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

Monday, April 20, 2015

links end

last friday i think i could have answered questions from
the audience all afternoon
they would have kept on asking me questions
here are some links i promised to post today

for the lady whose husband may be experiencing some
memory loss

here below is a link to a pamphlet in the form of a pdf file
there explains dementia and what workup and treatment
should be done for this disease

the texas dept of health came out with clinical guidelines
for evaluating and treating dementia and memory loss
click on the far right pdf file

also here is a brief summary of what will be put in the
algorithm for evaluation of a patient for memory loss
that will eventually be available to all the primary care
providers in the state
the gold standard to be followed for evaluation of memory

the first thing you need to do is go to this link
21 question questionnaire
answer the questions about your husband
score the answers
this gives you a good idea of where his memory loss is
copy this form off
take the answered and scored form with you when you
and he go to the doctor
yes dont let him go by himself

also make a written list of what you and he have noticed
to give to the doctor

he should have a good thorough medical history taken
and a good examination
looking for causes of memory loss
old head trauma  excessive alcohol   depression   anxiety
stress   sleep disorders like sleep apnea or restless legs
medications side effects   drug abuse   poor controlled
blood pressure or cholesterol   lack of exercise
obesity   diabetes    family history etc

then a memory in office test is done
they may do
a minicog test-3 words are named then you are asked to
draw a clock and put the time on a clock then you are
asked to recall the 3 words
if you dont do well on this one the patient may be more advanced

most neurologist will do a standardized test
the best to use is the moca test
its more sensitive for picking up early memory loss
eg i didnt do well on this one at my first evaluation

if the score on this one isnt normal
the full neuropsychological test should be done
administered by a psychologist or neuropsychologist
its the gold standard of memory tests

almost all neurologists do these
cbc   metabolic profile(electrolytes, kidney and liver function and
glucose levels)   tsh for thyroid function   b12 level   vitamin d level
others would add
folate   homocysteine level(elevated levels may be associated with
stroke heart attack and alzheimers disease)   lipid profile hiv
my b12  and vitamin d levels were low
my homocysteine level was elevated

a mri should be done to rule out explanations for memory loss
like stroke old head trauma tumors too much fluid in the brain
brain shrinkage etc

after this complete evaluation then your husband should know
why he has memory loss
then can be told what he can do to help

other things to consider if further workup is desired but they
are not usually covered by health insurance are
the beta amyloid scan amyvid that shows if he has the bad
stuff beta amyloid built up in the brain

spinal tap for beta amyloid and tau proteins
these protein levels are abnormal in alzheimers disease

hope this is useful
anything less than this for workup of memory loss is
not acceptable

for the others who asked
if you go on your computers
not on your smartphone
go to my blog
at the top are links to
a video my wife she and i did for the
alzheimers center
a newspaper article form the austin american statesman
a newsletter from the alzheimers center at ut southwesteren dallas

thanks for attending the dementia and aging conference
for asking such good questions

the organicgreen doctor

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