Monthly Archives: March 2013

Why do I even have voicemail?

I am pretty organized.

I have excel spreadsheets for my bills, and have them open when I pay bills to stay organized.  I have a weekly calendar for our vacation so we can keep up with who wants to do what when so we don’t overlap activities.  I have a weekly menu posted on a white board in my laundry room (along with the boys’ chore chart) so we all know what is on the dinner menu every day.  I have file folders with taxes, and medical receipts, and recipes, and blog stuff.

I try to stay organized.  But there is one place where I completely fail.

Voice mail.

voicemail

I have not listened to my voice mail in two weeks.  I hope there is nothing urgent on there.  I am going to have to break down and listen to it today.

I don’t even know why I don’t listen to it.  I look at the phone, see that there is a voice mail, and think, “well, I can’t listen to them right now, I will in a little while.”  Then I don’t and I feel bad because I haven’t and a vicious cycle ensues.

In my defense, my voice mail message DOES say that I rarely listen to my voice mail, so if you really want to reach me you need to text me.

Maybe I should just change my voice mail to say that I only listen to my voice mail once every two weeks and hand out my house phone number.

Bluebell is really good about listening to the answering machine.

Am I the only one?  Are there more people like me out there?  Please help me feel better about my voice mail apathy!!

This is my life.  **headdesk**

This is my life. **headdesk**

 

Let’s talk about Acne

I have been working for a local dermatologist for over 8 years.  He has been the President of the  National Medical Association and was named the 2008 Practitioner of the Year by the National Medical Association.  He has been in private practice for over 27 years.

I have learned an amazing amount of information from him.  Prior to working for him as a medical assistant and Skin Care Specialist, I spent 20 years in the Navy as a corpsman, so I have over 25 years of expertise in the medical field as well.

Today I want to talk about acne, which affects 40 to 50 million Americans at any given time according to the American Academy of Dermatology (AAD).  Acne can affect people of all ages, and some women don’t develop their first case of acne until they are in their 40’s. Acne causes many people emotional distress!  They are embarrassed and upset by their skin.  Let’s be real, your face is the first thing most people look at, and we want to put our best face forward.

I can’t tell you how many times I have heard patients say, “I have NEVER had an acne bump….why am I getting them now in my 30’s..(or 40’s)…(or 50’s)???”  This is more common than you might think.  Often when an adult develops acne it is called “Rosacea” also referred to as “adult acne”.

However, let’s back up a bit and debunk a few myths about acne that most people think are true.  First of all, despite what your mother told you, (or what you are telling your kids), fried foods, soda, and how much water a person drinks has NOTHING to do with acne. Fried foods and soda do not make acne worse, so eat french fries and drink Mountain Dew to your heart’s content.  It will not make your acne worse.  It will however cause your waistline to increase, but that is not the topic for today.

Okay so now that you know what does NOT make your acne worse, let me tell you what DOES.  Hormone and stress levels are a huge factor in acne.  As a matter of fact many times I have heard from high school patients that their acne was doing really well after seeing the doctor and getting on a regimen of medication and products and procedures, but when they went off to college their acne got much worse.  Many patients come home on their first school break with their acne flaring out of control.  Let’s face it, going to school is stressful, especially if it is their first year away from home.

Many of my female patients will often tell me that their acne is worse just before their menstrual cycle.  Even if they no longer cycle due to menopause or birth control, they will notice that their acne goes through monthly cycles of better and worse.  That is because our bodies’ hormone levels still go up and down.

Acne is caused by the skin not shedding properly.  So the skin clogs the pores, thus backing up the oil in the pore causing whiteheads and blackheads (comedones) or larger “juicier” bumps also called pustules.  This is where acne medicine comes in.  For comedonal acne, (blackheads and small whiteheads) the retinoids are a great medicine to use.  These are medications such as Retin-A, Tretinoin, Tazorac, Epiduo, Differin, among others.

Topical medicines

Topical medicines

These medicines “teach” your skin to shed or slough properly so the oil can flow and not clog your pores.  They can sometimes be irritating or drying, (especially to sensitive skin), so there are a couple of “tricks of the trade” you can use to help combat the irritation.  1) Use the medicine every other night to start so your skin can get used to the medicine.  2) Mix a dab of moisturizer in with the amount of medication you are putting on your skin so the moisturizer acts as a  “buffer” it to make the medicine less irritating.  Even with all of that you may notice some peeling with these medications.  Of course if you have any concerns discuss them with your medical provider.

