Category Science & Body Modifications

Point 74: President’s Corner – Brian Skellie

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Brian Skellie working with asepsis

Brian Skellie headshot at 2014 APP conference by April BerardiBrian Skellie
APP President

Technology for infection prevention:

Why the introduction of more technological advances help to reduce cross contamination risks

The benefits of thousands of years of advancements in infection control are applied and built upon daily: a brief history of sterilization.

Charles Chamberland’s Autoclave (1880), the first steam sterilizer
Chamberland’s Autoclave (1880), the first steam sterilizer
Denis Papin’s digester (1680), the first pressure cooker.
Papin’s digester (1680), the first pressure cooker.

Chamberland’s Autoclave (1880), the first steam sterilizer patterned after Papin’s digester (1680), the first pressure cooker.

Asepsis is the most effective technological advancement for a purposeful reduction of microbes to an irreducible minimum. This begins with policy and training, and follows through with checklists, review, and reminders for implementation.

Primum non nocere = above all else we should do no harm.

Antonj van Leeuwenhoek’s microscope (1683)
Antonj van Leeuwenhoek’s microscope (1683)

Physics was the first step in decontamination, using thermal energy: fire and the effects of the sun. Advances have been made in E-beam and radiation, both ionizing and non-ionizing, for sterilization. As a result, new equipment and supplies are now available providing an almost infinite sterilization shelf life. Part of what was found useful from the sun, apart from drying, was the power of short wavelength ultraviolet light to disrupt the DNA of cells. This has been harnessed for disinfection of exposed environmental surfaces, air, and water, but this form of sterilization is not appropriate for initial piercing jewelry. Further study of properties of the sun have resulted in functional plasma etching and cleaning processes and H2O2 gas plasma sterilization. At some point, gadgets for disinfection of procedure rooms such as UV-C robots and hydrogen peroxide (H2O2) vapor foggers may have an application in scale for our trade.

Joseph Lister’s antiseptic sprayer (1867)
Joseph Lister’s antiseptic sprayer (1867)

Chemistry was the next big step in the fight against preventable iatrogenic infection with germicides, from chlorine solutions and carbolic acid to EO gas. Recognizing the potential for stopping infection transmission during procedures by thoroughly cleaning the worker’s hands and the subject site with a germicidal product was an enormous step that has become part of our established thinking. Materials themselves can be used to leverage the natural properties of copper (Cu+) and silver (Ag) that make touch and transfer surfaces inhospitable to microbes, and other embedded compounds have been developed for similar purposes. Some even work with nanotech surface treatments.

Instrument cleaning technology is constantly improving on the basic two fronts of physical action and chemical reaction. Advancements in products safe for the worker and environmentally friendly have brought forth alkaline or enzymatic detergent, or peracetic acid options.

surgical tools from the late 1800s
outmoded surgical equipment from the late 1800s

Consumables have long been a source of worker and client protection and potential oversight. Gloves and other Personal Protective Equipment (PPE) do create a barrier when used correctly, but do not take the place of adequate hand hygiene and application of asepsis. For further protection against exposure to environmental hazards, wearable vapor detectors can be used to alert the worker of chemical hazards from cleaning and disinfecting products. Essential detectors for sterilization or cleaning parameters should be used for validation of each process. Test Soils with protein detection for washing instruments, even manual cleaning should be tested, and Chemical and regular Biological Indicators for sterilization loads.

Cleaning appliances have made validation tests easier and more repeatable, with the availability of small automated instrument washers and medical and dental ultrasonic cleaners. Our last line of defense against cross contamination comes from our environmental air quality, which can be improved with air cleaners equipped with HEPA filtration and UV, thermal or plasma disinfection, and floor scrubbers to vacuum up the dust, wash and dry the floor automatically and robotically.

The health and safety of our clientele and personnel depend on adequate sterilization and disinfection. The advancements listed have changed the way we do our jobs and protect ourselves from risk. As we look towards the future it is impossible to know the impact further technological advancements will have, but they will undoubtedly continue to change how we practice our trade.

