Notes from November: Medical Training is a Journey

November has been a whirlwind of angst and excitement for me.  It began with cramming for my final USMLE board exam.  After sitting for the two-day test, I flew directly to Chicago, where I attended my first AHA Scientific Sessions and presented a poster on bystander AED use at the Resuscitation Science Symposium.  Upon returning home to Atlanta, I pored over the list of fellowship interviews I had attended in the last two months and agonized over last-minute adjustments to my rank list.  Such is the life of a third-year internal medicine resident.

This Wednesday, I stumbled home after a 24-hour hospital shift and opened my email account.  That’s when I found out I had not only passed my board exam but also matched at Emory, my home institution and top fellowship choice.  In spite of my exhaustion, I was so elated that it was hard to fall asleep.

Reflecting back on the month, I’m reminded of Dr. Ivor Benjamin’s address at the AHA Presidential Session.  He waxed poetic about his circuitous journey–growing up in Guyana, traveling to the U.S., and training at several premiere academic medical centers.  He spoke about fortuitous relationships with key mentors that propelled his career as a basic science researcher.

Listening to Dr. Benjamin’s narrative was a delight and an inspiration.  His account echoed the stories of many impressive residents and fellows I met at AHA.  It was also a reminder of my own humble roots—born in Shanghai, growing up in the rural Midwest, and studying at Vanderbilt and Emory.  For each of us, medical training is long, and it is transformative.  I look forward to the next stage, and I hope to return for Scientific Sessions in 2019.  By then I will be a cardiologist in the making.



Why Attend #AHA19?

After returning home from the #AHA18 Scientific Sessions a few weeks ago, I was eager to tell my colleagues back in Los Angeles about my experience.

“What did you like about it?” they would ask. While my replies would consistently begin with, “Well, despite the freezing cold…” I found my answers that followed were widely varied. The innovative science, the networking with potential collaborators, the audible excitement over Late Breaking Clinical Trial results, the discussions about whether the trials would be practice-altering, the reunions with old friends from earlier in my training. There were countless things to choose from.

Curious to whether other trainees shared the enthusiasm I had for #AHA18, I asked some who attended to describe their favorite part of the meeting. Here were their responses:

David Paik, PhD (@dtpaikPhD), post-doctoral fellow at Stanford University:

“This year’s meeting in the new 3-day format was highly organized, with superb talks from all breadths of clinical & basic cardiovascular research. The focus on early career & mentorship was excellent, and I hope it continues in the next years’ meetings!”

Aly Sanchez, MD (@AlySanchezMD), Internal Medicine resident at the University of Miami:

“There were many new things introduced at AHA this year & a huge focus on prevention as well as women’s health. I loved seeing the force behind the women in cardiology movement. It’s great having inspirational females leading as well as the supportive men making this happen. The AHA could not have sent a better message & we should continue to remind ourselves to be a relentless force for a world of longer, healthier lives.”

Kevin Shah, MD (@KevinShahMD), Advanced HF & Transplant Cardiology fellow at Cedars-Sinai Medical Center:

The networking! The Scientific Sessions and especially the AHA FIT and Early Career programming provided a tremendous opportunity to connect with old friends, meet new colleagues, and gain valuable career advice from faculty as we continue to grow professionally.”

Their sentiments and mine may have been palpable via Twitter feeds or news releases, and this year, the AHA offered a live-stream of Scientific Sessions for those unable to attend in person (see posts by Dr. Saurav Chatterjee and Dr. Dan Tyrell).

Yet nothing compares to attending Scientific Sessions in person. As elegantly summarized by Dr. Elizabeth Knight in her recent post, there are serendipitous collaborations that can arise from wandering around the meeting, as well as new research ideas that can emerge from a “cross-pollination among disciplines.”

In trying to encapsulate my own reaction to the meeting, however, I realized that the most important benefit of attending #AHA18 in person came down to one emotion: Leaving inspired. Inspired by meeting your heroes in cardiology, by meeting peers who are doing outstanding research, and by learning about new topics that can influence your own research ideas.

