Process of elimination

I’ll never be cured of the eczema that has plagued me since birth, but I’m as close to normal as I have ever been. For six weeks I’ve cut out sugar, wheat and rice from my diet, and although I’m jonesing for toast and jam, I have to admit I’m less itchy than I’ve been my entire life.

Four years ago I endured six months of skin torture – by far the worst eczema breakout of my life, which I tried to fix with Prednisone, which didn’t fix the eczema but triggered shingles on top of it all. Desperate, I researched the universe of eczema remedies and tried every one that seemed like it had a chance, including a stringent elimination diet that excluded dairy, sugar, all grains and even some vegetables. I threw everything at the problem, but my condition was out of control, and nothing seemed to make a difference.

In the end, I finally got back to California – we were living temporarily in Ohio at the time – and my enthusiastic, upbeat Stanford dermatologist (who says I’m not the worst adult eczema patient he has…just the second worst) eventually subdued my renegade rash with a new arsenal of cortisone creams.

Dermatology is strong on symptom management but not much focused on root causes. My exceptional dermatologist finally developed a system to reduce the bacteria load on my sensitive skin, which helps tremendously, but when I told him about my elimination diet efforts, he was honestly confused as to why I would go through the trouble when I can manage my eczema with medication.

But I can’t ignore what seems like a relentless message from my body, telling me I’m doing something it doesn’t like. I’ve always muffled it with medication, but over time the unhappy message has gotten louder. I’m trying now to understand what my body is saying. It seems like a mistake to ignore it.

So when my mom’s excellent acupuncturist recommended an herbal detox combined with the wheat/sugar/rice elimination, I groaned but was willing to give it another try. This time I would be under the supervision of a skilled professional instead of my own frantic fumbling of four years ago.

I didn’t think it would work. But I can’t deny that I’m noticeably better. Usually by the end of the day I’m scratching compulsively like a dog. Now even when I’m itchy, I’m not desperately so. I’ll never be normal, but I’m closer to normal.

The good news is, elimination helped. The bad news is, elimination helped. Where do I go from here?

In my view, long-term elimination is too hard and not necessary. Reduction, even significant reduction, is far easier than elimination and more sustainable long term. As with everything, the 80/20 rule applies.

I can cut out 80 percent of my white-food intake pretty easily by subbing out big stuff (bread, pasta, white rice). Cutting out the last 20 percent isn’t worth the crazy vigilance of label-reading and avoiding every sauce and breadcrumb. I keep the freedom of indulgences. Even if I cut out half of the wheat, sugar and rice I used to have, that’s pretty great too.

Barring food allergies, I don’t think it makes sense to be an extremist with food. If you can hone in on a specific food that links to a negative result, it’s clearly good to avoid that trigger.

But while true food allergies are rare, some level of food intolerances seem increasingly common. Some think maybe we have heightened awareness, some think our bodies are more sensitive as a result of our increasingly processed and chemical-laden diets.

In any case, increasing the good foods (unprocessed, whole foods) and reducing the bad stuff (processed foods, sugar/sweeteners) is a smart idea.

Aside from that, it’s learning what works and doesn’t work for you.

Every body is optimized for different fuel. I’m a carb girl no matter what – even eliminating bread and pasta couldn’t make me a raging carnivore. Without carbohydrates, I have no energy. But I can eat less-processed carbs, like root vegetables. The doc allowed me some brown rice, an easy substitution, and having pasta sauce over polenta instead of pasta is another easy fix. And of course vegetables and fruit remain a major part of my overall consumption.

I love sweets, so it’s been hard for me to go without sugar entirely. But I’ve gotten used to tea and milk without sugar, and plain yogurt with fruit. I’ll eat a plump medjool date or two when I really need a sweet fix – they’re nature’s soft brown sugar candy, but with great fiber and potassium. And even when I’ve cheated with a pumpkin cookie toward the end, I’m satisfied with less.

So I keep listening and learning. Persistence is everything. The hard problems in health – and life – aren’t solved with a magic bullet, just the repetitive work of trial, error and trial anew. I’ve been at it for a while, sometimes despairing, but I think I’m finally getting somewhere.