It's an Engine That's Running 

It's an engine and it's running. Maybe it's even a steam engine.

Since January I’ve been struggling with the worst kind of illness: one that is incredibly annoying but not serious enough that anyone gives a crap about. Cholinergic Urticaria. Prickly heats. Heat rash. I’ve tried every tincture, salve, cream, ointment, powder and potion you can name but it’s all nothing but temporary. A dose of cortisone or similar steroid usually does the trick but not this time. After describing it to a friend when he noticed I passed on drinking a beer (beer, wine and liquor all make it much worse) he responded, “I get it. It’s an engine that’s running.” Which really is the best way to describe it. It is an engine, it’s running and I can’t find the brake.

Each time it subsides I feel the uncertainty that this is the time it will stay quiet. Yet, sometime, usually in the middle of the night, the itch awakens and I find myself scratching uncontrollably like a dog flaying at a tick or a flea. When it quietens down, I feel the burn that I brought upon myself. No one else did this. I did this to myself. Sometimes I scratch myself until I bleed but mostly it’s more like I’ve been rubbing sandpaper over my skin. I’m red and raw mostly in the webs of my arms or behind my knees. Once someone pointed out that I had a rash on my legs as if to say, “Hey, I don’t know if you know this but that rash of yours is on your legs too.” Why, thanks. I’ve never noticed the very thing that has been tormenting me constantly for months. Of course I noticed. Did you think I carry my skin around like a piece of luggage and not notice when it gets scuffed?

During the summer when I rode my bike from Toronto to Ottawa I thought I hit a turning point. Each day was roughly 90 kilometres and sunny and hot. The sun would pour down on my arms, and I would turn up my internal furnace with every pedal crank until my forearms would be covered with hives like some kind of giant goose bumps. It was as though my skin was bubbling bacon, burning under the heat, about to erupt in hundreds of pustules. Because I couldn’t or wouldn’t take my hands off the handlebars I rode through it and pushed on without scratching. After one particularly long day the AirBnB host I had arranged welcomed myself and riding partner and said, “That must’ve been a long day in this heat. You’re welcome to the pool. The temperature is just right.” No truer words have ever been spoken. I stripped off my things and waded into the pool and floated. I cooled down quick as hot steel quenched in cold water. Immediately the rash disappeared. For days after I avoided putting any irritant on my arms like sun block or any kind of moisturizer and my skin cleared and healed noticeably. It was like I had been baptized and healed from that cooling pool. Again, the relief was temporary.

Another trigger that activates the itchiness is alcohol. Specifically beer, wine or whiskey. Within minutes of drinking the rash becomes unbearable for hours. The only reasonable explanation I’ve heard is the histamines in the beverage worsen a rash that’s already there. For years I never drank wheat beer or red wine (everything else seemed fine) for fear of triggering an attack. Now it’s almost everything. Weirdly I’ve noticed that clear alcohol such as vodka, rum (clear not brown) or gin (again only if it’s clear) have no effect. I know I sound liked the crazed General Jack D. Ripper from Dr. Strangelove and his obsessive compulsion to only consume pure grain alcohol but it’s true. This has provided more insight into other people than it has my own condition. For instance I would hate to be an alcoholic trying to live their life saying, “No thanks. I’m not drinking.” Whenever I turn down a drink, there is a barrage of other alcoholic drinks offered, then questions that are usually something like, “Is it a medical thing?” Why can’t it just be a, “I’m not drinking, it’s none of your business and you can stop with all the stupid questions kind of thing”? Maybe people don’t even realize they are doing it. Or maybe they are idiots who will stop at nothing to ensure alcohol passes my lips for absolutely no reason other than its own objective. It’s not as if I’m stopping them from drinking. Why is it so hard to ignore what I am doing? Is it possible we could consume something without alcohol? Apparently not without a fight.

Then there is explaining the “how” of this affliction. Over heating is what causes it, but, in my experience, once it appears there’s nothing to do but wait it out. I don’t have to be hot for it to start now that I have it and it doesn’t take much “heat” to start it. And no, eating spicy food won’t make me itchy. Now that the weather has taken a sudden chill, I’ve got a fighting chance of avoiding excessive heat. This summer, just sitting, holding a book up to read was enough to cause warmth and sweat in the web of my arms to start itching. Sitting in a plastic chair would cause my back or backs of my legs to become inflamed. Once it has started, it runs. Right now it’s an engine that’s running and all I can do is to wait for it to run out of gas.