Thursday, February 25, 2016

Am I one of "those people"?

Where do I begin.

Thread 1:  FOOD!
I hold fast to the part of my identity that loves food and will eat whatever I want whenever I want. That's not to say that I eat terribly all the time, but I don't really think about what I eat and if I'm getting enough vegetables, etc.  I love dairy - especially cheese, I love meat - especially a delicious cheeseburger, I love vegetables, I love fruit, I love carbs, I love sugar.  "Everything in moderation". Love that.  I have been known to roll my eyes at "those people" who don't eat such and such. Judgmental, but true.

Thread 2: SKIN
I have never had good skin.  Always really dry.  Always really sensitive.  I also have been struggling with acne.  Again.  For like the millionth time in my adult life. The first time I really had an intense blow out was right before a good friend's wedding.  The woman doing makeup for the event basically had to shellac it on.  I remember crying in the bathroom at the reception to one of my grad school friends at it.  I was prescribed some things, it got worse, and then magically it got better and stayed that way for a while.  When I was pregnant with my daughter, my skin was again terrible.  I was prescribed some cream that was conducive to pregnancy and breastfeeding.  Things got a little better. Then I got pregnant with my son and my skin was decent.

And now, here I am 2 years later.  Again with the acne.  Full force, cystic.  Awful.  My now five year old daughter asks "Why do you have those red bumps all over your face, Mom? I don't like them." Yeah, neither do I.  Can I put a bag over my head now?

I tried paring down products, switching to natural, responsibly sourced products.  Things got a little better, but not much.  My skin was red.  Itchy.  Inflamed.  Angry.

My primary care doctor prescribed something last fall.  Tried it, when the tube was gone, and my face was still gross, I made an appointment with a dermatologist.  She confirmed hormonal acne, and prescribed me spiranolactone.  "Spiro" is actually a blood pressure medication which has been shown to improve hormonal acne.  "You're gonna love it", she said.   I was so wanting a magical elixir that I didn't ask any questions except to ask how long I would have to take it.  She answered, "It would be something you would always take."  She also gave me some samples of Aczone, an acne cream, with a prescription for that.  I drove straight to the pharmacy to fill both prescriptions.   Pharmacist warned that the Spiro is a diuretic and also can cause dizziness.  Ok great.

$300 later, I had them in my hand.  GULP.  THREE HUNDRED DOLLARS.  And that was with a coupon.  Damn high deductible health plan.

Days later, it occurred to me that something that lowers blood pressure, causes dizziness and is a diuretic may not exactly be the greatest thing for someone training for a marathon, who already has low blood pressure.  I haven't had many noticeable side effects, but I also still have to go in for a blood test to confirm that potassium isn't ruining my kidneys.

I have been taking the Spiro and applying the Aczone 2x a day for about 40 days.  Nothing really dramatic has happened.  No changes.  I know this from experience - acne medication can take a while to work.  12 weeks is usually the magical wait time.

FOOD + SKIN
I have been researching hormonal acne a bit because I am still uncomfortable with the thought of taking this medication long term.  After reading a bunch online, some common themes, related to diet, emerged.  Dairy.  Sugar.  Something called "anti-inflammation diet".

I toyed with the idea of giving up dairy and reducing sugar.  I stopped eating yogurt - which really kills both birds with one stone.  I replaced half and half in my coffee with coconut oil "bulletproof" coffee.

And then I ate half a pan of cheesy, gooey lasagna.  Old habits die hard.

Enter Skin Cleanse and Diet Cults.

I read Skin Cleanse in about a day.  It's easy to digest, no pun intended.  It brought together the disparate threads of what I was reading online. The author is a nutritionist by training, and also developed the skin care line SW Basics. My takeaways from this book were:

1.  Reactions to skin are symptoms.  Dermatologists usually treat symptoms, but often do not address the cause of the reaction.

2.  Food MAY triggers reactions.  "For 99% of you [who suffer breakouts], it likely will be cheese."

3.  Keep a food/symptom journal to see if there are patterns.

4.  Ingredients in skin care products MAY trigger reactions, particularly if you have sensitive skin.  The author was very much from the "responsibly sourced, beauty industry is evil
 camp (e.g., the book contained a list and description of ingredients that you should try not to put on your skin, e.g., parabens) but I liked how she talked about the fact that just because the ingredient is responsibly sourced, all natural, etc, it STILL may cause a reaction in your skin.

THUS

5.  Stop using all skin products.  Use olive oil as a moisturizer if you need one.  Introduce products back one by one.  Keep a products journal with the same purpose of identifying what contributes to flare ups.  (Honestly, the author went a time where she used ZERO products - just water - to clean her whole body.  I'm not that brave.)

6.  Eat more fruits and vegetables.  Eat less processed food.  Eat more "good fats".

7.  Most people do not drink enough water.

Confession: I did not read Diet Cults, with the exception of the last chapter on agnostic eating.  The idea that there are no bad foods resonates with me.  His advice is to make the bulk of what you eat, vegatables, fruits, nuts, seeds, oils, whole grains, and high quality meats.  Try to use sugar, refined grains, low quality meats sparingly. Very similar to Michael Pollan's simple and wise, "Eat food.  Not too much. Mostly plants."

So marrying the two, I am now trying to really eat mostly vegetables and fruits.  For a time, I am trying to not eat dairy to see what will happen.  I, QUEEN OF DAIRY, BOUGHT FLAX MILK PEOPLE!  I am also trying to drink more water - always a problem for me.  Trying to limit sugar.  I am also keeping a food journal right now.  Honestly - I ate vegetables probably 2x a day if I was lucky before.  And I always tried to eat one fruit a day.  The bulk of my diet was really in the "eat sparingly" list - lots of refined grain.  I'm a runner - I'm supposed to eat carbs, right?!

Switching to eating "mostly plants" has been pretty eye opening to how few plants I ate before, even when I thought I was eating decent.  I probably have quadrupled the amount of items we buy in the produce section for the past 2 weeks.

I am also paring down the skin care products for a time.  I am using olive oil to remove makeup, a gentle, paraben-free cleanser at night only, and olive oil to moisturize.  I am still using makeup because I really can't think about not doing so right now.  So Beautycounter foundation, Beautycounter eyeshadow and Tata Harper cream blush are still being used.  I am also still using both prescribed acne medications until my dermatologist follow-up next month.

I started parts of this two weeks ago, and really got serious on Monday, after my birthday.  I already feel a lot better and my skin is not nearly so red and inflamed.  Placebo? Possibly.  But I am continuing on!

I might be becoming one of "those people".

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