Mature Skincare on a Budget

Firstly, I’m trying on this “mature” label… unsure of the fit… wondering if I can make it sound sassy in context… perhaps during the 6th decade as I tailor it to suit. Secondly and more on topic, I’ve searched for skin care to meet my basic needs since I was 13. While pimples have been elbowed out by fine lines and discoloration, a non harmful skin care routine remained my unicorn for over 36 years. Red, embarrassing, and painful reactions followed my use of many popular skin care lines sold in the U.S. Can you imagine the amount of $$$ I’ve wasted on products that landed in a waste bin after just a few uses? A few years ago I settled on Aveeno Ultra Calming foaming cleanser and moisturizer as the least harmful (yet still stripping), most affordable option, until my skin changed again, perhaps due to autoimmune issues, hormonal issues, age, or a combination of all those things and a couple that haven’t occurred to me. I tried everything from diet to dermatology and found corticosteroid cream the only effective treatment, which is when I began researching products again. I knew I reacted to chemicals and needed more natural ingredients in my skin care, AND I needed my face clean to avoid breakouts, AND I needed to retain and add moisture.

Red and Reactive, Dry Beyond Belief

Our universe finally smiled on my skin care quest in November 2017, and took pity on my worsening irritation and painful skin. I hate trying new skin care products, and once again I was justified.

When I stumbled upon Renee on her YouTube channel Gothamista

during a search for low Ph facial cleansers, I had a raw itchy reaction across my cheeks and forehead that lasted for 2 weeks following use of CeraVe Hydrating Facial Cleanser, which is lauded by 90% of users as the best thing since coconut oil and matcha tea. Renee’s minimalist style and my-sort-of-girlfriend demeanor made me watch a whole eight minute video about pH levels and 2-step cleansing. Add free and engaging skin care education, and I may be a loyal follower. To cross the moat of my cynicism, the products she recommended needed to pass a 30-day trial, but I was willing to take a risk based on reviews across multiple platforms.

I have hypersensitive combination skin, at times with extreme dryness/dehydration, which is dependant on weather and skin care products. Low pH cleansers were the next logical step for me, however as my CeraVe trial proved, ingredients also played a role. 7 is a neutral pH level, or the level of water/tears, and I wanted to trial a cleanser with a pH level of 5-5.5, between weak coffee and normal rainwater. Our skin’s pH is approximately 5 and the goal is not to disrupt our natural moisture production by cleansing with higher pH products.  Cleansers and toners with a pH between human blood (7.5 pH) and seawater (8 pH) stripped my skin, which in turn reacted with an overproduction of sebum. It was a perfect  skin care nightmare with few low pH products available in stores.

This low pH cleanser changed my skin and made me very happy: 

60 Days Using COSRX Cleanser with No Reaction

Toners with humectants played supporting roles

I went with a local seller of natural matcha green tea cleansing cream for 1st step removal of makeup and sebum, but not until I used the COSRX cleanser for more than 30 days because our skin cells turn over every 28 days and I wanted a true trial (I don’t wear makeup 5 days/wk). I also added moisturizing toners, a departure from the drying alcohol-based toners I grew up with and believed were necessary to oust that pesky sebum.

Moisturizing Toners that I pat on my skin with my fingers

I enjoy my skin care routine (finally!) and haven’t reacted to one product recommended by Renee at Gothamista, however I must warn you–skin care can be addicting.

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Not Today, Death

“Don’t cry. Stop crying,” she commanded, as I trapped my sobs and focused on her words. “Don’t cry. You have one heart, one body, one life. YOU have to fight for it. Stop crying.” The Infectious Disease Doctor seemed exasperated with me, as if my tears were drops of weakness that made me sicker. Briefly I thought my illness must seem measly to the towering Serbian blonde. In that moment I felt so small in my hospital bed. It was day 4 and despite innumerable tests, no bacteria had been found despite the appearance of my lungs on x-rays and a CT. “Maybe you aren’t finding anything because RA is doing this to me.” “You have fever and pneumonia, all signs of infection. This is what we are treating with antibiotic, ” she waved her hand at an IV bag hanging from one of the poles next to my bed. An oxygen machine ringed in pale blue gurgled and hissed in my left ear. The night before a child with big eyes stood at my bedside wearing a dress in the same shade. Intuition said I should keep that to myself.

