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

Tuesday, April 30, 2013

alzheimers symposium

welcome to my blog for those of you who were at the
alzheimers symposium today at temple texas

below you will find

-the video that was shown on my story

-all my slides from the presentation

-a list of self administered tests that you can can do on yourself
or on a loved one or relative
these are screening tests for memory loss
remember the gold standard test is the neuropsychological exam

-next there is a  link to an article about whether or
not to start medicine in alzheimers patients

if you have a question feel free to go to the comment section below and
post the question
i will then answer the question for you and others to read

thank you
the organicgreen doctor

here is a link to 5 self administered tests for memory loss
the sage test is one of the better ones

here is a link to the 21 question alzheimers questonnaire test

here is the link to the article on whether you or a family member should take
medication if diagnosed with alzheimers
do alzheimers medications work, who should take them

feel free to leave a question in the comment section below and i will be glad
to answer it for you and others to read

the organicgreen doctor

Monday, April 29, 2013

old willie, scans


old willie will be 80 years old today 
according to him 
but according to states records its april 30
of course
i think he should change his birthday to 

if you dont understand why 4/20 and what it means
just ask you kids or your grandkids
my guess is they know what that means

willie played last night at the backyard in the austin area
im quite sure it was packed
and there probably was a strange odor in the air
and im sure austin kept the concert weird

i do admit when i see willie he looks 80 years old
all that rough living hes done
well he actually looks 100 years old
he still has that distinctive voice
and his old guitar

ive seen him play live twice
once in little rock at a concert at barton coliseum
a lot of drunk people
but it was interesting that the people in the crowd were
a mixture of all ages and sizes and looks
obvious red neck country people with dressed up city folks
with a lot of hippie looking people
all enjoying his music
thanks to my medical school friend for introducing us to
willie and his music
ive been hooked since

we took my motherinlaw to a fourth of july picnic in 
ft worth texas
it was hotter n hell
the place was packed all day as tons of other musicians played
then willie showed up when it was cooler in the evening
and everyone didnt seem to mind the wait
yes a lot were drunk and 4/20ed

my motherinlaw endured that hot sun and long day 
but it was worth it 
she sure loves willie

when willie finally leaves us one day which i hope is 
a long time away
there will never ever be another one 

happy birthday today or tomorrow willie
may you have many more

friday i went to dallas and had 
a mri scan of the brain as part of the adni study that im in 
typical mri scan 
louder than hell 
be still for over an hour
stuck up in that cylinder 
keep your eyes open for the next 7 minutes
you ever tried that before without blinking
sorry i blinked couldnt help
why dont you try it and see if you can do it

looked at my old mri scan report
and oops there were some white matter hyperintensities (wmh)
areas on my scan
had forgot about those
since the scan more has been written about these
they are found commonly in elderly patients 
but im not elderly
if you have an increased number of these they can be associated with 
an increased risk for developing dementia alzheimers and stroke 
are found in patients with high blood pressure obesity diabetics high cholesterol

this is why its important to keep these things under good tight control 
over a life time

i only have one or two which are not significant
hopefully all im doing to control things with my health 
living right eating right exercising controlling my cholesterol and blood pressure
and maintaining a normal weight will keep those wmh where they are now

then i had a glucose metabolism pet scan of the brain 
got an iv infusion of labelled glucose 
when i got home that night my wife she said you sure taste sweet 
when she kissed me

in alzheimers patients since they cant use the glucose in the damaged 
brain cells there is no uptake of the labelled glucose
and it will show up as blank areas on the scan 

my last glucose metabolism pet scan of brain was normal

spinal tap for beta amyloid and tau protein
amyvid pet scan of the brain for beta amyloid

the organicgreen doctor

Friday, April 26, 2013

alzheimers symposium part 4

please note the date was inadvertantly posted incorrectly last week
i will present a talk on my story with possible alzheimers
at the alzheimers symposium at the mayborn center in temple texas
on tuesday april 30, 2013

here is the the link to register for the event

part 4
the alzheimers graph

now that ive gone over the tests that are done in the adni study
and gone over my history lets look at the alzheimers graph

