Annie Lowry
Appearances
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
An upsetting amount of money that has led to a tremendous social crisis due to our treatment of pain. But it is also true that, you know, there's a lot of chronic pain and we have a lot of ways to treat it. And, you know, I think there's now a lot more emphasis on non-opiate medications to treat pain while also acknowledging that a appropriate opiate medications to treat pain.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
So there just wasn't a lot of optionality for treating itch. It wasn't the sort of thing that medical centers were going to make a lot of money by treating people with chronic itch because they didn't have options to give them. I also think that there's a social aspect. Pain is so awful. And I would never say that there's something ennobling about pain.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
But I think that there's a certain amount of social respect to people who are going through it. And itching, you kind of sound like a Muppet, right? I do think that itching, it's just a little bit disrespected. You look like a dog with fleas. It's embarrassing to scratch yourself in public. It's inappropriate to scratch yourself in public. I think people just kind of don't take it very seriously.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
I'd also thought a lot about how like you know, if you had a chronic itching support group, everybody would come into it and then just start scratching themselves and then make everybody else itchier by being in the simple presence of people who were itchy. So I don't know. But it's something that, you know, people suffer through alone. It's kind of embarrassing.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
And it's been so nice since the piece came out to get, I got a lot of emails from people suggesting lotion. And I was like, okay, thank you. Thank you for that. But then I got a lot of emails from people who were like, people don't believe me, but I've been itchy and they don't know what it is and I feel so alone. Or I have this cancer and it makes me itchy and it drives me completely nuts.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
And so it was really nice to get responses from people who didn't want to be alone and do have some trouble conveying to folks just how hard it can be. And this is not to, you know, there's no misery Olympics here. I'm not saying like pain is awful. Itching is awful. It's just that sometimes I think itch is not respected.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
It says, yes, I have tried lotions. So people, when you say that you're itchy, I think they kindly assume it's a dermatologic thing. And they're like, oh, yeah, I was itchy, too. And I tried this lotion and you should try this lotion. And I try not to get short with those people because they are trying to be helpful.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
But I'm like, I'm not saying I've tried everything, but I've tried a lot of things. Like I'm an expert in my own itch at this point. And if Userin fixed it, I can assure you that I wouldn't be experiencing it. But people are trying to be nice. And so I try to be nice back. I don't know that I succeed at that all the time.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
Itching, it's just a little bit like disrespected. You look like a dog with fleas. It's like embarrassing to scratch yourself in public. It's inappropriate to scratch yourself in public. I think people just kind of don't take it very seriously.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
Yeah, I try not to talk to people when that happens. I guess in some ways it's nice that usually when I'm really itchy, it's at night, like in the middle of the night. Because, you know, during the daytime, it would be pretty unusual for me to be severely itchy now. That was not true when I was pregnant so much. But now it's like the sun starts to go down.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
I'm leaving the office so I can go hide in my house if I'm itchy. You know, so for the past week that I've been itchy, it's mostly it's been at night. And I just excuse myself because it's just like sometimes I'll subtly try to scratch my head or scratch my feet or something. But it's noticeable. People kind of pick up on it. It's like not a cool thing to do socially.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
I think it leads to a sense of disquiet in the person that you're talking to. And then they end up scratching themselves. You've just you've allowed your itch to become contagious. Yeah.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
I often sort of tell it to shut up. I'm often like, I know, I know I'm itchy. You can stop it. I know. I don't need to itch. I don't need to be scratching. I don't know why it's happening, but it could stop and we'd be fine. There's no point to my itching. It's not helping me get something off of my skin. It's just interrupting. Yeah. Thank you so much.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
So many people come to better terms with that. And I always want to be careful to note, like, it's, you know, I don't think that illness is any kind of gift. And I don't think that there needs to be upsides to bad things happening to people at all. But I do appreciate the insight that I've had into myself, even if I wish that I never had occasion to have it.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
Just like you can endure a lot. Your body is going to fail you. You know, it can feel completely crazy making and obsessive and miserable and you can survive it. You can just keep on breathing through it. You can do really amazing, wonderful things. And again, that's not to say I think that it's worth it or that I'm taking the right lesson away from it.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
I really often just try to be like, not everything needs to be a lesson. You don't need to respond to things that are unfair and difficult in this fashion. But writing the piece led me to a much greater place of acceptance, and I really appreciated that.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
I'm so sorry. Especially the people who are always itchy. I'm really sorry. I hope you turned this off the second you heard it. You're like, nope, not me, not today.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
I hope so. I hope so. And it is all of us. All of us. It's yeah, it's not as common as chronic pain, but chronic itch is really common and everybody is itchy at some point.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
It is. I have been itchy for about four days now. So we're talking during the daytime, so I'm not terribly itchy. But my feet are itchy, my scalp is itchy, and my hands are itchy. But it's a two out of ten. It's manageable.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
At its worst, it was like having poison ivy in the acute phase of poison ivy, although my skin didn't show anything. There was no rash or anything like that. And it was completely maddening. It was impossible to do anything other than focus on scratching or trying to find relief from the itching. And the type of itching that I have is not sensitive to the medications that we have that normally...