When I created this blog 5 years ago I was 44, and fresh off losing a tough, unfair battle for my health and career. I’d been fighting since I was a kid, for myself and sometimes for those who I thought needed a champion, and I was spent. In hindsight, other people, especially those in power, not only preferred women who didn’t make waves, but rewarded them for not fighting. Maybe if I adopted a quieter, more graceful approach during the 5th decade, life would prove less bruising. In any case, I needed time to heal. What I didn’t know is that my fighting spirit would one day be the difference between life and death.

Lying in that hospital bed a few weeks ago, I feared going “…gently into that good night”, dying of pneumonia as the poet Dylan Thomas did, but after 5 years of curbing my fighting nature I was sorely out of shape. There are dreams I haven’t realized because I laid ambition aside, trips I haven’t taken, and works I haven’t written. Death takes who it can snatch away, especially if one cannot fight. Medical professionals are often champions when we are weak, their educated treatment hitting a bullseye and chasing away mortality. And then, there is luck and those who rage; “… rage against the dying of the light” – Dylan Thomas. One physician listened to my mumbles about rheumatoid arthritis as I was sliding near intubation, the ICU, and a large sucking mudhole next to my bed (According to a study published by the American College of Chest Physicians, every day a patient is delirious brings a 20 percent increased risk of prolonged hospitalization and a 10 percent increased risk of death). Once he consulted with my rheumatology office and hung a high dose bag of steroids, the mudhole disappeared. For me, rage didn’t look like the screaming, swing at the fences anger of my younger years. It looked liked grasping, holding on and repeating my assertion that RA affects the lungs, despite feeling small and weak. A reward for my tenacity is more time to write and dig my toes in the sand. Love is sweeter now, too.

My sixth decade begins in a couple of months, time enough to regain my strength, embrace my true passionate self, and resolve to live as loudly as I want. I understand now that I don’t have time to waste. Death is funny that way.

 

5 Things Rheumatoid Disease Patients Wish You Knew

  1. A Rheumatoid Disease diagnosis leads to a double life. Thanks to new treatments, many of us have hours every day when we appear to participate in life just as you do.  There are also private hours spent soaking in Epsom salt baths, taking pain medications, going to doctor’s appointments and physical therapy, meditating, exercising, journaling, supporting one another online, wearing compression gloves and socks, applying cold and hot packs, applying menthol creams and patches, dipping our hands in hot paraffin, napping, taking hot showers, and wearing splints and braces, all to possibly have a few precious hours of normal, or as close to it as we can get.  Sometimes it works, and sometimes the disease rules our day and all we can do is rest and take comfort measures.  This aspect makes traditional employment challenging for Rheumatoid Disease patients, 60% of which are disabled within 10 years of diagnosis.
  1. Different than Osteo-Arthritis, Rheumatoid Disease is an auto-immune disorder that affects people of all ages, even children. Rheumatoid patients around the world advocate for “Rheumatoid Disease” to replace the term “Rheumatoid Arthritis” due to wide-spread misunderstanding.  Rheumatoid disease produces destructive molecules called fibroblasts that attack the protective lining around joints causing inflamed and shredded tendons, cartilage loss, and finally bone erosion.  That is the part you may be familiar with, but Rheumatoid Disease also causes:
    1. Costochondritis (painful swelling in the ribs)
    2. Uveitis (painful eye swelling, may cause vision loss)
    3. Pleurisy or interstitial lung disease
    4. Cervical subluxation and myelopathy (compression of the spinal cord)
    5. Kidney disease
    6. Atherosclerosis (heart disease), the leading cause of death in RD patients.

Educating health professionals about rheumatoid disease manifestations would facilitate early treatment of co-morbidities and delay disability.

