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Dermatology of East Texas Blog

  • Be Unique in Your Own Way

    The wind was barely a whisper, speaking softly to the silvery green leaves; they whisper back in gently swishing undulations. I stepped quietly among them, a visitor to their sacred world, the pale-yellow sunlight filtering down through the canopy and playing with shadows on the soft ground. I felt peace, joy, and astonishment moving on the air in rhythmic waves, the signature of a magnificent creation rising and falling in great loops and swirls. The olive trees, although nestled into a communal grove, resist any easy categorization or description. The knarred and twisted root pattern of one will never be repeated by another, although both have been driven by the same drought or flood. The trunks and branches reach out with an infinite number of variations, rounding and deflecting unseen forces. Then, in an act of sheer brilliance, small snowy, delicate clusters blossom, with fruit beckoning as the long days of summer spend heat and energy on the fulfillment of nature’s order. Each tree is its own work of art, and I marvel that each of my patient’s presents as purely unique work of art as well. The curve of the mouth, the angle of the jaw, the fold of the eye is never repeated (even in twins, not exactly), and each person’s individuality must be respected, interpreted, and accounted for when doing either cosmetic or medical dermatologic procedures. And that is part of the art of medicine, cultivated and nurtured over years of practice. And that is why it is never boring, or the same, nor should experience by exalted over the humble appreciation that there is always something to learn.

    This month I elected to skip the glossy ad heralded by a young model that looks perfect announcing the monthly special. While these ads are eye catching and pretty to look at, that does not reflect what most of my patients are striving to look like. Most simply want a more rested, more youthful version of themselves. They come in all age groups, both sexes, and generally with very realistic goals. They do not expect this to change their lives but do note that it often gives a little boost of confidence, a little self-assurance, and frankly a little happiness. So, this month, in keeping with the overwhelming response to last month’s special on Allegan filler, we will feature the Galderma products in comparable special. Purchase one syringe of Refyne, Defyne, Restylane Lyft, or Restalyne Silk, and get a second half off. Purchase two syringes and get the third complimentary. As always this is while supplies last and is subject to my discretion of whether you are a good candidate for this procedure.

    I am also going to whisper into your ear a suggestion: Mother’s Day is approaching, and we have great gift ideas. A gift certificate allows her to choose whatever service she has been wanting. Let your Mom’s radiance truly shine this May!

  • March Madness

    painting-1 painting-2

    It’s March and there’s Madness in the air! Yesterday, in Dallas, the University of Loyola, Chicago’s basketball team squeaked out a buzzer beater basket to conquer the favored Miami in the NCAA tournament. As a graduate of Loyola University of Chicago, my heart swelled with pride, and my mind drifted back (way back!) to those glorious undergraduate days in Chicago. I attended that school on a combination of academic and financially based scholarships. Without that, there would have been no advanced education for me. It spring boarded me into a life beyond what my parents were able to reach, and the blessings just keep coming. The tournament is always fun to watch, in my opinion, because ANYTHING can happen.

    Loyola hasn’t been in that tournament since 1985, if my facts are straight. Small schools can come out on top of the giants. Even if they do not win another game, they won that one. And that’s history now. The continued ability to adapt, to keep exploring and thinking outside the box, to not be intimidated by those around you simply because they are bigger or more powerful, are all life lessons we can learn from the little guys. I’ve attached two very different paintings to this blog. Both are of flowers, but with completely different styles and strokes. Even as a painter, being open to new ideas and ways of doing things is important. Much of this I learned at Loyola, and below, this pattern was reinforced during my stint at the University of Oklahoma as well. Here’s to March, the madness, and the coming beauty of Spring!

    It was August, and it was hot. Good thing. The sweat dripping from my brow mingled with my tears, making the sadness less evident. I was 22, and standing at the gravesite of my father, who had just died from leukemia, a disease for which there was little treatment at the time. Evoking Scarlet O’Hara in the infamous Gone with The Wind, I vowed that I would do something about this. It was shortly thereafter I presented my fiery and penniless self to the University of Oklahoma, Department of Microbiology and Immunology, nearly demanding to be admitted for the purpose of beginning a career in research. Despite my appearance and naivety, I was admitted, and assigned to work with Dr. Madelaine Cunningham, a brilliant middle aged (at the time) woman whose shortness of stature was the ONLY thing small about her. She was working on developing a certain type of antibody that could be used to both detect and treat disease (a BIG simplification). To date people had been successful using the mouse, but developing something from the human system (which would be more useful) was proving harder.

