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

Wednesday, June 20, 2018

i cant sleep either

I CANT SLEEP EITHER
i have been known for my ability to fall asleep easily on folks as i have demonstrated quite well over the years
it hasnt gotten worse over the years but it hasnt gotten better either

one of the benefits of retirement is that you can program in a nap every day
usually what i do is lay down after my lunch
i usually watch the news floating across several news channels even some i dont agree with to get a feel of what the news is and how its being received
i also have a couple of sport shows that i watch if they are on at the start of my nap or after the nap is over

this picture above is from our camping trip this weekend
as demonstrated by this true actual not set up picture i can nap in midday quite easily despite all the activity around me

except for this week
i am now on my third day of not getting my afternoon nap
a rarity
never happens event

why cant i nap
well
you know if youve watched the news
its about all those kids that are being snatched away from their moms and put in those internment camps
yes internment camps
in south texas and elsewhere

it seems very few folks agree with this being done

now thats without even seeing or hearing those younger kids those babies and toddlers that are being snatched away
they wont let anyone see those kiddos
if they do
that will be the tip of the iceberg
the uproar will only get worse if that happens

i listened to those tapes and saw those crying kids looking up at their moms being handcuffed
its hard to look at and hard to listen
i will admit that i cried when i heard those tapes

its just uncivilized

i hope joining me on this insomniac journey are

mr trump
mr pence
dhs secretary nielsen
sarah huckabee sanders who looks like she will cry when she talks about it
i think the mother in her makes this hurt inside
chief of staff john kelly
any congressman who supports this cruel and inhumane treatment
any of you who support this treatment
this internment of these kids

i must say if those above are so heartless that it doesnt bother them
they dont deserve to be our leaders

the organicgreen doctor

Tuesday, June 19, 2018

love those avos

LOVE THOSE AVOS
this is one of six avocados that come in a package we usually buy each week at the grocery store
if we are lucky they are all at the different stages of ripening from slightly squishy to hard as a rock then you can have a just ripe avo every day
but
it usually doesnt work that way
they are usually all the same firmness so you do tricks to speed up or slow down the ripening which doesnt always work well
like
leaving it on the counter or putting it in a paper bag which speeds the ripening process up a lot or putting it in the refrigerator which seems to slow the process down a lot
if you are lucky and get things right you can almost get a good ripe one a day
if you dont guess right you can end up with several mushy dont taste right avos

we like to go to the farmers market here on saturday to pick out our avos
they some of the farmers have them lined up by their squishiness
from hard as a rock to soft to softer you better eat it today

heck they even have an avocado festival here each year since this area grows a lot of avocados
they have examples of all the avos
some are real tiny others are big as a football
they have avo margarita avo ice cream fried avo you name it they do it to the avos

also
if you are lucky to know someone with an avo tree then you can get real off the tree fresh ones
now those are the best

now avos like eggs got a bad rap for a long time but now they have determined like eggs that they are good for you since they have the good type of fat
avos have become the hipster food or the millennial food
well
im not either of those but i sure like avos a lot
i always feel like when i eat an avo that im helping my brain heal itsefl

why am i writing about avos this am
well
this company with some funding from the bill gates foundation has concocted a powder that you can spray on an avocado that inhibits the ripening
so
you can buy several and they ripen real slow
if you cut into the avo then the process speeds up since the ripening gas get released

this is a big thing for avo growers and those who ship and store them for sale
this stuff is made from plant materials that sounds like its left over from different fruits and veggies and grass no not the pot kind
it appears to be a nontoxic way to delay ripening
although they dont say it it sounds like its all organic

they also are developing ones that can be used on different veggies and fruit that wont be toxic like whats used now

these avos will appear first at costco and harps

someone it seems has been thinking outside the box

i personally would like to thank them
since
i love avos

avocado toast anyone

the organicgreen doctor

Monday, June 18, 2018

kids come first

KIDS COME FIRST
Image result for american flag with a kid on it
bbcamerica,com

i am sure if she was still alive she would agree with her daughter in law
yes
barbara would probably say it was cruel and immoral treatment

