HWTYLHMWLY

--The inscription on my watch given to me by my parents for my college graduation.  “Have we told you lately how much we love you?” It is similar to the inscription found on items that my Dad’s father gave to him.  

To say he came from humble beginnings is an understatement.  Being the eldest of five children growing up in hard times, my father grew up fast.  He was a strong and steady role model for his brothers and sisters.  He worked his way through college and married a pretty girl from Louisville, with similarly modest upbringing.

A degree in journalism and Regional Sales Director for the Courier Journal, my Dad was forced to quit his job due to the paper’s relocation while my Mom was pregnant with my older brother.  Determined to provide for his family, my father set out with his best friend to begin a magazine.  Funny things happen to funny people and from a bogus ad to fill space in the magazine—“Homestead Homes. Cut Your Living Expenses in Half with a Duplex.”—a new company was forged. 

If you know my father you’d vouch that he is quite possibly the luckiest man in the world but I’ll have you know that “chance favors the prepared mind,” and my dad is smart in the ways of the world.  He now runs a successful construction company with a few outside investments and along with my mother has been able to provide my brothers and me with every opportunity under the sun.  

Although, it is impressive to see what my father has accomplished from the small duplex we lived in on Chinoe Road, he doesn’t see his success that way.  “I measure my success by the success of my children” –is a sentence that has run through my veins since a young age.   With guidance and support from my father I will be the first doctor in our family.  My younger brother graduated from the University of Florida with a Industrial and Systems Engineering degree and now at the ripe age of 25 is praised by this superiors at the Baxter Corporation in Chicago, IL for his creation and implementation of new streamlined business models.  My older brother has an undergraduate degree from Kelley School of Business, went on to work as an analyst for Bear Sterns in New York City and an associate for Blackstone in Atlanta, GA before he received his MBA from Darden School of Business where he graduated in the top 10% of his class and now holds the position of Assistant to the Chairman at Raymond James in Tampa, FL. Needless to say, my father is proud. 

But it’s not enough to say that my dad is successful and an inspiring role model.   It has to be noted that he is the most loved and adored man around.  His jovial and charismatic personality calls everyone into his presence.  Striving to always be happy, his humor and laughter are contagious. 

Probably my favorite thing about my dad is his unwavering love of his wife and family.  I remember when I was younger my dad swinging my mom around the kitchen singing to her just before he dipped her back and kissed her.  Even to this day my dad will ring the front door bell with flowers to take my mom on a date.  He has the biggest heart and loves his family with all of our faults. 

I am beyond blessed that the greatest man I have ever known loves me unconditionally with every breath he takes.   And although I can never repay him for the multitude of things he has done for me I only wish to show him how grateful I am for him everyday.  Daddio, I don’t know if I’ve told you lately but “I love you more than air.”

Happy Father's Day!

Acne and Diet Revisited

Remember way back when I gave that spiel on how your diet can effect your skin, namely acne manifestations? As I said, those tips were based not on research but on my own experience and the advice of one internist. Since then I've done my homework. I did a comprehensive review of the literature on this topic and in August Dr. Silverberg (an esteemed Dermatologist in New York City) and I published that review (See attached journal article). Since most of you will never lay eyes on a Cutis Journal I'll provide the high points.

The literature shows that acne has clearly defined associations with consumption of Dairy (milk, cheese, ice cream, yogurt, etc.) and High glycemic index foods (refine sugars, simple carbohydrates). Here's why... Dairy products contain bovine hormones which increase your IGF-1 (a growth factor) which causes an increase in androgens (i.e. sex hormones like testosterone). Similarly, a rapid rise in blood sugar secondary to high glycemic index foods also increases IGF-1 and subsequently androgens. Androgens cause an increase in sebum production from the glands in your skin. This clogs your pores and allows for the acne bacteria to grow causing acne lesions. Many other foods have been studied in less detail.

Chocolate, or simply cocoa, has not shown to be associated with acne but perhaps the milk in milk chocolate or the sugar content could play a role in the activation of acne symptoms. Oily and fatty foods have not been studied in much detail and their role in acne is still uncertain.

So in summary, those who suffer from severe symptoms of acne should limit the intake of dairy, while supplementing with calcium and vitamin D, and refined sugars. Hope that helps! -B

Click here for Journal Article

Warnings from the fine print.

We all use over-the-counter medicines for headaches, pain, and fevers, but here’s what you need to know before poppin’ the pain killers.

For the party gals…
Acteaminophen (Tylenol and in some cold/flu meds)- no anti-inflammatory effects, just relief of pain and fever. This analgesic should not be used when drinking alcohol or for a hangover because it is metabolized through your liver and in the presence of alcohol can cause the build up of a toxic metabolite.