    For two years I traveled in the shadow of this woman; I was the grunt work to her genius, and thankful for it. I learned more from her than immunology. She was/is a pioneer in her field at a time when there were simply not many women at all doing what she did. She was/is fearless, tenacious, but kind. She demonstrated daily the fine art of criticism (an opportunity to improve), and how to NEVER compromise your ethical and moral position, even when tempted by greed or position. At the end of my two years, I once again found myself with tears trickling, as she added my name as an author to HER work of genius, announcing our successful production of human monoclonal antibodies. By this time, I had decided to slightly alter my course, and pursue a Medical Doctor degree as opposed to a PhD, and with her blessing I gathered my things and went to Medical school.

    The fire she ignited to always learn, and to think outside the box has never died. I cannot help myself, and continue to be a voracious reader of many things, including those outside my own field. There has been an explosion of new technology that has allowed the use of antibodies to treat many diseases, from psoriasis and melanoma (in my own arena) to cancer. Imagine my surprise when my own oncologist recently suggested I start treatment with a new medication, Prolia, a human antibody to help restore bone I have lost from my breast cancer treatment. The girls I work with just roll their eyes when I come in breathless, excited about a new advancement or way to do something. Just yesterday we did our first biopsy of a skin lesion using tape instead of cutting!

    There’s a computer model being pioneered at Stanford that can look at images and detect melanoma just as well as a dermatologist. Hopefully they will make it even better as we battle this monster. Recently my studies have included exploration of fields of nutrition, osteoporosis, the effects of technology on our brains, and the latest thinking in treating obesity. I am now onto Microbiomes. In dermatology, we have new things to treat and prevent skin cancer as well as new things to make our skin look better and brighter. And, (warning an uncomfortable topic approaching) Ladies, I have great news if you suffer from urinary incontinence (dribble urine when you laugh or sneeze or work out or have to CONSTANTLY look for the bathroom), vaginal dryness, or painful sex. Please don’t be afraid to ask me about this.

    So, as I MARCH into March, I thankfully travel on the shoulders of my Dad and my Mentor Madelaine, thankful I have had those that went before me to blaze trails and encourage me to never stop learning.

  • What's New This August

    One of my greatest pleasures as a physician is the privileged and honest conversation I have with my patients. While sometimes difficult and soul wrenching, they are often also joyful, humorous, and filled with insight and points of view that broaden my own thinking. I have, in the past, underestimated the value we give to people in the cosmetic arena. Patients have demonstrated to me, year after year, that gaining back (or getting rid of as the case may be) what time, nature, or disease has taken away from them is restorative. I learned this first hand after my recent surgery and reconstruction for breast cancer. Although the reconstruction was not a “necessity”, the restoration gave me back a sense of myself I wasn’t, at this time in my life, ready to relinquish. So, when patients start their conversation with “I don’t want to seem vain, but (fill in the blank)”, I want to reach out and assure them that is not my perception. I get it. In a very personal way. And, furthermore, it makes me smile inside as I watch satisfaction and relief touch others.

    We have recently added two new systems to our offerings at Dermatology of East Texas. I am very excited to announce we now offer CoolSculpting Technology. CoolSculpting is a noninvasive, nonsurgical method of fat reduction with no downtime. Using a process of cryolipolysis, fat cells are killed, but other types of cells are left alone. It is the only FDA approved device for this type of fat reduction. What I love about this device, besides its demonstrated safety and effectiveness, is its versatility. We can debulk large areas of fat, but also sculpt, and treat many different areas: double chins, love handles, belly fat, upper arms, bra fat, thighs, and under the buttocks rolls. Do not underestimate the joy of zipping up jeans and NOT having to search for a top that covers the overflow! Check out this area on our website for more information, and schedule your consultation. Many of you are now familiar with our other recent addition, the Venus Versa. This is a versatile platform utilizing multiple modes of technology that allows us to tighten and lift skin, treat red spots, brown spots, acne, reduce unwanted hair, and reduce fat. I bought this shortly after my first cancer surgery, selfishly realizing as the estrogen was ripped from my sweaty palms, that I would personally NEED these treatments to keep my skin looking good. (Stay tuned, as I address in future Blogs how to tackle hair loss, creepy skin, and temperature swings due to hormone deprivation).