Point 73: A Parent’s Guide to Safe Piercing for Children’s Ears

3 Comments read Issue 73, Medical, Public Education, Science & Body Modifications, Sterilization
Child's ear piercing performed by Becky Dill at Cold Steel Piercing Photo by Danielle Greenwood
Child’s ear piercing performed by Becky Dill at Cold Steel Piercing
Photo by Danielle Greenwood

Proper technique, sterility, piercing placement, aftercare, jewelry material, and style are among the many important factors that go into a successful piercing. First, let’s look at the technique itself. Piercing guns use pressure to force a pointed object, the jewelry, through the skin. While these mechanisms may seem like a quick, easy, and convenient way of creating holes, they can have major drawbacks in terms of tissue damage, inappropriate jewelry designs, and sterility. These concerns have been documented in medical literature over the years and provide proof of these concerns.

Due to the dull nature of the jewelry used in piercing guns, more damage is caused to the tissue when compared to piercings done with quality piercing needles. The effects are similar to a blunt force trauma including significant pain, swelling, scarring, and an increased potential for complications. The gun then pinches the back of the jewelry in place snugly against the skin, allowing no way for the new wound to breathe and heal properly. The customer is often told to turn the jewelry, which only further pushes growing bacteria into the wound, increasing the risk of infection and delaying the healing process considerably.

Additionally, it has not been documented how often piercing guns malfunction. Some operators report that the earring adapter that holds the jewelry often will not release the earring, requiring its removal with pliers. These pliers, which contact contaminated jewelry immediately after it has passed through the client’s tissue, may be reused on multiple customers without full sterilization. Few, if any, gun piercing establishments possess the expensive sterilization equipment necessary for such a process. Occasionally the intense pressure and speed of the gun’s spring-loaded mechanism is not sufficient to force the blunt jewelry through the flesh. In these cases, the earring stud may become lodged part way through the client’s ear. The gun operator, who may not be trained to deal with this possibility, has two options. S/he can remove the jewelry and repierce the ear, risking contamination of the gun and surrounding environment by blood flow from the original wound. Alternately, the operator can attempt to manually force the stud through the client’s flesh, causing excessive trauma to the client and risking a needlestick-type injury for the operator.

Diagram showing the differences in the "cutting edge" of ear piercing studs used in piercing guns. The bottom silhouette is a single use hollow needle.
Diagram showing the differences in the “cutting edge” of ear piercing studs used in piercing guns. The bottom silhouette is a single use hollow needle. Reference: Ear piercing techniques and their effect on cartilage, a histologic study

There may also be a greater likelihood of more serious complications when cartilage or structural tissue such as noses are pierced using a piercing gun. This type of tissue (cartilage) has less blood supply than earlobe tissue and therefore a correspondingly longer healing time; this means that infection in this area can be more likely and more destructive.

Another common concern is sterilization and asepsis. Any kind of procedure which involves contact with blood or bodily fluids requires strict adherence to crosscontamination prevention.

As is now well known, the hepatitis virus can live for extended periods of time on inanimate surfaces, and could be harbored within a reusable piercing gun for several weeks or more. Hepatitis and common staph infections, which could be found on such surfaces, constitute a serious public health threat if they are introduced into even one reusable piercing gun. Considering the dozens of clients whose initial piercings may have direct contact with a single gun in one day, this is a cause for serious concern. Babies, young children, and others with immature or compromised immune systems may be at a higher risk.

Some will argue that the piercing gun never comes in contact directly with a customer’s skin, or is sterilized or disposed of after a single use. This might be true, but the gun operator’s hands do—if they touch the customer’s skin and then touch the gun, the gun is now contaminated. When the gun drives the stud through the flesh— whether or not the skin starts to bleed – there is no way of knowing whether or not tiny particles of blood have been dispersed into the air contaminating everything around it. Piercing guns are usually made with plastic and cannot be adequately cleaned and sterilized for reuse. A quick wipe with an antiseptic pad is not effective in removing disease-carrying blood. Although many manufacturers now make disposable options, these do not negate concerns regarding possible damage to tissue, jewlery quality, or inadequate staff training.