Moreover, it is one thing to read about the results of a late-breaking clinical trial from home. It is another experience entirely to be immersed in a crowd of colleagues who are hearing practice-altering results together for the first time. The first results slide of the REDUCE-IT trial presented at #AHA18 actually elicited applause:


Overall, I like to compare it with how you interact with your favorite band or musical artist. You can listen to their album from the comfort of your own headphones. Or you can go to their concert and see them perform your favorite songs live while surrounded by other passionate fans, augmenting the impact of the music. Some prefer the former, but I always choose the latter when I can.

Save the date for #AHA19 – November 16-18, 2019 in Philadelphia. Come and be inspired. See you next year!



Any Physical Activity is Enough

When I was a nutrition intern in 2014, I would excitedly tell patients that walking 30 minutes a day, 5 days a week doesn’t have to be a daunting goal. In fact, research showed that accumulating bouts of 10 minutes conferred cardiac benefits.

Under the often cited “150 minutes/week moderate activity or 75 minutes/week vigorous activity” was the implication that if you couldn’t meet that goal, then why bother?

Did the research specifically say that? Nope. And over the years research on the so-called “Weekend Warriors” has flourished. Is it regular physical activity, or the cumulative amount, that reduces risk?

And then in 2016, the catchy phrase “Sitting is the new smoking” highlighted the birth of a newly emphasized term – physical inactivity – and the distinction between physical activity and exercise.

Earlier this month in Chicago, navigating the bustling 2018 AHA Scientific Sessions, the new Physical Activity Guidelines were revealed. Lo and behold, the news is even better – even a little bit of physical activity is worth it.

It’s not all about aerobic activity, either. We know that resistance training improves insulin sensitivity and helps maintain muscle mass as the human body ages. The result? Less frailty. “Healthy aging”. Fewer injuries from falls, and fewer falls overall.

The new Physical Activity Guidelines didn’t leave that goody out. Upper body weight training even once a week is beneficial – for your heart! Just when you thought you had to huff and puff to beef up your heart health.

With the new Hypertension Guidelines released at Scientific Sessions last year in Anaheim, a renewed effort surfaced for clinicians to encourage lifestyle behavior changes. Not enough time with the patient isn’t an excuse. Research showing that physicians who exercise are more likely to prescribe exercise hit headlines, and the simple fact that clinicians can utilize their position of authority to impart importance upon a topic.

“As a health care provider, you know it’s important to help your patients get more physical activity. But it can be challenging to motivate patients in the short time you spend together.” – Move Your Way, Physical Activity Guidelines 2nd Ed., Health Care Provider Fact Sheet

While not everyone feels comfortable taking on a counseling role with patients, there are key phrases and questions you can use to start the conversation. Check out this short Motivational Interviewing primer, which includes example wording to build rapport with your patient, empower them to make change, and establish a collaborative relationship.

  1. Help them set goals. “Are there activities you’d like to be able to do?” We’ve all heard “I want to be able to pick up my grandkids”. Knowing your patients’ motivations means you can work together to set goals that are important to them.
  2. Meet your patient where they are. Find out what they know, what they perceive as important and as barriers, and suggest small changes. Being able to walk a long driveway to get the mail is a better place to start than jumping from the couch to a 5K.
  3. Let them know what to look for. Instead of “aim for moderate intensity activity”, translate it to perceived exertion. A lazy walk is “I’m comfortable and could maintain this pace all day.” Encourage them to reach a Level 3 to 5 – “Comfortable but breathing harder – sweating a little but feel good and can carry on a conversation – just above comfortable, sweating more, and can still talk easily”. Everyone should start slow and build up to longer durations and higher intensities – take a look at the exertion table below to see what exertion level your patient should start in.



The new guidelines come with Move Your Way tools and resources to get the message out to your friends and family, your patients, and your community. Interactive tools and widgets, fact sheets and poster, and even videos, can help teach all Americans how they can move their way to move more.

Forming new habits is hard, and lifestyle change is no exception. We know the research, and we have the responsibility to translate that data into actionable information for our patients.

I had the opportunity to recap Scientific Sessions over dinner with my parents. What did I share? Just because you can’t run a marathon doesn’t mean you can’t reap the benefits of physical activity. A little bit goes a long way.



Tips for Networking at Scientific Sessions

Scientific Sessions never fails to bring forth a variety of opportunities for those who attend – The latest on what’s hot in the cardiovascular realm of research. Details on changes to healthy heart parameters. New tools for more efficient cardiovascular research. And let us not forget, networking opportunities!