    Finally, we have added some new products. As part of my recovery, I wanted nothing more than to go to a beach and rest. I live outdoors when I’m not working. Life is too short not to have fun. How, exactly, does a dermatologist do the beach? Very Carefully! I started by taking the oral supplement Heliocare 3 days before departure, and everyday during my vacation. This is a pill derived from a fern that has been shown to reduce the amount of damage done to your skin while you are outside. I take Niacinamide 500 mg twice daily, which has been shown to reduce the formation of precancers and nonmelanoma skin cancers. You need to check with me or with your primary care physician before taking this one, as it’s not for everyone. I slathered on our newest sunscreen ISDN, which utilizes technology gleaned from the Noble Chemistry Prize awarded in 2015 to the people that figured out how DNA fixes itself after damage. We have all of that at the office if you are interested, or you can find it online also. I wore UPF rated sun protective clothing (you can buy this or make your own), and stayed under an umbrella except for long walks and blissful swims. Most importantly, I had fun, relaxed, and counted my blessings of have such an amazing life with wonderful patients, family, and friends that make it something worth holding on to. Have a GREAT SUMMER!

  • Helen's Orchid

     

    Happy February!!!! Although unconventional, I am going to share a personal story about why the arrival of February is hailed with such glee at Dermatology of East Texas. In October, my “routine mammogram” took an unanticipated twist, and set me upon an unexpected path of ridding myself of breast cancer. After a bilateral mastectomy, I chose to pursue reconstruction. For me, this entailed the placement of expanders, what I visualize as rubber sacks with metal plates affixed, into my chest wall. Fluid is gradually added over the course of weeks to months, expanding the device, and the skin and muscle overlying. It’s about as comfortable as it sounds.

    On February 2, these charming instruments of elective torture will be removed, and in their place will be a glorious mixture of silicone, fat, and surgical creativity. Throughout this process, I have been the recipient of many acts of kindness, and I would like to share just one of these with you. As craziness and tempers collide in our world on all too regular a basis, take a moment to relish that there is good here, and celebrate February, the month of LOVE!

     

    Helen's Orchid

    The moonlight was beginning to filter in through the window, it’s great October glory a globe hanging just over the horizon, beckoning on the night. The white-blue paleness splashed on my blankets and I heard the gentle closing of a car door followed by carefully placed footsteps. The softest knock, followed by an entrance and warm, whispered greetings of concern, prompted me to locate the button on my electric chair, bringing my body to a position closer to upright. It is the tradition to bring food on occasions such as this day of celebration of a cancer eliminated, a body compromised, and a recovery in the making. I did not grow up in a family that practiced these cherished pearls of society. I was not schooled in the proper thank you note, the babies’ gifts, the showers, the societal strings that knit together a fabric of caring and concern. Perhaps it’s a southern thing, but I have adapted well to the south and have now been here longer than my northern exposure. “y’all” is officially my favorite term of endearment . Helen, the ultimate southern lady, had swept in with her aromatic roast chicken, green beans, and potatoes, a feast welcomed. The richness of the scent, and the richness of the giving, mingled as tears of appreciation welled. But she was gone in a blur, never to overstay, and only as the door closed did I see it, nestled in with the reparative protein; the loveliest of orchids, and what I would come to think of as my soul food from Helen.

     

    Packaged in a plastic pot and wrapped with unadorned clear wrap, the simplicity of its presentation daunted not its exquisite beauty. The exotic nature of its glossy, verdant leaves, so sharply demarcated and firm, dared anyone to describe them as delicate. I could much appreciate how, in their true environment, they would battle for space, nutrients, and the flickering sunlight, pushing up through the dark, rich soil and making their fierce and defiant claim. There were five of these, the topmost larger than the ones below, the powerhouses doing the hard work of photosynthesis, busily converting the sunlight it was given into the glory of the blooms above. It had no option other than to work where it was situated at the whim of some outer force, placed/planted wherever may be decorative or fancied. And yet it continued its work, paced, predictable, and without anger at its dictated circumstance.

