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The Fullness of Midlife

“You just need to know. Information is power.”

by Dr. Barb DePree MD


Michelle Robson with Dr. Barb 

Michelle King RobsonMichelle King Robson is the founder of HER Inc., a data-driven consumer health technology company making health and wellness better for women. Mobile and web platforms EmpowHER and SkinSAFE help women understand their health and wellness and improve their health choices. Michelle has become a nationally-recognized women's health and wellness advocate and spends her time speaking before women's groups, health care organizations, political leaders, regulatory bodies and the media about women's health and the importance of women advocating for themselves and their loved ones.

 

Dr. Barb: I’m Dr Barb DePree of MiddlesexMD. Our guest today, Michelle King Robson, has built an information powerhouse and a community in response to her own health challenges. The initiative she’s taken has not only made it possible for her to reclaim her own health, but also made it possible for thousands of women to get reliable information for their own wellbeing. Welcome, Michelle!

Michelle: Thank you, Barb. It’s so great to be with you. How are you?

Dr. Barb: I’m well! How are you?

Michelle: I’m doing great, keeping busy. Keeping busy with all these women’s health issues, like you are.

Dr. Barb: Yes, and you truly have created an empire, which I’m sure is demanding a lot of your time and attention. And I think our listeners would be interested in understanding, really, a bit of your journey that has led you to become such an active voice in promoting women and women’s health.

Michelle: Well, as you know, about—I launched EmpowHER about eleven years ago because of an unnecessary hysterectomy that I had when I was forty-two years old. And, of course, what happens when you have a hysterectomy, you tank. I lost all of my hormone levels within the first twenty-four hours, and then nobody knew how to get me back to my optimal health. So, I just completely declined over the course of a year. I spent that year trying to—going to different doctors, reading as many books—I think I read thirty-two books on the subject and became an expert by default, as I like to say, which is never any fun for a patient. But, it was really the lack of information that even the physicians had, the healthcare professionals had, about how to treat what was going on with me. I was given medication I didn’t need, now I have to take, I still continue to take. And then I was given things that just weren’t right for me.

So trying to navigate this whole healthcare system was a nightmare, and when you are sick and you are trying to advocate on behalf of yourself it’s even worse. And then you have no brain function, you have sleeplessness, you have everything, right? There’s nothing that’s going right in your body, and it’s very difficult. So I guess when I finally found the right doctor to help me, who happened to be Tucson, Arizona, and I lived in Phoenix at the time, and who knew she was there—and I went all over the country, right?

... You never want to get a woman mad, because she's going to start a company.So once I found her and I started to feel better after about five days—after not wanting to live anymore, which is not uncommon, which I’ve seen a lot since starting the company. Women silently suffer, as you know, and they don’t talk about what’s going on with them. And I was one of those silent sufferers, and it was hard for me to get out of bed. But she was my last-effort doctor, and she really helped me understand what was happening with me. She spent a lot of time with me, she got me well, and after about five days of, you know, feeling, starting to feel better, like myself again, I got mad. And I always say, when I speak, and I know you’ve heard me say this, “I got sick, I got well, I got mad.” And when you get a woman mad—you never want to get a woman mad, because she’s going to run off and start a company.

Dr. Barb: And I’m just going to say, thank you for your response to that experience! Because obviously you have changed the lives of so many other women, in ways that, as a provider, we’re pecking away one at a time, but you were able to create a platform and a voice to bring knowledge to so many people. So tell us a little more about that.

Michelle: I started to fight the FDA, actually; this is how this all kind of came about. And it was over a drug that was being pushed, and it was a drug that was—it was an interesting time in the world of women’s health. I knew a couple things, I knew that only 37 percent of the clinical trials were being done on women that had to do with medications, so I knew that we were getting medication that wasn’t tested on us, that was specifically tested on men. I knew women’s health was completely underserved—I knew that from my own experience and then I learned that as I continued to navigate more and more through and helping other women advocate. 