In the scientific community, we all hold terminal degrees and are considered experts in our respective field; thus, it is not always about what you know but more about who you know. Networking opens the door to opportunity for numerous people and is as simple as sharing your enthusiasm for science to a stranger. Gone are the days of hammering in the lab alone day and night cranking out single authored paper after single authored paper. Welcome to the new age of team science and who knows, this stranger could be the collaborator you have been longing for. However, on the spectrum of outgoingness, those of us in academia tend to fall more on the introverted side and find it slightly intimidating to make new connections. You do not want to be the person who opened his/her mouth and almost said something. Almost. But instead, watched in a state of paralysis wondering how life might have been if you had fought the urge and instead spoken up. (Khaled Hosseini, The Kite Runner) Lucky for us, Scientific Sessions helps to fix the phobia of making new connections by providing different opportunities for its attendees solely dedicated to networking. One example of this was the Early Career Speed Mentoring and Networking Session offered at this year’s meeting. However, if you were unable to attend one of the many networking sessions, let it be one of your resolutions to step out of your comfort zone and actively participate next year.

In the meantime, here are a few tips that I have searched and think are helpful when approaching an intimidating networking situation:

Arrive on time. Sometimes if you arrive late than groups have already been formed. As a result, it will be more difficult to jump into conversations. It may be scary to be the first one there but it will be more beneficial in the long run.

Ask easy questions. Get the conversation started! However, make sure to include the other person in and not monopolize the conversation

Share Your Passion. People can tell when you are genuinely excited about something. Use your inherent drive for your research to win this new person over!

Smile. This one is easy, the more inviting and authentic you appear the more people will want to talk to you and the less forced the conversation will be.

Research attendees and come prepared with question. While this may seem like extra work that you do not want to do. Being prepared with questions can make the conversation run seamlessly and appear less forced and more authentic.

Bring a friend. It can sometime be awkward to talk yourself up, but by bringing a wingman, you now have the someone to help talk up your accomplishments without coming off as boastful. Having a friend also helps to ease the discomfort associated with talking to new people.

Don’t forget to follow-up. You have done all of this hard work to make great new connections so do not let the conversation end here. Make sure to exchange contact information to be able to keep in touch.

Are there any additional tips that you can think of?



Council, Forbes Communications. “10 Networking Tips To Help You Make A Great First Impression At An Event.” Forbes, Forbes Magazine, 23 Apr. 2018,

DeBaise, Colleen. “7 Tips for Networking.” Entrepreneur, Entrepreneur, 3 May 2012,

Joubert, Shayna. “The Importance of Networking in Science.” Northeastern University Graduate Program , 9 Aug. 2018,




Highlights of AHA18 – Bridging Lifestyle Medicine with Contemporary Medicine through Science

This year’s annual scientific meeting of the American Heart Association (AHA) held in Chicago, Illinois November 10-12, 2018 was excellent. The abbreviated 3-day meeting received positive feedback as this allowed practicing physicians to attend the meeting over the weekend and be able to return to their practice early in the work week rather than having to spend an extended time away from the office. It was great being a part of the AHA Early Career Blogger group as this allowed access to many of the embargoed sessions. At these sessions I was able to listen to the AHA 2018 updated Lipid Management Guidelines1 as well as The Physical Activity Guidelines for Americans, Second Edition2 prior to their release at the meeting. This gave me a chance to ask the guideline committee several questions related to patient management.


Opening Session:

The opening session by Dr. Ivor Benjamin, the President of the American Heart Association, delivered very powerful messages throughout his speech. He highlighted the track of his career and the important role of strong mentors throughout his career and the impact it had on his advancement throughout the field of cardiology. He also discussed both the importance of mentoring and diversity in the cardiology profession highlighting the fact that African American men account for only 3% of Cardiologists in the United States and the need to bridge this gap. I found this session very inspiring and encouraging especially with regards to mentoring and supporting junior colleagues and being grateful for the mentors I have had thus far in my career. I also welcomed the message of the importance of diversity and inclusion as this leads to a healthier work and training environment.


