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Diseases of the Gut Show at Your Skin

September 5, 2013

Tags: food, abscess, African-American, ageing, armpit, axilla, bloating, boil, cancer, cheese, chronic diseases, dairy, diabetes, diagnosis, digestive system, Diseases of the Gut Show at Your Skin, disfiguring, female, fish oil, fistula, genetics, gluten intolerance, gut, hidradenitis suppurativa, hormones, inflammation, inflammatory, lumps, Mediterranean, non-foods, obesity, overweight, painful, pilonidal cyst, pizza, probiotics, prognosis, pus, rash, relapse, resolution, skin disease, sugar, sweating, sweat glands, sweets, swelling, vegetables, weight loss

Less than a month ago, a young woman in her mid-twenties called me for “lumps in my armpit”. Now, that can be a thousand different things, not all easy to diagnose, some with dire prognosis. So, I told her I needed to see her.

She came, and the diagnosis needed one look only: Hidradenitis suppurativa. This poorly understood skin disease can’t be confused with any other: The patient has multiple red swellings and scars in the axilla, sometimes at other areas, too. You could describe it as boils in the armpit. They are painful and disfiguring. Conventional medicine describes them as inflamed sweat glands (which is what “hidradenitis” means, and suppurativa means “leaking pus”). They are similar to boils, pilonidal cysts, chronic abscesses, fistulas and different kinds of cysts. They might be exacerbated by hormones, excessive sweating, and overweight. Genetic factors clearly play a role – hidradenitis suppurativa is more common in females, and in people of Mediterranean and African-American descend.

Medicine might not understand the cause of it, but any layperson can see that hidradenitis suppurativa is a highly inflammatory disease. This young, pretty woman was slightly chubby – not badly, indeed. But I advised her to eat more vegetables with olive oil, and leave out all sugars and dairy products, as the most inflammatory foods. She also was bloated and had a family history of gluten problems, so I asked her to leave out gluten, too; at least for a few months. I also recommended anti-inflammatory fish oil and probiotics to help her poor, inflamed bowels to heal.

What happened to the young woman? - Within two weeks, she was dramatically better and had lost some pounds, and all the bloating. I never counsel to lose weight; I recommend a better diet, and the weight loss will follow automatically. She was happy about the result.

Unfortunately, then she went to a party where she indulged in all the wrong foods, including pizza, cheese, and sweets. The boils immediately recurred. I was not worried about the relapse: It only confirmed what she had learned: That what she eats has a beneficial or not so beneficial effect on her digestive system, and her health. – Her choice, really.

I know that at this age, all the young woman wants is to look good and be able to were a sleeveless top, and there is nothing wrong with that. But I will make a prognosis – even if I might not be around to see the result: If this twenty-five year old will be able to stick to her resolutions (at least most of the time), she one day will be vibrant fifty-year old. If not, she will go the way most people go in our society that adores foods that I’d call “non-foods” – and she will experience obesity, diabetes, cancer and the myriad of chronic diseases that seem to pop out of nowhere as we age. – Let’s see which way she chooses …

On a Rainy Summer Day: Read!

July 29, 2010

Tags: order, African-American, Austen - Jane (1775-1817), Barbery - Muriel (born 1969), biography, books, Brontë sisters, cello, Chesterton - G.K (1874-1936), China, Chinese, Colbin - Annemarie, declutter, Dickens - Charles (1812-1870), Father Brown, gardening, Hill - Laurence (born 1957), Kleist - Heinrich von (1777-1811), Kuriyama - Shigehisa, lightning, Loti - Pierre Ebert (1850-1923), Maigret - Commissaire, Mantel - Hilary (born 1952), Mitchell - David (born 1969), Mittelmark - Howard, Mungello - David (1943), mysteries, Newman - Sandra, novel, philosophy, On a Rainy Summer Day: Read!, Oshinsky - David (born 1944), polio, rain, reading, Rowley - Hazel (1951-1911), Simenon - Georges (1903-1989), Stead - Christina (1902-1983), Stewart - Katherine Silberger, summer reading list, swimming, writing, yoga

What are you doing if it is raining? Do you let it ruin your day/your summer/your life?

This is what I do (not to mention that not everyone is on vacation, of course):

Declutter. I take one corner in my house, and start. I plan to do only ten minutes, but if I get carried away and stick with it longer, so be it. Yesterday, although it was not raining, I started in my study. Because it needed it sorely– and heat can be just as forbidding for the outdoors as rain is.

Play the cello. Still badly. But since my recent summer camp, with 120 adorable kids (I was one of them), I extended my repertoire to jazz and swing. Really fun!

Read. And this is what I want to write about today: my summer reading list. One summer, in Maine, I read one Dickens novel after the other; another summer, I tackled Jane Austen and the Brontë sisters. This year’s is without rhyme and reason – just what tickles my fancy:

• This summer, I want to read as many of Georges Simenon’s mysteries as I can get my hands on. Superintendent Maigret is the hero. So far, I have read about six. A joy to rediscover him.
• G.K Chesterton’s Complete Father Brown Stories. Finished already. These mysteries did not age quite as well as Commissaire Maigret’s but if you like an old-fashioned, Catholic sleuth – this is for you.
• David Oshinsky, Polio: An American Story. If you grew up in the fifties, this one will touch you.
• Hilary Mantel, Wolf Hall. Won the Booker Prize. A engrossing novel about Henry VIII, Anna Boleyn and the whole mess they created. Beautifully densely written – not for breezing through.
• Howard Mittelmark, Sandra Newman, How NOT to Write a Novel. This is a re-read for me. Easy to read, and instructive.
• Christina Stead, by Hazel Rowley. If you read Stead’s The Man Who Loved Children, you might want to learn more about the life of its Australian author.
• David Mungello, The Great Encounter of China and the West, 1500 to 1800. Is on my reading list because of the Chinese novel I am writing. Probably too scholarly for the average reader.
• David Mitchell, The Thousand Autumns of Jacob de Zoet. Also a must-read for my Chinese project – but more fun.
• Another reread: Annemarie Colbin, Food and Healing. There are so many interesting details that once in a while I have to take it out again.
• Shigehisa Kuriyama, The Expressiveness of the Body and the Divergence of Greek and Chinese Medicine. Very interesting, very philosophical. Kuriyama teaches at Harvard.
• The Elegance of the Hedgehog, by Muriel Barbery. An intelligent delight – finished it already.
• Pierre Ebert Loti, An Iceland Fisherman. Warmly recommended by my friend Diana. This is an old book – from 1886. A different pace, a different voice than what we are used to now.
• Laurence Hill, Someone Knows My Name. A gripping tale about African slaves coming over the ocean to our shores, against their will.
• And an enjoyable little fluff: Yoga Mamas, by Katherine Silberger Stewart. Fluff - but taking yoga serious.
• And my old stand-by, perhaps the best story ever written in German: The Marquise of O, by Heinrich von Kleist.

I get my books either from the library or buy used – otherwise I could not sustain my reading addiction.

This is what I could do: Go for a swim in the rain. It’s exhilarating. Just make sure there is no danger of lightning. Every year, about one hundred people are killed in the US by lightning, mostly in the southeast. Worst state is Florida; Alaska is safe – you guessed it.

Or go deadheading the roses and dahlias in the rain. Might be adventurous too. Because, as I always say, Nature build me water-tight: No rain gets through my skin.
Aspen eyes, by Peggy Peters

Iguazu Falls, by Xin Liu

Alexa Fleckenstein M.D. 2012, by Lolita Parker jr.

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