there are 4 living ex first ladies or first ladies

ms bush 2 says its immoral and cruel
the present first lady doesnt like separating those kids from their mothers
you can see some folks who are suppose to be agreeing with whats going on
well you can see them squirm and hem and haw
you know they are uncomfortable with whats going on
you see they are mothers who have held their babies and their kids
they know how that mothers bond that mothers instinct how strong it is
they know its not right

this folks
it transcends religion race politics
you can see religious leaders some already outspeaking against separating the moms and kids
they know for those who are religious be they protestant catholic hindu muslim
they know its not right

i think back of all the refuge pictures from that mass exodus from the middle east to the european countries i dont remember ever seeing or hearing of any country separating women and children
they know its just immoral to do that

we in our country have done some immoral and cruel things
slaughtering hundreds of american indians
murdering and killing blacks across the south
putting japanese in interment camps
stealing their land and property
thats immoral and cruel

this it seems is another layer of cruel and immoral

have you ever been in texas in the hot summer
even with air conditioning its uncomfortable
now put yourself in a hot tent city in southern texas
thats almost cruel treatment there

i must say i agree with those two first ladies
and im sure the other two living ones agree also
that this isnt right
its immoral whats being done

quit pointing fingers
just
stop it
do whats right for our civilized country

may god have mercy on your soul if you dont

the organicgreen doctor

Friday, June 15, 2018

alzheimers news-3 more and what it is

ALZHEIMERS NEWS-3 MORE AND WHAT IT IS
Image result for organicgreendoctor
yesterday at the ucla infusion center i received my 17th infusion in the biogen aducanumab study of either a placebo or the drug aducanumab
aducanumab is an antibody against the bad beta amyloid that is thought to be the cause of alzheimers dieseae
the aducanumab is the most promising drug thats being investigated now to eventually make to the market if it shows promise in slowing down or stopping the disease

yesterday i had a bad headache when i got home which for me is a good sign since thats a major side effect of his drug
if my headache which is still present this morning despite acetaminophen is from my infusion then that would mean i am getting the real drug which is a real good thing
as i discussed with the research director and nurse yesterday if i have side effects thats a good thing
folks like me who have the apoe4 gene are much more likely to have this headache side effect

in fact if i am getting this real drug the dose will be a lower dose to prevent worsening headaches which is caused by microbleeds where the bad beta amyloid plaques are being removed by the drug

a little micobleed i can handle
like i told them
the option for me and others well there really isnt one right now
a little headache and microbleed we will accept

dont worry they do regular mris of the brain to make sure this hasnt happened
in fact i have one in 10 days back at ucla

the only problem is if i were to have a microbleed which means im getting the drug then im out of the study
a bad thing that would be

starting in october all of those 1200 plus folks in the study who want to can continue for another 2 years receiving all of us the real drug and not the placebo with the possibility of getting it even longer if its promising in its effect against this awful disease

so if its approved for use i and we may if we didnt get the placebo get 4+ years of this drug before it reaches the market

for me eg it would have slowed down the disease for me so i would have more cognitive presence here on this earth

thats why i and the others have gone on this journey in hopes of getting some treatment not available elsewhere

otherwise it just taking meds like aricept (donepezil) and its cousins and living a healthy life and taking some recommended supplements
those are your options

its well worth the effort being in this study if it works
if it doesnt work then we have solved whether this approach works or not and science can move in another direction

this week the nih thats the national institute of health published this youtube video on
HOW ALZHEIMERS CHANGES THE BRAIN

if you have it or if you have a loved one who has it or if you are worried you have it
then
watch this video below to see what happens inside the brain



the organicgreen doctor

Tuesday, June 12, 2018

what to do with this stuff

WHAT TO DO WITH THIS STUFF
Image result for glob of plastic in the ocean
huffingtonpost

archaeologists and historians love trash
even the american indians had trash piles where they put everything trash in them so you could dig through them years later to learn something about that american indian tribe

so it was with farmers ranchers old western towns old factory towns

i remember when we grew up we always had a burning barrel where we burned everything then what was left got dumped in a heap usually away from the house
during that time when you went to the store you got this paper bag to put stuff in and you used it for other things when you unpacked the groceries
that was before plastic and plastic bags

did you know when you drive from the most eastern border of texas to the california coast that when you get halfway there you are only in amarillo on the western border of texas
well
theres a plastic accumulation in the ocean the size of texas
folks if you have ever made that drive in the hot summer with no air conditioner you have a pretty good idea how big and huge that amount of plastic is

