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21 July 2010 @ 08:20 am

For reasons not entirely clear to us, though the landlords had kept the recycling and trash bins in front of the house, the compost bin was in the back garden. Today is compost-collection day, so last night Ted brought the bin in through the kitchen (the only way it can be brought in) out to the front.

In the brief time it took to do that, one jillion fruit flies swarmed out of it.

We set out hole-punctured plastic-wrap-covered jars of cider vinegar, which got most of the little fuckers, but there are still enough to make me shudder. Hopefully a few days of vinegar-jars will get rid of all of them. *shudders more*

Also, I appear to have athlete’s foot (& have had for some months now) which has not been killed by the applications of tea tree oil, and as a rule all the other homeopathic cures involve sitting around lollygagging with feet soaking in vinegar or bleach or whatever for 20 minutes at a time twice a day. *snort* Yeah, right. But I’m loathe to use topical ointments while breastfeeding (or while pregnant, which is why I’m still infested). Argh.

This morning’s post brought to you by mildly gross things, apparently. :p

(x-posted from the essential kit)
Autopopeautopope on July 21st, 2010 07:39 am (UTC)
Athlete's foot: forget the tea tree oil, just go for chemical warfare. I'd start with clotrimazole (aka Canesten™) cream, twice daily. If that doesn't produce rapid results (decrease in itching within 72 hours) switch to miconazole (aka Daktarin™) cream. If that doesn't work, see a doctor (you may have a resistant strain).

If one of these creams produces a marked reduction in itching, keep applying it for two weeks, even after all signs of athlete's foot have gone away. Fungus is persistent! Stop too soon and you'll be back to square one within a month.

If you can find a branch of Boots in Dublin (they're in Ireland, right?) they do a "dual action" athlete's foot powder containing tolnaftate and chlorhexidine (the latter being a general purpose bactericide). Spray it in your shoes before wearing them; spray it in all your frequently-worn shoes, in fact, and change shoes regularly.

I had persistent athlete's foot last year, which was finally fixed by nuking the pair of shoes I was wearing 80% of the time -- I was curing the infections using antifungal cream, then reinfecting myself from spores hiding in the leather uppers.

Breast feeding: there's a lack of research on these agents. It doesn't mean they're definitely unsafe -- it means that the pharmaceutical companies see no profit in and lots of grief in conducting clinical trials on babies, so they didn't do that.

The Boots athletes foot powder is considered to be safe during breast feeding. Clotrimazole: no research, but it's been used extensively during pregnancy with no significant side effects noted. Miconazole: the language is somewhat more cautious. In any event, if breast feeding, do not use these agents where your baby will come into direct contract with them or ingest them.

Edited at 2010-07-21 07:41 am (UTC)
Autopopeautopope on July 21st, 2010 07:58 am (UTC)
I feel I should unpack the significance of those ghastly warnings: "this drug has not been tested for safety when breast feeding and should only be used if the benefits outweigh the risks ..." just to set your mind at ease a little.

Suppose we have a new drug for athlete's foot. It is sold by a big, profit-oriented corporation. They got its product license by testing it on healthy adult males (this is the normal way they do things -- or did, until recently).

You are female, as are 50% of the population. You will on average live 78 years -- call it an "adult" life expectancy of 70 years in medical terms -- and be pregnant 3 times at most. So you'll be pregnant for 2.25 out of 70 years, i.e. 3.2% of your life. Averaged over the entire population, we (humans) spend 1.6% of our life -- or less -- pregnant.

Assuming athlete's foot affects everyone uniformly, proving that it is safe to use the medicine during pregnancy will therefore at best only increase $BIGCO's market penetration by 1.6%. But there is a risk -- low, but non-zero -- that such testing may reveal that the medicine is unsafe during pregnancy. In which case there will be (a) pay-outs to the affected parents and children, (b) draconian restrictions on use (forget ever selling it over the counter -- it'll be prescription-only, so doctors and pharmacists can prevent it being used dangerously), and there will be a concommitant fall in profits.

Ergo, test new meds on pregnant women? You jest! Let's just slap a warning on it saying HERE BE DRAGONS, PROCEED AT YOUR OWN RISK.

Much the same cost/benefit calculation goes into breast feeding. Proving that the new pharmaceutical is safe during breast feeding will cost lots of money and expand the market for the drug by 1-3% overall. Learning that it isn't safe will drop the hammer on over-the-counter sales. So it's best not to ask, if you're a flinty-hearted executive.

Now for the good news.

All these anti-fungals -- tonaftate, clotrimazole, miconazole -- have been in use on a wide scale worldwide for more than 25 years. As new anti-fungal agents, they were originally licensed for use under prescription; they're now available over the counter in pharmacies, which is only permitted for medicines that have been on prescription for a long time and are believed to be safe.

(The screaming exceptions are aspirin and paracetamol, for which a grandfather clause applies; they've been around for a very long time indeed and would not be licensed for use in humans, even on prescription, if they were presented as new drugs today.)

This is not to say that you can't poison your baby with them, but you'll have to work hard at it. Topical preparations applied to areas of really thick skin with poor blood circulation (the feet) are very unlikely to be absorbed and circulated through the rest of your body -- and the dose you'll be applying to deal with a local fungal infection is too low to have a systemic anti-fungal effect. (Squirting it on your foot will not cure the ringworm on your head.) The most likely risk factor to your baby would be if you applied it to your breasts, right before breast-feeding.

But don't take it from me. If you have any doubts, go and pin down your local pharmacist: "I have athlete's foot and I am breast-feeding. What's the safest non-homeopathic, non-herbal treatment option?"

Edited at 2010-07-21 08:07 am (UTC)
kitmizkit on July 21st, 2010 11:16 am (UTC)
I have gone forth armed with your wisdom and gotten ... the sort of ointment the intarwebs generally seem to say "my doctor said this was fine" about. Thanks, Charlie. :)

(and I do know the whole drugs in pregnancy/breastfeeding thing operates on a better safe than sorry mindset, and athlete's foot cure is not one of those things that comes with a warning that says "if you have ever seen a pregnant woman in your life, even from a distance, do not take this drug", but, y'know, well. Paranoia reigns.)
Mspiritdance on July 21st, 2010 12:41 pm (UTC)
If it helps to ease your mind any, when I ended up with a yeast mastitis with DS1, I was offered a couple of options, including chlortimazole (what I used)

When it feels like you've got ground glass in your breast, and it gets worse when your baby latches on, you get really desperate, really fast :) (and yes, he got treated for his thrush at the same time)

I'd suggest doing as autopope suggests, and washing your hands before handling the baby :)