Bridging Lifestyle Medicine with Contemporary Medicine through Science:

This year’s meeting highlighted the value of integrating lifestyle medicine with contemporary medicine to achieve the best outcomes for patients with regards to the prevention of cardiovascular disease. This was supported by the release of the updated 2018 American College of Cardiology (ACC)/American Heart Association (AHA) Guidelines on Lipid Management on the first day of this meeting1. This updated guideline emphasized the importance of the cholesterol management at all stages of adulthood along with the importance of therapeutic lifestyle changes1. The utility of coronary artery calcium (CAC) scoring with cardiac CT was also emphasized as a useful tool to further refine patients’ risk to determine the best management for patients who are at intermediate risk for atherosclerotic cardiovascular disease (ASCVD)1. This guideline also had included ezetimibe and PCSK9 inhibitors as having a complementary role when used with statin therapy in selected patients at high risk for ASCVD1. The release of this updated guidelines will be a useful in my management of patients with regards to primary and secondary prevention of ASCVD. I appreciated the role of CAC scoring which will be very helpful for the management of the intermediate risk patients.

The release of the U.S. Department of Health and Human Services’ second edition of the Physical Activity Guidelines for Americans on the last day of the meeting was also well received2. This second edition emphasized the importance of increasing physical activity for all age ranges throughout the population including women in pregnancy and the postpartum period, as well as adults with chronic diseases or disabilities2. This guideline update will assist me with counseling patients with regards to increasing their physical activity to improve their overall cardiovascular health.


Networking Opportunities:

There were many networking opportunities during the meeting. These included the Council on Clinical Cardiology dinner on the first night of the meeting which honored Dr. Judith Hochman the recipient of the James B. Herrick Award for Outstanding Achievement in Clinical Cardiology. Dr. Stacy Rosen was also the recipient of the Women in Cardiology Mentoring Award. This dinner was attended by many leaders in the field of Cardiology and was a great opportunity for me to meet these leaders. The Women in Cardiology Committee also hosted a networking luncheon on the first day of the meeting during which Dr. Sharonne Hayes from the Mayo Clinic was the keynote speaker. Dr. Hayes gave a very riveting interactive talk on leadership for women in cardiology, she was also the recipient of last year’s Women in Cardiology Mentoring Award. Her talk was useful with very powerful messages on navigating your professional and personal life to achieve overall job satisfaction, career success and personal happiness. I learned several tips that I will apply to my own career as well. Dr. Annabelle Volgman and the faculty at Rush University was gracious to host a wonderful networking dinner for Women in Cardiology (WIC) on the second night of the meeting. This dinner provided a great opportunity for me to meet fellow WIC colleagues and to discuss several relevant issues related to our practice in the Cardiology field.

Social Media Coverage:

There was also a broad social media coverage of the meeting on Twitter and this was assisted by the AHA Early Bloggers writing group. I was able to share live tweets during several sessions and this generated a lot of discussion amongst members on Twitter. This also allowed many colleagues who were unable to attend the meeting to be able to follow and comment on several meeting highlights.


Looking Forward to AHA 2019:

This year’s AHA Scientific Sessions embrace of lifestyle medicine and the value of preventive cardiology was refreshing and empowering. This meeting highlighted the importance of not only treating ASCVD but also the importance of preventing disease and empowering our patients to take responsibility for their health as well. In the words of Goethe as mentioned in Dr. Ivor Benjamin’s opening session “Choose well….your choice is brief, and yet endless.” We look forward to next year’s AHA 2019 meeting in the beautiful city of Philadelphia.



1. Grundy SM, Stone NJ, Bailey AL, Beam LT, Birtcher KK, et al. 2018AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol. JACC Nov 2018, 25709; DOI: 10.1016/j.jacc.2018.11.003

2. The Physical Activity Guidelines for Americans: THe HHS Roadmap for an Active Healthy Nation. Second Edition. ADM Brett P. Giroir, MD.



