welcome to the organic green doctor blog

i am a family physician who was diagnosed with
early mild cognitive impairment(mci) amnestic type on december 21, 2010
this is a precursor to alzheimers disease
because of this diagnosis i have opted to stop practicing medicine
this blog will be about my journey with this disease
please feel free to follow me along this path
i will continue blogging on organic gardening, green living,
solar power, rainwater collection, and healthy living
i will blog on these plus other things noted to be interesting

Thursday, January 18, 2018

alzheimers news-trumps memory test

Image result for organicgreendoctor
ill be the first to admit
i dont like donald trump
lets be fair to him regards his memory test

alzheimers starts in the brain 15-30 years before
any symptoms start
before any memory tests are abnormal

there are subtle things that can happen before the
memory tests become abnormal

sometimes the first thing is spatial things
missing things in your peripheral vision
which can show up when driving
sometimes subtle memory things happen
im speaking from personal experience here
things you notice that others do not

eventually when the time comes
the memory tests become abnormal

first let me say
if you are going to need memory testing anytime
dont be reading whats in those memory tests
it affects how accurate they are

now i have personally been administered the same memory
test he had done more than 15 times over the last 8 years
i have personally administered that particular test to
family members and friends several times
i am quite familiar with the moca memory test

when you go to a doctors office
he might administer one of three tests

one is the minicog test
it involves being told three words to remember
you are given a time and asked to draw that time
on a clock

if you dont pass that one
you have memory issues
you need more evaluation

its a quick and simple test
its not sensitive though in picking folks up early
with memory loss

the next is the mmse
multimental state exam
its scored up to 30
get 30 and you might be ok
for those like me when i was first tested
it missed me
i got a normal score on the mmse

the third test is the moca
thats the one that trump took
the best score you can get is 30
a normal score is 27-30

when i was first tested in 2010
my score was 25
which was abnormal
its in the mild cognitive impairment range

the moca test is a more sensitive test to pick
up those early changes
like what you see with early alzheimers or mild cognitive impairment

its not a 10 minute test
its a 20-30 minute test

so with a normal result
a 30 score
as of right now
trump probably doesnt have any symptoms of dementia
or short term memory loss
the first thing that usually shows up in alzheimers disease

my scores earlier this year on one of the moca test
was 30
a perfect score

so why did mine get better
medication ie aricept (donepezil)
correcting things like cholesterol blood pressure weight exercise
stress sleep staying mentally engaged
all helped to make my scores improved

so i have a perfect score on my last moca test
does that mean i dont have alzheimers disease
the diagnosis is made on more than just the moca test

they use
family history
past medical history
risk factors
spinal fluid for tau and amyloid
a pet scan for amyloid the amyvid pet scan
genetic tests
serial memory tests
the gold standard
the neuropsychological exam
eg mine is abnormal even though my last moca was normal

the neuropsychological exam is more accurate
if there are memory issues it will show up
yes you can have a normal moca and have
an abnormal neuropsychological exam
it take 2-3 hours to do this exam

the moca test is a screening test
it doesnt rule out alzheimers disease

there is a state
prealzheimers or prodromal alzheimers disease
the memory tests are all normal
the scans and spinal fluid levels are abnormal
in this stage
you just dont have symptoms yet

either does not have alzheimers disease at all
he is in that prealzheimers state or prodromal state
a time that can last 10-20 years

as a medical doctor
as a family doctor
as someone who has had this test multiple times
as someone who has administered this test multiple times
as someone who reads 10+ articles on alzheimers disease each day
as someone who has lectured on alzheimers disease multiple times
as someone who has been and is now in two of the most
important alzheimers studies ever done
i feel like
i can speak with some authority about alzheimers disease

if i was trumps medical doctor
if i had administered the moca test to him
i would tell him
right now there is no evidence that you have memory loss or dementia

i would tell him to correct those other health issues
the what i called heart attack levels of the ldl cholesterol
he is just a point or so away from being labeled morbid obese
get more sleep
get more physical activity
greatly improve his diet
let your calcium score on that heart ct be a warning
if a heart attack or a stroke dont get you
demential or alzheimers might in the future

the posting of the moca test for all to read
i think does a disservice to those who may need a moca test
in their workup for memory loss
practicing or reading the tests affects its accuracy
i am not allowed in my studies to have other memory testing
since it causes what they call testing effect

this doesnt mean trump doesnt have mental problems
or psychological issues
this moca test this screening test
doesnt check
for anxiety
for depression
for bipolar disorder
for psychosis
for paranoia
for narcissism

those are tested usually by a psychologist or psychiatrist

no he dont appear to have active dementia or alzheimers
manifesting itself right now

lets all move on from this

mudslide update
maybe next week the 101 will be open
no new recoveries no change in the death toll
we saw what seemed to be miles of trucks loaded with mud
and stuff on the freeway waiting to go to a dump place
way north of santa barbara
they are expecting to dump over 20,000 dump truck loads of
stuff in those dump sites

thatcher update
he is awake
tape free
looks like iv free except for the pic line
oxygen free
soon to be moved from icu
you go thatcher

here is his gofundme account
#thatcher strong

the organicgreen doctor

Wednesday, January 17, 2018

did i or you get faked newsed on facebook

Image result for facebook
during the election i got tired of all the stuff that was
appearing on facebook
from both sides
i found an app and put it on my facebook page
it filters out political stuff
especially any mention of trump or clinton
if folks got too aggressive on their political postings
i used my darwinian clicker and blocked them
i must admit i blocked more folks who believe
like i did then those who have opposing views from mine
if racists or bigoted or homophobic stuff got posted
i blocked that person also
what was left was a much more pleasant read each day