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
turn the itching dial down. So the two big ones being steroids and antihistamines. And it just became all encompassing. I would spend hours in cold baths. I would walk to try to get rid of the itch. It was most intense. I've been pregnant twice. I have two kids. And at the end of one pregnancy, I asked my surgeons, I was like, if this doesn't stop, I don't want these limbs on my body anymore.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
It was really debilitating. And I'm not like that all the time. And in fact, the itching has never been quite as severe as it was in my pregnancies. Now the itching is much calmer, although it is persistent. But it comes and goes. At its worst, it's really, you know, just like pain is debilitating, itch is debilitating.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
The amount that you might itch and the place that you might itch has to do with the network of nerves inside your body and the messages that those nerves are receiving from chemical irritants from outside your body or the chemical messengers within your body.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
And my understanding, and I'll just note that I am not a scientist, I am not a doctor, I am a lay person who knows a lot about this, unfortunately, from experience, is that when you have a lot of So basically itchy receptors, nerve fibers that accept itch and you have a lot of chemicals that engender itch like histamine and others in those sites, you'll feel itchy.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
And one thing that happens to me and I know happens to other people with chronic illness who get itching is that it actually you'll feel itchy on the inside of your body. Like, you know, in your guts, right? Like part of your body that has, you know, you're not itchy on your skin and you can't get to it. So there's no way to scratch it.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
And I remember talking with a number of dermatologists who were like, well, you don't really have the nerves for itching on the inside of your body. And, you know, I would talk to other doctors or doctors. patients, people who itched, and they'd be like, no, no, no. And I felt this way too. I was like, no, I swear that I feel it.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
And I finally found this one neuroscientist who was like, oh, no, no, some of those fibers exist inside your body. So yeah, anywhere where you have those, there's probably a little bit of itching possible. And I felt very, very good knowing that. But yeah, so I think that your hands, your hands are just enormously sensitive, right?
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
Like so many of these touch receptors and receptors for hot and cool are on your hands. I think your feet and your scalp are also places that are just really, really sensitive in your body, whereas, you know, like, you know, the small of your back or something might be less innervated in that way.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
Absolutely. I've tried to come up with a lot of metaphors for itching, and I feel like we have a lot of metaphors for pain, right? Unfortunately, all of us in human bodies experience pain and often really severe pain. And itching is basically a universal phenomenon also. But itching feels kind of qualitatively different to pain, at least to me in some ways. It can be really hard to tune out.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
I always describe it as being like a car alarm, right? Like you can't stop thinking about it. It interrupts you somehow. It feels like being trapped inside your own body. And, you know, maybe pain has these qualities for other people. Sometimes I describe it as like a feeling of drowning. It creates in me a sense of fight or flight, but there's nothing to flee from and nothing to fight.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
I guess you can scratch yourself and you're fighting your own body. It has this kind of hallucinatorially strange quality for me sometimes. You're feeling things that aren't there. And sometimes I even get that sense, I will feel things on my skin when I'm looking at the skin and there's nothing there. And it's It can be spooky in a way. And notably, there's lots of different ways to feel itchy.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
There's burning itch. There's kind of electric itch. There's sunburn itch. Our brain is amazing at sensing things in unbelievably refined ways. And so, yeah, you know, sometimes it's just a bug bite. And sometimes I'm like, I could write a book trying to describe this.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
I think everybody who listens to this is going to do that. We can talk about why that is. Why is that? Tell me why that is. So just to go back to one thing that you said, and then I'll answer that question. But yeah, scratching, it engenders pain in the skin, which interrupts the sensation of itch. And it gives you the sense of relief that actually feels really good.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
It's really pleasurable to scratch. And then when you stop scratching, the itch comes back. And the problem is that when you scratch or you damage your skin in order to stop the itch, to interrupt the itch, you actually damage the skin in a way that then makes the skin more itchy because you end up with histamine in the skin.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
And histamine is one of the hormones that generates itch within the body. But to go back to what you were saying, there's actual studies that show that itching is contagious. So watching somebody scratch will make a person scratch. There's this interesting question.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