AHA18 Reminded Me We Need to Do More for Women

On the surface, it doesn’t really seem that surprising men and women develop heart disease differently or experience different symptoms for the same types of cardiac episodes. However, even though heart disease is the number one killer of both men and women, women have traditionally been omitted from clinical trials and female animals have either not been included in preclinical research studies or the two sexes have been combined1. We just simply weren’t taking half of the population into account at every level of cardiovascular disease (CVD) research for quite some time. I spent my graduate career focused on understanding the baseline differences in the heart between the sexes, and was extremely passionate about this work. Since I spent most of my scientific career working in this field, I wanted to switch it up as a postdoctoral fellow and am currently not researching sex differences. However, when I went to AHA sessions this year, I made it a point to go to any events focused on sex differences and women to get updated on what I’ve been missing this past year. Luckily the “State of the Heart For Women: Top Ten Advances in Gender-Specific Medicine” session provided the perfect summary. After ten great talks focused on a variety of gender specific concerns ranging from heart failure to pregnancy, the take home message was clear: women are still very much at risk, more likely to be misdiagnosed, and are still under-represented in clinical trials. These issues are also worse for women of color.


While this is a widespread issue across disciplines, the cardiovascular field has been particularly biased with regard to including women in clinical trials for drug development, leading to drugs being either not as effective in women or causing different side effects2. The good news is, things are changing. In the early 1990’s, reports from the Food and Drug Agency (FDA) demonstrated that less than 20% of participants in clinical trials were women and recent studies reveal that this number is steadily increasing – even in the cardiovascular field3. Fixing this imbalance is the result of the tireless work from many dedicated researchers over the past several decades. One of the main advocates this field has is Dr. Nanette Wenger, who was the first speaker of this session and actually let me ask her a some questions later during the conference while we were both in the Women in Science and Medicine Lounge. When I asked Dr. Wenger about her strategy for making this issue a priority in our field she explained the key steps to creating change:

  1. Investigate — people can’t ignore what the data is clearly telling them
  2. Educate — teach your peers & patients
  3. Advocate for the change
  4. Legislate — it took a long time, but we’re slowly transforming the strategic plan of the NIH

Dr. Wenger also stressed that since the emphasis in our field now is personalized care, many researchers and physicians are more supportive of including sex in their experiments and/or trials, but we need to move forward by not assuming that women are a homogeneous group. Other factors such as race are also important and must also be considered.

While progress has been made we still have a long way to go on many accounts. While there are more women in clinical trials than in the past, women still only make-up about 34% of the total participants in cardiac clinical trials3. Hopefully, with the passing of the 21st Centuries Cures act and the NIH policy mandating sex be included as an biological variable in basic research studies in 2016, these numbers will progressively increase. At the session before the talks even began, I immediately noticed that all but one of the ten panelists were women (which is awesome, but strange for the cardiac field) and the majority of people in the audience were also women. We will need to continue to advocate for this issue and we need men to join us and take it seriously for real change to be made. Additionally, while I really enjoyed this unique session, the speakers were only given ~10 minutes each to summarize their extraordinarily complex topics, which just wasn’t enough time. It would be great if gender-specific cardiovascular issues were given more time at AHA Scientific Sessions as well as other conferences in the future. This session reminded me just how pressing making CVD treatment equitable for all truly is and thankful for the researchers making it happen.



  1. Blenck CL, Harvey PA, Reckelhoff JF, Leinwand LA. The Importance of Biological Sex and Estrogen in Rodent Models of Cardiovascular Health and Disease. Circ Res. 2016;118(8):1294-312.
  2. Regitz-Zagrosek V. Therapeutic implications of the gender-specific aspects of cardiovascular disease. Nat Rev Drug Discov. 2006;5(5):425-38.
  3. Pilote L, Raparelli V. Participation of Women in Clinical Trials: Not Yet Time to Rest on Our Laurels. J Am Coll Cardiol. 2018;71(18):1970-2.



Trainees and Cardiovascular Conferences

I recently viewed a live-streamed session from the American Heart Association’s Scientific Sessions 2018 from the comfort of my own home, and I also attended (in-person) a scientific conference for a different topic within the same month. I began to think of how scientific societies engage trainees, graduate students, and post-docs at conferences. This is all from my perspective as a post-doc, so my observations should be taken with a grain of salt.

The first thing I noticed is that, in my opinion, PI’s typically outnumber trainees at conferences. This is interesting because most labs usually have one PI and several trainees. You might expect a similar parity at conferences, and I believe the reason that most conferences I’ve attended have fewer trainees is the cost of attending. I have been extremely lucky in finding travel awards to attend conferences, yet there have been several that I wanted to go to or committed myself to attend without having funding to support the trip. This can be extremely stressful and is fairly common because as a trainee, your position is not very stable.

