Bert Stein in his office.
Bert Stein in his office.

Former professor publishes his results in prestigious medical journals.

Talbert Stein is not a physician. He doesn’t even play one on TV. But the former physics professor is a scientist, so while it’s unusual, it’s not totally surprising that he has had two pieces published in peer-reviewed medical journals. Both are based on his experience developing treatments for his own medical problems.

“The basic theme of this developing story is that if nature gives you lemons, make lemonade,” said Stein, 81, of Huntington Woods.

“When something goes wrong, as a scientist I get excited,” he said. “It’s an opportunity to learn.”

Although he retired as a full professor at Wayne State University in 2004, Stein stayed active, playing his fiddle and writing new tunes. (A 2014 Detroit Jewish News article described how one of his tunes won an international competition.) He enjoyed walking several miles every day near his Huntington Woods home. He and his wife, Elaine, who died in 2018, enjoyed traveling, frequently visiting their daughter, son-n-law and two grandchildren near Los Angeles.

Bert Stein walks the stairs, which helped improve his condition.
Bert Stein walks the stairs, which helped improve his condition.

In 2015, he said, he started noticing the “ravages of old age.” He was used to walking two or three miles a day, but severe pain in his right calf made it impossible to walk even a complete block without stopping to rest. He was diagnosed with peripheral artery disease — a narrowing of the arteries that lead to the extremities. In many cases, blockages affect the blood vessels in the heart. In Stein’s case, a blockage had formed in a major artery in his right thigh that reduced blood flow to his lower leg.

In someone with clear arteries, the blood pressure at the ankle should be just about the same as the blood pressure in the upper arm, where it’s usually measured. In Stein’s case, the blood pressure in his ankle was just over half what it was in his arm.

He started resting during his walks until the pain resolved, then walking again, repeating the cycle as long as he could. His walking ability gradually improved, but after a year the problems returned and became even worse.

Stein developed a spreadsheet to measure how other activities affected his ability to walk. He discovered that walking was a lot easier if he walked every other day and worked out on a recumbent stationary bike on the other days. He also kept records of when he exercised related to when he ate and found that fasting before a walk — not eating after 7 p.m. the day before and doing his walk early in the morning before breakfast — made a big difference.

Before long he was walking several miles at a time with no pain and no need to rest.
His vascular surgeon, Paul Bove, M.D., of Troy, told Stein he approved of his approach and saw no immediate need for surgery.

Stein wrote up his experience and submitted a report, “Correlation of Daily Activities with Intermittent Claudication in a Patient-Designed Individualized Quantified Community Walking Program,” to the Annals of Vascular Surgery, which published it as a correspondence in 2020.

Another Problem Tackled

In 2018, Stein’s disease took another turn; his ankle blood pressure fell below 40 percent of his arm pressure. In January 2020, non-healing open sores and blackened nailbeds formed on the toes of his right foot, a condition that can lead to amputation.

Since the arteries serving that part of his body weren’t working, Stein tried to encourage other arteries to carry blood to the affected area. He thought lifting his body weight might help — and climbing stairs was a good way to do just that. Most days he climbed 30 flights, resting after every flight and spreading the flights out throughout the day.

He started the project In February 2020 and saw improvement within a month. After six weeks, the open sores were healing, and the nailbeds were no longer black. Before three months had passed, the only signs of a problem were very small, healing wounds, which were gone entirely by the end of August 2021, 18 months after he started his study. His right ankle blood pressure, which he monitored at home with a Doppler device, steadily improved throughout the study.

Stein says that over the course of his two-year study, he climbed a total of 22,185 flights of stairs, equivalent to 42 miles of elevation. “For comparison, the height of Mt. Everest is 5.5 miles,” he said.

Stein’s account of his experience, “Patient Experience with Stair Climbing for Peripheral Artery Disease,” was accepted for publication in the Journal of Vascular Surgery Cases, Innovations and Techniques, a selective, peer-reviewed journal. (Read it at www.jvscit.org/article/S2468-4287(22)00158-7/)

“I believe it is highly unusual for a patient who is not a physician to have a paper published in a high-powered medical journal,” he said.

The journal’s editor-in-chief, Matthew R. Smeds, M.D., noted, “We don’t see this type of manuscript from the patient’s side of things.”

Stein’s vascular surgeon, Bove, calls him “an exemplary patient.”

“Dr. Stein had incredible insight into those factors that allowed him to walk further. When patients understand this and can implement change, whether it is in their activity, as in Dr. Stein’s case, or other aspects of their lifestyle — for example plant-based or Mediterranean-style diets and smoking cessation — that is when you get the best results.”

Bove said he often tells other patients about Stein’s experience.

Stein says he hopes some “real” doctors will be inspired by his articles to do a multi-patient controlled trial testing his approaches.

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