this graph was produced by dr schaefer a well known 
alzheimers researcher speaker and writer who does an 
excellent job of doing all of them 

it shows when beta amyloid accumulation starts and progresses
when tau protein destruction starts
when the brain structure changes starts-mri scan
when memory loss starts
when the loss of clinical function starts

this is a graph of a typical alzheimers patient although
those of us who have family members with the disease or who have
treated patients with the disease know that there is no such thing as 
a typical alzheimers patient

this typical patients graph after looking back now i realize that my 
mother followed this path and knowing what i know now
i appear to be following this same path

my younger brother however was diagnosed earlier and his stuff
all started 20-25 years before my mothers and mine and this 
typical alzheimers patients graph

look at the bottom scale that goes from birth to 100
then look at the symptomatic area that red streak that seems
to start as faint in the early 50s then darkens as time progresses

now follow up the graph from the early 50s to the amyloid line
you can see that in the early 50s there is already a significant
amount of beta amyloid present

now go to the early 40s and go straight up to the amyloid line
you can see that appears to be when the beta amyloid level is
normal then starts to be abnormal
the disease process has already started

now go back to the 50s line
my mother was in the prime of her career as a  nurse
she was offered  a chance to go to college to get her 
bachelors degree in nursing

i was in my early 50s in the prime of my career working at 
kings daughters clinic in temple and belton then transferred to 
austin regional clinic in austin and cedar park

at that age the beta amyloid would be significantly elevated
on both of us
there would be the beginning of the tau protein destruction 

then move to the 65 y/o line  and go up 
this is when most people retire and draw social security and 
my mother retired at this age 
i worked with her at the hospital as i was fulfilling a 3 year 
federal obligation to that area
she did not have a memory problem 
if you follow up to the amyloid line you can see that even 
more amyloid accumulation had occurred as well as a significant 
amount of tau protein destruction 

she may have had some memory issues noticable to herself
but not to others

then move forward on the graph 10 years
things would have gotten worse
there is a lot of beta amyloid accumulation plaques tau destruction
inflammation tangles and oxidation 
the disease had progessed signficantly
her scans showed atrophy
her memory was getting worse and her clinical function had worsened
the disease was marching on 
then worsened even more over the next several years

now go back and look at 58 y/o when i applied for my long term care
insurance and passed the evaluation without problems
the amount of beta amyloid and tau destruction was significantly 
but there were not memory issues

then at 60+ i notice memory issues my mri scan is normal but 
my beta amyloid and tau levels are abnormal

by brother was diagnosed in his early 50s 
since his disease occurred 20+ years earlier than this graph that
my mother followed and that i seem to be following

look at the 30 y/o line which is like our 50 y/o line
he was halfway through his career as a fireman
but he would have already been accumulating beta amyloid and having
tau destructioin going on 

then at 40 y/o when he retired as a fireman and started the 
fire academy as their top cadet
he would have accumulated even more beta amyloid and tau
there were no memory issues yet

then at 50+ y/o when he was diagnosed the levels were even higher
the mri would be abnormal 
there was memory issues noticeable to himself and others
since then things have deteriorated 

so what if we could do something to modify this accumulation of 
this beta amyloid and then the tau production at the early years
30s for him and 40s for me

what if something could be done to grab that beta amyloid and 
remove it or prevent it from accumulating
what if something could be done to keep it from being produced

that time may be now
there are three studies starting up this spring

the first is the colombian family study where there is a family 
of 5000 people in an isolated area of colombia that have a 
lot of members who have the gene for alzheimers
if they have the gene they get the disease in the early 40s

now they are taking some of the members who carry the gene
who do not have any symptoms yet
who are in their 30s and will be doing the same tests that 
we are having done in the adni study
neuropsych test blood profile mri scan spinal taps for beta
amyloid and tau pet scan for glucose metabolism and pet scan 
for beta amyloid 
these will be done every year for 5 years
they will be given an alzheimers vaccine where antibodies will 
bind to the beta amyloid and remove it from the brain and prevent
it from accumulating
if this beta amyloid theory is correct and this vaccine works
then these family members who are destined to get alzheimers
wont get it or will have a milder form of the disease

