bookofjoe

BehindTheMedspeak: Psychodermatology — 'If You Think It, It Will Clear'

Natasha Singer's story in the July 28 New York Times about the rise of this new specialty caught my eye.

As did the great graphic (above) by the Dynamic Duo Studio that accompanied the article.

Long story short: psychodermatology can be nicely summarized by the quote in the headline of this post, also the Times headline.

Joe Duke, a Philadelphia purchasing agent, said in the article, "For me personally, biofeedback has been like anger management for my skin."

Tell you what: Joe Duke should be in advertising, not purchasing — he knows how to coin a slogan.

The Association of Psychocutaneous Medicine of North America had 12 founding members in 1991; it now numbers over 40 practitioners, including physicians and psychologists.

With a growth rate like that they'll reach triple figures by 2025.

Here's Singer's article.

If You Think It, It Will Clear

Stress may be inflaming your pimples.

And hypnosis may help clear them up.

Or deep breathing exercises.

Or maybe imagining yourself lying on a beach in Aruba.

At least that's the idea behind an emerging medical specialty that explores the interaction between the mind and the skin.

Its practitioners believe that for some patients, stress may play a role in skin conditions from acne to psoriasis, rosacea, warts, eczema, blushing and hives.

These doctors, who identify themselves as psychodermatologists - "derm shrinks" or "skin shrinks" for short - concentrate less on medicating the skin and more on getting at the psychological components of what ails it.

They do not ignore traditional medicine.

But they add treatments like psychotherapy, meditation, relaxation, hypnosis, acupuncture, yoga, tai chi and even anti-anxiety drugs.

These strategies, psychodermatologists say, have the potential to help the tens of millions of Americans who suffer from chronic skin ailments.

And many patients, frustrated by skin conditions that seem resistant to traditional medicine, are apparently willing to give them a try.

Mary O'Leary is one who has.

A surgical nurse in Boston, Ms. O'Leary had so many plantar warts on one foot, it was painful for her to stand all day in the operating room.

Her dermatologist prescribed antiviral creams, but nothing helped until she met Ted A. Grossbart, an assistant clinical professor of psychology at Harvard Medical School who specializes in skin problems.

"I spent months learning self-hypnosis," Ms. O'Leary said.

She visualized her immune cells fighting off the virus and imagined healthy skin replacing the warts.

"It's bizarre and amazing, but it worked."

Some doctors are skeptical of treatments based on stress relief.

Larry E. Millikan, chairman of the dermatology department at Tulane University School of Medicine in New Orleans, likened some psychodermatology methods to the wart-treating strategies Tom Sawyer recommended to Huckleberry Finn: burying a dead cat at midnight or sticking one's hand in a wet, rotten tree stump while chanting "spunk-water, spunk-water, swaller these warts!"

"The proven benefit for skin problems comes from traditional dermatology," Dr. Millikan said.

"That will remain true until we have hard science showing the effects of meditation and acupuncture on skin."

But psychodermatologists say the anecdotal evidence is enough to convince them that their approach is worthwhile.

"We all have patients whose hives, pimples and eczema get worse when their personal lives or work situations get complicated," said Dr. Richard G. Fried, a dermatologist and psychologist in Yardley, Pa., whose staff includes an acupuncturist and a biofeedback therapist.

"But dermatologists have customarily ignored the root causes and just treated the visible symptoms."

Joe Duke, a purchasing manager in Philadelphia, is one of Dr. Fried's patients.

"Two to three hours after a stressful situation," Mr. Duke said, "I used to get a psoriasis flare-up with 20 to 30 lesions across my chest, arms and legs. You look like a leper."

He had spent decades trying ultraviolet light treatments, prescription ointments and creams, antibiotics and even methotrexate, a drug that suppresses the immune system.

Some of these worked temporarily, while others had worrisome side effects. So Dr.

Fried suggested that Mr. Duke try biofeedback, which teaches patients to reduce tension by practicing deep breathing and muscle relaxation, and by imagining themselves in idyllic landscapes.

"I started biofeedback about 18 months ago, and last summer I even wore shorts for the first time in years," Mr. Duke said.

"For me personally, biofeedback has been like anger management for my skin."

The result, he said, has been fewer breakouts and less reliance on prescription creams.

The number of skin specialists who combine physical and psychological treatments appears to be rising.

The Association for Psychocutaneous Medicine of North America, which includes physicians and psychologists, has grown to more than 40 members from 12 in 1991.

