What's the Sherpa Up To?

To contact us Click HERE
I have decided to write an update to what the Sherpa is Up To. Why? Well, after 5 years of hard work, Lee Gutkind is about to publish a work of creative nonfiction. I am one of the main characters. The other characters are also very compelling. 


I was able to preview a copy and am very excited. 


But, after reading, I thought I should give you an update on what the Sherpa is doing. Let me explain my madness. Here is my thought. As my good friend John Setaro MD would say. 


"There isn't any genetic advantage that can't be overcome with aggressive environmental modification."


This was me. I was overweight, the practice was stressing me and killing me. I needed to lose weight. I did. 30 pounds of weight. Mostly fat. This changed my life. How did I do it? FitBit, metabolic testing using gas exchange, calorie tracking, some things that a guy like Eric Topol MD would call mobile health.


I began to pay attention to obesity. I noticed that obesity is a huge familial disease and an epidemic in the US. But, the genetic markers soft at best. So I say again, family history matters more. I studied fat metabolism and began to realize this disease was very similar to some mitochondrial deficiencies. I began to align genetics, family history, obesity and preventative care. Truly personalized medicine. I will sit for the obesity boards this year.


I understand the future of medicine and the potential of personalized medicine to enhance disease cure and prevention. In this case, I have been able use my understanding of metabolic genetics, clinical genetics, bariatric medicine, pedigree analysis, mobile health, medicine and wellness, to help cure diabetes, hypertension and depression. It is amazing how people feel better when they are no longer obese.


I along with 2 other physicians, my 3 nurse practitioners and our 3 offices (yes, a long way from a genetic counselor and a part time office on Park Avenue, NYC) devote every day to early detection of disease and prevention of disease.


You will soon be able to see the fruits of our labors. We are modifying environment aggressively to overcome genetic and familial risks. We take family history, environmental history, genetic testing (if indicated), mobile health tools, technology, social history and use these tools to maximize human life.


A concept we call Arete (R-eh-Tee). The Sherpa is creating the best system to cure disease, using the model developed from his own 30 pounds of weight loss and journey to health. Come see us, we are still in Greenwich, 115 East Putnam Avenue, 23 Maple Avenue, 49 Lake Avenue. 203-869-0451.


The Sherpa Says: We have made camp, 1/3rd up the mountain, beans and lamb are on the fire, with quite an ascent coming. Genomes, Environmental, Technology. Coming soon! But for now, go buy Lee's book!

Dealing with other people's pregnancies

To contact us Click HERE

This is something I've been asked about a few times, and something I was just thinking about, so thought I'd share. In the months after Joshua's death, some people were hesitant to tell us they were pregnant in case they upset us, some tell us before anyone else because they want to tell us in person rather than on the grapevine. That really didn't bother me, I'm generally excited to hear about friends pregnancies. Ultrasounds were hard to look at, and baby showers were hard to go to, and still are. Joshua died 2 days after our baby shower, so baby showers just don't have that same level of fun anymore, memories of our loss just come flooding back.

The other thing that's hard to deal with is other people's loss, but for a slightly different reason - my heart just aches for them. A very close friend had an early miscarriage a few months ago, and my heart ached for her. Another good friend who has also had a rough year has just suffered a 2nd trimester loss, and it breaks my heart. I don't want anyone to ever feel the weight of loss like we did. I know a loss earlier in the pregnancy is probably a bit easier to deal with, but it's never easy, and once you start planning names, planning how the room will look, what you'll need, changes you'll need to make, and start thinking about the future they're going to have, it's so hard to have it all ripped away.

It's something that really affects you for a long time, and I think it's important for people to understand that.

Catching up (yes I'm still alive)

To contact us Click HERE

It's been a really busy few months! I'll go back to September.

We went on holiday to the Seychelles and Dubai for 2 weeks in September which was fabulous. My aunt Vicki lives there with her husband Chris and their two boys, Jack and Harry. Chris has a job as part of the United Nations, which is based in the Seychelles and they've been living there about 4 years now.

The Seychelles was fascinating. The economy is completely broken - they have the highest level of debt of any other country, and since we were there the International Monetary Fund has agreed on a $26 million rescue package, and the currency has floated and been devalued. A lot of things were run down, the roads were terrible, there's a big divide between the rich and poor and everything has to be imported, so the black market is rife.