For the family planners…
NSAIDs- “Non-steroidal anti-inflammatory drugs” – Naproxen (Aleve), Ibuprofen (Motrin), Aspirin, Meloxicam and Ketorolac. Used for fever, pain and inflammation. These are okay to use when drinking alcohol because they are metabolized through the kidneys. However… These should NOT be used in the last three months of pregnancy. All NSAIDs decrease prostaglandin levels that are important for the patency of a duct that shunts the blood away from the unformed lungs of a fetus.

For the hot mommas…
Aspirin (also an NSAID and a Salicylate) used for fever, pain and inflammation. This drug is most often used in a low dose for it’s anti-platelet effect for prevention of heart attacks and stroke. It can have negative effects in viral infections (i.e. the flu or chicken pox), especially in children. It can cause Reye’s syndrome (brain and liver dysfunction).

So…. Pay attention to the over-the-counter medicine labels, don’t mix drugs if you’re not sure about their side effects and try to remember these 3 things when it comes to OTC pain relievers.
1. Tylenol and alcohol don’t mix.
2. You can’t drink when you’re pregnant but you can use Tylenol. (Forget everything else).
3. Chicken pox and the childhood flu only get worse with Aspirin.

It's all about the presentation!

That’s one thing my mother, the queen of the flawless presentation, has taught me; food tastes better when it looks better. (She also says food tastes better when someone else fixes it, but I digress....)

I went over to my parents’ house the other day for a casual Sunday dinner … As I walk in the door I am greeted by an impeccable cheese tray (appe-teaser!) and a dining room table that looked like something from a magazine.

Just my parents and I, but the setting made an atmosphere and the atmosphere made dinner an occasion and the food, well it was delicious!

So here’s what you need to throw together a gorgeous cheese tray, no cooking required, and have your Sunday dinner guests talking about your mad hostess skills…

• Variety of cheeses. I like Smoked Gouda, Brie and Goat Cheese (or simply Cream Cheese if you prefer). It is nice to go ahead and slice the harder cheeses (Gouda) but the others you can simply toss on a decorative knife (less work, very chique).

• Fruit. Dried Figs (Sun-maid sells them in a red bag), sliced Apples (great with the Smoked Gouda), and/or Grapes.

• Nuts. Almonds I have found are pretty universally liked and a safe bet. Walnuts, cashews, etc. Really anything except peanuts (unless you’re at a ballpark).

• Meat. Prosciutto is lovely but hard to find and pricey. Hard Salami is a nice flavor but difficult to chew so be sure to make it into thin slices.

• Crackers. A water cracker with minimal flavor is ideal. Stay away from the sweet (Club or Wheat thins) and the salty (Saltines and Triscuits) that could take away from your other flavors. You can also substitute crackers for thinly sliced French bread (more work).



You can add, delete or change these items to suit your taste. I wouldn’t recommend anything that needs to be heated or cooked and nothing that creates juice (olives, etc.) or waste (i.e. strawberries unless you remove the leaves first).

Once you’ve got everything you need, find a nice tray or even a wooden cutting board to display it on. Step back and make sure you can see a little bit of everything. It’s okay to save some in the fridge to refill later because I’ll tell you if it looks good, it will be eaten!!!



More on how to set a gorgeous table later… perhaps I’ll let the queen-bee blog that one herself…

From the inside out...

I've been doing a little acne research for my summer internship and before I tell you what the experts say I want to tell you about my experience.

If you’ve known me for a while you know that skin problems are the BANE OF MY EXISTANCE! Since puberty struck me it’s been acne city!

Through years of treatment with antibiotics, retinoic acid, proactive, Oxy10, salicylic acid… I finally had my acne situation under control, livable, no longer embarrassing.

Then I started medical school last fall and HELLO, PIZZAH FACE! I’m not kidding. I was feeding my stress with Diet Coke, lots and lots of Diet Coke, and candy, lots and lots of candy. But the zits kept coming and I was MORTIFIED!

So I tagged along with my mom to her “Women’s Health Doctor” who said she could help.Apparently, the artificial sweeteners (aspartame) in Diet Coke and the corn syrup & partial hydrogenated oils in the Laffy Taffy were feeding the normal flora in my intestine. The bad bacteria/yeasts were overgrowing the good bacteria in my gut and being absorbed into my blood stream… Well, who knows if that is true? It is still a theory of debate in the medical world because the organism of focus (Candida) is a yeast that typically only manifests symptoms in people would are severely immunocompromised (AIDS, cancer, & transplant patients). That being said, the following suggestions are not based on research (more to come on that) but rather my own personal experience.

I was desperate. I followed the doctors orders, got rid of the candy, chips, and diet coke (completely). I moved on to tea and water, lost the candy and a few lbs. She also told me to take 2 probiotic pills a day. Two weeks later I noticed a difference in my skin. After four weeks it was completely cleared up. Six weeks later I tapered myself off the probiotics and could have a diet coke every once in a while without any problem.

This past year I went back to drinking Diet Coke a lot more frequently and noticed the acne coming back (not as bad, Thank goodness!). Once again, I took probiotics and went back to drinking water… And my face is clear again!

