I went to medical school knowing I wanted to pursue primary care and have been doing so for 20 years. Being a doctor is so much more than prescribing medicine, it is getting to really know you, taking time to listen and understand your life situation, your aspirations and even fears. There are many determinants of someone’s health: your past experiences, your current circumstance, and your goals for the future all need to be taken into account. I consider it a privilege to know my patients over many years and to be able to help you achieve fulfillment in life despite ailments, acute or chronic.
If you would like to know my past, present, and future goals, I’ll tell you briefly that I was born and raised in Belgium, came to the US at age 19 to study at UCLA and UCSF Medicine, and met an earthquake researcher who has been my husband for 31 years. We have two children, one college bound, the other a sophomore in high school. I love to travel, hike, garden, take photographs but above all, spend time with my family. I hope to keep practicing medicine for many more years and thus continue to meet interesting people who teach me so many valuable life lessons. I feel fortunate to be part of the Stanford community.
- Internal Medicine
Clinical Assistant Professor, Medicine - Primary Care and Population Health
Medical Education:University of California at San Francisco School of Medicine (1991) CA
Chief Residency, Santa Clara Valley Medical Center (1995)
Residency:Santa Clara Valley Medical center (1995)
Board Certification: Internal Medicine, American Board of Internal Medicine (1994)
Community and International Work
Patient Opioid Education
Opportunities for Student Involvement
Regional Opioid Safety Coalition for Santa Clara County
California Health Care Foundation and Santa Clara County Department of Alcohol and Drug Services
Opportunities for Student Involvement
Current Research and Scholarly Interests
The treatment of chronic pain with long term opioid medication is what has fueled the so called “opioid epidemic” with drug overdose deaths quadrupling in the past decade and addiction rates estimated to be more than 20 percent of patients taking medical opioids long term. Associated complications with these medications are not generally known to the patients. The project enables the patient to examine risks versus benefits, presents safer and more effective alternatives to opioid therapy and educates about options available for reducing or transitioning off opioids.
Massive leptomeningeal amyloidosis associated with a Val30Met transthyretin gene
1996; 47 (4): 988-992
We report a 69-year-old woman of Mexican origin with a 6-year history of progressive paresis, mild peripheral neuropathy, and recent onset of fluctuating mental status. Head and spinal MRI revealed contrast enhancing thickened meninges which on biopsy disclosed amyloid deposition. Immunohistochemistry identified the amyloid as transthyretin (TTR), and polymerase chain reaction/restriction fragment length polymorphism analysis of blood revealed a Val30Met mutation in one of her TTR genes. This mutation causes familial (hereditary) amyloidotic polyneuropathy of the Portuguese type (FAP 1). However, unlike FAP 1, in which peripheral neuropathy is a dominant feature, our patient's clinical manifestations, which included communicating hydrocephalus and myelopathy, were more suggestive of familial oculoleptomeningeal amyloidosis (FOLMA). In summary, the clinical presentation of TTR Met 30 mutation is more varied than previously suspected, and leptomeningeal amyloidosis should be considered in the differential diagnosis of obscure conditions involving meninges.
View details for Web of Science ID A1996VN29500024
View details for PubMedID 8857732
- PULMONARY TUBERCULOSIS, AMENORRHEA, AND A PELVIC MASS WESTERN JOURNAL OF MEDICINE 1994; 161 (5): 515-518
ANGIOTENSIN II-INDUCED RHYTHMIC JAW MOVEMENTS IN THE KETAMINE-ANESTHETIZED GUINEA-PIG
1989; 478 (2): 233-240
The EMG activity of the left anterior digastric muscle as well as associated jaw movements were studied in ketamine-anesthetized guinea pigs that had received i.v. infusions of angiotensin II (ANG-II). Rhythmic jaw movements with two distinct movement profiles were associated with ANG-II infusion. One movement profile was typified by vertical jaw opening and closing movements with little or no associated horizontal movement. The second rhythmical jaw movement profile was unlike the first in that jaw closing was accompanied by a significant horizontal deflection of the jaw. Both jaw movement profiles were similar in that little or no horizontal movement occurred during jaw opening. Tongue protrusions were also observed during jaw opening in both cases. The results show that ANG-II induces rhythmic jaw movements in anesthetized guinea pigs. ANG-II-induced jaw movement profiles and digastric muscle EMG activity are similar to those seen after an i.v. injection of apomorphine in the anesthetized guinea pig, and to those associated with lapping in the awake animal.
View details for Web of Science ID A1989R855700004
View details for PubMedID 2924127