i saw where this soda straw made of plastic was stuck in one of those big ole sea turtles
it took folks a long time to get i removed
what a blood mess that was
have you ever stuck accidentally of course one of those up your nose
it hurts bad and it bleeds alot

now we my wife she and i have been good recyclablers for a long time
for awhile at the country n we were able to recycle all plastic including plastic bags at our local
do it yourself recycle place
then
we were told to stop

the only trash we had after aggressively recycling was that plastic stuff that if put in the trash and if it goes to the landfill its always there for the archaeologist to find
tons and tons and tons
then
some well alot of it gets into the ocean where it either washes ashore or seems to get all joined together somewhere somehow in the gigantic texas size glob of stuff that is there for ever for all to see

i always wonder if one day some country as that glob gets bigger and bigger and thicker and thickker
if they can claim it as their territory
i can see china doing that maybe even using it to land planes on
heck as big as that glob is they could start a new country new plasticonia

i just went into our kitchen and looked in our trash
we have two
trash and the other recycling

now we save all our garbage stuff to either feed the chickens at the gardens or i feed it to my worms in my 8 5gallon worm buckets in my garden or i dump it in the compost
since we rarely eat meat there is rarely any meat stuff

i dug down into my recyclable bag
there is cardboard newspapers magazines mail all kinds of recyclable plastic stuff and some glass occasionally but not often
we do manage to fill it up fairly regularly

then
i dug down into the trash bag
theres cleaning disposal rags in there and an awful lot of plastic things like ziplock bags veggie plastic bags wraps for cheeses and other veggies and grain bags and bags the beans and rice and things like that come in plastic that comes on boxes you see through and the list goes on and on
most of our trash is plastic

im hoping it all doesnt go into the ocean somewhere that it all goes into some landfill that im sure will one day be this big blob of plastic stuff that takes over the landfill
never to go away

i wonder if one day there will be so many of these blobs of plastic that the world will be thrown off its axis and just whorl out into space like those old spin tops use to do when we played with them as a kid

i feel like we are doing our part my wife she and i to cut out the plastic trash that we produce but its hard really hard not to generate a lot of it
i rarely if ever use the veggie bags for our veggies as i commonly just put them loosely in my shopping cart

im sorry but ive said all this and i didnt offer a solution
im sorry but i dont have one
all we can do is do our part
to find a way to limit this stuff in our trash

we take care of our little world our little space
thats all we can do
while hoping yall do the same

this article on suggestions is helpful

the organicgreen doctor

Monday, June 11, 2018

why tony why

WHY TONY WHY
Image result for anthony bourdain
cnn.com

i let him into my world my dvr world a few years ago especially when he started his new show on cnn about parts unknown
i dvr a few shows that i and some my wife she like to watch like sporting events man i hate to watch commercials and tv specials and the voice and americas got talent and some hbo shows and gardening shows and the nightly pbs news show amongst other shows we like to watch
but
his shows i dvred all of them since i didnt want to miss them

he was special

his shows were about more than just food
it was about life
he could grab and he seemed to grasp the essence of where he was visiting

he seemed restless but in a calm way as he gave us a lesson on where he was at
like a special docent with a unique view

three of his shows that he did that we saw seem to stick in my mind

one was the one he did on west virginia
he seemed to get those people
now im sure he didnt like trump but he was in the middle of trump country there in west virginia with all its economic problems and drug problems
the latter he seemed to understand the most since he fought those demons a lot the drug demons

he seemed to fit in and seemed to understand those guys eating stuff that for me was well what i ate a lot when i was growing up
yes ive eaten fried squirrel and squirrel dumplings before
he did to
loved it he did

after you watched the show at least for me i thought i understood them

another show was the one on viet nam
a place that almost destroyed our country in the 60s and 70s
a country at war for 100s of years that finally is able to be at peace with no war going on
it was like listening to a history lesson and food lesson and social lesson of viet nam

then the one show that maybe all of us should watch
it was on the area in massachusetts where he grew up
the place where his demons that followed him everyday of his life got their origin
and grew and took him over like a cancer that was kept at bay but not completely defeated
obviously his demons like that cancer took him over and won

