"It’s a myth that Accutane is always unacceptable for women in their childbearing years"

A Case for Accutane [Inbox / Issue 798]

I felt a mix of emotions reading the Inbox letter from the woman who’s come to terms with her cystic acne after years of running after every new cream, treatment, and diet. I applaud her decision to work on her self-confidence instead of focusing on the state of her face. That’s really what we should all be doing: It’s the inside that counts! However, I was extremely confused by her reluctance to go on Accutane for such a bad case of cystic acne.

I had a very similar case to the letter writer’s — some pimples in high school that turned into a terrible case of monstrous cystic acne while pregnant with my first child. I went from looking like your regular happy newlywed to being pointed at in the street, laughed at by children. I once heard a small child ask his father, “What’s wrong with that lady?”

The cysts were painful, unsightly, and did not immediately go away after I gave birth. After consulting with some of the top dermatologists in my area, I decided to go on Accutane. Six months later, my skin was perfectly clear, and over the past 15 years, it’s stayed perfectly clear, through many healthy pregnancies and births of healthy children.

Accutane cannot be taken while pregnant but may 100 percent be safely taken during childbearing years, as long as the patient is under the care of an experienced dermatologist and a comprehensive medical plan is drawn up. The letter writer bemoans the fact that “sometimes there are no options,” yet has made the unconventional decision not to try the very best option for cystic acne:  Accutane. While I respect her personal decision, it’s a myth that Accutane is always unacceptable for women in their childbearing years, and it’s one that shouldn’t be perpetuated.

The effects of cystic acne on one’s self-esteem, the scarring it can cause — both physically and mentally — and the fact that Accutane can be taken safely, should all be points to discuss with one’s doctor when deciding whether or not to take this extremely effective drug.

R.L.

Smarter Saving [A Better You / Issue 797]

I was happy to see the section “Starting Off Successfully,” about parents preparing daughters for financial responsibilities before marriage. (I hope parents will apply those same principles to their sons as well!).

I particularly appreciated the reference to investing and retirement accounts. While important at any age, long-term investments are most valuable during one’s teens to early twenties, as the impact of compounded interest increases exponentially over time. For instance, an indexed stock fund linked to the S&P 500 will generally DOUBLE approximately every ten years. So, to give a simplified example, imagine that two people invest the same amount of money, person A at age 20 and person B at age 30. At retirement, person A will have twice as much money as person B.

Many people do not realize that an IRA retirement fund can be opened at any age, as long as there is earned income. Even a minor teenager who mows the lawn or babysits, can invest their earnings into an IRA (with a note from their “employer” for proof of income). Consult your tax consultant for details.

Numerous charts are available online to demonstrate the benefits of early investing. Sharing them with your child will likely make them a die-hard investor. With online investment websites like Charles Schwab, Vanguard, and Fidelity, investing is easy and can be done with a minimal amount of money to start. This is a priceless gift you can give to your child.

Alisa Avruch

Queens, NY

My Hidden Pain [Broken Butterflies / Issue 797]

Thank you so much for the incredible story, “Broken Butterflies,” about a woman’s struggles with postpartum depression. I shared almost all of the feelings of the author, but I sadly did not mention my sadness or pain to anyone, even my husband (whom I have a great relationship with). Even though I knew it was irrational, I was nervous about the label of depression.

My youngest is now nine months, and what I experienced after his birth was nothing like what happened after my two previous births. I felt lost, like I just could not cope with life anymore. I kept shoving the words “postpartum depression” from my mind, even though I knew that was probably what I was experiencing. I stayed in denial — partly from shame, partly because I told myself I was overreacting. I never did get help or open up to anyone at all. All my pain was inward.

My husband saw that I was a mess and had a hard time doing the basic tasks I have always done. I barely got dressed, left the house, did laundry, or cooked supper. But we both outwardly blamed it on the brutal transition from two to three. And that my baby was particularly hard.

That was all true, but I knew that wasn’t where it ended. I still don’t know what he really thought, or if he suspected anything different. I still have some hard days, but I’m mostly doing much better now.

I read the article through tears. As my husband sat next to me on the couch, I quickly wiped them away and turned my face in the other direction. Someone felt just like I did. And she even spoke to her husband about it! I’ve already decided that after future births, should I need it, I will open up to my husband and doctor to get the help I so desperately wished I could have just asked for. It’s not fair otherwise. Not to me, not to my husband, and not to my kids.

Thank you for printing such a moving and beautiful article.

I may even show it to my husband.

Appreciative

Keep the Gefilte [Kitchen Encounters / Issue 796]

Like many in the Jewish community I consider myself a “sushi guy,” and I enjoyed the well-researched, all-around stellar article about sushi. But I wanted to comment on the cover text, which read, “Move over, gefilte fish, sushi is here.”

When it comes to replacing food that’s been with us for a long time, something feels off to me. As Jews, we have mitzvos (and eating gefilte fish is surely not one). But we also have what the secular world would call “Jewish culture,” and what we would call “our mesorah.” Chazal teach us that the Jews in Mitzrayim didn’t change their clothing. It doesn’t say that they did this to avoid immodest dress; it seems that just keeping the cultural dress code has significance.

If we don’t change culturally, we will keep apart from the other nations, and in matters of real importance — Torah and mitzvos — we will stand strong.

We have a mesorah. Doros of Yidden have been eating gefilte fish, and it’s now become a part of our culture. Silly as it may sound, you would have to be a fool to try and uproot this. Serve sushi too, if you’d like, but don’t cancel gefilte fish.

Yossi Sapirstein, Brooklyn

Wonderful News [Off the Rack]

I am sure that many of your readers joined me in shouting,” Mazel tov!” upon reading of the engagement of Rechama Jaffa, from the diary serial, Off the Rack!

What a brave, courageous, honest, and real person she is. I would like to wish her and her lucky chassan much nachas as they build their bayis neeman b’Yisrael!

Much mazel and brachah,

Mrs. B. Willig

Kew Gardens, NY

(Originally featured in Family First, Issue 799)