The Association of Professional Piercers does not support the use of piercing guns because the reusable versions can’t be sterilized using APP approved equipment, such as an autoclave. Without proper sterilization, the risk of spreading diseases such as Hepatitis and staph infections increase.

The Bottom Line: Professional piercers use a more modern approach to piercing that’s less traumatic, cleaner, and more likely to result in a smooth healing process.

The Point Issue 73 - Professionals dont use piercing guns

Point #70: The APP wants to thank North Bay Bioscience

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The APP wants to thank North Bay Bioscience, LLC (NBBS) and Autoclave Testing Services, Inc. (ATS) for working with us to find an efficient streamlined process for the reporting of spore tests results for the APP Members who test with them.  Once the APP Member gives permission for their testing company to release spore test records to us, we will be able to review test results online.ATS-Logo-small

The APP can now get information/reports on our Members who test with NBBS or ATS via an online portal.  This will make maintaining records much easier and allow the APP to have immediate access to test results.  Members who test with them will no longer have to send in their spore test results monthly/quarterly; instead if for some reason we are NOT seeing test results we will contact the Member.

We have also sent out an inquiry to SPS Medical in the hopes of doing something similar.

Point #61: An Exploration of Pain

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By Kendra Jane

“The secret of success is learning to use pain and pleasure, instead of having pain and pleasure use you. If you do that, you’re in control of your life. If you don’t, life controls you.”
– Tony Robbins

By all accounts, my own life has not been one that most would consider physically painful. I’ve suffered a single broken bone, a couple of surgeries, and a few car accidents, but all were fairly insignificant. On the other hand, my chosen body modifications stand out as having caused me far more pain, but they also offered me more healing than any prescription or medicine ever has.

Growing up watching National Geographic with my parents I would often find myself marveling at what I was seeing. So many lovely faces, so many modifications. All I could do was think about how beautiful these people were, and how different they were from anything else I had ever seen. The stretched lobes of the Dyak tribes of Borneo, the crocodile skin scarification of the Korogo People in the Sepik region of Papua New Guinea, and tattooed faces of the Ukit tribes from the Chin region of Borneo – each and everyone made a specific impression in my mind.

However,  and perhaps strangely enough, I only developed a superficial anthropological interest in anything other than the aesthetics of body modification. I believe that this is unfortunately where most North Americans’ interest in body modification stands: a vague curiosity of the unknown and the bizarre. Quotes such as the following only further support that idea:

“Bound feet, stretched necks, deformed skulls, flesh permanently marked and scarred, elongated ear-lobes- as suggested by the standard terminology of “mutilation” and “deformation” itself, these are practices that have long fascinated the West where they have been viewed as exotic distortions of the body.” (Mascia-Lees et. Al. 1992: 1).

Now with that being said, other than the concern about whether it will look nice, the majority of my clients all want to know, “Is this going to hurt?” or “Didn’t that hurt?”  My answer – always truthful – rings out in a single word, “Yes.”

One would think that the answer would be obvious. Pain is pain, right? What I cannot explain to them in one word is just how that pain, and the experience, will feel to them personally.

The International Association for The Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.” However, pain is a symptom that cannot be objectively assessed. I cannot look at one of my clients and precisely know what hurts, how badly, and what that pain will feel like. Pain, therefore, is subjective; it is whatever the person experiencing it says it is. There will be no evidence – logical, empirical, theoretical, or even theological for that matter – that will be able to fully explain the multitudes of experiences pain can cause.

You see, pain is seen as an unpleasant sensation often caused by intense or damaging stimuli, such as stubbing a toe, burning a finger, or putting alcohol on a cut. This pain then motivates an individual to withdraw from damaging situations and to protect themselves while the wound heals.

“We rarely see the gifts that pain can bring, as a doorway to awareness” (Ferlic, 2005). This means that, for most people, the fear of the pain itself will cause us to avoid any and all situations that may cause pain. Yet pain, undoubtedly, is a central aspect of the lived realities of human experience.