Women coming together... that's what I needed.And that’s what really prompted me to start EmpowHER, because there was such great need and demand for it, and there was nothing like it that existed on the web back eleven years now. The web was a very different place, and I still always say, it’s still in its infancy. But, I wanted it to be good, credible information for women: that women could ask us questions; we would respond within 24 hours, which has really helped make us successful to this day. We’ve been doing this for years. I wanted great content, I wanted people like yourself, who could come on, we could videotape, you could share your information knowledge, because you have such vast knowledge as a healthcare professional. And I wanted the ability for women to have access to, you know, doctors like yourself, to other women who are sharing their stories, so that they could connect to each other, because there’s nothing like another woman. You don’t know until you’ve walked in somebody else’s shoes, and it was one thing to have doctors, which we’ve got a lot of doctors on the site, but it was another thing to have these women come together, start their own groups on EmpowerHER, give information to one another, because that’s what I needed.

I needed someone who could advocate on my behalf, who could say, here, you need to read this book, here you need to check out this doctor. All the things that I was in search of, I did not have access to. And I wanted to make sure that no woman on my watch was ever going to experience what I experienced, not if I could help it. And that’s when I dedicated my life to women’s health and to helping women, you know, whatever it is. Develop a checklist for women, so when they go to the doctor they know exactly what to do before they get there, during the visit, after the visit, because they always forget things. Just the very basics, but also, having seven hundred fifty conditions on EmpowerHER that are all focused on women and then having about sixty five topics, again all focused on women, like sexual health and relationships would be considered a topic, so I wanted to just give women everything that they needed that was good for them and helpful for them. It isn’t my decision to say, you need to do this and not do that, it’s options and choices, right? It’s something that we’ve never had as women. We’ve never really been given options and choices around our health—you’re not the norm. I know you do that, but you know, a lot of doctors don’t even talk about sex, let’s just be clear. They don’t say the word vagina, it just kills me what goes on. And these are really important things for women, hugely important, they’re life changing.

Dr. Barb: And I just want to make sure that our listeners know, EmpowHer, so for those who are interested in knowing more about your site, again, it is robust, it is complete, it is comprehensive, and so much of what is online is individual’s opinions and experiences, but you bring together that, which is of value, but also leaders in healthcare to help facilitate some of the discussions and try to put a clinical evidence based element to the information that you provide. So again, thanks for what you’ve done.

Michelle: Yeah, no, you’re exactly right. And just to add to that, you know, I looked for the best and the brightest in the field, like yourself, so I wanted healthcare professionals, scientists, researchers, everybody who really has touched women’s health in a significant way—those are the people that I went after for my board. Those are the very healthcare professionals that are on the site, there are videos. Because, again, there’s lots of information, especially in the technology age where you have access to everything. The problem is, that the accessibility is so easy but yet the content isn’t so great. And you know, you can be led down a rabbit hole very quickly if you’re not careful, and I want to make sure that women have good, always science-based, professionally based information. Even though the women are sharing their stories, that’s great and it’s hugely helpful for them, but they also need to have access to doctors, like yourself, who really are experts in their field.

Dr. Barb: So this leads me to inquire about your more recent endeavour around SkinSAFE?

Michelle: Yes, yes.

Dr. Barb: So, tell me about that and what prompted you to pursue this issue?

Michelle: Well, one of the things that happens, as you know, we both know, and I say this when I speak, is that when you have a complete hysterectomy and or you’re menopausal, you’re going through menopause, everything gets dry. So your skin gets dry, everything dries up, as I like to say. That’s one of the things, of course, that happened to me. But it really happened where my skin was concerned. So I became allergic to ingredients, I started to develop allergens that I never had. Number one, I couldn’t get a cream to penetrate the top layer of my skin. So it was like pouring water in oil, what happens? It doesn’t go anywhere. It was the same thing with my skin. I don’t care what product, if it’s La Mer, if it’s $500 to you know, the most very basic thing, putting olive oil on my skin. I tried everything, but nothing would penetrate the skin. And I went from really oily skin, Barb, to really really just dry as can be. But with that came rosacea, I was having allergens to my skin was flakey, dry, red, it just was a whole host of different things. And it wasn’t just my face, but it was also my body, so I went again, in search of, “I need to figure this out.” Right? Because this isn’t good, I can see my skin is changing quickly.