Comedonal acne

Comedonal acne

For the larger, “juicier” bumps, there are other things a medical provider can use.  Benzoyl Peroxide is a great medicine for larger bumps, as well as topical or oral antibiotics.  Benzoyl Peroxide can also be drying, so start that every other night also if you notice your skin being more dry than usual.

Pustular type acne

Pustular type acne

For people who have that really large acne all over their face that is painful and deep in the skin, (called cystic acne) they DEFINITELY need to seek out medical care.  I have seen many patients put on Isotretinoin (aka Accutaine, Isotret, and a few more).  This medication has many side effects and has to be monitored VERY closely by your dermatologist with monthly visits, blood tests, pregnancy tests (for females) among others.  However, I have seen this medication literally work miracles for patients.  I always think about the teenagers who went from kids with poor posture, hiding their faces behind their hair, poor self esteem before the medicine to kids who sit up straight, have improved self esteem, and smiling MUCH more.  It can make a HUGE difference, but as I said, it needs to be closely monitored by a medical professional.

Nodulocystic acne aka Cystic acne

Nodulocystic acne aka Cystic acne

There are also some great products that can be used to help with acne.  Glycolic acid cleansers are a wonderful product for people (even with sensitive skin in the right amounts) with oily, acne prone skin.  A couple of glycolic cleansers that we sell in the office that I like (they can be purchased at many dermatologist’s office or online) are:

Glyderm Gentle Cleanser

Glyderm Gentle Cleanser

Glyderm Gentle cleanser (made by Equalan Pharma) is a daily cleanser with 2% glycolic acid (also known as AHA or Alpha-hydroxy acid).  It is very gentle and can be used by most people.  The glycolic acid helps exfoliate the skin. However, it is a creamy cleanser and will NOT foam up.

Vivite daily cleanser

Vivite daily cleanser

Vivite Daily cleanser (made by Allergan) has a 12% glycolic acid compound in it, and is therefore a bit more exfoliating than the Glyderm.  It is also stronger and can irritate sensitive skin.  It is a creamy cleanser.
For those of you who LOVE to use a scrub, Vivite makes a nice one.  PLEASE stay away from scrubs with nut shells as the exfoliating ingredient….nut shells can be sharp and scratch the skin. I really like the Vivite Exfoliating cleanser.  It has a 15% Glycolic acid compound and very nice soft exfoliating beads that scrub without scratching or causing irritation.  It should be used no more than two to three times per week.

Vivite exfoliating cleanser

Vivite exfoliating cleanser

Other products to try:
We have some products made by Topix Pharmacuetical that I love.  You can also get these at many dermatologist’s office or online. One of the reasons I really like Topix products is because they use many botanical ingredients in their products.  I like botanics and more natural ingredients.

Glycolix/Topix 15% Glycolic pads

Glycolix/Topix 15% Glycolic pads

Topix 15% Glycolic pads.  I love these because they don’t make your face sticky at all.  You can use them in the morning after cleansing, or during the day if you get hot and sweaty and yucky……(love that medical term?)  I tell my clients you can out some in a baggie and carry them with you during the day or to the gym, or the beach, etc.

Topix/Glycolix 5/2 Gly/Sal pads

Topix/Glycolix 5/2 Gly/Sal pads

These are Gly/Sal 5-2 pads.  They have 5% glycolic and 2% salicylic.  They are great for acne spot treatment.

Glycolix/Topix 10/2 Gly/Sal pads

Glycolix/Topix 10/2 Gly/Sal pads

ly/Sal 10-2 are pads with 10% Glycolic and 2% Salicylic acid.  Stronger than the 5-2 pads, they are also great for acne spot treatments.

There are lots of other products out there, too many to name them all.  I shared with you just a few of my favorite acne treatment products.  Generally speaking a product with salicylic acid can help with bumps.  Glycolic acid is also a good product for skin too sensitive for Salicylic acid.

