antihistamines to control it, as long as they don't give you brain fuzz. If you don't already know which ones work for you, I would only try new ones on your "break" days. Or stick to topical creams (Benadryl makes one) so you minimize systemic effects. Other than Claritin (loratidine) for OTC you have fexofenadine (Allegra) and ceterizine (Zyrtec) and diphenhydramine (Benadryl).

Personally I find Claritin useless. In your shoes I would take fexofenadine; but I know it relieves my symptoms and doesn't give me brain fuzz. That may not be true for you. E.g. many people like Zyrtec, but it makes me stupid (not tired, just stupid!) So I can only take it at night.

If the itch is bad enough to interfere with sleep, you could also consider Benadryl-- it knocks everybody out, but how functional you are the next day varies. So if you're pretty desperate, you could try taking it the night before a break day and see how you fare.

In a different direction- advice I have heard for people finishing dissertations or studying for the bar exam -- which I assume holds for boards too-- is to not change anything if possible. Now is not the time to quit coffee, start exercising, quit your drug habit-- or in this case, maybe now is not the time to try a bunch of allergy meds you aren't used to.
posted by nat at 4:12 AM on April 12, 2015

This happened to me once in college around finals. Benadryl makes me super sleepy, but it works. I washed it down with coffee. I felt kinda tweaky, but I was functional. Try taking it at night and see if it carries over into the next day.

Are you actively itchy?
posted by jrobin276 at 4:18 AM on April 12, 2015

Oh yeah... It's not the hours of study. The stress comes from what's riding on your passing the exams.
posted by jrobin276 at 4:21 AM on April 12, 2015

How are you sure it's not seasonal allergies? You can develop seasonal allergies at any time. I had no seasonal allergies at all until I was 20 and my lab partner said "did you know your eyes are bright red and bloodshot?". Now I get them every spring.

It's different for everyone but I think Zyrtec and Claritin are the best in terms of not affecting you cognitively. Try taking one right before bed and see how you feel the next day.
posted by telegraph at 4:50 AM on April 12, 2015

If you have time for a doctor's appointment, singulair works the best for me without making me sleepy. Half a dose of benedryl at night usually leaves me perky by the next day, but YMMV.

Have you changed your house cleaning schedule? As in maybe things are a bit dustier? Is it time for the airfilter to be changed? I tend to let that kind of stuff go during crunch time, but it can make my allergies s bit worse. As long as I'm not very itchy or stuffy, I let it go until crunch time it's done.
posted by ghost phoneme at 5:18 AM on April 12, 2015

I get stress hives too. No fun! Benadryl dies help, as does a ton of water (I know you said you're drinking it but try more?).
posted by dawkins_7 at 6:00 AM on April 12, 2015

What does your schedule look like on study days?
posted by ocherdraco at 6:38 AM on April 12, 2015

It may not be stress or environmental, although I hope it is. It could be something that's coming from within - chronic idiopathic urticaria - unrelated to your exam schedule, what you're eating, or your laundry detergent. (Idiopathic just means "we don't know why")

IANAD/IANYD If you seek care, a general doc may suggest a few days of prednisone, which, with your exam schedule, I wouldn't suggest - it can be an emotional roller coaster going on and off of it and it's tough on your body. You can't be on it for very many days without starting to harm your body. If it was me, and if you can hang in there for awhile, I might consider going on a four day course that's aligned with the actual exam because it'll make you feel great physically (in my experience.) I wouldn't try it in the weeks leading up to the exam, because going off of it can put you into even more terrible, bounce back hives. And screw with your emotions. Some people's hives spontaneously remit, and sometimes that spontaneous remission happens while taking prednisone, so it looks like the prednisone "cured" the hives. There's no doubt that while you take prednisone, you will not have hives; they disappear within hours and it's miraculous. The question is, what happens when you come off the prednisone (also, if you take prednisone for more than a few days, you'll need to taper off of it.) Prednisone is serious and seriously amazing. But serious.

You don't describe your hives - how awful are they? Do they grow and "buzz"? Cover your whole body? (It sounds like it's not that bad because you sound level-headed and not out of your mind.) The cocktail of drugs that got my hives into remission was a combo of over-the-counter and prescription, all prescribed by a dermatologist (who specializes in chronic hives.) She biopsied the hives before prescribing. I ended up on Zyrtec, high doses of hydroxyzine (only at night - highly sedating, it's been described as '10x benedryl') Actually, at first I took some at night and some in daytime, but only after I'd already driven to work. A ridiculous amount of sulfasalazine. Sulfasalazine is an IBS med but is ALSO an antihistamine. Montelukast (which is singulair, mentioned above.)

I've tapered down and stopped taking a lot of the meds. I keep the singulair because it helps with my asthma, and 2 years later, I still take smaller doses of sulfasalazine and hydroxyzine (at night). I ran out of hydroxyzine last weekend and it was terrible. Full on allergies and the hives started coming back.

In terms of topical help - ice. I used to pack ice packs into my clothes. I took cold baths/showers, and used the Aveeno oatmeal bath powder to make a paste (add water) to apply directly to the hives while I stood in the shower. Topical benedryl made me feel sick (probably because I was also taking antihistamines by mouth) and didn't help with the itching.