this vaccine was given previously to patients who were more advanced
in their disease and it didnt work
the thinking was it was given too late in the disease when so much 
brain cell destruction had occurred
its like taking some one who has had a massive heart attack and saying
lets control their blood pressure cholesterol diabetes weight and exercise
but it doesnt help because so much damage was done 
it should have been started 20-30 years earlier

so it may be with this vaccine

then there is the a4 study
a 1000 people who are 70+ y/o who have a positive beta amyloid scan 
or amyvid pet scan but who have no symptoms
they will be given an alzheimers vaccine and followed for 3 years

we may have our answer soon if the vaccines work
if removing this beta amyloid works

then there is the bexarotine study
bexarotine is an anticancer drug thats given to patients who have a 
certain type of skin cancer
its fda approved for this and is now commercially available
its due to go generic in 2 years

bexarotene was given to rats who are genetically programmed to get
alzheimers disease
it shuts down the production of beta amyloid 
the rats did not get alzheimers

now they are starting a study in humans who have beta amyloid 
accumulation to see if it will stop the production and accumulation 
in the brain 

so now we may have if they work two ways to slow the disease
down early on in the process
the vaccine removes the beta amyloid and the bexarotene slows 
the production of the beta amyloid

now go back to the alzheimers graph and see the blue modifying line
and the green preventative line

what if there was something we you and i could do now to help
to maybe slow down or even prevent this disease

well it appears there may be

its the same things that ive been telling patients for years
and what your doctors have been probably telling you

control you wieight blood pressure cholesterol and diabetes
remember those white matter hyperintensities (wmh) that show up 
on mri scans
they are associated with patients who have these four things
and patients with several of these wmhs in their brain 
have an increased chance of developing dementia or 
alzheimers disease and having strokes

in a recent study in patients who have the apoe4 gene like i 
have they found that there was an increase in beta amyloid 
in patients with apoe4 and uncontrolled blood pressure the 
rate of beta amyloid production was even greater
if the blood pressure was controlled the rate when down 

diabetics have a 5 times increased risk of developing alzheimers

control depression and anxiety

you dont have to join a gym 
walk 30 minutes 5 days a week

eat a mediterranean diet
its not complicated
olive oil vegetables fruits nuts lean meats fish milk products
its all about moderation

get adequate sleep
if you have sleep apnea get it treated

limit alcohol use

no smoking

avoid a stressful life

be happy

listen to music

so these are things you can do now to slow down or maybe
prevent this disease

as more and more people are diagnosed with this disease as more
people get these tests mentioned above we as a society and a 
medical community will need to decide what to do with them
economically socially psychologically and medically 

hopefully a cure or treatment will become available if not for 
my generation maybe for future generations

the organicgreen doctor

Thursday, April 25, 2013

doing it again

tomorrow will be round 2 of 3 rounds of testing that
i have for the alzheimers disease neuroimaging initiative
i have to travel to dallas to have two more tests done
and of course i get to stop at the czech stop and bakery in
that town that most americans now know where its located
for the wrong reason
the explosion that killed all those people and injured over a
hundred people

i wont get my kolache tomorrow morning as i have to be fasting for
one of my tests
on the way back home to the country n ill be able to stop
and get an afternoon snack of that blueberry cream cheese
so it wont be too bad and the trip will be worth it then

the first test i have done is the mri scan of the brain
in the study they are interested in the underneath surface
of the brain where memory is located as thats where
alzheimers disease starts at before it takes off to the
rest of the brain later on in the disease process

they can measure the volume of this area to pick up
subtle changes that can occur earlier on in the disease

it is a potential test for detecting early changes and possibly
helping early diagnosis in the future
an abnormal neuropsych test with normal labs and
an abnormal mri scan of that underneath surface of the brain
may be an accurate and cheaper way to diagnosis
alzheimers disease than using the spinal tap and the amyvid
beta amyloid pet scan

i get to get in that cylinder and with ear plugs listen to that whirling
noise that sounds like a freight train for a long time
then they put a red dot on my temple and do a special scan
where i have to keep my eyes open for 7 minutes
i cant help it i have to blink
this is where they are taking special views of that underneath part
of the brain
where they will measure the volume of this area