when i go on facebook i want to know
how folks are doing
how their family is doing
not that other stuff

i started hearing about the true fake news stuff
not trumps fake news he rants about
the real fake news that was mainly put out by
the russian hackers it seems against the clinton
run for president

it seems from court and legal documents that the russians
wanted trump to win
the russians as most agree hate and loathe clinton
they did these fake news stories and posted it
mainly on facebook
mainly to folks in areas that determined the election
michigan and wisconsin and pennsylvania and a few
other states

after i heard about all this
i no longer click on any news related stories on facebook
i consider anything that gets posted there as
possibly fake news

i get all my news online from 3 different news feeds
that gives me a variety of news sources from
across the news spectrum
i decide for myself what to believe
not just what some reporter wrote

so i wondered
did i read fake news on facebook during the election
that may have affected my thinking

so kim komando the computer guru
posted this link that you can click on to see if you
got faked news

here is her article click here

here is the facebook link to see if you got faked

this should disturb you that this has happened to us

no i didnt click on any fake news sites on facebook
according to this link

mudslide update
the hwy 101 is still closed between santa barbara and los angeles
since i have to have an mri at ucla to get my next infusion
i cant get it anywhere else since this is all part of the study
we had to make it down to los angeles yesterday to be here
for our mid morning mri scan today
so off we went north for about an hour up the 101
then up and over the  mountains
a slow trip that was quite curvy
but i must add quite beautiful
the line of cars and trucks seemed to extend behind
us for a couple of miles
all moving slow
lucky for us we seemed to be number 3 in line
then after 3 hours of driving we made it to the
interstate 5 south of bakersfield
lucky for us
we drove during the right time of day for the la traffic
missing all the backups on the notorious 405
we made the trip in a little over 5 hours
it could have easily take 7 hours
but it didnt
if we are lucky in 1 week the 101 will be opened some
so we will not have to go back the way we came

the mudslides were the result of a perfect storm
it turned out to be a 1 in 2000 year event
in all my reading on this this morning
there was a flood several years ago
down the creek that is a block away from our condo
it was a 15 foot of mud rocks debri that caused flooding
in the part of santa barbara we live in
yes it closed the 101 then

so in the south
you have tornadoes and floods
we here it seems
have mudslides and fires and i must add earthquakes
although the south is getting a lot of earthquakes now
from all the fracking thats done

there has been no change in the death toll
someone who was displaced in the mudslides
will be staying at our condo while we are gone
our contribution to the cause

he is extubated
his ivs are out
his pic line in in
his oxygen is off
he smiled
he sucks on his pacifier
he drank a bottle of formula
his parents have got to hold him in a chair
he grabbed his dads hat off his head
the miracle child

here is his gofundme account
#thatcher strong

the organicgreen doctor

Tuesday, January 16, 2018

new tax calculator

Image result for tax calculator
as we have downsized moving out here to california
we downsized our taxes some
we thought
we downsized or lost some of our deductions
trumps tax law wiped out what was left

i ran across this trump tax calculator online
click here 
from clark howard the consumer guru and marketwatch

its fairly straightforward
you only need a little information to do it
many of you like us will lose some of the deductions
property taxes
sales taxes
medical expenses
mortgage interest
since the trump law increased the amount of standard deductions
you take

i ran my 2016 tax info through
last year we had a lot of medical deductions
along with those deductions above
for us our 2016 taxes were lower because of those deductions
if we had ran them through the new tax law
if it had been in effect
we would have still had more deductions than
the standard deductions
our calculated taxes would have been higher
we would have fallen in a sort of donut hole spot

now lucky for us
for 2018 all our stuff has been streamlined
since we have removed those things that allowed
us to take deductions
but also removed some taxable income

running our numbers through this trump calculator
we would owe close to $2000
running our numbers through the h r block tax calculator based
on the 2017 law we would have owed no taxes

so we lost
plug in your numbers to see where you will be in 2018

we all know from reading
this law is apolitical
if you are democratic or republican or independent and you
are wealthy
you will make out like a bandit on this new law

for now
many of you will come out ahead under the new law
but your kids and grandkids
they wont

mudslide update
20 people died
3 are missing including a 2 year old whose family died in the flood
155 houses destroyed
its unlikely any of those homes were worth less than a million
many were multimillion dollar homes
close to 250 houses were damaged
the 101 freeway the way folks go south is still closed and will
be closed for at least 1 more week maybe more
folks are traveling via amtrack and boats to get back and forth
a special bus convey is being used to move needed workers
like teachers firemen rescuers medical folks weaving back
and forth with a police escort to get to santa barbara
there is waiting lines on all these
the rainy season hasnt started here yet

we have to drive an extra 5 hours by going north then east
then south around the mountains to get to ucla for my appointment
tomorrow for my mri and blood work
i have to have the mri before i can get my next infusion
we have decided to stay there since i have to come back in a week
to get my aducanumab infusion
we are hoping in a week the 101 will be opened
if not
its back the way we came around and across the mountain
at least its a pretty drive

thatcher update
he is extubated
he is able to suck his pacifier
a pic line was placed which will allow some of the ivs to be
his little sister got to facetime him yesterday
he is playful
he is on 100% oxygen to help keep up his levels
he is off some of his drips like the epi drip
he is slowly getting there

here is his gofundme account
#thatcher strong

the organicgreen doctor