The fact is that any cholesterol we get from food is too much; our bodies just don’t need it. That’s because there are actually two different methods by which serum cholesterol is elevated: through the intake of dietary cholesterol and through the internal manufacture of cholesterol by the body itself in response to high intakes of saturated fat.

It’s important to understand, first of all, that cholesterol is not an essential nutrient, which means there’s no need for it in our diet. In fact, dietary cholesterol – the cholesterol found only in animal products – has been proven harmful to our arteries and has no known benefits at all. So even though cholesterol is a vital part of all of our cell membranes and is a precursor to many hormones and to vitamin D, we don’t need to eat a bit of it. Why not? Because our cells can make all we need – even if we’re on a cholesterol-free diet.

Every cell in your body is capable of making cholesterol, but by far the greatest amount is produced in the liver and intestines, which manufacture about 500 to 1,000 milligrams a day. Even if you never ate any cholesterol at all, your body would still produce whatever cholesterol it needed. Remember, too, that whenever you eat foods containing saturated fat (whether they contain cholesterol or not), your liver responds by automatically overproducing cholesterol – none of which is needed – and reducing its ability to remove dietary cholesterol from the bloodstream.

It’s clear that whatever cholesterol we do get from our food represents a surplus. And for most of us, sooner or later that surplus could contribute to cardiovascular disease. While most people can handle small amounts of dietary cholesterol with reasonable safety (up to about 100 milligrams a day, a little more than you’ll find in 3| ounces of skinless chicken breast or lean beef), Americans on average consume over 400 milligrams a day – a chronic cholesterol overdose. The obvious antidote is a simple but lifesaving one: Limit our intake of animal products, since they are the only source of dietary cholesterol. But that alone isn’t enough; it’s essential to limit our intake of saturated fat as well. Moreover, as we’ll learn shortly, to attain a truly safe serum cholesterol level we also have to increase our intake of foods that contain soluble fiber.

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Be as fit and healthy as you possibly can be going into surgery or treatment – low fat, balanced meals; no drug taking. Many of the contributors admitted to ‘drowning their sorrows’ immediately after the diagnosis as a way of coping with the shock. All admitted it didn’t help – the j hangover just slowed their preparation. However, if smoking and drinking alcohol is a pattern of normal life, pressure by others to give these habits up at this time may increase your stress. Some women on organic and natural therapies increased the quality of their diets and lifestyle. Drinking alcohol just before chemotherapy may interfere with the drugs and set you back. One specialist presents his patients with a bottle of champagne after all chemotherapy is finished – a terrific time to celebrate!

Organize and delegate the household management to family and friends. It is not often in life that so much assistance will be offered. Graciously accept it. Be ‘Goddess of your Kingdom’ and list all the chores that take most of the time, which will deny loved ones time with you, or ‘mental ease’. Ironing, cooking, cleaning, creche/school pick up/ duties. A ‘dirty’ house however is not the end of the world. Sometimes doing what you need to do (such as household chores) feels good if it distracts and makes you feel better. Just don’t exhaust yourself.

Inform work and organize sick leave if you need and want to. Some women like to continue working; delegate career projects; organise your salary entitlements or income protection insurance, if you have it. You will need to decide who needs informing of your condition at this stage, and how you will share the information. Cancer Councils have excellent resources to support organizations and their staff. Nominate someone to be the information contact point. The professional relationship will wear thin if your home /hospital is bombarded with zillions of calls from concerned colleagues. Find out from your doctor a realistic time for you to go back to work. Think about easing yourself back to work by going part-time.

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Signs and Symptoms

Patients with folliculitis have scattered pustules and small red papules centered around hair follicles. Lesions may be mildly pruritic or painful. Systemic symptoms are very rare.

Pustules are confined to hair follicles, typically in one region of the body such as the chest, thighs, or back. However, follicles throughout the body can become infected over the course of a few days. In bacterial infections, most pustules still have a hair shaft protruding from the center. There may be some surrounding erythema and slight swelling.

Main Causes

Staphylococcal Folliculitis: Staphylococcal infection should be suspected if erythema, swelling, and tenderness are striking. If needed, culture should be performed by shaving a pustule with a scalpel and sending the whole pustule for culture. Oral antibiotics are preferred when staphylococcal infection is suspected.

Gram-Negative Folliculitis: The gram-negative organisms Klebsiella, Enterobacter, and Proteus can also cause folliculitis. Infection typically occurs on the faces of acne patients treated with long-term antibiotics active against gram-positive organisms. Topical erythromycin is usually effective. Severe cases are treated using amoxicillin-clavulonate (Augmentin) or even isotretinoin (Acutane).

Hot Tub Folliculitis: Folliculitis acquired from wet objects such as hot tubs, whirlpools, loofah sponges, or wet suits is usually caused by Pseudomonas aeruginosa. Lesions appear on exposed areas of the trunk and extremities between 6 and 72 hours after contact. In immunocompetent patients, lesions typically resolve spontaneously within 10 days. Treatment is not required, but the source should be cleaned and new tub water properly sanitized. Pseudomonas in a loofah sponge is killed when the sponge is simply allowed to dry completely. Soaks in 1% to 5% acetic acid, topical silver sulfadiazine cream, or garamycin cream may be helpful. If needed, systemic fluoroquinolones can also be used.

Treatment

Topical antibiotics work well in most cases of superficial bacterial folliculitis. Antibiotics should be targeted against the presumed etiologic organisms. Therapy should be continued until lesions resolve.

If follicles are widely distributed, systemic antibiotics can be used.

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