Like most North Americans, I grew up afraid of pain. The idea of being harmed intentionally or otherwise was horrible. In order to better understand the multitudes of experiences that my clients may have (or may be hoping to have), I decided to explore my own personal definitions and experiences with pain. This in-depth exploration began two years ago when I was approached with the idea of becoming a body piercer. My first response was, “No. No, definitely not.” The idea of causing other people (what I, then, perceived to be) pain was not something I could do. However, from that point on, my idea of pain has been evolving to its current definition. This is not to say that it will be the same definition that my clients, colleagues, or peers will share. However, as important as it may be to define pain for myself, it is my own interpretation of pain and how it serves me that will better allow me to understand the varied motivations and experiences of my clients.

By most standards in my industry I am still relatively unmodified. The majority of my modifications have occurred in the past two years. In the beginning, the first few piercings I got were based on my limited knowledge and interpretations at the time, and were chosen for aesthetic reasons. As my apprenticeship progressed and I began to develop a much greater appreciation and understanding of modifications for different motivations, the reasons for my own modifications began to change. I now find that I want to get pierced to be able to better relate to my clients.

The latest addition to my modification collection is a scarification piece on my ribcage. It is by far the most personal piece – as well as the most “painful” piece – I’ve ever had done. Halfway through the procedure I was asked if I was all right, as tears streamed down my face. I grinned, laughed, and just managed to say, “Yes.” Four hours later I was tired, sore, and bleeding, and still had no idea that the most difficult parts were still to come.

Like with any modification, scarification is done for aesthetic, religious, and social reasons. In biomedicine, pain and the body are reduced to biological phenomena. In theological or spiritual terms, they are understood through penance, on one hand, and visionary suffering and sainthood, on the other.

“Modern pain, of course, normally chains us down to the material world. It keeps us centered in the flesh. It places us within the secular circle of medical science. On the other hand visionary pain, or pain viewed from a more theological perspective, acts in providing release into pure communion with something divine, it becomes not something to be cured or even endured but rather as a means of knowledge, offering access to an otherwise inaccessible understanding. Visionary pain employs the body in order to free us from the body. It initiates or accompanies an experience that escapes the time-bound world of human suffering” (Morris 1993: 135).

In various contexts, the deliberate infliction of pain in the form of corporal punishment is used as retribution for an offense, or for the purpose of disciplining or reforming a wrongdoer. At times, it has been used to deter attitudes or behaviors deemed unacceptable. Yet in other cultures, extreme practices such as rites of passage are highly regarded.

Fakir Musafar points to the Kulavarna Tantra that, in speaking of “the left-hand way” in Hinduism, says that “spiritual advancement is best achieved by means of those very things which are the causes of man’s downfall” (Blake, cited in Vale & Juno 1989: 204, Musafar Body Play issue #13: 7). Through bodily pain we learn what the modern primitives argue; in a controlled context, it becomes possible to utilize pain for positive ends.

For many tribal cultures, the modern primitives argue that, when accompanied by some measure of self-control, ordeals of pain give insight and maturity to the sufferer. As we face our fear of pain we gain self-confidence and pride. “The experience of pain allows us to test our physical and mental endurance under safe, controlled conditions” (Body Play issue #9: 4). Whereas science sees pain as negative and avoidable, the modern primitives hold pain to be a positive and useful experience, ascribing its rich personal and spiritual meanings.

After the journey I have taken, I look not at what modification or pain have done to me, but what that pain has given me. Pain has given me my life back. I am no longer afraid to try or to fail, no matter how painful it may be. I now believe that it is so much worse to live in fear–fear of pain, mental, physical, or otherwise. To do nothing, to walk away, then to travel forward, endure the pain, and come away with a richer perspective.

EDITOR’S NOTE: While the APP does not have any official stance on scarifcation or the rituals associated with pain and piercing, we are aware that individuals embark on body modifications for a variety of reasons. Whatever the reason – or modification – we simply encourage  recipients to use discretion and seek out qualified, educated, and highly experienced piercers, tattoo or body modification artists.