Some of these practitioners treat depressed patients with disfiguring skin conditions or psychiatric patients who harm their own skin. But most also treat common skin ailments.

David Colbert, a dermatologist in New York, employs an acupuncturist to work with some of his rosacea and psoriasis patients.

And Philip D. Shenefelt, a dermatologist in Tampa, Fla., often uses hypnosis to treat itching or hives.

A few medical school dermatology programs also have begun to provide stress-relief treatments.

St. Luke's-Roosevelt Hospital in New York has a Psychocutaneous Medicine Unit where dermatologists and psychologists often treat patients in tandem.

And later this year the Johns Hopkins School of Medicine and the University of Rochester Medical Center plan to open psychodermatology clinics where doctors may recommend that patients try hypnosis or stress-reduction techniques.

Dr. Grossbart of Harvard, who has been treating skin complaints with psychotherapy for 25 years, said he was pleased that dermatologists were learning psychological techniques.

"If a dermatologist allots only 12 minutes to see each patient," he said, "that doesn't leave time to address underlying emotional issues."

Several recent studies have shown how stress can impair the skin.

In 2001 scientists at Weill Medical College of Cornell University subjected 25 volunteers to a fake job interview and 11 others to a sleepless night.

They then gave the volunteers microscopic wounds by peeling off a small, thin patch of skin with tape.

All the subjects' skin took longer than usual to repair itself.

A similar 2001 study, done at the University of California, San Francisco, looked at 27 graduate students during exam time and again during spring break.

While the students were studying for and presumably worrying about tests, their skin was slower to repair itself than it was during vacation.

There is less evidence to suggest that the opposite premise may be true: that reducing stress via hypnosis or meditation may heal the skin.

But there is some.

In 1998 a study of psoriasis patients at the University of Massachusetts found that those who listened to meditation tapes while receiving ultraviolet light treatments healed much faster than patients who did not use the tapes.

And a 1999 study at Johns Hopkins found that psoriasis patients who were susceptible to hypnosis treatments improved more than patients who resisted hypnosis.

The biological mechanisms by which these remedies may work are unknown.

It is possible that relaxation simply improves people's outlook and causes them to eat healthier food, sleep better and get more exercise, and that those changes affect their skin.

This uncertainty makes some doctors leery of mind-body treatments.

Mark Lebwohl, chairman of the dermatology department at Mount Sinai School of Medicine in New York, said that against his better judgment, he agreed to refer a psoriasis patient, Dennis Foglia of Queens, to a psychologist for hypnosis.

The therapist tried hypnosis and asked Mr. Foglia to visualize the rash leaving his body.

"I wouldn't tell other patients not to try it," said Mr. Foglia, a retired police officer, "but I can say hypnosis did not impact my psoriasis at all."

Richard D. Granstein, chairman of dermatology at Weill Medical College, questioned whether stress-relieving treatments could get rid of anyone's pimples.

"We can't be absolutely certain until we can prove that these therapies directly alter a patient's skin," Dr. Granstein said.

"It can't hurt your pimples to take up yoga or tai chi, as long as you're still using your acne creams."

Self–Service Dog Drinking Fountain

It's hot outside, have you noticed?

Your dog has.

Get fido one of these and never again will your parched pooch have to lie there semi–comatose until you remember to offer a bowl of water to the poor thing.

Connects without tools to any outdoor faucet.

From the website:

Clean, fresh water on demand

As your pooch approaches our innovative Dog Fountain a motion sensor triggers water flow, providing an endless supply of fresh, clean water.

Turns off when the dog walks away.

Requires 4 C batteries.

$89 here. (Batteries not included.)

And no — you don't have to be a dog to use it.

Sheesh.

As if.

Helpful Hints From Joe–eeze: How to get the most out of your dishwasher

Steve Eddy is the marketing director for dishwashing products for G.E.

He told Sarah Tilton, in the "Tricks of the Trade" feature in today's Wall Street Journal, how the experts do their dishes.

No matter how tired Eddy is after a day's work he insists on loading the dishwasher himself after dinner with his wife and two children.

From the article:

• Prerinse dishes only if you're using an older machine (five years old or more) — in newer models prerinsing can fool the sensors into thinking the dishes are cleaner than they are.

• When unloading start with the bottom rack so any water trapped in a cup above won't spill onto the dry dishes below.

• Pots, pans and plates go on the bottom because that's where the most water goes.

• Silverware goes in with the handles up.

