Sing Along Time!

I'm in a silly mood today, so I thought I would get everyone in a singing mood with a TSW anthem. It is based on the song "The Ugly Duckling" with a few words changed.

There once was an ugly duckling
With skin all flaky and red
And the other birds said in so many words
Get out of bed
Get out, get out, get out of bed!
 
And she went with a scratch and a waddle and a scratch
Sadly shaking her oozing head

That poor little ugly duckling
Gave an unhappy moan
 But at every place they saw her red face
Derms said: "Betamethasone".
Betametha...Betametha...Betamethasone!

And she went with a scratch and a waddle and a scratch
And a very unhappy groan.

All through the wintertime she hid herself away
Ashamed to show her face, afraid of what others might say
All through the winter, watching reruns on TV
Till a flock of swans spied her there and very soon agreed
You’re a very fine swan indeed!

A swan? Me a swan? Ah, go on!
And they said yes, you’re a swan
Take a look at yourself in the mirror and you’ll see
And she looked, and he saw, and he said
I am a swan! Wheeeeeeee!

I’m not such an ugly duckling
No skin all flaky and red
For in fact these birds in so many words said
Girl, you'll turn heads!


Not an itch, not a scratch, no more flaky oozy patch
But a glide and a whistle and a smooth white front and back
And a head so noble and high
Say who’s an ugly duckling?
Not I!
Not I!

Tips For Better Blogging

I have just spent the last 15 minutes looking at the ever expanding amount of blogs about TSW.

I have 65 on my list at present, but new ones are being added every day.

I love the diversity represented in these blogs. We have opinions from parents, young people, carers, partners and long-term sufferers. Everyone going through TSW will find someone to identify with on this list.

Now, when someone types in something like "eczema" , "worsening rash" or "steroid cream side effects", our blogs have risen high in the Google rankings and may be the first thing that someone clocks on, the first step on a path towards healing. It is a great feeling to know that you have helped someone to find the answers, just as I am grateful for finding Kelly Palace’s original “Addicted Skin” site which was where I first learned about TSW.

Many thanks to those who spend countless hours blogging, photographing and logging their personal TSW experiences. We may not think we are doing much, but we could well be helping to shape future attitudes towards medicine.

We have so much to learn about TSW. Our shared experiences fill in the gaps to form a big picture which will hopefully prevent others from falling into the steroid addiction trap.

Hints for Bloggers:

I thought I would share a few hints with you all to help your blogs become more successful and reach more people. Here are a few things that helped me.

1. Get your blog listed on the Itsan blog page. If you are registered on the Itsan forum, make sure you get your blog added to the big list on there. That is where I found most of the blogs on my list.

2. Link to other blogs. Ask other bloggers if they will include a link to your blog on their blog and do the same in return. This creates a network and is very useful to those searching about TSW as they can instantly access related content.

3.Comment on other blogs. Network and make friends. A big part of blogging is making connections with people and helping each other. We are part of a big community, a blogging family.

4. Add photos. I hate taking photos, but my posts with photos have much higher pageviews than those that don't. I think this may be due to the fact that many Google searches are specifically for images.

5.Update Regularly. This is so important. Nobody will follow a blog that is only updated once every couple of years and it will slide down the google rankings.

6. Create backlinks. You can do this by commenting on websites and forums and leaving a link to your blog. You could also write an online magazine article with a link to your blog underneath.

7. Its all about the SEO. Think about what people are searching for and use these phrases in your writing. Some good terms may be "steroid rebound", "eczema cream" and "steroid cream side effects". Use these phrases regularly, but keep it natural. Don't cram them into the text artificially.

8. Be true to yourself and write for your audience. Think about your target audience and write about what will interest them. All the time, develop your own unique writing style that will hopefully keep people coming back for more. Include plenty of useful information, balanced with personal stories and articles.

9. Think about grammar, spelling, presentation and international appeal. It pays to run a spellcheck after writing a post. It also helps to think about presentation. Text is more readable when set out in paragraphs with headings rather than a single block of text. Also think about colour. Black text on a white background is easy on the eyes whereas a dark background can sometimes be offputting. If your readers are coming from different countries, keep your wording simple, so that the translation bots can do their work. Local phrases and slang are not a good idea and won't be easy to translate.

I hope this helped everyone and that you all get an increase in pageviews after reading and applying this! The more people we can reach, the better.

Happy blogging!

The First Ever West Midlands Itsan Meet-Up!