Point #59: The Tongue-Drive System

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By James Weber

Late last February a rather curious news story made the rounds on Facebook and other social media sites and pop culture blogs. Various publications reported on an article about a project from Georgia Tech, one that enables a person with quadriplegia to control a wheelchair through the movement of the tongue by moving around a magnet worn in a tongue piercing. Piercers everywhere were sharing, reposting, and reblogging the article in a variety of places—including on my Facebook timeline. Fortunately, this was not news to me, as I’ve had the unique opportunity to be involved with the project as a consultant for several years. But after a dozen piercers forwarded me the article I realized it was time to write about my experience with the clinical trials of the Tongue Drive System.

In late October of 2009 I was contacted by Dr. Maysam Ghovanloo, Associate Professor at the School of Electrical and Computer Engineering at the Georgia Institute of Technology. Over the phone he explained the project that he was working on, titled in the research protocol Development and Translational Assessment of a Tongue-Based Assistive Neuro-Technology for Individuals with Severe Neurological Disorders. Simply, this is a system that allows persons with quadriplegia to perform a variety of computer-aided tasks—including operating their wheelchairs—by changing the position of a small magnet inside their mouths. The magnet’s changing position is monitored by a headpiece that looks like a double-sided, hands-free phone headset.

His team had, at that point, experimented with different ways to attach the magnet to the tongue with varying degrees of success. Adhesives were only effective for very short periods, and the idea of permanently implanting a magnet into the tongue was not considered a workable alternative1. This left a third option suggested by Dr. Anne Laumann: attaching a magnet to the tongue with a tongue piercing.

He then came to the reason for his call: he asked if I would be interested in being involved in the clinical trials as a member of the Data Safety Monitoring Board. As I listened to him describe the details of my involvement, I thought about the incredible places my life as a piercer—and my job as an APP Board member—have brought me. I enthusiastically and without hesitation said “Yes!”

For those not familiar with clinical trials (and I was not when I initially agreed to be involved with the study), the Data Safety Monitoring Board (or DSMB, alternately called a Data Monitoring Committee) is a group of experts, independent of the study researchers, who monitor test-subject safety during a clinical trial. The DSMB does this by reviewing the study protocol and evaluating the study data, and will often make recommendations to those in charge of the study concerning the continuation, modification, or termination of the trial. The inclusion of a DSMB is required in studies involving human participants as specified by the Common Rule, which is the baseline standard of ethics by which any government-funded research in the United States must abide. (The clinical trial is sponsored jointly by both the National Science Foundation and the National Institute of Health, but nearly all academic institutions hold their researchers to these statements of rights regardless of funding.2)

I was excited to be part of the project, and the following May I received the full details of the study. The clinical trial was to be performed in three phases, with three sets of participants. The first involved ten able-bodied individuals with existing tongue piercings. These participants were to test the hardware and software created by his team and to quantify the ability of those participants to operate the wheelchair with the specially-designed post3 in their tongue piercing. The second group consisted of ten able-bodied volunteers without tongue piercings. These participants were to be pierced, given time to let the piercings heal, and then monitored operating the Tongue Drive System. The third group of participants was to be a selection of thirty people with quadriplegia—without existing tongue piercings—who were to be pierced and then monitored while the piercing healed. Afterward, they were to be evaluated on their ability to operate a computer and navigate an electric wheelchair through an obstacle course using the magnetic tongue jewelry.

The study was to be conducted in two different locations: in Atlanta, at the Georgia Institute of Technology and the Shepherd Center; and in Chicago, on the Northwestern Medical Center Campus and at the Rehabilitation Institute of Chicago, with half of the participants in each phase of the study coming from each location. (Five from each city for the first two phases, fifteen from each for the last.) Drs. Maysam Ghovanloo and Michael Jones were to oversee the trials in Atlanta, and Drs. Anne Laumann and Elliot Roth were to oversee the trials in Chicago.

The DSMB charter specified the eight people who had been drafted to be part of the DSMB: The board chair is a professor of rehabilitation science and technology; one member is a director of a rehabilitation engineering research center; one a professor of rehabilitation medicine. There are two M.D.s: one a neurologist; one an associate professor of dermatology; two biostatisticians (one acting as study administrator); and me. Also included in the documents sent was the full study protocol. This document outlined the finer points of the study, including the protocol for tongue piercings to be performed by the doctors involved with the study. The email also specified the possible times of the first meeting of the DSMB, to be conducted via conference call.