So I went to, again, many dermatologist, I was put on more medication type products that I could use to help the rosacea, to help—they used a term called contact dermatitis. And contact dermatitis is just a big old bucket for anything that is wrong with your skin. So if your skin is broken out, they will throw it into the contact dermatitis bucket. So, I of course, had contact dermatitis, I have rosacea, I have all these things. They gave me medication, it didn’t work. It didn’t work. So, I finally found the right physician, the right dermatologist, again in my own backyard. Shame on me for not looking, because Mayo Clinic has a wonderful dermatology department, so I went to Dr. Jimmy Yiannias, who looked at my skin and he said, “I think I know what’s wrong with you, you need to be patch tested, because you’re having allergens, ingredient allergens.” and I said, “Okay, how long does the patch testing take?” and he said, “It takes five days.” and I said, “I don’t think you understand this, I just started another company called EmpowHER, I don’t have five minutes, let alone five days.” I’m such a good patient, aren’t I?

Dr. Barb: [laughs]

Michelle: [laughs]

Dr. Barb: And I can actually imagine that conversation.

Michelle: And Jimmy would tell you the very same conversation, because I think part of it was like, “Really, you really want me to figure this out?” But we started talking and trying to figure out why I only had five minutes and not five days to patch test, and he did say, “I’m pretty sure I can help you anyway.” And he found out why I was so passionate about EmpowHer and why I couldn’t take that five-day period. And I’m not saying that women shouldn’t do it, because everyone should be patch tested. Anyway he handed me about 25 pages of product and said to me, “Here’s a printout that I’ve created, this is the data that I’ve been collecting for [I think at that time it had been about twelve or fourteen years worth of data, from all the Mayo dermatologists],” and he said, “and I think that these are products that you can buy that I believe will help you with your skin, so that it will stop your allergens.”

And I said, huh. Should I look at this? And there’s all these different products, there’s Clinique, there’s Fannamean, there’s Maybelline, you name it. I said, “Well, where did you get this?” He said, “Well, my father suffered from ingredient allergens, so I’ve been doing this for a long time, because it’s just been a passion of mine.” And I said, “how do I get ahold of this? I want this for our women.”

So fast forward, I tried for, I think six years, to get it, and I finally, Mayo came and said, “Look we’re ready, do you want this data? Do you want this information, would you like to create some type of relationship where we can launch this thing called SkinSAFE?” and I said, “Absolutely, we are all over this.” And so we did. Jimmy was able to help me, Dr .Yiannias was able to help me with my skin, immediately. I left there—first of all, he compounded a cream for my face, which literally just changed my skin, completely, totally—and they compounded that at Mayo. And then I went shopping and I bought all new product, all product that was recommended on his list. And by golly, in a couple weeks, my skin was cleared up, it looked dewy, fresh, clean, no more dryness, no more rosacea, no more contact dermatitis, it was gone.

And that’s how we started SkinSAFE, same thing.

Dr. Barb: So this was a list of products that he had procured, understanding what the common skin allergens, irritants are, and obviously, compiling that and meanwhile, we as consumers, you know looking at it—

Michelle: —have no clue.

Dr. Barb: Exactly! You walk up to a counter and how do you begin? And how do you interpret labels, and then, you know, after how many failures of products, how do you try to cross-reference which products it might have been that was the irritant. It really is a nearly impossible journey to do individually.

Michelle: It is. You couldn’t be more spot on. And that’s what was happening, that’s what happens with everybody, because you can read the labels, number one. You don’t understand, if you are allergic to fragrance like I am, for example, I can’t have fragrance in my products. Well, botanicals are fragrance. Now, they may list on the front of it, it says, “It’s fragrance free” but, it’s not, because it has botanicals in it. How many of us have product, to your earlier point, that’s under the counter, that we try once, that doesn’t work, we can’t use it and we can’t take it back. And that happens all the time. And it’s actually bad for us.