Sunday 24th November 2013 will go down in history as one of those pivotal events that helped change the world...

Why?

Because me, Miss Kitty Fantastico and some fellow Itsan forumites met up at the New Art Gallery in Walsall for the first ever West Midlands Itsan meet-up (unless you count the time that me and Kitty met up in Ikea for a cuppa!)!

It started off when a member of the forum contacted me about meeting up, as she didn't live far from me. We arranged to meet, and I put out a general shoutout on the forum to see whether anyone else would like to join us, the more the merrier.

So it was that on a cold November morning, we got together for a coffee and a chat about all things TSW related.

There were six of us altogether: me and Kitty, a mum supporting her teenage daughter in her 4th month of TSW and a daughter supporting her mum, who is now 8 months into withdrawals.

I love meetups like this, because this is the only time that you will meet someone who understands EXACTLY what you are going through. We can happily chat away about things that would baffle most people, such as the infamous "red sleeve", symptoms like ooze and chills as well as the psychological trauma of TSW. It was great to meet with carers/supporters too. Support is so vital for us at this time and we truly appreciate our family members and partners who stick with us and give us the physical and emotional help we need to get through this.

I met a young teenage girl who is a complete inspiration. She is only 4 months off the steroids, some of which were very strong, so she is in probably the peak of withdrawals. Despite this, she is wonderfully positive and never moaned or complained about her TSW. A lot of adults, myself included (I was a complete cry baby in the early stages!), would be humbled by her quiet dignity and excellent attitude. She wants to be a make-up artist when she is older and I believe she will succeed in her goals, including the more short-term plan to beat TSW and heal. She is truly beautiful on the inside and outside.

One of the big subjects that came up in conversation was how frustrated many of us are when our doctors are dismissive of TSW. Some doctors are refusing to look at the information and articles about steroid withdrawal, dismissing it as Internet scaremongering. Here in the UK we are desperate for medical support and recognition. If anyone in the UK knows of any doctors who are sympathetic to TSW, please contact me via the comments section on the blog and I can forward the information on. We really need doctors and dermatologists who are willing to treat patients without steroids or immune suppressants like protopic.

The time went really fast and when I looked at the clock, I noticed we had been chatting non-stop for 3 hours! We all agreed that we would love to meet up again, maybe in a more central location like London, which is accessible to even more forum members.

Anyway, we took a few photos...

Here we are...merry group of TSW'ers with a positive attitude. We drank lots of coffee that morning!

Kitty brought her copy of Scratchy Monster for me to sign.

Thank you everyone for coming and making our meeting a success.

Nobody has to go through TSW alone. Get on the forums, find out who lives near you and get together!

As of today, Itsan has almost 700 members worldwide and the most users online at the same time is a whopping 201! The forum is burgeoning and growing at an exponetial rate, making it easy to locate someone who is local to you.

So go out and do it!

And then blog about it!

The Fundamental Problem With the Term: "Heal Faster" .

"...while I, weary traveller, must always take the slower path..." Doctor Who, The Girl in the Fireplace.

Nobody wants to be stuck in steroid withdrawals for any longer than is necessary.

Fact.

The thing is, when I started out on this TSW journey, I had it in my head that it would only take me 6-12 months to heal. It seems madness now that I think about it, especially considering my usage history, but at the time, there was not much information available about TSW and only a handful of blogs written by people who had no healed at that point.

Now that some time has passed, there is a wealth of evidence available about TSW healing times:

1. Children tend to heal relatively quickly, as they have not generally used as much TS as an adult. Keira, who I based my Scratchy Monster story on, took 9 months to completely heal from TSW.

2. Those with minimal use of steroids tend to heal quite quickly too. A member of the Itsan forum whose son used steroid creams for 3 months and became addicted reported that he was fully healed after 10.5 months.

3. For the rest of us, healing can vary dramatically. Rochelle, my fellow blogger, posted a healed video of herself at 16 months, Juliana, another blogger, at 24 months. Those with 40 plus years of heavy steroid usage, such as Kelly Palace, founder of Itsan, are reporting longer healing times. Kelly is now 4 years into withdrawals and mainly healed, but Dr Fukaya has told her that she may take 5-7 years in total to fully heal due to her usage history.

4. When Itsan interviewed a leading doctor on this subject, he started that, on average, most cases of TSW take 3 years to heal.

Based on these facts, we can see that there is a huge variation when it comes to healing times. Why is this?