there where he grew up they are fighting the fight that so many places in the us are fighting
drugs especially heroin that has destroyed and is destroying so many lives so many families

is there an answer to this problem
i dont know
its a social one a financial one with a lot of folks to blame
congress big pharma the medical community our social system our families us
there may not be an answer or a cure for this problem
but
we like he did have to control it
like the cancer kept at bay
we need to try to keep it from winning
keep it under control

we like tony have to try
as long as we can

he tried
he touched so many folks all over the world
he seemed to transcend race religion politics
he seemed to understand

he was a special person
he had so much more to give
maybe
he gave his all and could give us no more

he is missed

the organicgreen doctor

Friday, June 8, 2018

sb country n news-garden news

SB COUNTRY N NEWS-GARDEN NEWS
this sign above well its my approach to
how i like to live

it says

in the spring
at the end of the day
you should smell like dirt

thats my goal at the end of the day is to look down at my fingernails and see this rim of dirt running from my left to my right cuticles

why
just the other day miss b said to me after coming to see me at the garden whew whats that smell so i said
its the smell of spring
its my new perfume
the essence of fish emulsion and seaweed and molasses

when i smell like this and see those dirty fingernails and see my garden dirt stained shorts and shirt then i know im on the right path
doing whats right in this world
doing what i enjoy

somedays i wonder what those old farmers use to do
did they have permanent stained fingernails like a mechanic would
did they ever wash their work clothes
i could easily wear the same ones day after day seeing those dirt stains and smelling that garden perfume
have you ever smelled the essence of tomato leaf and basil together
it really should be sold in those little bottles like peppermint oil or rosemary oil
maybe do a essence of farmers

so when my wife she sent me that picture off a building near san francisco i knew that i was having a good spring here
i just took a deep breath smelling my garden my hands my clothes

yep
life is good

the organicgreen doctor

Thursday, June 7, 2018

alzheimers news-do you have any of these

ALZHEIMERS NEWS-DO YOU HAVE ANY OF THESE
Image result for organicgreendoctor
almost eight years ago when i was told i had some short term memory issues i went to the alzheimers associations website to look up the 10 signs and symptoms of early alzheimers

here is the link to the alzheimers associations discussion of them

below
well these are my thoughts on the subject

memory loss that disrupts your life
forgetting dates and events and having to rely more and more on reminders like sticky notes everywhere or phone reminders

its ok to occasionally forget names or appointments

i must say ive not had any of these issues except i am known for not remembering names

challenge in planning or solving problems
you may have problems following a recipe or paying bills

its ok if you occasionally make errors in checkbook

i must say i dont have this problem
well i must say my wife she has this problem but dont worry its a life long problem she has

difficulty completing familiar tasks
you may have trouble doing some daily tasks or things like driving to a familiar place or doing a budget or remembering the rules of a game

its ok if you have trouble like with recording a tv show or doing settings on your microwave

i must say i have no problem dvring my favorite shows
well i must say i have trouble dvring shows when my wfe she says would you dvr that show ive been wanting to watch

confusion with time or place
you may lose track of days dates or where you are or how you got there

its ok to not remember the date or day of the week but you figure it out later

i must say that since i retired and especially since i moved here i have lost track of what the date is
in fact on my memory tests they ask and i commonly dont remember the date
now i always remember the day of the week
thank goodness for that

trouble with visual images and spatial relationships
you may have trouble reading or judging distances or trouble with colors and their contrasts
this especially affects driving

some think this is the first thing folks have show up is this spacial issue

its ok to have visual problems due to cataracts

i must say i think i have some of the spacial issues such that i am much more cautious when i drive
ive noticed the traffic lights are set differently here and the pedestrians and bikers seem to come out of nowhere sometimes

problems with words and speaking and writing
you may have problems following a conversation or starting one or you may lose your train of thought in the middle of a sentence or repeat yourself or use the wrong word for something

its ok to occasionally have trouble finding the right word

i must say i sometimes lose myself in the middle of a conversation or cant find the right word for something
thank goodness like a twin my wife she will pitch in to help but this doesnt happen to me that often

misplace things or cant retrace your steps
you put things in strange places or you lose something and you cant replace your steps
this may become worse over time

its ok to lose things but usually you can retrace your steps

i must say this is a rarity for me but i did lose my billfold once and found it wedged weeks later under my duct tape chair

well i must say my wife she has this problem with her keys and her cellphone
honey would you call me i cant find my phone
should i be worrying about her instead of her worrying about me

decreased or poor judgement
you make poor judgement or you give large amounts to telemarketers or you make strange large purchases

its ok to occasionally make a bad decision

i must say i dont really have this issue
well i must say if i could keep my wife she away from thrift stores and garage sales and estate sales ...