You sound like you're doing an amazing job! Good luck with your exams!
posted by vitabellosi at 6:44 AM on April 12, 2015 [2 favorites]

Are you taking any antibiotics, by chance? (Like for a bladder infection). Some people react to sulfa drugs like that.
posted by gt2 at 7:43 AM on April 12, 2015

Response by poster: I drink so much water and tea that I probably nearly meet diagnostic criteria for psychogenic polydipsia, and I always have-- no new change in habits here. I'm not on antibiotics or sulfa drugs or any new meds. I have not recently changed my study spot. There is no new construction / renovation going on in my study spot that I know of, either. My house-cleaning schedule hasn't changed; I typically clean my room as a way to relax in the evenings or on my rest days.

Oh, and to be clear, I'm not congested and don't have a runny nose or itchy, watery eyes-- it's only the rashes/hives/skin changes and overall feelings of... inflammation-- I feel feverish without having an actual temperature.

My schedule on study days: Wake up at around 5:45 or 6:45, depending on whether I want to work out in the morning (if I don't, I work out during my mid-day break). If I choose to work out as my mid-day break, I eat breakfast while doing a light flashcard review of yesterday's material, 1-2 hours. Then I go to the library (15 minute walk) to set up study-camp and study for 3 more hours. After that, I take an hour to eat lunch with some light flashcard review again, or I use that time to work out. Either way, I take another 15 to 20-minute walk. After that, I just study until I feel like I'm getting diminishing returns from my studying (which happens anywhere from 8:30 to 10:30 PM; if I go home later I just eat dinner -- usually a salad and soup with crackers -- at the library too on a 20-minute break) and then head home (another 15 minute walk). Within the afternoon block of my studying, I usually take a 10-minute break every 60 to 75 minutes or so. Once I get home in the late evening, I watch documentaries or Youtube, talk to my friends, draw, walk around the neighborhood, write letters-- I don't study. I feel like this schedule has worked out okay-- I'm a little behind, but that's just the nature of trying to cram ALL OF THE THINGS into my head. In bed by 11:15.

I am mildly itchy, but as you have gleaned, it's not so much that the itchiness is getting in the way of my studying, but rather that I'm concerned that the hives and patchy rashes are my body's way of telling me that I'm not treating it right, and that this kind of stress/study schedule is not sustainable. Like I said, I don't want to hit a wall in a few weeks right before my exam. So part of this question is also to ask for tips on how to prevent that kind of burnout. Thanks, everyone!
posted by gemutlichkeit at 8:25 AM on April 12, 2015

Are you taking any antibiotics, by chance? (Like for a bladder infection). Some people react to sulfa drugs like that.

People can also develop an allergy to acetaminophen (Tylenol) -- if you take that regularly, you could try eliminating it. The folks I've known who developed this allergy mostly got migraines from it, though.
posted by vitabellosi at 8:33 AM on April 12, 2015

Try Aerius antihistamines (I think it's a generic now, the active ingredient is desloratadine). They're very effective but it doesn't cross the blood-brain barrier well so you don't get the associated drowsiness from other antihistamines.

If you're drinking too much water, try drinking half strength Gatorade instead (either dilute sports drink with water or make it up from powder with twice as much water as recommended).

As for 熱氣, is that "hot humours?" Get more sleep, consume less caffeine. Cut out alcohol if you're drinking. Smoke less if you're a smoker. Get a big pot of winter-melon soup. Or barring that, cold cucumber soup.
posted by porpoise at 9:17 AM on April 12, 2015

Response by poster: I very rarely take acetaminophen and haven't for months, so it's not that, either. No smoking or drinking, minimal caffeine (1-2 teabags a day). Am I not sleeping enough? I eat enough salt, so I don't think I'd need to drink Gatorade. Winter melon soup sounds like a good idea, and I'm making green bean soup as I type this.

Oh, and re: "熱氣" (火气大) - I think this is a pretty good explanation of what I am feeling: Is yeet hay “熱氣” just a load of hot air? :-)

Little tips to further improve my quality of life (which I honestly think is pretty darn good already!) and burnout prevention tips would be appreciated. Thank you!
posted by gemutlichkeit at 10:11 AM on April 12, 2015

I don't think there's a quick easy fix to this. It's not "sleep more" or "eat bananas!", I think it's "take the test already" or "make it mean less". What helped my stress hives was lots of Benadryl and finishing the semester. You need to just get through...
Meditate daily
Come up with a viable GOOD plan for what you will do if you can't take or fail. This will take some of the heat off!
Plan a nice long weekend after the test - camping, a B&B, etc so you can wind down and have something to look forward to.
posted by jrobin276 at 1:46 PM on April 12, 2015

Maybe you're actually having a genuine health problem, totally unrelated to studying. I hope you see a doctor.
posted by sam_harms at 3:40 PM on April 12, 2015 [1 favorite]

I like zyrtec for hives, because I don't get sleepy from it. IANAD.
posted by freezer cake at 1:27 PM on April 13, 2015

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