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The Best Time To Be Treated For A DVT

You know I am a cancer survivor – 15 years down the road from a leukemia diagnosis and enjoying a 10 year remission. So whenever something seems weird about my health it’s cancer coming back, right? Wrong! Just how wrong was proven last night. I am writing this from my hospital bed in Seattle.

The first symptom of a possible problem came three days ago when I had soreness in my right calf. A pulled muscle? Maybe. But I had not noticed straining it. Back at the gym the next day I had soreness again but thought it was no big deal. Last night it was worse. It hurt some to walk. I got home and, after my wife and son were asleep, got ready for bed. I had a slight fever and then noticed the right calf was not only sore, but swollen and warm. Very strange. I’d never seen that before.

Trying not to be stupid I called the 24-hour consulting nurse. She immediately began to focus on deep vein thrombosis (DVT), a worrisome condition that affects about two million Americans a year and can lead to a life threatening situation. She had a doctor call me. Normally those doctors would rather make a house call then send you to the more costly emergency room. But not this time. “Dr. Steve” urged me to go to the ER rather than let a DVT progress and endanger my life. An ultrasound exam would determine if it was really a DVT. Read more »

*This blog post was originally published at Andrew's Blog*

Father To Daughter: The Lessons Of Illness

Ruthie and Andrew

When I was diagnosed with leukemia my daughter, Ruthie, was just two and a half. She has vague memories of our household being turned upside down with worried, hushed conversations and friends and relatives calling A LOT. Because a leading specialist, Dr. Michael Keating from MD Anderson Cancer Center, advised against having treatment right away (something better was coming along), I did not have treatment for more than four years. By then Ruthie was seven. She has vivid memories then of me going off to Houston, accompanied by her mom, for a week of initial treatment and then successive weeks of treatment every month for quite a while back here in Seattle. She also remembers me tired, nauseous and, some days, in bed.  The better memory is me participating in a clinical trial that worked and then returning to a full and active life.

Ruthie and I had never really talked about her observations of this until last night. Now, almost 18, Ruthie will be headed to college soon. It’s been a “journey.” As with many teenagers, they can be rebellious and oppositional, at times. But, in most cases, they eventually return to that loving person you remember. Ruthie has been making that return and, as she does, we’ve been talking more.

Last Friday night Ruthie called me in a panic. Read more »

*This blog post was originally published at Andrew's Blog*

Herbal Medicine, Thunder God Vine, May Find Use In Cancer Research

Thunder god vine may not be a useful herbal medicine but the compounds isolated from it are fascinating – if not as medicines, then most certainly as laboratory tools. Nature Chemical Biology recently published an article where a research team from Johns Hopkins, the University of Colorado at Boulder, and Drew University in New Jersey, has determined the molecular mechanism of action of triptolide, an unusual triepoxide compound from the plant.

Tripterygium wilfordii Hook F, or thunder god vine, is known as lei gong teng in Chinese traditional medicine and has a history of use as an anti-inflammatory herb. As with many traditional medicines, usage patterns do not necessarily indicate scientific validity. In fact, a Cochrane review published just last month on herbal therapies for rheumatoid arthritis indicated that the efficacy of thunder god vine was mixed. More concerning is that the herb had significant adverse effects in some trials, from hair loss to one case of aplastic anemia.

Nevertheless, the herb’s components have been studied since the 1970s for since they also appears to kill tumor cells in culture with nanomolar potency and have immunosuppresant activity in animal models. The group of the late natural products chemist at the University of Virginia, S. Morris Kupchan, first identified the unusual structures of triptolide and tripdiolide from Tripterygium wilfordii as described in this 1972 paper from the Journal of the American Chemical Society. Cytotoxic activity toward tumor cells in culture was used to guide the chemical fractionation of extracts. The unusual presence of three consecutive epoxides in the structures of both compounds led Kupchan to hypothesize later in Science that they target leukemia cells by covalent binding to cellular targets involved in cellular growth. Read more »

*This blog post was originally published at Science-Based Medicine*

Match Devan Tatlow’s Bone Marrow, Save His Life

Four-year-old Devan Tatlow’s struggle with leukemia has caused quite a stir on the Internet, prompting celebs like Paris Hilton and Kim Kardashian to encourage people to donate their bone marrow. Dr. Jon LaPook talks with Devan’s family about their search for a match.


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Umbilical Cord Blood: Save It and Save Lives

Imagine throwing a lifesaving treatment in the garbage. That’s exactly what happens in the United States over ten thousand times a day because we do not routinely offer to collect precious umbilical cord blood at the time of birth. Thousands of Americans — many of them children — needlessly die annually because they cannot find either a bone marrow or umbilical cord blood match to help treat conditions like lymphoma and leukemia. Yet umbilical blood is discarded as medical waste in the vast majority of the more than four million births occurring each year. Read more »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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