So this was created because we know that—we know Mayo’s top ten allergens that cause the vast majority of people to suffer from babies to teens, preteens to adults. And even more mature skin, which is what my skin is. So it goes across all barriers, so everybody uses this, we actually, you can scan a product into the system. There’s two ways: with SkinSAFEProducts.com, which you can go to online and you can look at all the product on SkinSAFEProducts.com, and there’s ten categories. The way this system works, it’s personalization for your skin. So you can turn on and off filters, so you can turn on and off fragrance—if you’re not allergic to fragrance you can turn it off. But, you’re allergic to MCI, you’re allergic to parabens, you’re allergic to other things, you can leave those filters on. Then what it does, it will show you product that actually is okay for you to purchase. It takes all the angst out of it. The other way that you can do it is, you can download SkinSAFE, it’s all one word, you can download SkinSAFE on an iPhone, Android, and you can go in and you can scan your product into the system, using your barcode; if the product is in they system already, it will come back to you immediately and tell you how it ranks.

The ranking is based on the top ten allergens again. So, let’s say we scan Maybelline—an eyeliner, which I actually use, for $3.99, or Revlon, excuse me. And you scan that in and it comes up in the system, it shows you what it is, shows you the product and also says it’s “Top Free”; that means that it doesn’t have any of those top ten ingredients that are bad for you, and so that’s a product you know you are going to be safe with. There are 30,000 products in the system today. They’ve all been scanned in by the consumers, it’s crazy at the rate that we’re going with the amount of people that are scanning. Because so many people are suffering from allergens.

The other thing that I will say is SkinSAFE—the number one reason people go to the doctor, and I don’t if you know this, Barb, but I didn’t know this, I didn’t know any of this when I started the company: The number one reason Mayo says people go to the doctor are for skin conditions—number one!

Dr. Barb: Yeah, I saw one yesterday, and I’m not a dermatologist, so I’m probably not a great person to try to help women discern. But I think having this tool to refer patients to, who are suffering, and as you were talking earlier about what you experienced in menopause, you couldn’t see me nodding, but I was nodding as I’m recognizing this generalized dryness and feeling like the products I’ve used, while I don’t know if I’m so sensitive to them, but I feel like the effectiveness isn’t what it once was.

My understanding is, from your app, you're not necessarily promoting the best, you know, wrinkle cream, or the best moisturizer, you’re really helping individuals understand the likelihood of tolerability and again, lack of irritation or—

You just need to know. Information is power.Michelle: Exactly, so they can actually—we show you all the ingredients, every single ingredient. We also, let’s say the product ranks 91 percent. You can click on the ranking, on 91 percent, and it will show you why it doesn’t rank “Top Free,” why it’s not 100-percent okay for you. Lot of times when it’s 91 percent it’s because there’s fragrance in it. And you know, it’s just really personalization for everyone around their skin. We don’t promote any particular product, we simply say, these products are “Top Free,” these products rank 91 percent, these products rank 83 percent, and then we show you all the ingredients, we show you why it ranks that way, and then you get to make the decision. Maybe this product is fine for you, maybe this is a product that you’ve been using and you scanned it into the system and you’ve never had a problem with it, and it doesn’t rank as high as I would like it to rank, but you’re okay with it. That’s fine too. You just need to know; information is power. Just like with EmpowHer, information, knowledge is power. And this is putting the knowledge base into the hands of the consumer.

By the way, there’s a back end for the dermatologists, so the dermatologists, the allergists, the pediatricians, Barb, you should probably have access to the back end too, for your patients. You can give them the front to go to, but the back end actually allows the physicians to pinpoint what the allergens are, because they’ll patch test their patient, or just know what they are, give them a PAC Code, which is a “Patient Allergen Code” and they send them to the front end of SkinSAFE, where they can see only product that’s good for them. And that product then they can purchase right there on SkinSAFE; they don’t have to go anywhere else.