When I was a PhD candidate in 2015, I attended a non-AHA conference. At the conference, I volunteered to be the junior representative for the graduate student/post-doc section of the society. I was elected to the position and had to return to the conference in 2016 to accept and begin my term. I was obligated to attend the conference again in 2017 as I transitioned from junior representative to senior representative and again in 2018 as the outgoing senior representative. That means I was supposed to attend the conference 3 years in a row with no clear funding path to pay for any travel. To top it all off, I graduated with my PhD in 2016, just 3 months prior to the 2017 conference date, with no justification for why my post-doc advisor should pay approximately $1,500 for my expenses to present my graduate work. At the 2018 edition of this meeting, I could finally present my post-doc work and luckily received a travel award to offset the cost of the meeting. To make a long-story simpler, 3 or 4-year conference commitments for trainees can be valuable because over that time period I met and worked with many more senior scientists, but shorter commitments would likely entice more applicants to volunteer and greatly reduce the stress involved.

One of the reasons I was elected to the volunteer position in the first place was because I was one of the only graduate students/post-docs to apply. And when I asked other trainees why they hadn’t applied, most said they would be graduating before the 3-year term finished and they didn’t know what type of lab they would end up in. An alternative option for societies is one that I recently sought out and has been surprisingly refreshing. That is the Early Career Blogger Program from the American Heart Association. To lift the veil a bit, I applied after reaching out to one of last year’s early career bloggers, Shayan Mohammadmoradi, who is now a Senior Early Career Blogger with the AHA. This is a 1-year volunteer position, and while it requires attendance at the AHA scientific sessions (I’m planning to attend in 2019), there are some incentives as an official Early Career Blogger that make it possible to attend. First, the conference registration is covered, and if you want to attend other AHA meetings throughout the year, the registration is covered for those as well. AHA also provides access to live-stream their largest annual conference, Scientific Sessions.

I study cardiovascular diseases in the context of aging, and I think supporting early career professionals is a great strategic plan for AHA or any scientific society from the perspective of aging. Early career professionals eventually become middle- then late-stage career professionals and are the next generation of PI’s. By showing that they value early career scientists, AHA will likely reap the benefit in the future.



Interview with Roxanne at AHA18

Imagine having an annoying pain that you thought was just a pulled muscle. No, I am not referencing that episode of The Resident, a medical drama prime time series aired by Fox, where a young immigrant was having pains in her side and it ended up being a rare cancer. However, I am referring to a real-life hero story about Roxanne (an organ recipient) and Michael (an organ donor). Roxanne had complaints of side pain for about a week, but she continued to work because she thought it was a pulled muscle. She tolerated the pain for about six weeks before she arrived at the emergency room (ER) where she was diagnosed with cardiovascular disease (CVD). She was immediately taken into cardiac care, underwent extensive diagnostic test, and her medical team concluded they could not give her the required treatment locally. Roxanne was transferred to the Cardiac Care unit in Bronx, New York where she was admitted to the hospital for nine days of extensive medical consultations. Upon receiving the diagnostic results, her primary physician approached her with both good news and bad. The bad news was that her heart had started to fail; the good news was she was in a state of stable instability. Roxanne was placed on list to receive a heart transplant as Stat 2.

By Christmas 2009 Roxanne’s health started to rapidly fail. She was losing weight at a rate of five pounds per day going from an average weigh of about 140 lbs to less than 90 lbs. By the spring she was upgraded on the transplant list from a Stat 2 to a Stat 1; that was when she was offered her first heart. She accepted, but she was second priority of the patients admitted to receive the heart. Thus, the wait continued. The second viable heart offer came, but the heart itself was damaged. Roxanne never gave up hope. Although her health was rapidly declining, and her family was feeling the stress of potentially losing her, she held on to her faith that her healing would come. The next heart offer was made but the donor was HIV positive. At that time AIDS was considered a deadly disease, so she rejected the heart. At this point she had been in the hospital for 100 days; her prognosis was becoming grim. Seventy-eight days later an unfortunate accident caused her to get an offer.