  1. Even when symptoms appear controlled, Rheumatoid Disease marches on and adapts to treatment.  RD insidiously erodes cartilage and bone while patients feel perfectly fine, especially during the first 5 years.  Recent MRI studies confirm that even in clinical remission, there is inflammation around the joints, indicating a need for life-long treatment. The first RD medication I took stopped working after 4 years.  Currently, my rheumatoid antibodies are eleven times the norm after 3 years on an expensive biologic injectable.  Our super-immunity develops work-arounds to the medicine.  In the near future I will need to add a low-dose chemotherapy drug to suppress my immune response.  We will have to try other medications that may or may not slow the disease as my immune system keeps adjusting.  There are many RD Warriors who haven’t found a medication that works well enough, or who have run out of options.  One friend of mine injects herself every week for a 20% improvement in Lupus and RD symptoms.
  1. Rheumatoid Arthritis drug commercials exaggerate ability benefits and list a litany of risky side effects in a low monotone.  Actors appear in full remission without Prednisone moon-faces, but more than half of patients never achieve clinical remission for even a short period, and most medications help to a degree if at all.  Don’t get me wrong – I LOVE Enbrel because I can walk, fevers are less frequent, my pain is manageable, and I have little to no bone erosion.  While this miracle drug makes my life worth living, it doesn’t make running on a sandy beach or toting around a toddler on my hip possible.  More importantly, the medication doesn’t make working full-time possible because the disease is still active and unpredictable.  What it does make possible are life-threatening infections, which is why patients whose symptoms are fairly controlled often choose to risk joint erosion.  The risk-benefit ratio is tough to navigate, especially with the booming vitamin/supplement industry promising their own brand of remission.  Just like wrinkle cream promises, none are entirely accurate.
  1. We need you to help us spread the word. Rheumatoid Arthritis is one of the 6 most debilitating diseases in the world, yet the number of rheumatology research projects funded by the National Institutes of Health dropped by 52% from 2010 to 2014, while the number funded by private foundations fell by 29% over that period, according to data published by the Rheumatology Research Foundation (RRF).  A cure is on the horizon with new immuno-therapy breakthroughs, but funding is moving in the wrong direction.

Knowing Your Boobs Could Save Your Life

On Tuesday, the American Cancer Society published new Breast Cancer Screening guidelines reducing the recommended frequency of mammograms for women over 54 to every 2 years and increasing the age for a first mammogram to 45 for women with an average risk of breast cancer.  They also kicked the clinical breast exam to the curb.  How much can a physician know about my boobs and my “normal” by feeling them once a year?  Now me, I can touch them every day if I want, and I certainly see them during my daily ritual.   Early diagnosis is key to beating breast cancer and many are triggered by women who notice a change in the look or feel of their boobs.  Our breasts feel differently in each decade.  Natural changes occur, especially as we bear children and get older.  Tiny, swollen, lumpy, I know intimately the phases my boobs passed through to land happily at soft tissue.  I know what my skin looks like, where there are stretch marks from pregnancy, and the color of my areola, however I need to use the mirror more often with arms raised.  Rashes, dimpling, or swelling also occurs in the breast tissue on our sides, and is more likely to go unnoticed.Breast Exam

The American Cancer Society is careful in its language, stating a woman should have the choice at 40 to request a screening mammogram and become educated on mammography limitations.  Women at high risk (20-25% lifetime risk) should begin annual screenings at 30.  They recommend breast MRI in conjunction with mammography for women at high risk because the two detect different types of cancer, so if I found a lump or had other breast cancer symptoms such as skin or nipple changes, my plan is to request both.  False positives are more likely with breast MRI, but despite the American Cancer Society’s concern about causing me ” a lot of worry and anxiety”, I prefer an unnecessary biopsy with a huge slice of peace of mind to later-stage cancer.  And despite a statement that self exams do not show a clear benefit, I trust my judgement on this one and will continue to feel myself up in the mirror on a regular basis because self-love is a beautiful thing and the new guidelines for breast cancer screening are not definitive, but leave the responsibility with me.

 

Endometrial Ablation, An End to the Bloodbath

 

*Warning:  If discussions about menstruation and lady parts make you queasy, this post is not for you.

Since perimenopause set in eight years ago, I developed penis envy, not so much because I’d like one, but simply to eradicate several unpredictable and exquisitely painful periods per month.  Never prepared, no matter how many bloody tidal waves assailed my linens, my pants, my chairs, my life, I was taken off guard.   I am unaware of a more irritating interruption than a distinct gushing feeling in the middle of a meeting, especially when you are the one taking minutes.  Several times I prayed for a fire alarm.  When my red blood cell count fell to a level worthy of a gynecological consult, I felt relieved.  Dr. Burns, well into his 8th decade, said I seemed a good candidate for an endometrial ablation as long as fibroids did not lurk in my uterus.  Two tiny fibroids, one smack dab in the middle of my uterus and likely the painful trouble-maker, showed on ultrasound.  Fortunately, Dr. Burns has practiced for more than 40 years and was competent in more than one ablation procedure.  The simplest ablation procedure used a triangular mesh electrode that expanded in the uterus and delivered an electric current which cauterised and destroyed the uterine lining, and if needed, he had a back-up plan that used a roller-ball for the trouble-maker fibroid.

Elective surgery, while not typically as serious, entails risk and pain.  Infection is the scariest risk to me, likely due to a 3 month post-surgery infection following a previous gynecological mini-surgery.  I did not agree to an endometrial ablation sooner because of it.  Fear is a bitch, worthy of a post all its own.