     

    Although I could not see the roots, I could only imagine them curled and tangled below the surface, wedged tightly into their potted universe, despite their very nature to reach out and explore new territory. I felt my own chest tighten against this restraint, my breaths pushing against the plastic and steel devices now implanted in my chest. The epinephrine began leaking out, and, with quickening pulse, anxiety fell over me as a heavy shroud. With tight fists I pounded out the number of days until my release, each motion assuring my determination was not without value. I promised the orchid a new pot, as soon as I was able.

     

    Two thick, pole like stems pierced the soil in such an unnatural fashion, it seemed they had just been placed there as one would place a wooden support stick in a spring garden. Yet defying the utilitarian nature of these main supports were the blooms that danced on each of the gentle nodes projecting outward at a soft angle. Glorious, violet and pink and purple velvety petals placed in a delicate pinwheel of a swirl, I wanted to gently blow on them to see if they would circle. There were twelve blossoms altogether, and it was only after educating myself on these delicate beauties that I would discern they would be nature’s clock for me. Three months the orchid would bloom; three months until my reconstruction.

     

    I placed the orchid close to a window in the pantry, where light would filter through the magnolias outside, a tethered wish of reminiscence of ancestral origins. As my strength and mobility grew, so too did the beauty of the orchid. The leaves became more glossy and fat, rising up and out of the soil. Each week, without fail, I placed the required number of ice cubes onto the soil, as per instructions, and secretly begged for it not to die. Please, please, do not die. And each day it survived, and so did I. And the days, then the weeks, then the months passed.

     

    It was a subtle gesture, the lime tone of the stem giving way to a warm, buttery yellow, that signaled my time was drawing near. With mixed emotion I watched each day the strength of the blooms give way to time, the bold fabric of purple taking on a wispy tissue paper consistency. But not all blooms at once; rather one by one, waiting their turn, in a progression so steady and certain there was no point in arguing or trying to cling. Even as they fell they were beautiful and evanescent, resting on the leaves below their previous perch, and then making their way to the soil below, the resting place until they would rise again, recycled, renewed.

     

    Now, as I am just days before my reconstruction, the last bloom has fallen. The leaves and roots are alone now, no showy trophies of effort well spent. The bittersweet memory of each petal lost a measure for me of a journey unfinished. I have repotted as promised. The roots singing and reaching, the leaves busy with energy conversion, and always the expectation of completion to come, despite the difficulty of the endeavor. I will carry this, the thought of my lovely orchid, with me as modern medicines sing their gentle lullaby in my veins, surgeons sculpt and create, and the work of wholeness begins anew.

  • About 2017...

    Welcome to our new website!  As 2017 begins, we are happy to usher in a host of new services to make your life easier, and our time together more  productive.  As technology develops and changes, so must we.  We are now offering On Line Visits to our established patients. Concerned about a growth  that you don't think can wait until you can be seen? Busy with college  and away from Tyler? Now you can upload images, answer a few questions, and together we can get you the help you need with a few clicks.

    We have also added payments on line, and many of our products are now available for purchase on line so you can let us do the packing and the shipping.  You will still earn points with  our Rewards Program Benefit that you can use on our expanding menu of cosmetic services in our aesthetics department. Look for exciting new treatments to help with brown spots, red spots, wrinkling, and  skin tightening, and fat reduction in our aesthetics department.

    Many of you are unpleasantly aware of the soaring costs of medications (those used in dermatology in particular). We can work with you to help you find your medications at the most reasonable (of unreasonable) prices. We have researched ways to help you find the best deals available. Many of our patients are experiencing insane deductible and insurance costs, and are wondering how to get needed care. Please let us know if you have a particularly difficult situation, so we can do our best to work through it together. Medicine is changing, but our commitment to you will remain.

    Warm Wishes, Lisa Lowry

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