Meanwhile, Michael, an E3 Fireman with the Coast Guard, was brought into the Bronx hospital after a motor vehicle accident. July 2010, his dream to become an Aviation Maintenance Technician and a Flight Mechanic was brought to an end. Upon being guided by his family he registered to become an organ donor. Michael was a generous person with a spirit that prompted him to help others even postmortem. However, to his parent’s dismay they lost their son that night and was faced with the decision to donate his organs. In their grief, it took them a few days to reconcile whether to offer his body up for organ donation. From Sunday to Wednesday for his family wrestled with making the decision. Michael was their only male offspring! How would a father, a mother loses an only son and have his organs scattered from hither to thither? To strangers nonetheless? Ultimately, the family decided to allow the medical team to make their son a lifesaver for people they may never know. Michael has saved people from different cultural backgrounds. Scott, a Caucasian male received a double lung transplant allowing him to become a father. Elijah, an African American male, the kidney recipient, was afforded the opportunity to complete high school. Zhou, an Asian was able to return to work with his liver transplant. Finally, Michael’s heart, the most important organ of the body, went to Roxanne. Michael and his family gave freely; without cultural limitations, transcending socioeconomic barriers, and without regret. This heroic story of a man that was guided by his family to be an organ donor and unbeknownst to them lost their oldest only son, I could imagine was the hardest decision they could have made, but a necessary one.

Michael through his tragic accident saved the lives of four people changing them forever. Roxanne, determined to make the most out of this opportunity to live another day, became an advocate for organ donations; possibly signing up a record number of donors with over 11,000 people committed to organ donation. Michael had given her another chance at life; one she would not take for granted. Upon asking if anything in her life had changed, she indicated she developed a love for power tools. She had never had an interest in them before, but now she made daily trips to Home Depot just to look at the tools and dream of projects that she could take on. Along her life’s journey she expressed her interest in meeting the donor’s family. She dreamed about how she would respond to meeting the mother of the person that saved her life. Serendipitously, she was in Home Depot during her regular wish trips and was approached by the staff from The Oprah Winfrey Show. She was invited to go on the show to tell her story and encourage people to become organ donors as well as increasing minority organ donation, but during the airing, she met the donor family. Oprah introduced her to Michael with a photo, and subsequently his parents came out. Roxanne could not look upon Michael’s father without emotion. She thought she would have that feeling about his mother, but she found there was a close father-son bond between the two. It was then she found that Michael had a passion for mechanics and working with his hands. He and his father worked together on projects and build a bond that can only be between a father and his son.  Roxanne feels receiving the organ increased her desire for crafts. She has taken on some projects since but intends to continue with small do it yourself changes around her home. Roxanne remains in touch with the family and does various outreach and social projects together.

Roxanne has changed her activity of daily living to accommodate the dietary habits suggested by her nutritionist in addition to referencing a book she received outlining the things that she could and could not continue to remain healthy. She was adamant about following the instructions that were given because she did not want to risk damaging her new heart. She is now a self-proclaimed foodie although she had no interest in food or cooking to the extent she has developed. She has taken cooking classes and learned more details about mixing spices. Roxanne regularly attends conferences and deliver seminars to assist in her goal of encouraging people become organ donors. Roxanne has become an advocate for people that cannot advocate for themselves. This is an example that all can admire. Michael, real-life superhero, lives on though Roxanne as she goes on a mission to change people’s outlook on organ donations.



3 Key Reasons to Attend Scientific Sessions Early in Your Career

What is the value of traveling to a large cardiovascular meeting, when the information communicated in the sessions will be available via Live Streaming and the major news will be published immediately? Why go through the expense and the hassle of time away from work? Attending an event like Scientific Sessions is not easy for most of us — especially Early Career professionals who experience high demands on our time and limitations on our resources. So what makes it worthwhile? Of course this depends on your career type and your goals, but I believe the following three reasons are important for everyone in academia:

  1. Hearing and learning things you would not have sought out. When you’re at a professional conference, you have set aside time for learning. You are less likely to be squeezing learning in between other tightly scheduled commitments at home. This time allows for serendipitous exposure to new areas. For example, even though my research focuses on symptoms, risk, and communication, I heard some very interesting sessions about the microbiome. Similarly, this kind of broad exposure enables cross-pollination among disciplines that share common goals but diverse methods. What can basic scientists learn from nurses? What can interventional cardiologists learn from computer programmers?
  2. Personal connections. The power of small interactions— a chat in the coffee line, a well-put question during a session— is undeniable. The opportunity to make such connections with people at all levels in your field and related fields is one of the major benefits of attending a conference. Certainly this includes people who are “big names,” but also people whose work you might now take an interest in since you’ve met them (and vice versa). When I attended a 10-day seminar in Tahoe last year, I sat around the campfire with Dr. David Goff, director of an NIH division, and I was also the roommate of Dr. Sherry-Ann Brown, a junior scientist whose work I’ve since cited. I was able to reconnect with them and other old connections from the seminar at Scientific Sessions this year, and was genuinely interested in their work on a new level because I knew them.
  3. Momentum and enthusiasm. I always come home from events like this brimming with ideas. Science is a highly creative endeavor, and anything that sparks creativity is good for science. To make the most of this aspect, I keep good notes and make a priority list, including names, references, and contact information if applicable. I review my list on the plane ride home and identify “action items” for follow up. An event like Scientific Sessions also gives you a great feel for the overall state of cardiovascular research, and for the current priorities of different stakeholders. Using this information in long-range planning is smart and increases changes of successful projects going forward.

While it’s not feasible to attend every event that interests you, I highly recommend making an event like Scientific Sessions a priority, especially early in your career.

Why do you go to Scientific Sessions?

AHA Early Career Bloggers had the opportunity to get to know one another during Scientific Sessions 2018



New Cholesterol Guidelines From A Neurologist’s Perspective

The American Heart Association’s annual premier conference “Scientific Sessions 2018” concluded on Monday. This meeting showcases the latest advancements and discoveries in the field of cardiovascular medicine and is attended by clinicians and researchers from across the world.

Being a vascular neurologist, I have attended the International Stroke Conference organized by the AHA several times, however, this was my first time attending Scientific Sessions. I was able to attend the conference via Live Streaming while sitting in my office in Burlington, Massachusetts.

There are a lot of overlaps between cerebrovascular and cardiovascular disease and I was particularly interested in attending the sessions pertaining to stroke prevention and brain health. One of the most anticipated presentations was the release and discussion of the new AHA/ACC Cholesterol Clinical Practice Guidelines.

Some key takeaways from the updated guidelines:

  • The guidelines continue to underscore the role of lifestyle and dietary habits in addition to lipid lowering medication use to treat cholesterol disorders. There is emphasis on the concept of shared decision making with the patient which should include discussion of their individual risk and the treatment options to reduce that risk.
  • Addition of Ezitimibe and subsequently PCSK-9 inhibitors is now recommended in patients who cannot achieve target LDL levels despite maximum tolerated statin doses. There is some concern about the cost effectiveness of PCSK-9 inhibitors, but these medications are expected to become cheaper in the future.
  • Risk enhancing factors are introduced as part of a personalized approach to risk assessment prior to initiating statin therapy. These include persistent elevation of LDL>160 mg/dL, history of pre-eclampsia, family history of premature atherosclerotic cardiovascular disease, history of chronic kidney disease and chronic inflammatory disease, among others.
  • There is a recommendation for expanding use of calcium score as part of the risk assessment, especially in patients where risk benefit analysis is uncertain.


In addition to the guidelines for medications and lifestyle changes to treat cholesterol disorders, I especially enjoyed Dr. Laurence Sperling’s talk about the safety of statins.

Patients should be prescribed statins again at a lower dose or modified drug regimen if the reason for discontinuation was mild side effect symptoms. Although rare, but some patients do develop severe myopathy with statin use. These patients should be prescribed alternate non-statin therapies to achieve the target cholesterol levels. There has not been any proven benefit of Co Q10 to prevent or treat statin associated muscle symptoms. Despite the increased risk of diabetes mellitus with statins, it is recommended to continue the drug in patients who may be at risk or develop new onset DM. These patients should be counseled about the net clinical benefit of these drugs for long term cardiovascular event prevention. It appears reasonable to initiate statin therapy in the presence of an appropriate indication despite a history of stable liver disease. In patients without hepatic disorders, there is no clinical benefit of routine creatine kinase and liver enzyme measurements.

Very often patients have questions and concerns about initiating and continuing their statin medication. I believe that these data and recommendations further reinforce my personal practice to encourage patients to continue their statin medication as the risk benefit ratio remains favorable despite mild side effects.