As I participated in the conference call several weeks later it was hard not to feel I was out of my element. While I routinely lecture at several local universities, it’s been quite a while since I’ve been in academia. But I soon realized I was not there for my academic credentials but for my position and experience—and as a de facto authority on piercing. This I could do.

During that first meeting I expressed the concerns I had about the piercing protocol, specifically about physicians performing the piercings—physicians with little or no experience doing so. “Do any of the members on the research team have prior piercing experience?” I wrote. “Even though it is not a complicated procedure, it is better for doctors who are involved in this task to have prior experience with tongue piercing.”

I was told that the physician overseeing the piercings in Atlanta had performed at least thirty tongue piercings in his private practice. And although Dr. Laumann—who was responsible for the tongue piercings in Chicago—had no prior piercing experience, she had conducted extensive research on piercing and tattooing4 and had often observed professional piercers at work. (Furthermore, she is considered an expert among dermatologists in the field of piercing and tattooing.) While my concerns were addressed, I do remember feeling hesitant at the close of that meeting.

The second DSMB meeting was held six months later, in December of 2010. At this time the results of the first and second phases of the clinical trial were to be discussed. Before the meeting I was given information about the second study group and about the tongue piercing method performed at the Chicago location—and including images from both locations. From the images provided, I was concerned that the piercings performed by the physicians looked as if they were done by first-year piercing apprentices—which, in a way, they were.

Of the twenty-one study participants who received a tongue piercing, five were noted as complaining about the placement of the piercing, and three piercings resulted in embedded jewelry. Based on the photos I guessed this was because either the piercing had been placed too far back on the tongue or the length for initial jewelry was improper—or both. I pointed out to the committee this left only about 60% of the subjects who were both comfortable with the placement of the piercing (at least enough to not state the contrary to researchers) and who did not have problems with embedded jewelry. I stated I thought this was far too small a percentage to ensure the well-being of each research participant. Even though it was outside my role as a DSMB member, I further stated the results of the study may be affected by the improperly placed piercings, as more than a few of the study participants had taken out their jewelry and dropped out of the study within a few days of being pierced, saying they were either unhappy with the placement or found the position of the piercing uncomfortable5.

I went on to express concerns about the piercing protocols and to question whether piercers could perform these procedures instead of physicians. Unfortunately, I was told the parameters of the study, and the rules at the medical centers where the piercings were being performed, did not allow non-medical professionals to perform the piercing procedures6.

Despite my concerns, my suggestions and criticisms were well-received. Dr. Ghovanloo agreed to re-evaluate the piercing protocol and I offered him whatever help he needed. Most importantly, I got the impression the two doctors performing the piercings were somewhat humbled by the experience. While there was no doubt that these physicians have anatomical knowledge and surgical experience that far surpasses mine, they were quickly realizing this didn’t make them proficient piercers.

Several months after that conference call, I had the opportunity to finally meet Dr. Ghovanloo in person. The quarterly meeting of the APP’s board of directors was scheduled in Atlanta in February of 2010, and Dr. Ghovanloo arranged for me to meet some of the trial staff at the Shepherd Center. I had the sense he was excited as well, and he also arranged for the physician doing the piercings during the clinical trials in Atlanta to be there: Dr. Arthur Simon. As I was at a board meeting with Elayne Angel (the APP’s then-Medical Liaison, current President, and resident expert on tongue piercings), I asked about having her attend as well. He readily agreed.

When Elayne and I arrived we were greeted by Shepherd staff member and study coordinator Erica Sutton, and we were soon led to our meeting with Dr. Ghovanloo and Dr. Simon. Compared to the necessary formality of the DSMB meetings, it was a friendly and relaxed meeting. Dr. Ghovanloo and his colleagues were somewhat starstruck by Elayne (she often does that to people) especially since her book, The Piercing Bible, was used so extensively in drafting the trial piercing protocols.