Dr. Barb: So it’s a store as well

Michelle: It is. It’s a great way for the dermatologist to have access to all the ingredients, and this is constantly changing, too, by the way. So, we change, we just added a propylene glycol is a big offender in a lot of products, so we just added that particular badge to our system. So we are constantly adding things. We have what we call a “Teen Safe Badge” because we know there was a study done last year regarding young, preteen girls who were putting an average of eighteen products on their skin, and it was affecting their hormones. There’s about nine different ingredients that affect a young woman’s hormones. And so we took those nine ingredients and we put those into the system, so that our algorithm knows those nine ingredients are in there or not, and then it will give a badge and it says “Teen Safe,” which means that teens can use it and it’s safe for them.

We created a “Lip Safe” badge, because I just had a situation, and a lot of people do, I’ve had chapped lips forever, but I was at the dermatology conference a couple weeks ago, and my lips blistered. I put something on them, and they literally blistered. I was in so much pain, and here I am talking to all these different brands, and I can’t hardly speak, because my lips are swollen and they look just awful. So I said to Dr. Yiannias, “Can I create a ‘Lip Safe’ badge? And how many people have trouble with chapped lips or what I’m having, the blistering?” And he said, “It is so common, you have no idea.” So I said, “Good. I’m going to create a ‘Lip Safe’ badge.” And I did. And it was so interesting, because for men, toothpaste is the biggest offender for them getting chapped lips. Then they go buy chapstick, and chapstick is not a “Top Free” product, so now they are adding insult to injury. For women, it’s the lipsticks, the lip glosses, those types of things that we are putting on our lips that are not “Top Free,” or there’s something in there, and typically it’s lanolin that causes the problem, that causes the lips to do what mine did, which is blow up and blister.

This “Lip Safe” badge, we created it, I couldn’t wait for it, because I couldn’t wait to find a “Top Free” product, because I can’t find a “Top Free” product or lipstick or lipgloss to save my life. And sure enough, the first one I tried, which was Neutrogena, it’s a hydrating lip gloss, and it’s I think, like $3 a piece, no more chapped lips. I’ve had chapped lips for at least the past 15 years, maybe 20.

Dr. Barb: Wow, it’s fascinating, so again, thank you for leading this charge. Now, with what I do, through my practice and my website, MiddlesexMD, we’re talking to woman about vulvar healthcare, vaginal healthcare and women are reaching for lubricants and moisturizers and products to address vaginal/vulvar health, sexual health, and certainly we understand in menopause, that’s an area that becomes uniquely challenging and more sensitive as well. Does your site, does the SkinSAFE site address the sexual health related products?

Michelle: It does; yes, it does. I knew this would be a topic of discussion for us, because of course, anything that touches the skin is going to be in the system. So whether it’s eye drops, whether it’s mouthwash, whether it’s lubricants, whether it’s anything feminine hygiene—you bet it’s in the system. And if it isn’t in the system, it needs to be scanned by whomever is using it, you know whatever consumer is using it and we’ll get back to them and let them know, you know, this is how it ranks. Because, I believe that women should only be using what I would consider “Top Free” product as lubricants. It also deals with condoms and everything else. Anything that’s touching the skin needs to be put into that system, and so, yes, there is a whole area, it’s called “Personal Care,” and from “Personal Care” you can go to “Hygiene,” it just covers everything. I can’t wait for you to go use, really take a deeper dive, because your patients are going to absolutely love this; I mean everyone is loving this, but particularly women, because as we know women are buyers, they are buying for the family. But, I will say, it really does tell you what products are good and which aren’t.

The other problem that we have with all of these products is that you can get one batch, so let’s say you buy a bottle of shampoo, and it works great. The next time you start having a reaction, and you don’t know where that reaction is coming from, because it can’t be from the shampoo, because you’ve been using the same shampoo forever. Well, not necessarily. It can be the shampoo, because there’s an ingredient change that occurred from batch to batch. Either they couldn’t get that ingredient, or they got a cheaper ingredient or substitution for that, and they don’t have to tell you this. So, you as a consumer, you're scratching your head, no pun intended, trying to figure out why you’re having this issue with your scalp, and it’s because there was an ingredient change and you didn’t know about it. So we always recommend you scanning in that new product as well, even though it’s the same product you’ve been using, to see if there’s been an ingredient change, because they won’t tell you. And it’s more frequent than you think. And when it says hypoallergenic on it, again, there’s no such thing.