withdrawal from work or social activities
you may avoid social activities or hobbies or have trouble following your favorite sports teams

its ok if you get tired of work or family or social activties

i must say i know whats going on with all my favorite sports teams
maybe too much
i dont seem to be withdrawing too much from social activities and i enjoy my hobbies just as good as ever
well i must say my wife she is a much more social person than i but thats not new

finally

changes in mood or personality
you know this well if youve ever had a loved one with alzheimers disease
in fact this one for some families bothers them the most
you can get paranoid suspicious anxious depressed angry even violent

its ok to get a little irritable if things are done different than how you like to do them

i must say
ok ok i know im guilty of this one
well for a long time
well i  must say my wife she isnt that guilty of this one
ok honey youre right she says
just ticks me off when she says that
no im not displaying anger here

so if you are worried like all of us are that we are getting alzheimers disease or a loved one is getting this awful disease just look at this list real good

if there is an issue
get help early since its been found that folks who get help early on do much better over time

the organicgreen doctor

Wednesday, June 6, 2018

infrastructure being ignored will catch up with us eventually

INFRASTRUCTURE BEING IGNORED
WILL CATCH UP WITH US
EVENTUALLY


thefiscaltimes.com

we hear it every 4 years
it receives a lot of attention as all those
politicians try to get elected
then
silence after the election

our infrastructure for our roads and
bridges are falling apart

if we dont get them maintained and
repaired we will deal with it only with
crisis intervention
which means it will cost more and wont
be done right or may not even need to be
fixed

here in california they raised what i call
an infrastructure tax
it was levied on each gallon of gas
it is 12 cents a gallon for repair and
improving infrastructure

when i go to the gas station to buy gas
which since ive moved here isnt but
about once a month
it seems when you look at the price
its more like the bump you see
sometimes around a major holiday or
when the gas supply gets limited for
some reason

i sort of notice it but it doesnt bother
me since i know i and us here will
benefit from what the money is being
taxed for

we cant ignore this infrastructure thing
too long
if we do itll cost us a lot more

this infrastructure thing got more personal
recently
our condo complex was found to have a
gas leak
off goes the gas to everyone
nope it cant come back on until all the
lines are replaced
thes lines leaked off and on for several
years getting replaced as they broke
in a method thats called crisis intervention
yes
youre right
it will cost a lot more now that it has to
be done
and
a lot of inconvenience
and
more than two months

think cold showers no gas dryers cold
swimming pool no gas heaters no gas
cooking
i must say a nice cold shower is
invigorating
its better than a bold cup of kava

what if this had all been fixed or repaired
when it was recognized it was a problem
we wouldnt be as inconvenienced or have
a bigger hole in our pocket books

dont worry we are able to put in a
temporary electric water heater while they
are doing the gas lines

so soon it will be all good
then
theres the old sewer lines and the old
water lines then the old electric lines then
the old phone lines then the old cable lines
so
you can see where this is going

like in our condo
our infrastructure across the us is
crumpling
its in need of repair

it has to be taken care
it will take a tax to pay for it
theres no other way
it seems a gas tax is the best way to
do it
with the caveat that the gas tax
can only be used for the infrastructure
and not anything else
ever

the organicgreen doctor

Monday, June 4, 2018

why do they leave us so young

WHY DO THEY LEAVE US SO YOUNG

so why are more young folks dying in the
last few years than in the past
there was this trend downwards in young
folks dying from 2000 to 2014
then
the trend started going upwards
while
the trend for everyone else has continued
a slow descent

there has been this rise in accidental deaths
suicides and homicides amongst young
folks

why

they dont know
for sure

they are dying from
traffic deaths
drug overdoses
homicides
suicides

suicides dropped during the few years
before 2016
then increased 56% in 2016

homicides dropped also but increased
26% in 2016

guns accounted for 87% of homicides
and 43 % of the suicides

so why are they dying at a higher rate

here is what i think
Samsung Galaxy Express Prime 2 - AT&T PREPAID - Black - Mobile Phone

