What's the Sherpa Up To?

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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

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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.

I'm a Golden Retriever!

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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!

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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!

Treatment of Acute myelogenous leukemia (AML)

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Treatment of acute myelogenous leukemia depends on many factors, as well as the subtype of the disease, your age, your overall health and your preferences. In general, treatment falls into 2 phases:

• Remission induction therapy. the aim of the primary section of treatment is to kill the leukemia cells in your blood and bone marrow. However, remission induction sometimes does not wipe out all of the leukemia cells, thus you would like more treatment to forestall the disease from returning.
• Consolidation therapy. conjointly referred to as post-remission therapy, maintenance therapy or intensification, this section of treatment is aimed toward destroying the remaining leukemia cells. It's thought-about crucial to decreasing the danger of relapse.

Therapies used in these phases include:

• Chemotherapy. Chemotherapy is that the major style of remission induction therapy, though it may also be used for consolidation therapy. Chemotherapy uses chemicals to kill cancer cells in your body. individuals with AML usually keep within the hospital throughout chemotherapy treatments as a result of the medicine destroy several traditional blood cells within the method of killing leukemia cells. If the primary cycle of chemotherapy does not cause remission, it may be repeated.
• Other drug therapy. Arsenic trioxide (Trisenox) and all-trans retinoic acid (ATRA) are anti-cancer medicine that may be used alone or together with chemotherapy for remission induction of a definite subtype of AML referred to as promyelocytic leukemia. These medicine cause leukemia cells with a selected gene mutation to mature and die, or to prevent dividing.
• Stem cell transplant. Stem cell transplant, conjointly referred to as bone marrow transplant, is also used for consolidation therapy. Stem cell transplant helps re-establish healthy stem cells by replacing unhealthy bone marrow with leukemia-free stem cells that may regenerate healthy bone marrow. before a stem cell transplant, you receive terribly high doses of chemotherapy or radiation therapy to destroy your leukemia-producing bone marrow. Then you receive infusions of stem cells from a compatible donor (allogeneic transplant). you'll be able to conjointly receive your own stem cells (autologous transplant) if you were previously in remission and had your healthy stem cells removed and stored for a future transplant.
• Clinical trials. Some individuals with leukemia value more highly to enroll in clinical trials to do experimental treatments or new combos of known therapies.

Addison's Disease

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Addison's disease is a disorder that happens when your body produces insufficient amounts of bound hormones created by your adrenal glands. In Addison's disease, your adrenal glands manufacture too very little cortisol and infrequently insufficient levels of aldosterone furthermore.

Also referred to as adrenal insufficiency or hypocortisolism, Addison's disease happens in all age teams and affects each sexes. Addison's disease is life-threatening.

Treatment for Addison's disease involves taking hormones to interchange the insufficient amounts being created by your adrenal glands, so as to mimic the useful effects those naturally created hormones would normally manufacture.

Symptoms of Addison's disease

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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.