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FDA Warns of Gilenya Risk, Name Confusion, Looks Into GBCA Use

Pharmacy Focus

The U.S. Food and Drug Administration has issued warnings regarding the multiple sclerosis drug Gilenya and about reports of confusion between the names of the antidepressant Brintellix and anti-clotting drug Brilinta. Also, the agency is investigating the risk of brain deposits following repeated use of gadolinium-based contrast agents for magnetic resonance imaging.

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Surgery Grand Rounds

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Grand Rounds

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Education Schedule

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Education Schedule - August 2015 (PDF)

Surgery Scheduling

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Resisting Heart Failure

Larry Lewis chats with his surgeon, Francisco Arabia, MD, surgical director of the Mechanical Circulatory Support Program.

Larry Lewis literally lost his heart on a July day a few years ago, but with his optimism and determination — and the expertise of the cardiac-care team at the Cedars-Sinai Heart Institute — the retired Marine Corps staff sergeant and educator is going strong today.

"On that day in 2013, I had a plane ticket to attend my wife's family reunion," Lewis said. "I was supposed to fly to the event after one last heart test. By the grace of God, I never got on that flight."

Larry Lewis is thriving with his new transplanted heart.

For seven years, Lewis had been suffering from fatigue, insomnia and tenacious head colds — problems he knew were connected to his heart's slow decline. When cardiologists conducted that test at the Heart Institute, they determined he was suffering from complete heart failure.

Eight days later, Lewis went into surgery to have a device implanted in his chest that would take over the job of pumping his blood. But when the surgeons removed a portion of his heart, they discovered cancerous tumors in it that had been at the root of his health problems. To make things worse, the cancer had already spread to his lower intestine, diminishing his chances of survival.

Not one to be counted out, however, Lewis is living today at his home in Victorville. He has a new donor heart, he's cancer free, and he's in excellent spirits.

"Cedars-Sinai provided the boost of confidence for me to get through this," Lewis said. "I knew the hospital's reputation, and as I got to know the doctors and staff I realized that everyone was a consummate professional."

But there was more to his survival than trust in his expert caregivers.

"I never felt that I had a chance to fail — it was not an option," he said. "I've had to fight my whole life. That's my personality."

Indeed, the same steely resolve he tapped to pull himself from death's door at age 50 had empowered him decades earlier to free himself from a potentially ruinous start to his adult life.

"I was 'that' kid, and I should be a statistic," Lewis said of his teen years. "The places where I grew up and the situations that I was in. … Well, several people I knew then have been in and out of prison. Several are dead."

Lewis was not born into a life on the edge of crime. His dad was a Navy man, his mother a stay-at-home mom. The family lived in Oakland, and his parents had a clear vision for their four sons, whom they sent to private school.

"My parents only had ninth-grade educations, but they had unbelievably high expectations for me and my brothers," Lewis said. "My mother was a beast with education."

But when Lewis was barely a teenager, the family disintegrated. His parents divorced. His dad moved to Southern California with the two oldest boys. Shortly thereafter his mother suffered a stroke.

"At 12, 13 years old I grew up," Lewis said. "I paid the bills. I went to the store with the food stamps. And we moved from the Oakland hills to the Oakland ghettos."

‘I never felt that I had a chance to fail — it was not an option. I've had to fight my whole life. That's my personality.’

— Larry Lewis,
Cedars-Sinai heart transplant patient

Ridiculed by the kids on his new block for "talking proper," Lewis had to learn how to play by the rules of the street. His mother eventually moved away to get care for her illness.

"I lost my identity because I didn't have older brothers or a father to identify with any more," Lewis said. "I was doing all the things you think teenagers do in the streets."

He recalled a day when he was 18 and talking to a friend about what they were going to do for money after high school graduation.

"My buddy said, 'I'm going to start slinging hard'" — selling drugs. "I said, No, I'm going into the military.

"I didn't have anyone telling me I needed to do this, but I knew I had to escape the inner city. My father and brothers were military, so it was the family business. I had the presence of mind and the foundation to get out."

Lewis would spend the next 20 years in the Marine Corps, where he served as an aircraft maintenance data systems analyst, an advocate for victims of domestic violence and a substance-abuse counselor.

After the end of his military career, Lewis threw himself into being an educator and teaching young people his brand of optimistic resilience. He was already acting as a youth director at his church and a coach of sports teams, so it was a natural transition to pick up a teaching credential and then master's degrees in curriculum and instruction, and educational leadership.

"There are not enough African-American educational leaders — especially men," Lewis said. "My job is to fight for kids who can't fight for themselves. I understand the dynamics of their lives. I know that if those kids have an opportunity to thrive, they will."

From 2000-11, Lewis was a teacher, assistant principal and eventually a principal in the Adelanto School District in San Bernardino County. His medical condition forced him to retire in 2011 from his position as principal of Desert Trails Elementary School in Adelanto.

Then came that critical July day in 2013.

After surgeons removed his heart, they implanted a SynCardia Total Artificial Heart. The device helps the sickest of the sick, replacing the lower chambers of the heart (the ventricles) and all four valves. An external driver powers the implant, enabling it to pump. It is a remarkable, temporary therapy for patients who might otherwise die while waiting for a heart transplant.

Yet the device could do nothing about the fear Lewis was feeling.

"I was uncertain about my future and uncertain about my ability to come back from heart failure," he said. "I felt fear, but I wanted independence. I was going to have to earn that."

Lewis lived for 16 months with the SynCardia device. He said he drew strength from his faith, his love for his wife and children, and his desire to work again with young people.

He was back in the hospital at Cedars-Sinai when he got one of the most emotional phone calls of his life.

"They had a donor heart for me, if I chose to have it," Lewis recalled. "I certainly chose to have it!"

When he awoke after his heart transplant, he felt a profound difference.

"When you wake up, you just know that you're alive. You're attached to about a thousand wires, but through it all you can feel that, in fact, there is a heart that's beating."

Lewis plans to continue mentoring youth. Although retired from teaching, his fond memories of serving students from myriad backgrounds has inspired him to start a group called My Brother's Keeper through the church where he is an ordained deacon.

"The idea is that, yes, I am my brother's keeper," he said, "and I do have a responsibility to help the next young man to be successful, to navigate life and to move forward."

Lewis said he also feels a responsibility to the donor heart beating in his chest:

"I need to make sure that I'm positive in the things that I do, to honor the person who I got the heart from."

Click the image below to hear Larry Lewis talk about his transplant experience.