then the next test
the reason i cant have my morning west kolache
is called the glucose metabolism pet scan of the brain
i have to have a normal blood sugar for them to run the test
so i get a finger stick blood sugar
ouch those things always hurt more than an arm blood draw
if its ok then
they start an iv and infuse a radioactive labeled glucose that will go
to the brain and wherever the brain cells are using glucose
it will show up as reddened hot areas
if there are areas of alzheimers disease
where beta amyloid has accumulated tau protein destruction has occurred
plaques have formed and inflammation and oxidation has occurred then
the damaged brain cells and nerve cells cant utilize the glucose and
the scan will not show glucose uptake

here is an example of a normal brain on the left and a mild alzheimers
brain on the right
on the scan on the right see the areas on the sides where there is not
reddened areas
thats where there is alzheimers disease and none of the glucose
is being absorbed there

hope both my scans are normal
which very early in the disease process like mine they both may be normal

next thursday
the spinal tap for beta amyloid
followed by the beta amyloid pet scan of the brain the amyvid pet scan
then i get a break for a year

the organicgreen doctor

Wednesday, April 24, 2013


i dont mean hello in spanish
but this old method of delivering water in drought or
water conserving areas
has been around a long time

this is a picture of one thats been around for a long time
you bury it in the ground and fill it with water
the water slowly diffuses itself into the surrounding soil
then you plant your plants close by
and they send their roots to the area around the pot
theres no loss of water to evaporation or runoff

then here are homemade versions of the same idea
clay pots glued together
the bottom hole is sealed off
the top upside down pot is filled with water
then you let time go by and the water will move
through the porous clay pot into the soil

i havent personally done this yet in my garden
but i can definitely see it in my future

since we now seem to be in a drought area
and especially when that hot dry summer hits and im
trying to get my tomatoes peppers peas egg plant squash
christmas beans cukes malabar spinach and okra through
the hot dry summer months

ive used a lot of water saving techniques so far that seems
to be helping
i have drip irrigation to all my garden beds that run from my
rainwater tanks by gravity
the tanks are at about a 3 foot elevation up hill from my garden
and i have a good pressure to my drippers

as the weather gets warmer and drier i add a 3-4 inch layer of
some type of mulch usually leaves or pine straw or newspapers
then between the beds i put a thick layer of leaves
to those of you have donated your leaves to my use
this is what i use them for
this 5 inch layer of leaves hold moisture in the soil around my beds
and also works as a water sink to hold a lot of water in the leaves
and mulch themselves
then over time they break down so i just dump them into my garden
beds for additional compost

below you will see pictures of my garden so far
the best ive ever had
below the surface of all those plants are the result of the anthill method
or hugelkulter method
layers of old logs cardboard newspapers leaves that will hold moisture
deep in the soil
over this is layers of rough compost leaves soil compost leaves newspapers etc

i also in my tomato garden buried black pots to ground level
filled them with leaves and compost and every two weeks i fill the pot
with compost water
this supplies not only moisture deep into the soil but also a lot of nutrition
from the liquid compost

in my two keyhole garden beds that i made from old watering tanks
that central composter also works like an olla providing moisture
deep into the soil as well as nutrition from the compost thats
in the center

hopefully all of these things added together will make for a nice
healthy well watered garden this summer
despite the prediction of a hot dry one

i do see ollas showing up though in my garden
probably peaking up between my okra plants

here are some pictures of my garden as it heads towards the
end of spring and is getting ready for that summer marathon
hoping my water conservation techniques and soil enrichment
methods will help this year

wild leeks


hola olla

the organicgreen doctor

Tuesday, April 23, 2013

deja vu

thats what it was like yesterday
deja vu

i walked into that room with the window
the same room for those of you that have seen the video
on my story with alzheimers disease that i am sitting in when
they filmed me doing part of my neuropsychological exam
and there was that window where i looked out of when
that stone faced poker faced examiner read those words to me

she is such a good one as she never breaks down
well i did get her to smile once and granted now that she
knows me she smiles more than once when im being tested

