This site is intended as a resource for persons who have skin disorders and/or who have visited a dermatologist. We hope it will be interactive. You can find the area you are interested in under the Category Section which is in the right hand column of this page. Please note that we do not accept any money from pharmaceutical companies or device makers. The "A How To Use" page will be helpful.
In a recent column in the NY Times, David Brooks opined that there is "a common form of contemporary hubris — the belief that it is possible to solve political problems as if they were engineering problems, with rational planning." There is "a distinction between technical knowledge and practical knowledge. Technical knowledge is the sort of information that can be put in a recipe in a cookbook. Practical knowledge is the rest of what the master chef actually knows: the habits, skills, intuitions and traditions of the craft. Practical knowledge exists only in use; it can be imparted but not taught. Technocrats and ideologues possess abstract technical knowledge and think that is all there is. Their prefab plans come apart because they simplify reality, and don’t understand how society works and the rest of what we know." from David Brooks, Really Good Books.
This holds true for the practice of medicine as well. The “experts” often recommend cookbook approaches that just don’t work in the real world. These academic specialists often do not practice in the real world and their advice is based on hypotheticals. Sadly, there are few expert clinicians around who are available to share their hard-come-by experience.
Prepared by Rhianna Flanagan, Massachusetts College of Pharmacy
Liquid nitrogen (LN2), sometimes called cryotherapy, a cold, liquefied gas with a temperature of 196° below Celsius (-321°F), is used primarily to freeze and destroy superficial skin lesions such as warts and keratoses. It causes stinging and mild pain as the growth is being frozen and then thaws. The discomfort usually lasts a few minutes when keratosis are being treated, but considerably longer when it is warts, since warts need to be frozen for longer than keratosis.
After LN2 treatment your skin will become swollen and red; it may even blister. Then a scab (crust) will form. It will fall off by itself in 1 - 3 weeks. The skin growth will come off with the scab, leaving healthy new skin.
No special care is needed after the liquid nitrogen treatment. Just ignore it. You may wash as usual and use makeup and other cosmetics. If your clothing irritates the area, cover it with a small bandage..
Sometimes the cryotherapy treatment fails. If the growth is not cured by LN2 , please make a return appointment.
[This is an important piece. It is likely that bullying has similar effects to adverse childhood experiences (ACE). The latter is more common, but it may turn out that bullying has the some of the same longterm effects. DJE]
Victims of bullying may develop long-term physical and mental health problems, and now researchers have found one possible reason: Being bullied raises the blood’s level of C-reactive protein, or CRP, a marker of systemic inflammation and a risk factor for cardiovascular and other diseases.
Scientists followed 1,420 boys and girls ages 9 to 21, interviewing bullies, victims and their parents. They assessed CRP levels with periodic blood tests.
After controlling for initial levels of CRP and for many factors that affect it — sex, age, race and various health and socioeconomic issues — the researchers found that CRP levels in victims increased in direct proportion to the number of bullying incidents they experienced.
Bullies, in contrast, had low increases in CRP, even lower than those in children not involved in bullying at all. The finding suggested that a bully’s increased social status might have biological advantages, the scientists said. Their study was published online on Monday in The Proceedings of the National Academy of Sciences.
“The only other kind of social adversity where we see this kind of long-term effect is in children who are physically abused or neglected,” said the lead author, William E. Copeland, an associate professor of psychiatry at Duke. “We don’t think about bullying the same way, but I’m moving toward the position that we should. This kind of social defeat is more potent and long-lasting than we previously thought.”
What’s Your ACE Score? (and, at the end, What’s Your Resilience Score?)
Background
There are 10 types of childhood trauma measured in the ACE Study. Five are personal — physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect. Five are related to other family members: a parent who’s an alcoholic, a mother who’s a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and the disappearance of a parent through divorce, death or abandonment. Each type of trauma counts as one. So a person who’s been physically abused, with one alcoholic parent, and a mother who was beaten up has an ACE score of three.
This questionnaire was developed by the early childhood service providers, pediatricians, psychologists, and health advocates of Southern Kennebec Healthy Start, Augusta, Maine, in 2006, and updated in February 2013. Two psychologists in the group, Mark Rains and Kate McClinn, came up with the 14 statements with editing suggestions by the other members of the group. The scoring system was modeled after the ACE Study questions. The content of the questions was based on a number of research studies from the literature over the past 40 years including that of Emmy Werner and others. Its purpose is limited to parenting education. It was not developed for research.
Adverse childhood experiences (ACEs) cause kids to have a hard time learning, making friends and trusting adults. They can’t keep up in school, so they shut down or get in fights. They’re the “problem” kids. Schools suspend them. There’s lots of ways for kids to cope with their trauma. Alcohol. Drugs. Smoking. Food. Kids become daredevils and break their bones. Sleep around and get STDs. Grow up too fast and become workaholics. ACEs can cause health problems later in life, too. Vincent Felitti and colleagues found a strong graded relationship between the breadth of exposure to abuse or household dysfunction during childhood and multiple risk factors for several of the leading causes of death in adults.
For background information on ACEs, please see the website: ACEstoohigh.com.
We heard about Lice Aunties from a patient who took her daughter there. She thought the care given there was great! If you live within driving distance, and your child has a difficult case of head lice, Lice Aunties should be considered.
Fom their website: "Julie Blumenthal started Lice Aunties in 2008. She has her one-time six-year old daughter (now in college) to thank for that, a still memorable lice infestation. She and her staff combine best practice combing techniques and the science based AirAllé™ treatment to get rid of your family’s lice and nits in one visit, guaranteed."
There are at least two ways that you can save money on prescriptions if you do not have a drug plan with your insurance. The first we heard about was GoodRx (which is an excellent service).
So far, it's a bit harder to figure out the NPSN card, but we think that consulting both GoodRx and NPSN will help you to get the best price for the drugs you purchase. GoodRx tells you the price of medication at a number of local pharmacies, while NPSN guarantees a certain discount but does not tell one the price. With GoodRx the customer must print out a coupon; while NPSN does not have this requirement.
If you want to save money on prescriptions, please experiment with both services.