But the beaches were gorgeous, the weather was fabulous, the sky was oh so clear at night, and the stars were stunning. Sitting out on Vicki and Chris' deck every evening watching the night sky was an amazing way to relax. We were a very short walk from the beach, and just enjoyed our 10 days there relaxing.

It was great to spend quality time with Vicki, Chris and the boys. Vicki lived with us for a few years when I was younger, so I've always felt very close to her, and Jack and Harry are such great kids, we had a lot of fun with them.

Here's a few pics from the trip:

The markets



Amazingly clear water



Full moon over the fishing boats that were at port due to the worries over the Somalian pirates



We hiked to a beach called Anse Major, which was quiet, and so pretty



On our way to Anse Major




View from Vicki and Chris' balcony



Everyone. Vicki doesn't usually look so grim, and no, Andrew didn't bother with shaving while away :)



A couple of gorgeous sunrises







After Seychelles we spent a few days in Dubai on the way home since we were flying with Emirates (best airline I've ever flown with by a long shot), and stopping in Dubai anyway.

It was Ramadan, so we couldn't eat or drink in public during daylight hours, and a number of places were either closed for the month, or closed for a few hours in the afternoon, but it wasn't a big deal. We had a really nice hotel which we got a great deal on due it being Ramadan, and therefore the low season, the city in general wasn't too busy, and we just did a double decker open top tour bus tour the 2 days we were there, which supplied us with complimentary cold bottles of water which we guzzled as soon as we got on the bus - so we probably drank more water than we would have otherwise.

It was stinking hot - over 40 c, and about 90% humidity, and the heat was disgustingly oppressive. We had a fabulous time though. It was such an interesting place, and there was so much to see and do. And being so hot, it made us very aware that we were in a desert, and the regular calls to prayer from the temples made the whole experience more authentic. It's a place I would like to go back to some time to further explore - 2 and a bit days definitely wasn't enough!

Some pics:

Down on the water - there were boats coming and going loading up with goods to be transported to other nearby countries, carrying tourists around, and general water taxis for transport.




A small selection of gold in one of the windows at the Gold Souk (market)



A shopping centre called Wafi - it had designer shops, and an upmarket "traditional" souk area - the place was deserted due to Ramadan, and most of the shops weren't opening the entire month.



One of the water taxis



Dubai is a construction zone! There were cranes everywhere you looked. The sky was never clear, it's pretty much one big sand storm. And this highway made American highways look tame!



The new Metro system they are building which will make a huge difference to traffic - you can see Burj Dubai in the background which will be the world's tallest building



In front of Burj Al Arab, Jumeirah - the water there was toasty warm!



And then Ski Dubai... so bizarre!



One of the big mosques



One of the mosques near us. They were having the evening iftar buffet (breaking of the daily fast)



And Andrew on Dubai Creek at sunset



The rest of the photos are here

I'm a Golden Retriever!

To contact us Click HERE

According to this website, if I was a dog breed, I'd be a Golden Retriever :)



Yep, sounds like me :)

Golden Retriever

The Charmer

Laid-back, sociable and well-groomed, you've got your own hip little pack of groupies who just love to be around you. You have a brain inside that adorable little head of yours, though you use it mostly to organize your hectic social calendar. You never poop out at parties, and since you're popular with ladies and men, as well as children and adults, you dish out your wit, charm and luck to whomever is close enough to bask in it. The top dog likes you and wants to be your best friend, despite the fact that he doesn't really know what the heck you do. No one does, in fact, but everyone loves you all the same. A true foodie, you’ve got your keen ears fine-tuned to make sure you don't miss out on the opening of a trendy new place to nosh. But your youthful days of being able to wolf down food 24-7 are wagging behind you, meaning you've got to watch what you eat so you don’t pull a Brando and outgrow your coats.

The kitties and their Valentine's Day dates!

To contact us Click HERE

The girls had a lovely time for Valentine's Day. They all had very handsome dates, and they dined on caviar, drank the worlds finest milk, and indulged in some catnip to top off the evening ;)

This is Lily, my middle girl, and her date Stoli, a handsome Russian Blue





Smudge, and her date, Luxor who is an Egyptian Mau.