but there was that room
it was it seemed more surreal than before
i guess since ive being working on my presentation and have
thought more about the neuropsychological testing and that
initial one that was done
when i looked out that window
yes i did sweat some
as i realized that the moment arrived when i had developed
some problems with my short term memory

as i wrote yesterday she read me those 10 words from three
different word categories the first time i was tested and
those words just sailed through my brain and went somewhere else

you know like when you talk to your kids and they arent listening
sure mom ill do it
they didnt hear a word you said
you talk to your wife she while she is on her smartphone
she smiles and says sure
so i said
the cat ate the dog and laid 3 red eggs today
really thats good
she didnt hear a word i said

the same yesterday
that poker faced examiner (ok now she is a nice smiley person when
she is out of character)
im going to read you ten words and when i finish i want you to repeat
as many words as you can back to me
i said ok
im ready this time
she gives me a word and i try to associate some of them together
she slowly reads the list to me
i start associating words together
damn where did those first words go to
i learned quickly to repeat back the last words read to me

my score 3 of 10
i know thats not very good
but she does it several times and has me identify the 10 words out of
a list of about 30 words
i wonder if thats cheating
i got a few more
but i realize
no ive not improved in 2 1/2 years but ive not gotten worse

damn that room

then after that test i went to get my beta amyloid pet scan of the brain
the amyvid pet scan
the one that for me may give me the final answer

as i was laying on the table wanting for them to get the iv stuff ready
i was on my smartphone looking at a link my wife she sent me
it was a blog that a doctor in washington dc does about his journey
with a new diagnosis of mild cognitive impairment amnestic type thats
looking like its early alzheimers
story sounds familiar right

he is laying on a bed at georgetown university hospital recieving as part
of a study one of the new alzheimers vaccines that is being tested to see
if it will remove some of the beta amyloid from his brain and maybe
help him

i do feel a tie to him and his situation
it did seem surreal as i laid there about to get that test that will tell
someone somewhere whether i have beta amyloid accumulating in
my brain also
one question that i hope to have an answer to soon
what will i be able to do about it
it may be nothing thats the bad part
nothing may be the answer unless that stuff hes getting iv shows itself
to work and help by removing that beta amyloid from his brain

then after reading his blog and mentally getting ready for the infusion
and hearing that pet scanner whorl around and sound like im
underneath a freight train
im told there was a problem with the stuff i was going to be given iv
it needs to be remixed

so all this waiting gets delayed now for ten more days when i
will get another chance at getting this 2nd amyvid pet scan done

as part of another study im in i had to do smell tests on 30+- odors
to see if i could recognize them
see that ofactory nerve the smeller nerve goes right to the area
underneath the brain where alzheimers disease starts
heck if that will help in someway advance the knowledge ill smell things
all day long i if i need to

next on friday i do an mri scan of the brain
then that will be followed by a glucose metabolism pet scan of the brain

then next week
its spinal tap time for beta amyloid and tau protein then
followed by the amyvid the beta amyloid pet scan of the brain

those are the two final answer tests that i have
they will give me the final answer
do i have it or not

the organicgreen doctor

Monday, April 22, 2013

happy anniversary


today is my anniversary
its the two year one
the two year followup visit to the alzheimers research center
at the university of texas southwestern medical school in dallas
for the alzhiemers disease neuroimaging initiative study
the adni study

i now get to repeat all of the studies that i had done when i
originally started the study
they will be spread over 3 days over the next 10 days
which means i have to drive to dallas three times
the good part is i get to stop at the czech stop bakery 6 times
over that time period
and of course from a distance see the destruction done by the
west fertilizer factory explosion
my thoughts with the people of that town
but they are a tough resilient town that will recover eventually
but will always remember that day

i have the sucky test
the one that of all the ones i have done
the one that i dread the most
the neuropsychological examination
with those 10 words from 3 different word categories that i
despite how much i try i cant seem to remember them all as
they seem to just pass on through my brain to some abyss and
they stay there
there are several other portions that measure short term memory
all of which i have some problems with

although i never get to see a final report
i know after i take it exactly where i am
whether or not ive gotten worse or stayed the same
it seems getting better on these tests
dont seem to be an option

