Do As I Do, Not As I Say

This is not an advice blog.

I am not a doctor, nor am I a therapist, nor am I a life coach. If you want advice, there is plenty of it out there, so don’t ask me for it. I can only speak to my own experience.

That being said, a lot of people do ask me for advice, specifically, advice on what I did after cancer to stop looking like a corpse, because a lot of cancer patients keep that distinctive grey pallor for years.

I am, in popular parlance, not down with that.

The makeup industry thinks that you can fix the problem with cosmetics. That doesn’t work for me. I might look good, but it does not make me feel better. It makes me feel as though I had come out the loser in a run-in with a professional in the field of mortuary science.

When I was in treatment, I chose the route of brutal honesty: I wore sunglasses and a ski cap. This had as much to do with comfort as anything, but there was a certain amount of passive-aggressiveness involved in my look: if I was going to endure having cancer, the people who looked at me would have to endure knowing that I had cancer. My family had it particularly bad: at home,  did not always wear a hat (it depended on whether my head was cold), and all my hair had fallen out except the greys, so at home, I looked like Gollum.

For a year or so after I finished treatment, I continued to look like a zombie, and I knew it, but I didn’t care, because I also knew there was not much I could do about it. I gradually began to care, sort of, and so I gradually began to figure out what works for me, as well as what does not work so well.

Here is a list of the resources and practices that I do in order not to look like an escaped extra from Dawn of the Dead, along with a layman’s explanation of why chemotherapy made me look so extremely … dead, and what I have done to fix it. This is going to be a long post, and one full of too much information. Stop reading now if you don’t want to get grossed out.

You should talk to your doctor and do your own research and do what works for you. Here is what works for me.

Skin Care

Chemotherapy, at least the kind that I had, attacks all of the rapidly-dividing cells in your body. It kills cancer cells, and it kills a lot of healthy cells as well, including hair follicles, fingernails, skin, and mucous membranes. Oh, you should know, mucous membranes include the entire lining of your digestive system including mouth and lips, the insides of your eyelids, all of your lady parts, and the area around your anus. By “attack” I mean that the cells in all of these parts of your body will die, and will continue to die with each round of chemotherapy. You never think, what happens to the dead cells? At least, you never think that until you go through it.

With the hair, it’s obvious: it falls off. Shaving your head is a ritual that every cancer patient goes through, and it’s a mawkish and poignant chapter in most of the cancer stories that you read in those moving books, the ones I never read, the ones that my friends all sent me, that I brought straight from the mailbox to the recycle bin, because no one’s cancer was quite like my cancer, and besides, hair is the least of it.

Here is what happens to the dead cells: you shed them. Your skin leaves a powdery residue wherever you go; it sinks into your sheets, and it settles on the floor around the chair where you sit, and if you are like me and play Warcraft all the time, it leaves a dust of death all over your laptop and your mouse and mouse pad. It smells. Those cans of compressed air? I needed to keep one next to my computer and spray it off every hour or two.  I still do. Chemotherapy also attacks the collagen layer of your skin so it gets dry and thin, like the skin of a very old lady. It’s a one-two punch: your skin needs help exfoliating, because the normal processes aren’t able to keep up with the massive amounts of dead skin you need to slough, but your skin also gets thin and delicate so you can’t exfoliate it as vigorously as you normally would.

The chemotherapy books address this, but they don’t give it justice.

My situation was further complicated by the fact that I’m the point at the end of the nausea spectrum, so the least little thing would make me feel like throwing up. The nausea associated with chemotherapy has a lot of factors causing it.  The disintegration of the mucous membranes lining your intestines is certainly up on the list, but in my case, nausea triggers included the smell and feel of a lot of things, especially most lotions.

My solution during chemotherapy was to use a a combination of the following products on my skin to combat dryness: Desert Essence Organic Bulgarian Lavender Hand and Body Lotion with a shout-out to my friend Heather who first sent it to me, olive oil, coconut oil, a product called Egyptian Magic that is extremely expensive, and worth it, and, on my face, diaper rash ointment.  I prefer to use Weleeda Calendula Diaper Care but I also like the Desitin Creamy Diaper Ointment with Aloe.  I also can tolerate Earthscience Almond-Aloe Moisturizer without feeling queasy, even the one with sunscreen. My favorite moisturizer, Nature’s Gate Everyday Moisturizer with Vitamin E, seems to have been discontinued; at any rate, I can’t find it and if an alert reader would point me to a web site that stocks it, I would be grateful.

During radiation, they told me not to put anything on my skin, so I didn’t. My skin in the radiation fields pretty much fell off: I had huge swaths of raw areas that oozed, like a bad sunburn. They gave me stick-on bandages that  helped hugely, and as I healed, I found the best treatment was Egyptian Magic, or coconut oil. I was given a lot of radiation gels, but they did not work as well for me as they do for other people.

Also, someone, and I am not even sure who, but I think it was a friend of my mom’s, sent me a box of beauty supplies that included a salt-and-oil exfoliating body scrub with a heavenly smell that cut through any nausea to clear my head and make me feel better. It came in a little dark glass tub. I’d love to know what it was so that I can say “Thank you” and also buy some more.