Stoli and Luxor are brothers and best friends, and Smudge and Lily are sisters and best friends, so they double dated :-) Their mum, Renovia, does amazing art work, particularly cat sculptures, so check out her Etsy store if you're looking for a good present.

And last, but not least - Stumpy and her date, Dorian Grey aka Dorky. They make a good pair!

Symptoms of Addison's disease

To contact us Click HERE


Addison's disease symptoms sometimes develop slowly, usually over many months, and should include:

• Muscle weakness and fatigue
• Weight loss and decreased appetite
• Darkening of your skin (hyperpigmentation)
• Low blood pressure, even fainting
• Salt craving
• Low blood sugar (hypoglycemia)
• Nausea, diarrhea or vomiting
• Muscle or joint pains
• Irritability
• Depression

Acute adrenal failure (addisonian crisis)
Sometimes, however, the signs and symptoms of Addison's disease could seem suddenly. In acute adrenal failure (addisonian crisis), the signs and symptoms might also include:

• Pain in your lower back, abdomen or legs
• Severe vomiting and diarrhea, resulting in dehydration
• Low blood pressure
• Loss of consciousness
• High potassium (hyperkalemia)

When to see a doctor
See your doctor if you've got signs and symptoms that commonly occur in folks with Addison's disease, such as:

• Darkening areas of skin (hyperpigmentation)
• Severe fatigue
• Unintentional weight loss
• Gastrointestinal issues, like nausea, vomiting and abdominal pain
• Dizziness or fainting
• Salt cravings
• Muscle or joint pains

Your doctor will verify whether or not Addison's disease or another medical condition could also be inflicting these issues.

Causes of Addison's disease

To contact us Click HERE


Addison's disease results when your adrenal glands are broken, manufacturing insufficient amounts of the hormone cortisol and infrequently aldosterone similarly. These glands are located simply higher than your kidneys. As a part of your endocrine system, they turn out hormones that offer directions to nearly each organ and tissue in your body.

Your adrenal glands are composed of 2 sections. the inside (medulla) produces adrenaline-like hormones. The outer layer (cortex) produces a bunch of hormones referred to as corticosteroids, that embrace glucocorticoids, mineralocorticoids and male sex hormones (androgens).

Some of the hormones the cortex produces are essential forever — the glucocorticoids and therefore the mineralocorticoids.

• Glucocorticoids. These hormones, that embrace cortisol, influence your body's ability to convert food fuels into energy, play a task in your immune system's inflammatory response and facilitate your body answer stress.
• Mineralocorticoids. These hormones, that embrace aldosterone, maintain your body's balance of sodium and potassium to stay your blood pressure traditional.
• Androgens. These male sex hormones are made in little amounts by the adrenal glands in each men and ladies. They cause sexual development in men and influence muscle mass, libido and a way of well-being in men and ladies.

Primary adrenal insufficiency
Addison's disease happens when the cortex is broken and does not turn out its hormones in adequate quantities. Doctors confer with the condition involving harm to the adrenal glands as primary adrenal insufficiency.

The failure of your adrenal glands to provide adrenocortical hormones is most typically the results of the body attacking itself (autoimmune disease). For unknown reasons, your immune system views the adrenal cortex as foreign, one thing to attack and destroy.
 Other causes of adrenal gland failure might include:

• Tuberculosis
• different infections of the adrenal glands
• unfold of cancer to the adrenal glands
• Bleeding into the adrenal glands

Secondary adrenal insufficiency
Adrenal insufficiency may occur if your pituitary gland is diseased. The pituitary gland makes a hormone referred to as adrenocorticotropic hormone (ACTH),

that stimulates the adrenal cortex to provide its hormones. Inadequate production of ACTH will cause insufficient production of hormones normally made by your adrenal glands, albeit your adrenal glands are not broken. Doctors decision this condition secondary adrenal insufficiency.

Another additional common reason behind secondary adrenal insufficiency happens when folks that take corticosteroids for treatment of chronic conditions, like asthma or arthritis, abruptly stop taking the corticosteroids.

Addisonian crisis
If you've got untreated Addison's disease, an addisonian crisis could also be provoked by physical stress, like an injury, infection or illness.