i have in the last 2 1/2 years taken 7 of these 2 1/2 hour exams so
i know whats coming and know that its frustrating not to be able
to get things correct
i call it the torture test
give me the spinal tap anytime
well except that my wife she doesnt faint with the neuropsychology test

then i have a neurology visit to look at my medications and how
im doing
today i will discuss with the neurologist the fact that i have in hand
a xray request for a amyvid pet scan that i will have done in may
here in austin
i feel like that test will tell me as close as possible as to whether i
really have alzheimers disease or not
when you take all of my tests and history and then add the amyvid pet scan
for beta amyloid in the brain
ill feel like ill know
the only 100% way to know for sure is a brain autopsy
which will happen eventually as ive signed the papers to have that done
when i die

then later today i will have the amyvid pet scan
the beta amyloid pet scan of the brain
where they give me an iv with a substance it it that will bind itself
to the beta amyloid in the brain
the hallmark of alzheimers disease

i will not get to see the result of this amyvid pet scan today
but feel like it will be positive

sometimes i think about the ethics of my not getting to know the
results of this test and i know that part of the deal signing up with this
study was that i would not get the results of any of the tests unless
something abnormal was found like a brain tumor or some treatable
disease that i needed to know about

it seems that after being in this study for two years now
reading a lot about alzheimers and giving talks on alzhiemers
that having a positive beta amyloid pet scan and not letting me
know about it is the same as them finding some other disease
like a tumor or mass or normal pressure hydrocephalus or
anuerysm etc

i wouldnt ever get out of the study though as that is what happens
if they have to let you know the results
i am able to duplicate these studies in the private world
at i might add some expense
eg $3000-$6000 for the amyvid pet scan next month
which i will be able to afford to do
its important to my psyche to know the result now
and not to have just my family know for sure after i die
when they do my brain autopsy

tomorrow i will let you know how the day went

the organicgreen doctor

Friday, April 19, 2013

alzheimers symposium part 3

i will present a talk on my story with possible alzheimers
at the alzheimers symposium at the mayborn center in temple texas
on tuesday april 30, 2013

here is the the link to register for the event

part 3
the alzheimers disease neuroimaging initiative

i was on the aricept (donepezil) for three months and was stable
so i was allowed back on the alzheimers disease 
neuroimaging initiative study in the early mild cognitive study group

this study called the adni study is the largest alzheimers study 
and the most important one that has been done so far
its a large multicenter study 
when the data and results are collected and processed the
information is available to researchers all over the world

hundreds of research articles have been published using 
this data

during this study we have multiple tests done
i am not able to see my results of the tests as this is a blind study

here is the list of the tests we have done

the neuropsychological test is done
although i dont get the official results i know when i take the 2+
hour evaluation where i am with my memory loss
i have not changed in the last two+ years

then we have blood work done thats similar to the blood work
i had done when i saw the neurologist

the next test is the blood biomarkers and genetic tests

the two blood biomarkers are beta amyloid and tau protein and
the other proteins that they are trying to use to develop a protein
profile from the blood to be able to predict whether someone
has or will get alzheimers disease
in a recent study the test may be 88% accurate
its not available yet
but in the future you will go to the doctor and get this blood test
and find out whether you will get alzheimers disease

the genetic tests are testing for the genes for alzheimers
if you have the genes you get alzheimers
these are  rare and represent a very small percentage of the
alzheimers cases

then there is the apoe4 gene that is associated with an increased risk
of developing alzheimers disease
15% of the patients with alzheimers carry this gene
the apoe2 version tends to protect you
the apoe3 version tends to give you a mild case of alzheimers
the apoe4 version gives you the increased risk
if you have the apoe4/apoe4 double version you have a 15x increased
chance of developing alzheimers disease in your lifetime
if you are having symptoms and carry this double gene you have
a 60-90+% chance of developing alzheimers disease in your lifetime

i was able to have my genes done at a private lab
and i carry the double apoe4/apoe4 genotype
the sucky combination
so i have a 15x increase in my chances of having alzheimers
and with my symptoms i have a 60-90% chance that i have alzheimers