Well, it mainly has to do with steroid usage and potency. In theory, a person who has used a small amount of hydrocortisone over 6 months should heal a lot quicker than someone who has used oral and potent steroids for 40 years.

Even if someone uses the same cream as someone else over the same time period, usage will vary. One person may get through a 30g tube every week, another every month. Clearly this will affect healing times.

Of course, there are other factors too. Race and skin type may play a part and I hope that as time goes on and more people share experiences, that we will find out if certain skin types take longer to heal. I have a theory that as I am fair skinned and European, it may take me longer to heal than say, someone of Asian or African descent. Of course, the opposite may also be true. I would love some facts and figures on this too see if it is true.

Geography may play a part. some of us live in hot countries, which can be a problem at the start of TSW, but beneficial later on. Others live in cold countries. As temperature affects blood vessels, this will likely play some part in healing times.

Allergen exposure may prolong TSW. If we are constantly in contact with irritants, it makes sense to assume that the skin will be slower to heal. This was true for one of Dr Fukayas case studies, who had a severe rebound after moving house and coming into contact with allergens that caused a severe reaction.

...OK, which brings me to the point of this post. Everyone with TSW wants to know how to heal faster.

But when they ask this question, they are missing an important word.

THAN.......

It makes sense, doesn't it? If something is faster, the word than should come after.

So...faster than what?

So here is where we need a level playing field. Which, by the way, we are never going to get.

Take for example two ladies we will call Mrs X and Mrs Y. Lets say they stopped steroids the same time as me, November 2011.

Now lets say Mrs X took 24 months to heal, Mrs Y took 18 months and I took 3 years.

Why did Mrs Y heal faster? There are simply too many variables to provide a sensible answer. We may all live in different countries, be different ages, eat different food, have different allergies, use different detergents, do different jobs, have different immune systems and have different usage histories,The list goes on.

There is no level playing field. We simply cannot compare these three individuals and come to a conclusion as to why one healed faster than the others.

Now lets say Mrs Y claims to heal faster because she used "snake oil" every day.

As we can see from the above argument, there are far too many variables to validate the efficiency of "snake oil" as a substance to speed up TSW.

So how could we validate the effectiveness of "snake oil"?

Well, an extreme way would be to get a set of identical twins with identical usage histories, put them in a sterile box for 2 years, feeding them with identical food and dressing them in identical clothing, giving one twin "snake oil" and letting the other go without and seeing who healed first.

A more sensible way would be to study two large groups of TSW patients with similar usage histories. Give one group the "snake oil" and see if they healed substantially quicker than the other group.

Repeat the experiment enough times and you will have convincing evidence about the efficacy of "snake oil".

...then repeat the same experiment with the many supplements, creams and "cures" touted for speeding up TSW.

Unfortunately, the fact is that at this point in time, the 20th November 2013, No such experiment has ever taken place. Hopefully, one day it will, but as things stand we have zero evidence for cures that speed up TSW. No studies, no papers, no articles. Zip, zero, Nada.

Therefore, if someone comes along and claims that they have a way of speeding up TSW, demand proof. Demand to see the article, the study, the document, that PROVES what they are saying is true. By the way, the fact that it worked for them personally does not count as evidence, just like someone saying "There is no proof, but this is my opinion, it is obvious", is utter nonsense.

Maybe one day things will change. It is my sincere hope that they do. I hope that one day, scientists will devise a remedy to shorten TSW healing times substantially. But until that time, please do not allow  yourselves to be duped by those who promise the world. In my experience, those who make such promises usually want money and nobody should spend $$$$$ to cure their TSW.

So next time someone claims that "snake oil", or something similar will clear your TSW faster, just reply:

"Faster than what......?"

Topical Steroid Withdrawal and Oozing Skin

In this, the second of my special anniversary posts, I am going back to a subject that I discussed previously: Oozing skin. The reason for this is because my post on oozing skin has been by far the most popular post on the whole blog, with almost 5000 hits. In this post I aim to discuss the subject in more detail, but would recommend that you familiarise yourself with the original post first.

What oozing is NOT:

I'm going to start by correcting the common misconception that oozing is toxins leaving the body. I have seen this mentioned a lot on the Itsan forum, where people think that oozing is a good thing because it means that the steroids are leaving the body. Oozing is nothing to do with steroids or toxins leaving the body. Besides, those going through TSW need not worry too much about steroids in the body, as they leave the body naturally within the first couple of weeks after stopping the steroid creams.