Image result for drugs

Image result for guns
we as a society have to address these
causes
or
we will continue to lose our kids forever
at a continuing increased rate

click here to read the article on this

the organicgreen doctor

Friday, June 1, 2018

alzheimers news-right to try

ALZHEIMERS NEWS-RIGHT TO TRY
Image result for organicgreendoctor
there is not much i agree with trump on
but this one i do
its the right to try legislation that basicallly
lets folks who have run out of options take
drugs that are in phase 1 trials

now phase 1 is the first start to a process
that can take up to 10 or more years before
the drug gets approved and out to the public

eg
my drug aducanumab in its phase 1 study
did fairly well
it removed the measurable amyloid on
pet scans and showed some improvement
in memory for folks who got the
real drug

under this law one could access this drug
now to get treated for this incurable diseease

an advanced cancer might be a better
example though
weve all read about terminal cancer patients
trying to get access to a new drug still in
research

what do they have to lose
right

now alzheimers disease might not be the best
example since when you are in the terminal
stage its too late since so much damage has
been done that the brain cant be fixed

if you were early in the disease process like i
am then you might benefit from these
experimental drugs since the earlier the disease
is treated the more likely it can be slowed
or one day treated

so looking at all the stuff in research for
stopping alzheimers thats in phase 1 2 or 3
my drug aducanumab would be the one i
would choose
it seems it might help slow things down

now
in about 3 months i will definitely get the
real drug so i wouldnt do anything different
than im doing now

but lets say it was 2010 when i was diagnosed
via positive pet scans and positive spinal fluid
and positive genetic tests and positive memory
tests
well in 2010 if this drug was available and this
law was the law i could apply to get this drug
under the right to try law

i wouldnt hesitate one iota to do it

this warning though for folks
you will really have to do your homework on
the right to try drug to be sure you are not
getting some rip off drug or some drug that
is more toxic than your disease

nope i woulnt blink an eye since doing
nothing has only one outcome
its not a good one

i looked at all the stuff im taking now to slow
down this disease and i have noticed that
almost every prescription pill im taking
and every supplement im taking is not
approved by the fda for treating alzheimers
disease

why then am i doing it
well
the options are
well
theres not any

most if not all the things i take are based
some on scientific research some which
is done on animals

heres my list

aricept  (donepezil) is approved for use in
folks with alzheimers but not my diagnosis
mild cognitive impariment
the fda says i shouldnt be on this stuff
yet
new and old research suggests that starting
aricept (donepezil) early may and very
likely helps to prevent the deposition of
amyloid in the brain so starting it early
may be important in slowing down the
disease and not just the symptoms

irbesartan i take for high blood pressure
its also in a class of drugs that may slow
down the disease
again not fda approved for this

atorvastatin thats lipitor for cholesterol
control
again in studies lowering your cholesterol
may slow down the development of
alzheimers
not fda approved

folic acid and vitamin b12 for a high
level of homocysteine which is associated
with a increased risk for alzheimers as
well as heart attack and stroke
not proven not fda approved

omega 3 ditto
vitamin a ditto
curcumin or turmeric acid ditto
coconut oil ditto
probiotics ditto
co q 10 ditto
vit b 100 with all the b vitamins again ditto
bacopa ditto
melatonin to improve sleep ditto
aspirin ditto
and others

so you can see there is this level that most
of these are at that they are not definitely
proven to slow down or prevent alzheimers
but there is trending evidence that they
do or might work against this awful
fatal disease

if i wait for fda approval it may not ever
happen
so i have the right to try them if i want
to but i am careful to read and be sure
that none of these are snake oil type
drugs

if they work then im glad i did take all of
them
if they dont work then what have i lost
just a few bucks each month

if you decide to do the  right to try thing
make sure you know a lot about the drug
and what good researchers think it may
do

ive read a lot of stuff about drugs that
are definitely snake oil worthy

i try
i have the right to
as of now
theres not much else to do

the organicgreen doctor