the next test we have done is the mri scan of the brain
of course they are looking for the same things that i mentioned before
to explain any symptoms
but they are also especially looking at the underneath surface of the brain at
the hippocampal area where alzheimers starts
they can detect subtle changes in the volume in this area early on in the
disease process

my mri scan as reported earlier was normal

the next tests we have done is a spinal tap analysis for beta amyloid and
tau  protein
the theory is that beta amyloid accumulates in the brain and causes a
sticky gooey substance that eventually forms plaques then later the tau protein
which forms the microtubules in the brain cells and nerve cells that carry
nutrition get damaged

the tau proteins as they are damaged become unwound
the body sticks phosphorus on the end of them
they form tangles and eventually inflammation and oxidation occurs
as the brain cells die

the tau proteins leak into the spinal fluid and can be measured

the beta amyloid protein is normally found in the spinal fluid
it goes to the brain
bathes the brain
is filtered through back to the spinal fluid
some people think the filtering mechanism gets messed up
some think there may be an overproduction of beta amyloid
whatever the cause it accumulate in the brain and the amount
in the spinal fluid decreases

so in a normal person like some of you
you have a normal amount of beta amyloid in your spinal fluid
and a low level of tau proteins there also

but in a person like my younger brother who is in the later
stages of alzheimers disease their beta amyloid level in the
spinal fluid will be low since its being deposited in the brain
and the tau protein levels will be high since the tau proteins are
being destroyed and leaked to the spinal fluid

so here is an graph where these result can be plotted out

in the upper left portion of the graph someone like you who are normal
with a normal amount of beta amyloid and a low level of tau protein
will plot out in the area not consistant with alzheimers disease

in the lower right portion of the graph someone like my younger
brother with alzheimers disease with a low level of beta amyloid
(its being left in the brain) and a high level of tau protein will
plot out in the area consistent with alzheimers disease

i was able to send my spinal fluid to a private lab and see the
asterisk in the middle that is my results
in the indeterminate range
this is consistent with my early diagnosis

these results along with my positive apoe4 double genotype makes
my diagnosis of possible alzheimers disease more likely

the next test we have done is the glucose metabolism pet scan
of the brain

we are given a radioactively labeled glucose in an iv
wherever in the brain that there is glucose being used by the brain
it will show up as increased activity

in alzheimers disease as the cells are being damaged they cant
utilize glucose well

so a normal patient will have increase uptake throughout the brain
while an alzheimers patient will have areas where there is decreased
or no glucose uptake

some people think that alzhiemers disease is a form of type 3 diabetes
there is resistance to the insulin so that the glucose cant be easily taken
up by the brain cells

studies are being done to use nasal insulin
the insulin travels up the olfactory nerves to the underneath surface of the
brain where alzheimers starts and where memory is processed
the patients are being evaluated for
improvement in their memory after using the nasal insulin

here is an example of the glucose metabolism pet scan
the one on the left is on a normal patient
you can see there is diffuse uptake ie red areas throughout the brain

the scan on the right shows a mild alzheimers patient
you can see on the sides of the brain there is no uptake
of glucose ie no red areas

my glucose metabolism test is normal
which is consistent with my early diagnosis

then the last test we have done is the
beta amyloid pet scan of the brain
amyvid is the only commercially available fda approved one

i have had two of these done with the study

in this study an iv material is given that will bind to beta amyloid
in the brain and will show up as high lighted areas

the amyvid pet scan is now commercially available in the dallas houston
san antonio areas
its expensive
it cost $3000-$6000
its not covered by health insurance or medicare or medicaid
there are $500 vouchers available at some sites

here is an example
the top scan is of an elderly control person who does not have
alzheimers disease
you can see that there is no red areas so no beta amyloid is  present

the bottom scan is of an alzheimers patient
see the red areas diffusely in the brain
that is beta amyloid
the hallmark sign of alzheimers disease

i plan on having one done at the austin radiological association in
austin texas next month

i expect mine to be positive

so now we have new tests available to possibly diagnose alzheimers disease
most of these are or will be commercially available some time in the future

next friday april 26
i will blog on
part 4
the alzheimers graph and what can be done

the organicgreen doctor