Another misconception is based on the fact that ooze can sometimes be a yellow colour, which some may confuse with infection. However, just because the skin is oozing yellow fluid, it does not automatically mean that infection is present. Signs of infection include a raised temperature, localised redness and swelling and a cloudy pus discharge. If you are unsure whether oozing is infected or not, it is best to see a doctor. I should also point out that many of us test positive for staph on our skin. Again, this is not surprising, as a large percentage of the population, especially those with skin issues, have naturally occurring staph on the skin anyway.

What oozing IS:

As mentioned in my previous article, oozing has to do with dilated blood vessels. When we quit steroid creams, our blood vessels dilate after being suppressed for so long. People going through TSW have been shown to have high levels of Nitric Oxide in the blood. Nitric Oxide is a natural vasodilator and is used in medicine to open up the blood vessels in patients suffering from angina. It is also the reason that Viagra does what it does!

Because our blood vessels are dilated, we lose fluid through the skin. This fluid is blood serum because the red blood cells are too large to permeate the skin. It is also known as interstitial fluid or serous exudate. The ooze is high in proteins.

I found a couple of really good articles that I would like to share. The first is a Nursing Times article entitled "Current options for managing the problem of excess wound exudate". All TSW'ers should read this. It explains:

"Exudate is a fluid produced as part of the normal wound-healing process, and is essentially blood from which the platelets and red cells have been filtered out (Thomas, 1997a). It leaks from capillaries in the tissues surrounding a wound as a consequence of increased capillary permeability.


Increased capillary permeability occurs either as part of the early inflammatory response that follows any tissue injury or as part of the host response to large numbers of bacteria in the wound bed (White, 2000). As the single-cell (endothelial) capillary walls are stretched widely spaces appear between the cells and fluid leaks into the interstitial spaces and ultimately into the open wound bed. The fluid varies widely in appearance, consistency and quantity."

The article also goes on to explain that complications, such as infection and maceration can arise from the wetness of the skin and that great care should be taken with oozing skin.

Another really good article that I found was "Serous Inflammation: What is it?" The article again states:

"The inflammatory reaction to injury begins with a dilation of blood vessels and an increased blood flow. This is accompanied by an increased permeability of vessel walls, which leads to the escape of a protein-rich fluid into the interstitial spaces. The fluid is an exudate, forced out of the vessel by increased pressure and leakiness."

Dealing With Oozing Skin

Oozing is by far the most distressing aspect of TSW. It looks horrible, it smells and it is uncomfortable.

For most people, such as myself, the best way to deal with the ooze is to let it air dry. Exposing the wet skin to air tends to dry it out nicely, although it can sometimes cause a crust to form. Dr Sato, a Japanese doctor who is an expert in TSW recommends leaving the dried ooze on the skin and not wiping it off as he believes that the proteins reabsorb into the skin and help it to heal. I too have found this to be the best method. I have found that wiping the ooze off just leads to more oozing and that applying creams to these areas often leads to irritation. It was best for me to leave it alone.

If the area is swollen, it can help to raise the affected limb. I used to raise my legs above heart level and found that it slowed the oozing and swelling.

I used to have a bad wet wound on my leg, which I treated in a different way. I used a moist wound healing technique by applying vaseline to the wound and covering with a dressing, replacing the dressings frequently. This helped the wound to heal, although great care must be taken with this method, as covering an oozing area can be problematic and also create a breeding ground for bacteria. I’m not a medical professional and this is just my account of my personal experience with this issue. Please seek professional medical advice about the best way to deal with your skin problems.

Preparations such as Domeboro, an astringent, can help dry up oozing areas. Epsom salt baths are also soothing and a little Epsom salt dissolved in water can be dabbed on the area to calm it down. Again, speak to your doctor about this.

If oozing is a problem at night, it can be good to replace cotton or synthetic bedding with silk, which is cooler on the skin.

As TSW progresses, the oozing will eventually subside as the skin calms down and the blood vessels return to normal.

I hope that this article will help anyone going through the oozing skin stage at the moment.

Special Anniversary Post: Review of the Year

Its that time of the year again folks! On the 21st of this month, I will have been off steroids for 2 whole years! This time last year I did 3 special anniversary posts to mark the occasion. They are well worth a read if you haven't read them already. They were:

Reflections 12 Months Off Steroid Creams
12 Months Off Steroids: Skin Changes
12 Months Off Steroids: How To Cope

They were landmark posts for me and the last one in particular, should be a post that EVERYONE going through TSW should read.

