Dangerously Thin: A Case Study on the Genetic Code
At 65 years old, Henry Blake was in excellent health and enjoying his first year of retirement. Upon returning from his dream trip to the Great Barrier Reef in Australia, he noticed that his left leg was swollen just inferior to the knee. He already had scheduled an appointment for a complete physical, so he knew that in a few days he would be able to have his physician look at his leg.
Dr. Strickland had been the Blake family doctor for more than 40 years. Knowing that Henry had planned to do some traveling, Dr. Strickland opened with a question that Henry initially found to be a bit out of the ordinary.
“Any chance this swelling showed up after a long flight?”
“As a matter of fact it did,” Henry replied.
“My gut tells me that you may have a clot in that leg, but we’ll have to have a look at it before we’ll know for sure.”
Dr. Strickland knew that Henry’s family had a history of clotting disorders, and he had recently treated Henry’s brother for a deep vein thrombosis (DVT), a disorder that gets its name from the blood clots that form in a vein deep within the leg. A DVT was confirmed by the Doppler ultrasonography results (a test that uses sound to create images of blood flow). Dr. Strickland placed Henry on a “blood thinning” drug called warfarin, which works by preventing clots from forming.
Henry returned to his retirement plans but quickly found himself back in Dr. Strickland’s office after suffering from frequent nose bleeds. A laboratory test called an INR (International Normalized Ratio) was performed. This test measures the time it takes for blood to clot and compares it to an average. The test revealed that the time it took for Henry’s blood to clot was well above what would be expected for the dose of warfarin that he had been placed on. Dr. Strickland immediately