I am happy to answer any questions you all may have, and if you are local to the Hampton Roads area I do offer free skin care consultations at the doctor’s office where I work, so you can call me or email me, or comment to schedule an appointment.  🙂  Please note I do NOT get paid by any of these companies, nor do I get paid for FREE consultations……

Ghiradelli Chocolate Lava Cake

Last week I wrote about my Culinary Bucket List and listed a few things I would like to attempt to cook and or bake.  Bluebell and I really wanted to try to make Cannoli, but apparently in order to make Cannoli you need Cannoli molds….who knew?  AND they are difficult to find.  They can be ordered online from a few places, but are not carried in the store…sheesh.

So it was on to plan B.  Plan B ended up being Chocolate Lava Cakes. You know, those supremely chocolatey cakes with chocolate oozing from the center.

chocolaveacke

Well, here is my story about our venture into the world of Chocolate Lava Cake.  I found the recipe on the Ghiradelli web site.  I doubled the recipe because I wanted to use 6 oz ramekins instead of 4 oz ramekins.

Individual Chocolate Lava Cakes
Yield:
6 Servings

1 1/2 (6 oz)  60% Ghiradelli Bittersweet Chocolate Baking Bars   (I actually used 3 oz bittersweet and 3 oz semisweet)
2 eggs
1/4 cup heavy cream
8 tablespoons (1 stick) unsalted butter
2 egg yolks
1/3 cup sugar
1/2 teaspoon vanilla extract
1/4 cup cake flour

Directions

To make centers, melt 2 ounces of chocolate (1/2 a baking bar) and cream in double boiler. Whisk gently to blend. Refrigerate about 2 hours or until firm. Form into 6 balls; refrigerate until needed.

To make cake, heat oven to 400°F. Spray six 4-ounce ramekins or custard cups with cooking spray. Melt 4 ounces of chocolate (1 baking bar) and butter in double boiler; whisk gently to blend. With an electric mixer, whisk eggs, yolks, sugar, and vanilla on high speed about 5 minutes or until thick and light. Fold melted chocolate mixture and flour into egg mixture just until combined. Spoon cake batter into ramekins. Place a chocolate ball in the middle of each ramekin.

Bake about 15 minutes or until cake is firm to the touch. Let it sit out of the oven for about 5 minutes. Run a small, sharp knife around inside of each ramekin, place a plate on top, invert and remove ramekin. Garnish with raspberries and a dollop of whipped cream.

Here is how it looked:

melting butter and chocolate in double boiler

melting butter and chocolate in double boiler

Melted butter and chocolate

Melted butter and chocolate

After sitting in fridge for 2 hours I divided into 6 equal (ish) pieces and

After sitting in fridge for 2 hours I divided into 6 equal (ish) pieces and

rolled each piece into a chocolate ball

rolled each piece into a chocolate ball

Choco balls going back into fridge while we make the cake batter

Choco balls going back into fridge while we make the cake batter

egg, sugar mixture after about 4 minutes on high in Kitchen Aid mixer

egg, sugar mixture after about 4 minutes on high in Kitchen Aid mixer

Pouring melted chocolate mixture into batter

Pouring melted chocolate mixture into batter

Folding in flour

Folding in flour

Ready to go in  ramekins

Ready to go in ramekins

spooning batter into ramekins

spooning batter into ramekins

dropping a choco ball into center of each ramekin

dropping a choco ball into center of each ramekin

Ready to go into the oven

Ready to go into the oven

out after about 20 minutes

out after about 20 minutes

Flipping out onto a plate

Flipping out onto a plate

It didn't come out as cleanly as I would have liked. (I did spray the ramekins)

It didn’t come out as cleanly as I would have liked. (I did spray the ramekins)

Not so cute, but

Not so cute, but

A little whipped cream can cover the hole.  *wink*

A little whipped cream can cover the hole. *wink*

NO chocolate lava coming out.

NO chocolate lava coming out.

A bit disappointing.

A bit disappointing.

we tried another with the same result.

we tried another with the same result.

So the bottom line is:  the cake was yummy, although it was definitely bittersweet.  The boys took a pass, as they said it was too bitter.  Although the Hunter took his, mixed in about a cup of whipped cream and pronounced it “ok”.

I would not make this again, as in my opinion the results did not live up to the effort of making them.

NOT a winner for my family.