Anyway, I've decided to do something similar this year and I'm starting off with a review of the year, starting where I left off with my anniversary posts. This year has been amazing for me and I wanted to share some of the highs and lows with you all.

November 2012: November last year was a rough month for me. It started with a bad flare, but ended with good skin. By the end of November, my skin was in better shape than ever and I was feeling good.

December 2012:..Unfortunately it did not last. December was a really bad month for me, due to the really bad weather we had here in the UK. However, a big boost for me was the news that fellow blogger Rochelle had finally healed of her TSW after 16 months. Her wonderful vlog gave me the courage to go on. December was also my blogoversary, and I celebrated the fact that I had 83,000 hits!

January 2013: New year, new skin? In January, the blog viewership passed the 100,000 mark and I was jumping for joy. The best thing that happened in January was the fact that I got to meet up with some other red-skinners on a very cold day at Festival Hall in London. It was an amazing experience and I felt a connection with everyone I met. Another high point was fellow-blogger Joey winning an award for her Squidoo article on the dangers of steroid creams.

February 2013: February was another miserable month for me thanks to the bad weather. The only high point was receiving an appreciative email from someone who had read my blog and said it had literally saved their life. By February there were lots and lots of new TSW blogs popping up, giving TSW a greater profile on the Internet.

March 2013: March was snowy and the cold weather was relentless. My skin was still going through flare cycles and I was desperate for the good weather to rescue me. I also had a go at reducing my steroid inhaler dosage, but it just wasn't happening for me at all.

April 2013: Things started to change in April. The weather was better and so was my skin. I was very happy to receive an award from Itsan for all of the hours I have put into volunteering. Itsan had their first international get-together in California and I wish I could have been there. The sun was out in the UK too and my skin went through a huge metamorphosis and cleared up nicely. The best thing that happened in April though, was the release of our lovely book, Taming the Scratchy Monster, which was a result of over a year's hard work and planning. I am grateful to Kristina for helping make my little story into a big success.

May 2013: I only updated the blog 5 times in May because I was out there living life to the full. In May I hit the 18 month marker. My skin was almost clear and the blog hit the 170,000 viewer marker. The best thing this month was meeting my blog-pal Miss Kitty Fantastico on a busy Saturday in Ikea. We had a lovely time and I am a big fan of hers. Meeting other TSW'ers is always a huge buzz.

June 2013: In June I had more good news. Another blogger, Juliana posted on her blog that she too, was finally healed. This was a big boost. My skin was also better than ever and looking nice and pale! The Internet was bursting with new TSW blogs and I was over the moon.

July 2013: In July, our book was finally available to order from the Itsan website. All of the money raised from the book has gone to Itsan and has helped many, many families understand how TSW affects the body. July was also the month in which Itsan released an informative video about the dangers of steroids, which can be viewed here. Here in the UK, we had a heatwave, which cleared my skin up to the stage of almost being completely healed.

August 2013: I had a great August because this was the month that we went on holiday to Devon! I have great memories of sitting on the beach at Ilfracombe, getting lots of sun on my skin and I was even brave enough to have a paddle in the cold sea. I could finally tolerate alcohol again and was able to enjoy a nice drink every evening during the holiday as we watched the sun go down. I only wrote 4 posts this month because I was so busy having fun. I was even able to tolerate scented bath products! Yummy.

September 2013: September was a big month for me because it was the month that the Itsan forum went live. We previously had a Google group, but the forum was woefully inadequate and it was hard to keep track of previous threads. The new forum was wonderful and a lot easier to manage. I came on board as a moderator to help Joey out and a few more of us "vets" came on board as forum staff, meaning that we were better able to keep an eye on the forum 24/7. In the few short months that the forum has been running, we have had almost 600 people join us and there is a wonderful, welcoming atmosphere on there. The International nature of the forum means that there is always someone online and always someone to answer questions or provide a shoulder to cry on.

October 2013: By this stage I almost thought I was healed, so it came as a bit of a shock when the weather turned and so did my skin! I had a massive rebound at the end of the month which completely knocked the wind out of my sails. TSW is so unpredictable. On a more positive note, the blog passsed the 250,000 pageview marker, which was massive for me.

..Which brings me to now...This year has been amazing, despite the ups and downs. I would have loved to say that I am now healed, but I think I need to "cook" a little longer yet. Hopefully this time next year things will be different. I had a massive break in the summer though, so I can't moan too much. Itsan have accomplished so much in getting the word out there. It has been great to have been a part of it.

