Thursday, December 7, 2006


[This post has been slightly edited since first written to correct broken grammar. The edit is flagged within the text. The original text is cited immediately below.]
Being that the person is not a medical doctor, in fact I wish I didn’t for her knowledge comes from suffering through much of what I am now experiencing. But I am truly grateful for her timely and informative e-missives nonetheless.
No, I’m not talking about the slightly officious toady assistant to Cap’t Hook in J.M. Barrie’s classic Peter Pan. That was ‘Smee.’ SME is an acronym for ‘Subject Matter Expert.’ SMEs are people who offer expertise in a specific area to third parties, such as Congress, courts, and even Internet E-commerce architects like me. To me, SMEs provide essential information during planning such as business requirements, corporate accounting rules, legal policies and company regulations, and prospective end–user feedback on user interface models.

Twice in the course of writing this blog I have stumbled over arcane medical issues. This is in part because I am slightly removed from the diagnostic process insofar as I have only once been with my father during a diagnosis and thereby be able to inform myself by asking questions.

The first stumble was the calcium drip. As usual, I went to the oracle. Although it returned voluminous amounts of information, nearly all of what I found in the first several hundred returned search matches were of a far too rarified nature to comprehend without investing a fair number of hours. (Not that I am lazy but I do have other important demands on my time.) Yesterday I couldnt immediately fathom the ramnifications of the many little blood clots.

In both cases I received an e-mail from one of my father’s favorite colleagues, a few hours after posting. Each contained a lucid, concise explanation such as the one I cited to elucidate the calcium drip. I now have a cancer SME. [begin edit] The person is not a medical doctor. Her knowledge comes from suffering through much of what I am now experiencing. I am truly grateful for her timely and informative e-missives.[end edit]

Following is my cancer SME’s explanation for the clots, which I provide in full:
The clotting that your father is experiencing is probably of the type called “disseminated intravascular coagulation [DIC],” which is relatively common in people with advanced and/or aggressive cancer. This is a serious condition.

There is a large medical literature on this topic, but the vocabulary invoked in the technical descriptions of the condition can be overwhelming. The following sources are intelligible and may help:
  1. DIC at
  2. DIC at Wikipedia
  3. Merck
If you feel like delving into the clinical literature, abstracts of relevant technical papers are available through the National Library of Medicine, e.g.:
  1. NHI Abstract #1
  2. NHI Abstract #2
The next time you have access to one of your father’s physicians, it would be worthwhile to ask if your father is suffering from DIC. Treatment with various anticoagulants (heparin, warfarin) and other agents that target the clotting cascade is usually followed.
Given that the new drug being administered is Warfarin and I am now aware of a couple of other facts, I believe the foregoing to be exactly correct.

This same person has written several thoughtful, kind, empathetic and helpful e-mails in regards to other posts, including yesterday’s on fear. Lest she expressely allows me otherwise, I shall keep her identity anonymous. Regardless, I truly and deeply thank her.

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