As we talked about the clinical trials, it was hard to not be affected by Dr. Ghovanloo’s enthusiasm for the project. We spoke at length about the issues the doctors encountered when performing the piercings. Doctor Simon in particular was humbled after his experience. “How do you hold those little balls to screw on?” he asked at one point during the several hours we met, a little exasperated and only half joking. I can’t speak for Elayne, but I left with an immense respect for Dr. Ghovanloo, his staff, and the whole project. I also left with the impression that they had a lot more knowledge of—and a little more respect for—what we do as well.

Since that time, stage three of the clinical trials has already taken place. I’ve been informed by Dr. Ghovanloo that the third and final meeting of the DSMB will be scheduled in the coming weeks. In fact, trials are being planned using a new prototype that allows users to wear a dental retainer on the roof of their mouth embedded with sensors to control the system (instead of the headset)7, with the signals from these sensors wirelessly transmitted to an iPod or iPhone. Software installed on the iPod then determines the relative position of the magnet with respect to the array of sensors in real time, and this information is used to control the movements of a computer cursor or a powered wheelchair.

I’m looking forward to hearing when the project is out of the trial phase and more widely available to all who can use it. When that happens, I’m sure I’ll be hearing from Dr. Ghovanloo—and seeing the news again posted on Facebook.

More information about the current trials can be found on the Shepherd Center’s web site.

  1. Unlike implants under the skin, the tongue has no “pockets” in which to encase a foreign object, and there was also concern about the need to remove the magnet for surgeries and MRIs. ↩
  2. The history of research ethics in the country is simultaneously fascinating and shameful. Most of the modern rules now in place concerning clinical trials in the U.S. are as a result of the public outcry over the Tuskegee Syphilis Experiment, a study that ran for four decades, from 1932 and 1972, in Tuskegee, Alabama. This clinical trial was conducted by the U.S. Public Health Service and was set up to study untreated syphilis in poor, rural black men who thought they were receiving free health care from the U.S. government. The study was terminated only after an article in the New York Times brought it to the attention of the public. more information ↩
  3. In one of my early conversations with Dr. Ghovanloo I gave him the name of several manufacturers who I thought would be willing and/or able to make the jewelry needed for the trials. Barry Blanchard from Anatometal came through by manufacturing special barbells with a magnet encased in a laser-welded titanium ball fixed on top. Blue Mountain Steel also donated the barbells and piercing supplies for the initial piercings. ↩
  4. Dr. Laumann has co-written several published papers on body piercing and tattooing. The most recent is titled, “Body Piercing: Complications and Prevention of Health Risks.” ↩
  5. Dr. Ghovanloo and the other physicians had suggestions for the reasons for the high dropout rate among healthy subjects. In response to an early draft of this article, he wrote, “We simply lost contact with a few subjects after piercing, and cannot say for sure what their motivation was in participating in the trial and consequently dropping out after receiving the piercing.” Dr. Laumann, commenting on the Chicago site, wrote, “We prescreened thirty-two volunteers. Ten of these were screened and consented. Three of these were ineligible due to a short lingual frenulum, or ‘tongue web.’ This would have made the use of the TDS impracticable and for research it would have been considered inappropriate to cut the lingual frenulum. We pierced seven subjects and—you are correct—our first subject dropped out related to embedding of the jewelry and pain on the first day. After that we were careful to measure the thickness of the tongue and insert a barbell that allowed for 6.35 mm (1/4 inch) of swelling. Otherwise drop-outs came much later during the TDS testing phase related to scheduling and unrelated medical issues. One of the subjects, a piercer herself, was particularly pleased with the procedure, the tract placement and the appearance.” ↩
  6. Though the protocols did not allow the procedure to be conducted by non-medical personnel, Gigi Gits, from Kolo, was present during one of the phase-two health subject’s piercings and Bethra Szumski, from Virtue and Vice, was able to offer advice at the first phase-three piercing session in Atlanta. ↩
  7. Dr. Laumann: “The problem with headgear is that it needs to be removed at night, which means that the disabled individual cannot do anything in the morning until the headset is replaced and the TDS recalibrated. With secure intra-oral sensors, recalibration will not be necessary in the morning, nor will the sensors slip during use, which gives the wearer a great degree of independence. Of course, a dental retainer takes up space in the mouth and this may be difficult with a barbell in place.” ↩