Dr. Burns used the electrically charged mesh with success.  Prepping me with information, introductions, consent forms, and anesthesia took longer than the ablation, positively making me comfortable before asking Patrick to hurry up with the anesthesia in the operating theater.  Such a simple procedure to require such a dramatic environment, but…the risks.

My recovery nurse enjoyed my eyes-closed rendition of Gin and Juice and said I was her new favorite patient.  Apparently, I had my mind on my money.  Over the next few days I got to know the pain-killer norco as my uterus healed and I laid about on the couch drinking lots of liquids and eating toast.  So this is what it’s like in the 5th decade.  We endure procedures, therapy, and surgery to make life doable, and in this case, better than previous decades.  Little spots of blood every couple of months are all I have now.  Feminine hygiene companies are devastated by the decline in sales.

 

 

Walking & Gawking in Ireland – Part 2

Leaving Glendalough we wound our way through the Wicklow mountains to the Hollywood Inn, where we were introduced to the Hurling Finals and learned a few Irish turns of phrase not mentioned in guide books.

Great food, beer & patrons at the Hollywood Inn

Great food, beer & patrons at the Hollywood Inn

Ravenous from hiking about, I dug into fish and home-cut chips, fascinated by the muscular men on the field balancing a tiny ball on short clubs while running, hitting the ball and being hit by it, all with no protective gear, but plenty of blood and bandages.  The excitement rivaled a Superbowl party and Hollywood Inn was more than I hoped for with an uneven stone floor, heavy dark wood , a stone courtyard, tasty fresh food and superb service.  Our first day in the Irish countryside was a success, now we had a real drive.

Bolstered by a hamburger he described as “very lean”,  Jim drove us on narrow back roads to Kinsale, a quaint harbor town in County Cork, where we stayed at the Actons Hotel overlooking the harbor.

Actons Hotel in Kinsale, County Cork

Actons Hotel in Kinsale, County Cork

Our TomTom was set to avoid toll roads, which made each trip a bit longer and more scenic than motorways.  We had no trouble finding “toilets”, a convenient petrol station in many towns we passed through.

Billy, our bartender in the lounge at Actons, patiently explained how children in Ireland begin their first day of school with a lunch box, a backpack, and a hurling stick.  An older gentleman at the bar put us through a course of Irish dialect in a descriptive telling of a helicopter ride over County Tipperary that his daughter gifted him with on a recent birthday.  They both asked what we liked most about Ireland thus far.  I said I loved the water everywhere, especially the streams flowing down mountains and bubbling over rocks.  The old man said, “Ahhh, that’s the piss!”, then laughed open-mouthed as did we.  I told him I also like the potatoes, they were better than at home.  He said, “Ahhh, yes the new potatoes are in, but don’t eat the chickens!”.  Billy told us of growing up in Kinsale and said he would like to visit the Wicklow Mountains someday.  Huge sprays of Asiatic lilies and eucalyptus graced tables throughout the hotel while small bouquets of hydrangea and roses adorned each stall in the lobby bathroom.  Our room was modern  and bright with clean lines and a warm breeze blew through a tall unscreened, tilted window.  Sailboats rocked in the moonlit harbor.  We slept deeply.

Kinsale Harbor

Kinsale Harbor

 

After our first day of venturing we had a true appreciation for a full Irish breakfast, which consisted of an array of juices, fruit, pastry, cereal, breads, cheeses and smoked salmon.  We ordered eggs and sausage and the plate unnecessarily came with white and black pudding and a grilled tomato.  Each day seemed as though it may be the one to try  the pudding, but I never did chance it, afraid my stomach might upset our plans.  We walked around Kinsale’s colorful streets while our breakfast settled before taking off for Blarney Castle.

Kinsale, Ireland

Colorful Kinsale

Colorful Kinsale

Blarney Castle was THE castle of our trip and we took our time exploring all the nooks and scary crannies.  Stone stairs spiraled up to the stone with a rope on one side to hold on to.  As we ascended the walls grew closer and the old man in front of us stopped in fear, the opposite of my typical run through it reaction.  Voices filtered up from the stairs and signaled a group coming up behind us.  I felt trapped already, barely able to breathe.  I jumped back down two stairs and yelled to my husband that I’d see him when he came down.  My discovery of the family room, murder-hole above the castle’s main entry and arrow shaft views throughout the castle rooms thrilled me more than if I kissed a stone that through my camera zoom looked wet.  Ugh.  But, do not let claustrophobic me deter you.  Blarney Castle

Manicured grounds, gardens and a long carriage house were lush with vintage blooms and beside the castle stood a poison garden planted with castor beans, foxglove and other nefarious, yet pretty, flowers and plants.  We rested and took in the groups of people who dotted the expansive lawn before we perused the gift shop and purchased a watercolour that I would carry on the plane to insure its safe arrival home.  Our breakfast worn off, we headed back to Kinsale and away from tour bus crowds in search of a late lunch and a pint.