You can say anything on a label... but that doesn't mean it's true.We’ve created the standard with Mayo for hypoallergenic; there’s been no standard. You can say anything you want on a label when it comes to skin care, but at the end of the day that doesn’t mean it’s true. That’s the same with organic; you can have one little teeny tiny organic thing in there and the rest is not organic, and yet they’ll claim it’s organic. You know, buyer beware, this gives the opportunity to the consumer to actually understand what they’re buying and getting the best product for them. And the lubricants, the condom, all those things that are so critical, and at some point I want to have, and I know we’ve talked about devices, and you and I can talk about devices all day long. But, devices as well, need to be put into this system, so that we make sure that there’s nothing that can irritate the skin. Whether you’re using them for sexual pleasure or you’re using them because you need to ensure that you keep everything healthy.

Dr. Barb: Do you have any optimism that there might be more push for truth in advertising or—

Michelle: Absolutely, yes.

Dr. Barb: I would like to think, as you know, hearing about understanding more about the contracts we enter into unbeknownst to us, when we even sign up for an app and you know, the knowledge that these companies have about us, I’d like to think that this knowledge will lead to consumer advocacy for more transparency

Everyone wants to know what's in their products.Michelle: Totally. You know, our market really has been, the millennials that are really, you know, they want transparency, they don’t believe marketing, they don’t believe any company who’s marketing their product, they want to know. They want to know what’s in it, and if they don’t know what’s in it, if you’re not honest with them, if they’re not giving us the ingredients that we can put into the system, they’re not buying it. They’re not having it. And we talk about the millennials and we think that’s just happening with them, I will say that it’s, yeah, I’m going to make a broad statement and say, it’s not just the millennials, it’s everyone. Everybody wants to know what’s in their products. You know this hit and miss, that’s the way we used to practice, that’s the way we were used to doing things. Now as these tools are being created to help the consumer, you know the consumer is using them. Because we make it very easy and simple for someone to find out what works and what doesn’t. And the price point varies too. You can go from a very expensive product to a very inexpensive product. Like I said, my Revlon colorstay lip—not lip liner, eyeliner, which I had a huge problem with eyeliner for years, never knowing I was allergic to is, is like $3.99. I was buying $60 eyeliner that was causing me to have an allergic reaction.

Dr. Barb: Yeah, it is a tough, tough place to navigate, so again, thank you for all the work you’ve done, not only behalf of women in this case, but everyone who is searching for a better option.

As we close our time together, Michelle, can you share with our listeners, where do you find richness at this stage in your life?

I want women to have everything they want and need to live happy, healthy lives.Michelle: I think my richness comes from several different things. I think my richness comes from my relationships with my family, with my friends, with my partner. And I will say that my richness, my true richness is the passion that we both share for and around women’s health and wellness. I want women to have the opportunity to have everything it is that they want and need to live happy, healthy lives. And if I can make just a little bit of a difference in as many women’s lives as I can, that’s my goal. And that’s what I wake up every morning thinking, did I save, change or improve somebody's life? And we can monitor that actually that on EmpowHer, and every morning I’m not disappointed, because we’ve done just that. Now, I’d like it to be a million women a day, but you know, it’s really, I find it so enriching for me to be able to do what I do every day and knowing that I’m making even a small difference in the life of someone.

Dr. Barb: Well thanks for sharing, and I can say I know you are making a difference, too. And it’s so great to spend time around you, recognizing the passion you bring to everything you do, and the get-it-done approach, because I don’t know if I know anyone who’s been more successful in getting it done. So thanks for what you have been able to do and what you will continue to do on behalf of women.

Michelle: Oh, well you’re welcome. And thank you. I’d like to do more, I’d like to create more tools, I’d like to continue on to help the patients, but also help the healthcare professionals like yourself, because you’re busy, too. You’re navigating a very difficult system today and working, and you want to do the best you can for your patients and I want to try to help that become an even better experience.

Dr. Barb: Well, thanks for your time, Michelle.

Michelle: Thank you, Barb. Thank you so much.

 


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