Are people scratching empathetically in the way that we will mirror the movements of people around us in the way that yawning is contagious or crying can be contagious? But it turns out that no, it's probably a self-protective thing. If you see somebody scratching, there's some ancient part of your body that says that person is might have scabies.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
That person might, you know, have some other infestation. I'm going to start scratching to get this off of myself because scratching is in part a self-protective mechanism, right? We want to get irritants off of the body and that's in part why we scratch.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
Yes. So histamine is an amazing chemical that does many, many, many things in our body. And it's part of our immune response. It leads to swelling so the body can come in to heal. And the scratching is meant to get, you know, whatever irritant was there off. And the itch-scratch cycle ends when the body heals.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
So I think that that's all part of a natural and proper cycle that's part of our body being amazing at sensing what's around it and then healing it. But we have some itch that's caused by substances other than histamine. We've only started to understand that kind of itch recently. Similarly, we didn't really understand, science did not understand chronic itch very well until recently.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
And we're in a period, I'd say in the last 20 years, of just tremendous scientific advancement in our understanding of itch.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
I think the patients that he often sees, and he does a lot of things. He, you know, studies itch as a doctor who does medical research, and I believe that he also sees patients. I've talked to other dermatologists who've told me not to itch, who've, you know, tried to hand me cold packs and try to get my hands off of my body.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
and explained the itch scratch cycle and sort of said, OK, we might not be able to treat your underlying itch, but at least we can break the itch scratch cycle and stop that kind of secondary itch that's coming on top of it. And when I talked to him, he sees people that are so miserable and they know they know that scratching is not going to help them. But at some point it's reflexive.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
And I think that he felt like it was cruel to tell people to stop doing this thing. That is deeply irresistible and often the only source of relief that you might be getting, even if it's leading to a problem down the road.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
So short of having like a nice ice cold bath for somebody to sit in, telling somebody with no other answers at that moment to stop scratching themselves might feel a little bit rude. But I would say that all of the dermatologists I've ever seen have been very, very sympathetic and supportive. itches is something that they deal with on a daily basis is enormously common. And they mean well.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
I'm certainly not trying to get on dermatologist's case for that.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
Absolutely. So I have a poorly understood degenerative disease called primary biliary cholangitis. It's autoimmune in nature. It seems to be partially genetically, you know, you perhaps have a genetic predisposition, but then perhaps environmentally triggered. They don't really know why people get it. Right now, I believe that it's roughly 80,000 people in the United States total who have it.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
About 9 in 10 of those people are women, and the disease is most common in adult women, somewhat 40 and older. And it is a disease in which the body mistakenly attacks some of the cells in your bile ducts, in the lining of your bile ducts. It causes them to inflame. It hurts your liver's ability to secrete bile into your digestive system, into your body.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
And ultimately, if the disease is allowed to progress, will slowly progress towards cirrhosis. Disease used to be considered or was often considered fatal. They found a drug, an actually really old drug that dissolves gallstones, works really well to slow its progression. And so, yeah, so that's the condition that I had.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
I was diagnosed with it during my second pregnancy, though I clearly had it in my first pregnancy. And I was young, although not unheard of, young to get it. And my OBGYNs had never had a patient with it. It took a while to get to a hepatologist who recognized it.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
But it, like a lot of liver and kidney conditions, for reasons that are not understood at all, causes really, really bad itching that does not respond to antihistamines and does not respond to steroids.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
When scientists said that itching is a disease in and of itself, what they meant was was that chronic itching changes the body's own circuitry in a way that begets more chronic itching, that implies that itching is not just a side effect, it's a body process in and of itself.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
And so instead of just being a symptom, instead of being something where if you fix the underlying issue, you might fix the itch, itch itself can kind of rewire the body and can be treated as a condition unto itself. And a lot of dermatologists see itch that way. It's often a symptom, often a side effect, but sometimes it's really its own thing in the body.
Fresh Air
Best Of: Why Do We Itch? / Writer Richard Price
It's a great question, and I think that the answer is multilayered. So one is that doctors didn't understand itch, even just that basic histaminergic itch, very well until recently. There's not a lot of drugs to treat itch, and there didn't seem to be a lot of money in treating itch. there's a lot of money in treating pain, right?