One of many Blarney Castle Gardens

One of many Blarney Castle Gardens

stairs

Before the Blarney Stone stairs turn scary

Under Blarney Castle

Under Blarney Castle but not the dungeon

 

 

 

 

 

 

Blarney Castle Family Room

Blarney Castle Family Room

Blarney Castle TowerBlarney Castle

Blarney Castle looking at me from the topBlarney Castle window view

Walking and Gawking in Ireland – Part 1

Walking a mile to a mile and a half 4 times a week for 6 weeks prior to our Irish holiday deflated my middle and I lost five pounds, which to me means I can eat potatoes and bread (as long as I keep walking).  You hear wild rumors as you get closer to 40, but I had to experience gaining weight while subsisting on salads and water to accept that my squirrel-like metabolism is dead along with my desire to buy a swimsuit.  It all works out, though, because the rumor about fading endurance is also true. Just a few weeks of a walking routine increased my stamina and made Ireland more enjoyable than I imagined.  I was even able to imitate running to catch our connection at O’Hare.

We spent our first evening in Blessington, a tiny town with a lone little terrier scouting main street just south of Dublin.  On the winding gravel road back to our lodgings we got out of the car to peek at Blessington Lake.

Blessington Lake

Blessington Lake

The next morning we started off for Wicklow National Park and found ourselves stopping often to explore.

A park in Wicklow County

A park in Wicklow County

A park with a fast flowing stream over mossy rocks and a stone bridge called to us, as did a cemetery with Celtic crosses raised high. The faeries moved a bit too quickly for my eyes, but I swear I heard their giggles just beyond the bubbling gurgle of water.

Between my walking routine and Ireland’s vistas, I shed not only fat, but a bit of cynicism.  Dreams coming true take chinks out of a calloused soul.

Walking does not build much muscle and muscle burns fat, so when I stop moving, my metabolism does, too.  Motivation is plentiful on vacation, but hard to find on a snowy frigid days, which is when I discovered that truth.  Almost a decade ago Ireland renewed a walking culture  to combat the country’s growing obesity rate along with national dietary standards.  It is not difficult to persuade an Irishman or woman to go for a stroll and GMO-free counties offer up food that reminded us what food used to taste like.  My theory is that we do not eat as much when it is flavourful because we are more easily sated.

Exploring Wicklow

Exploring Wicklow

Low in the Wicklow Mountains

Low in the Wicklow Mountains

In the hills of Wicklow National Park I stumbled on loose rock and stepped in a deep uninhabited hole, highlighting the need for a walking stick.  Mountain rescue teams are stationed in every area for good reason.

We were off to find St. Kevin’s monastic ruins in Glendalough and mistakenly walked up a steep road to find St. Kevin’s Parish where we lit candles for loved ones in heaven.  There were lovely engraved garden sculptures on the grounds and I suspect my husband knew I would stop at the craft fair on our way back down as I was excited for any opportunity to visit with locals.

St. Kevin's Parish

St. Kevin’s Parish

Gardens at St. Kevin's Welcome Center

Gardens at St. Kevin’s Welcome Center

On the way up, I stopped to rest and take in the gardens  at St. Kevin’s welcome center.  It was all meant to be, I am sure.  Just down the road we found the ruins of St. Kevin’s 6th century monastery.  Raided for centuries by the Vikings, most of the standing ruins date to the 11th and 12th centuries.  A man in a kilt and hose played Uillean pipes, whcih lent a melancholia to the scene, but a little girl yelling at the top of her lungs, “Rapunzel, let down your golden hair!” brushed it away.  A spiritual place, the sun broke through the thick cloud cover just as I offered up my gratitude.

St. Kevin's monastic ruins in Glendalough

St. Kevin’s monastic ruins in Glendalough

Glendalough Beauty

Glendalough Beauty

St. Kevin's ancient church often called "St. Kevin's Kitchen" due to the chimney.

St. Kevin’s ancient church often called “St. Kevin’s Kitchen” due to the chimney.

My husband was usually ahead of me because I am quite the gawker.  Also quite the talker and writer, I have many a story to tell you about Ireland, so I will break our adventure into a few posts. Sláinte!  (Good Health!)