• If the load is heavy on plastics use the cooler plastics cycle so the items don't become misshapen.

• For especially large items such as oven grates and refrigerator crispers remove the top shelf.

FunFact: When I moved into the house I still live in (it was built in 1967 by the man who sold it to me) I used the dishwasher one time.

It made so much noise that I've never used it since.

I even had it disconnected from the plumbing.

Silence is golden.

I once read that the four most important features of a home are space, light, silence, and a view.

If you're near water that's a bonus fifth.

My house (photos taken from which appear above and below) is perfect, even down to the little creek that runs along the bottom of the hillside that descends from the plateau on which my back yard sits.

That's why I will die here.

Why would I want to live anywhere else?

It's possible to recognize when something is as good as it can get without exhausting one's self in a never–ending search for "a better haircut."

Trolley Box — 'Your personal moving man'

What is it, I wonder, with this inordinate, life–long fascination with things that fold up or expand?

It's a consistent thread in what interests me.

This clever invention fits right in with the transformation theme.

You start out with what looks a plastic valise with wheels.

Then, much to the amazement of everyone, your 3"–inch thick briefcase morphs into to a rolling box capable of handing up to 55 lbs.

All sorts of features:

• Easy snap–open action

• Stabilizing side clamps

• Rubber tires

• Flap–down bottom

• Telescoping 19" aluminum handle

Measures 15"L x 13"W x 14.5"H when open.

$24.99 here.

Would you eat a tattooed tomato?

They are no longer coming: they are already here (above).

Julia Moskin wrote a front page story for the July 19 New York Times about the rise of tattooing as an alternative to those annoying stickers on every single piece of produce you buy these days.

The tattooed fruit is created using a laser which etches the price look–up number (PLU) and any other information the retailer wishes directly onto the skin of the fruit or vegetable.

The tattoo is permanent, removing only the outer pigment to reveal a contrasting layer underneath and make the tattoo readable and scannable.

The lasers cut and cauterize the skin of the fruit or vegetable almost simultaneusly, similar to lasers used in surgery; the skin of fruit that has been laser–etched remains airtight.

It's possible to barcode the produce with its origin, when it was picked, even how many calories it has per serving.

Advertising might cover a green pepper using the same technology.

Here's the Times article.

Tired of Prying Off Stickers? Tattooed Fruit Is on the Way

A pear is just a pear, except when it is also a laser-coded information delivery system with a security clearance.

And that is what pears -- not to mention organic apples, waxy cucumbers and delicate peaches -- are becoming in some U.S. supermarkets around the country.

A new technology being used by produce distributors employs lasers to tattoo fruits and vegetables with their names, identifying numbers, countries of origin and other information that helps speed distribution.

The marks are burned onto the outer layer of the skin, visible to consumers and cashiers alike.

The process, government-approved and called safe by the industry, may sound sinister.

But it was designed with the consumer in mind: laser coding could mean the end of those tiny, stubborn stickers that have to be picked, scraped or yanked off produce.

Sticker-removal duty took Jean Lemeaux of Clarksville, Texas, half an hour one day last week.

"I was picking all the little stickers from the Piggly Wiggly off my plums and my avocado pears and my peaches," said Lemeaux, 76.

"Then I had to make fruit salad out of the ones that got hurt when I took the stickers off, and then I had to wash the glue off the other ones before I put them in the fruit bowl."

"One time," she said, "I got up the next morning and looked in the mirror, and there were two of them up in my hair."

The stickerless technology has a broader purpose, too: It is part of the produce industry's latest effort to identify and track, whether for profit or for security, everything Americans eat.

Since 9/11, the industry has been encouraged to develop "track and trace" technology to allow protection of the food supply at various stages of distribution.

In addition, next year federal regulations will require all imported produce to be labeled with the country of origin.

The tattooed fruit is being sold in stores nationwide as other tracing methods also are being tested: miniaturized bar coding and cameras with advanced recognition technology that can identify fruits and vegetables at the checkout counter.

In Japan, apples have been sold with scannable bar coding etched into the wax on their skin.

No one knows exactly when every piece of fruit will be traceable, but the trend is clear: Wal-Mart already requires all pallets delivered to its distribution centers to have a radio frequency identification check.

But the carrier of information about fruits and vegetables in America remains the tiny sticker called the PLU, for "price look-up."

It is unpopular not just with consumers but with the industry itself.