Let me break it down for you…

1. DRINK LOTS OF WATER!

2. Stop Drinking Diet Drinks or anything with an artificial sweetener (including Splenda, Sweet’n’low, Equal, etc.)

3. Real Sugar is okay. (Sucrose, Dextrose, & Fructose in fruits)

4. No highly processed foods (chips, crackers, sugary-cereals, cookies, etc.)

5. No candy. Especially the fruity/sticky/gummy ones.

6. Dark chocolate is okay in moderation.

7. Choose the organic, natural and/or whole grain varieties of your breads, snacks, and cereals

8. If you think you might have a yeast allergy, consider cutting bread and beer out of your diet for a few weeks.

9. And probiotics, a couple capsules a day will keep the acne away!

So if you’ve tried everything and still can’t figure out your acne situation, try this. But you have to be serious to see results! Good Luck!

Save your skin, save your life!

This past Friday some of my fellow dermatology groupies and I gave a presentation about skin cancer to some high school kids. And I realized that not everyone is as educated as we would like them to be. The truth is skin cancer is preventable!!!! But it can be fatal.

I thought I'd give you some quick facts and hopefully encourage you to take your skin care seriously. A few things that are good to know:

1. There are 3 types of skin cancer: Basal Cell Carcinoma, Squamous Cell Carcinoma and Melanoma.

2. If caught early BCC and SCC are mostly curable by removal.

3. Melanoma is the most aggressive skin cancer and accounts for 74% of skin cancer deaths.

4. About 1 in every 50 Americans has Melanoma and the incidence is rising.

5. Adolescents and young adults are at more risk of developing skin cancer.

6. Fair skin, blue eyes, blonde- and especially red-haired people make pheomelanin (not the darker, sun-protecting eumelanin) which puts them at increased risk of skin cancers.

7. People with a lot of moles are at increased risk of melanoma (dysplastic nevus syndrome).

8. There are 2 kinds of UV-rays. UVA is the aging, non-burning ray that penetrates deeper into the skin, causes more DNA damage, is present year-round and penetrates glass (riding in your car). UVB is the burning ray that most sunscreens protect against (SPF), present more in the summer. Be sure to get a sunscreen that protects against both.

9. Tanning beds are mostly UVA rays (you burn less but age more) and have 15X the potency as radiation from the sun. Spending 20 min in the tanning bed is like 5 hours in the sun.

10. Use at least a 30 SPF (~97% protection) and reapply every 2 hours.

11. Water reflects 100% of sun rays. Sand only reflects 20%. (More likely to get burnt in the pool.)

12. If you have darker skin you are more likely to get melanoma on your palms and soles.

13. You can get cancer in your eyes (Uveal Melanoma). Sunglasses with a UV400 score are 100% protective from sunlight.

That's the bad news.

The good news is skin cancer occurs mostly on sun-exposed skin (it can happen where the sun don't shine too). Which means we can see it and prevent it from progressing if we are diligent.

I've listed the ABC's of Melanoma below. The pictures aren't pretty. In fact, they are kinda gross but I hope they will help you to remember how to check for suspicious moles.

Remember, these are just guidelines. If you have any funny looking moles, freckles, lesions or spots have them checked out by a dermatologist. Statistically most people (myself included unfortunately) wait a year before seeing their doctor for suspicious spots and require more invasive procedures.

Most people should see their dermatologists once a year for skin checks (if you have moles and/or freckles). If you are at increased risk (previous moles removed, fair skinned, etc.) you should see your doctor every 6 months.

So wear your sunscreen, check your skin often and see your doctor if you have any question.

Chemistry Nerd

I am feeling rather nostalgic about college today. Not in the way I usually miss college... frat parties, mixers, being hungover in the dining hall and day drinking in a baby pool in the parking lot... No, this is more of a "I'm so lucky I had such great professors" feeling.

Today the National Science Foundation awarded my favorite college professor, Dr. Joel Karty (better known as Dr. J) a $180,000 3-year research grant. HOLY SMOKES! It's hard enough to be recognized for research at an academic institution but this is a tremendous honor. And I can't think of any one who could deserve it more.

I fondly remember asking Dr. J if he would write me a recommendation for medical school. He very directly said, "Brooke, I think you're smart enough but you need to show more time management." Ouch, he said the TRUTH!? It was just what this 20-year-old, socially-sidetracked, sorority sista needed to hear. In the following months I was transformed into a medical school hopeful. He wrote me that letter and many more after that...

And in the same thought bubble I remember a professor that took interest in me later in my chemistry studies. Dr. Gooch, my organic and NMR professor. The last day of finals he stopped me in the hall and said "Brooke, congrats! You knocked the pants off those people on your test!" I felt really cool. R.I.P. Dr. Gooch, you are missed.

I loved everything about Elon! And I'm happy for all the professors that help to instill a since of pride in myself. I wouldn't be where I am today without all their influence.