Attitudes are changing and hopefully next year will bring even more changes.

Full-Body TSW vs Nummular Type

I learned something new this week, which just goes to show that even after almost 2 years off steroid creams, there is always new information out there. Long may it continue to be so!

Anyway, on the Itsan forum, one of our members had been to see Dr Rapaport about their skin and came back with this report:

"He said what was interesting about me was that I don't seem to have it too bad. I do not have it at all on my face and my right hand has the smallest spot on the back of my hand. He said that 10% of cases present like me, that it is the nummular type, and this is about the extent of it. He said that a very large amount of my skin looks completely unaffected, and that's a very significant thing. He said that he only just met me now, and I'm only starting my third month, and he is cautious of being too hopeful, but he said that it was looking very good for me. He said he doesn't know what makes someone nummular and not full body, this is just how it happened to be for me."
This is really interesting. It seems that 10 percent of people going through TSW have a more localised withdrawal pattern, as is explained further:

"I'd like to clarify more on nummular eczema. That might be a new term for some of you. It means your eczema spots come up coin shaped. Not perfect circles, but the about the size of coins. Now mine were bigger and some smaller, but it means you have spots. Now in TSW, my spots all merged and some were really big like grapefruits, and some were small like quarters. But what it means is that I did not have a whole sleeve of red skin. On my leg it seemed like my entire shin and calve was involved, and my entire belly was involved. But Dr. R said he was glad to see a lot of healthy skin."

Nummular means "Coin shaped" and people with nummular type TSW have circles of rash rather than the overall redness that most of us get.

I find this exciting and great news for those that have the nummular type because their withdrawal may not be as severe as the full-body type.

I have mentioned this before, but my husband also went through mild TSW because he used to help me apply the steroids to my back and hard to reach areas. He got bad rashes on his hands and when he stopped using TS they got worse, with horrible cracks. Thankfully, after months of TSW he has recovered and his hands are normal. The TSW was only ever localised to his hands and never spread any further than his wrist, which makes me wonder whether he had a very mild form of the nummular type.

I think that it is wonderful that not everyone gets the full body type, as it may be a little ray of hope for those starting TSW that they may be in the 1 in 10 that does not go full-body and heals quicker.

A Picture of Hope

I just wanted to share a picture that my friend Kristina posted on the Itsan forum recently.

 

 

Her husband had the picture comissioned as a special gift and got back in touch with the artist, Gloria Piniero, who did the pictures for our book. He came up with the idea for the picture himself, as Kristina explains....

 

"

This painting really moved me as it is a picture of all the children lining up to get rid of their Scratchy Monsters, my daughter being one of them not too long ago == an endless line of children and individuals still suffering and in the middle of the TSW storm. As they heal from TSA, they leave their monsters behind in a coral (the coral should have a sign 'ITSAN' over it!) -- where the monsters can no longer torment the children. This painting is kind of closure to the hellish chapter in our life with my daughter now happy and healthy at the end of it all. I couldn't stop staring at the picture.

The girl behind the book stand is my daughter. My husband knows how much I worry about her after everything she went through -- none of us seem get through this experience unscathed (emotionally/mentally) no matter what age, though children definitely seem to be more resilient. The healing process doesn't just end with the physical healing, but continues on with the psychological healing and eventually the piecing back together of one's/family's life. It is a traumatic experience to say the least. He wanted to show me that our daughter is okay -- happy and healthy -- a story she is now sharing with others who are still in search of the answer to their on-going suffering. Perhaps, now I can make some sort of sense of what seemed like such a senseless experience of pain and suffering at the time, turning our lives upside down.

Instead of a lemonade stand, her early childhood led her down a different path which is unique to her life story -- one that has helped shape her into the amazing little girl she is -- one where rather than a lemonade stand, she has book stand with ITSAN's Scratchy Monster book.

Each child has their own unique monster next to them as their withdrawal experience is a little different from one another (of different colors and sizes and shapes) and as they drop their monsters off with their rashy skin, the sky brightens as they begin to heal, emerging from the dark storm. The main character of the book is also getting his copy of the book.

A powerful painting with so much mixed emotion behind it - darkness and sadness, but also one of hope with a happy ending and sunny skies at the other end."

Thank you Kristina for sharing your picture with us and giving us hope. Thanks also to your husband and Gloria for working together on the final image.

It is nice to have an image to focus on we we are feeling down. I hope we are all rid of those pesky Scratchy Monsters soon!