"If they are sticky enough to stay on the fruit through the whole distribution and sales network, they are so sticky that the customer can't get them off," said Michael Hively, general manager of Bland Farms in Reidsville, Ga., the country's largest grower and packer of sweet Vidalia onions.

But apart from the occasional crate of locally grown produce, "most supermarkets no longer accept fruit and vegetables that are not stickered," said Francis Garcia, a vice president of Sinclair Systems in Fresno, Calif., a major manufacturer of the stickers and of the automated systems that blow them onto fruit at packing houses.

To producers, the stickers are messy, expensive and inefficient.

"The industry knows that the days of the PLU sticker are numbered, and that there will have to be new systems," said Don Harris, vice president for produce at Wild Oats, a national chain of markets, and chairman of the industry's Produce Electronic Identification Board.

"Customers do not like them, and they don't hold enough information anyway."

In 2002, Durand-Wayland, a fruit grower and distributor in Georgia, bought the patent for a process that etches the price look-up number and any other desired information into the skin of the fruit.

Greg Drouillard, who patented laser coding for produce and who now works for Durand-Wayland, said the process permanently tattoos each piece of fruit, removing only the outer pigment to reveal a contrasting layer underneath and make the tattoo readable, even scannable.

"With the right scanning technology, the produce could even be bar-coded with lots of information: where it comes from, who grew it, who picked it, even how many calories it has," said Fred Durand III, president of Durand-Wayland.

"You could have a green pepper that was completely covered with coding. Or you could sell advertising space."

Bland Farms, the Vidalia grower, has started shipping laser-coded onions to customers including Wal-Mart and Publix.

Sunkist has used it on oranges sold in some California markets, and is testing it on lemons, using blueberry-based ink for more greater contrast.

Henry Affeldt Jr., director of research for Sunkist, said the technology works the same way lasers work in surgery, cutting and cauterizing almost simultaneously.

The fruit's skin remains airtight, Affeldt said, and the mark is permanent.

"When there was only one kind of apple at the supermarket, it was easy," said Harris of Wild Oats.

"But now at some markets you will have 12 different kinds of apples. You might even have lots of the same kind of apple: conventional Fuji, organic Fuji, fair trade. You can't expect cashiers to know them all, much less to recognize a cherimoya when they see one."

But can laser coding and beautiful fruit bowls co-exist?

"Anything that permanently changes the fruit is going to be a hard sell," Harris said, "especially to buyers of organic produce."

Vestax VRX–2000 Vinyl Recorder: Cut your own record

This nifty device (above and below) turns your vinyl blank into a real, old–fashioned record.

The machine employs a cutting stylus to create a classic LP from your cassette tape, CD, digital music file or any other audio source.

Bonus: the machine will even play your record back.

$15,000 here.

What goes around circles.

No — that's not right; what comes around is circular.

No, that's even more messed up.

In the room the women come and go, talking of... hey — that's Eliot, not an old saying, bozo.

Sheesh.

Ah, the heck with it.

One hundred years ago, 11–year–old Frank Epperson accidentally invented the Popsicle

It happened in San Francisco, in the year 1905.

One day young Frank mixed some soda water powder and water, a popular drink in those days.

He forgot that he'd left the mixture on his back porch.

Overnight the temperature dropped suddenly to a record low and the drink froze.

Frank took the stick of frozen soda water to school to show his friends.

Eighteen years passed.

In 1923 Frank, now 29, recalled his frozen soda water mixture and began a business producing what he called Epsicles in seven fruit flavors.

He applied for and received a patent in 1924 for "frozen ice on a stick," called the Epsicle ice pop.

His children took the ball into the end zone for him, renaming it the Popsicle.

By 1928 he had earned royalties on more than 60 million Popsicles.

In 1931 he sold his invention to the Joe Lowe Co. of New York City, from where it made its way to Good Humor.

Julia Watson wrote an article about this wonderful stroke of lightning; it appeared in papers all over the U.S. in late July.

Craftsman Locking Adjustable Ratchet Wrench

Here is an amazing invention for an unbelievably low price.

Sears' Craftsman division, maker of excellent tools with an unconditional lifetime guarantee, now brings forth an extraordinarily engineered adjustable wrench.

The genius is in putting in both a ratcheting action and a lock.

This should make tightening and loosening fasteners far easier and more pleasant, with much less in the way of damaged nuts, bolts and fingers.

Works on all common sized fasteners, standard or metric.

You get one 6" and one 8" wrench in the set of two.

$24.99 here.