After chemotherapy, I continued to moisturize, and as my skin healed, I began to exfoliate more deliberately. I quickly learned the hard way that the wonderful Japanese washcloth I had been used to using was too rough for my newly delicate skin; it gave me a rash that got infected. Unable to find the wonderful salt scrub, I concocted my own: Morton’s salt stirred into a mixture of either honey or olive oil, or both. I used this instead of soap for over a year because my skin was too sensitive to tolerate soap. As my body began rebuilding itself, exfoliation became more of an issue as the live cells pushed aside the dead ones. There is a peculiar smell associated with this process; in addition to shedding dead cells through my skin, I also shed them from the inside which has an interesting effect on my digestion, and my interesting I mean “OMG THAT IS DISGUSTING.” I use a lot of essential oils, mixed into the olive oil I put on my skin after a shower, or just in the bath. The smells I like are lavender, grapefruit, ylang ylang, orange, bergamot, and nutmeg.

I sometimes would take four or five showers a day, just to get rid of the smell, or the feeling of ick, washing myself with just honey on a washcloth. It’s a great cleanser and I still use it about half the time.

My lips continued to shed for two and a half years. I would leave a mark on every glass I drank from, not a lipstick mark, but a skin-colored lipstick-shaped mark that was actually a deposit of a thin layer of lip mixed with saliva and whatever I was drinking. If you think it sounds disgusting, you are right, but not as disgusting as having it happen to you. “Wear lipstick,” people kept advising me, but they did not understand what it feels like to smear greasy thick lipstick onto disintegrating lips, how the pigment in the lipstick mixes with the dead skin cells and makes pinkish clumps of goo all over my lips. It’s vile. The one product that worked for me was Badger Orange and Lavender Lip Balm, which is one of my favorite things. I learned to exfoliate my lips with a washcloth and also with Mary Kay lip scrub and a shout-out to my friend Sara who first gave me some. Now I can wear lipstick if I am careful to stay hydrated.

It wasn’t just my lips. The insides of my mouth also disintegrated into a goo that gave me too much insight into the process used to manufacture glue. I counteract this by continuously drinking water with a splash of POM pomegranate juice which my mother first bought for me. I don’t know why it works, but it does.

A lot of chemotherapy patients lose their nails. I never did, and I credit the fact that I rubbed Nature’s Gate Vitamin E Oil into my nail beds all the time.

The Deathly Pallor

Chemotherapy, in addition to knocking out your cancer, skin, hair, nails, and mucous membranes, knocks out your bone marrow, where you rapidly produce blood cells. That’s why it compromises your immune system, because you do not manufacture white blood cells, and causes anemia, because you do not manufacture red blood cells. When you don’t have enough red blood cells, you get tired all the time because your whole body doesn’t get quite enough oxygen, and you also loose the rosy glow that is the result of plenty of healthy red blood coursing through the capillaries under your skin. The lack of red blood cells, coupled with the fact that your skin is literally dying produces a look that is unmistakable, and if you happen to spend a lot of time in the embalming room, you will recognize it.

For the longest time, makeup just didn’t work for me. It sat on top of my skin and mixed with the thin layer of dead cells that ought to be exfoliated, plus the feel and smell of it makes me queasy. Now I can use Channel foundation, but it’s a recent development, and it only works if my skin is well-moisturized and exfoliated, so skin care is a priority for me even now, and by priority I mean that I spend almost an hour every day messing with my skin.

I fixed the deathly pallor the old fashioned way: with diet and exercise. My dietician told me to never eat red meat again, but I do, because I need the iron. It makes a difference for me. Huge. I tried to give it up recently and within two weeks I had once again begun to resemble something from 28 Days Later. I also get less tired if I eat a steak once a week or so. One of my doctors told me that my red blood cells are still a little funky, which perhaps explains a lot.

I don’t tan, and I try to wear sunscreen every day, assuming that the smell and feel of my sunscreen doesn’t make me queasy. Skin cancer is the last thing I need.

Beady Red Eyes

I have beady red eyes with bags and dark circles around them. Not bad ones, but they are there and it makes me unhappy to see them. Part of it is aging, and by aging I specifically mean the kind of “steals years from your life torture machine from the Princess Bride effect” that is a side effect of chemotherapy. I aged 20 years in six months, and the only consolation is that  I think of worse things.

I have tried every eye cream I can find and the one that works best for me is Preparation H. I also use concealer with my makeup when I wear makeup and it does make a difference. I’d like to get my eyelashes tinted again but my eyes are still super-sensitive from chemotherapy  — it’s the mucous membrane thing. They get irritated at the drop of a hat. Sometimes I soak cotton pads in Witch Hazel for a comforting eye soak, or I put tea bags on them, or I just wet my fingertip with tea and rub it on my eyelids when they burn.

Hair

I have hair, which is not something I take for granted, and I also have good hair. I wash it and condition it and ignore it, and Art, who is a genius, cuts it and colors it for me. I use Pert shampoo and Pantene conditioner because it’s the one thing in my routine that has not changed for 30 years. I know there are better products out there but I just don’t want to change.

Feet

My feet. It’s just a horror show, or at least it was. I don’t even want to get into the details, but what finally did the trick was washing them, putting lotion on them, and wrapping them in plastic bags for an hour while the lotion soaks in. Every day.

There are worse things to discuss, but, frankly, writing this post has made me sad so I am going to sign off and go mess with my skin for an hour before bed.

I hope someone somewhere gets something useful from all this. I used to feel confident in my looks, and now it is all I can manage to not feel ugly. My mom says everyone goes through that as they age, but it’s supposed to be a gradual process.

My advice is to wash your face and floss and brush your teeth every night before you go to bed, moisturize if you need to, wear sunscreen, and be happy.