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

Friday, May 24, 2019

organicgreendoctor: alzheimers news-its come down to this

organicgreendoctor: alzheimers news-its come down to this: ALZHEIMERS NEWS-ITS COME DOWN TO THIS the world health organization or who came out with what you can do in 2019 to slow down or treat alz...

alzheimers news-its come down to this

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the world health organization or who came out with what you can do in 2019 to slow down or treat alzheimers disease

when I read them I took a few minutes to think about them
I felt a rush of almost like a flush that went from head to toe
like a women who has had a hot flash
I realized
this is what we are left
my generation
this is all that can be offered
to treat and slow this disease

now for 8 1/2 years I have searched after that thing that treatment no matter what that will stop the disease process up in my brain

I entered the tarcc study in texas where I had yearly labs and a baseline mri and yearly memory testing and yearly neurological testing

I did a smell test study testing to see if my smelling had been affected
its one of the first thing to go with this disease since the smelling center is near where alzheimers disease starts

I did a video conference memory testing study using a remote video neuropsychological exam that would be used to do memory testing on folks at remote clinics so patients wouldn't have to drive hundreds of miles to get the neuropsychological exams

I entered the alzheimers disease neuroimaging initiative or adni in the mild cognitive impairment wing of the study
I tried to enter the study as a normal control but I got my diagnosis when they did the memory testing
I had labs and dna and rna testing memory testing genetic testing my whole genome done spinal taps mris pet scans amyloid pet scans
this study provides the important baseline thats used in all the potential treatment studies
its the framework they use

I also got on a regimen which interestingly has all those things in the who list plus others that might slow things down some
its the reversal of cognitive decline study from dr bredesen from ucla
many dont agree with all the recommendations but I see no harm in  my doing them
I am doing them and will continue to do so

finally I had reached a point where I wanted to be treated to find something that might stop or slow down the disease
I entered the most promising study the biogen aducanumab study using aducanumab that removes the bad beta amyloid from the brain thought to be the cause of alzheimers
it the study was abruptly stopped as were all of the others in that category
we dont know yet
soon it will be published
what I want to know did it help at all

as I am looking around now for a treatment study one that is promising I realize that this one the aducanumab was my chance
I very unlikely will not get another one to slow this down

like you I am left with this who release

 5 proven ways to cut dementia

1 exercise regularly

2 eat a balanced diet like the mind diet or mediterranean diet

3 stop smoking or dont smoke

4 drink in moderation or not at all
women thats <one glass of wine men thats <2 glasses of wine
that doesn't seem fair for the women does it

5 stay social and intellectually active

thats all we are left with

if you aren't doing this you need to start with these 5 things
if you are in the generations behind us baby boomers there will be a treatment or cure for you and you kids

here is what I plan to do now

do these things on the list
enjoy my life

the organicgreen doctor

Thursday, May 23, 2019

organicgreendoctor: santa barbara country n news-walking cabbage kale ...

organicgreendoctor: santa barbara country n news-walking cabbage kale ...: SANTA BARBARA COUNTRY N NEWS-WALKING CABBAGE KALE AND MORE a few weeks ago the garden manager at the community garden where I have my gar...

santa barbara country n news-walking cabbage kale and more


a few weeks ago the garden manager at the community garden where I have my garden plots said you want one of those
we had volunteer ones pop up around the mama plant
sure I said
I had been admiring it for two years now
I had watched them harvest the leaves and donate them to the food kitchen along with the kale and cabbage and broccoli and cauliflower
it seems they are all first cousins being from the brassica family

the plant given to me was about 6 inches tall
now in the garden a few weeks later it is about 5 ft tall

whats it called
well its got a lot of names
walking cabbage
walking stick cabbage
walking kale
walking stick kale
cow cabbage
jersey cabbage

they came from the channel islands
not the ones in the ocean close to here
they use to be grown to feed cattle and other farm animals
the sticks were grown to be harvested to be made into walking sticks
today they arent used for much in that area

fast forward to today and to my garden
it used in my garden
as a decoration
as a source of small leaves for our salads
as a source of larger leaves to be used in with kale in salads or cooked or stir fry greens

so this week I harvested

curly leaf kale and dinosaur kale


into a crock pot I added chopped walking stick cabbage kale leaves and kale leaves and amaryth leaves and onions and jalapeno peppers and garlic
all from my garden
to this I added vegetable broth crushed red pepper seeds and salt and black pepper and smoked paprika and mesquite smoke and a pad or two of butter and olive oil and herb mix and light brown sugar and apple cider vinegar
these were all mixed together and cooked in our crock pot for several hours
to yield
this yummy organic all from my garden vegetable greens

my wife she added her yummy iron skillet cornbread

as I said to her last night
dang that was good

the organicgreen doctor

Wednesday, May 22, 2019

organicgreendoctor: my story revisted 7

organicgreendoctor: my story revisted 7: MY STORY REVISITED 7 I wrote this blog the morning I was to drive up to the alzheimers research center at the university of texas southwes...

my story revisted 7

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I wrote this blog the morning I was to drive up to the alzheimers research center at the university of texas southwestern in dallas
I knew I was through
I did not discuss this with anyone but my wife she
there were a few people I think who knew that I was through
they could sense it

I  must say it was a long drive up to dallas that day
we always stopped at the west kolache shop for a kolache on the way
it was our halfway point

I did a lot of soul searching on the way up to dallas
I knew what was going to happen
I knew what I needed to do


THE DREADED DOCTOR VISIT  yesterday i said goodbye to my job as a practicing family physician
im leaving not because i want to but because genetics has
bit me in the ass
no one knows yet that yesterday was my last day
not my nurse, not my patients, not my fellow partners, not
the administration
no one got to say good bye to me
thats the way i wanted it

today i meet with a neurologist to review my neuro-
psychological testing that was done so that i can enter
studies in the university of texas alzheimers research studies
i entered this to be a control subject in their study
a control subject is someone who does not have a disease
who is followed along with patients who have the disease
it looks like i might be a subject now
not a control subject
i knew when i went there originally that i had noticed some
subtle changes

no one else had noticed these changes but i had
not even my wife she has noticed any changes
if you know me or met me you would not notice anything
(except i couldnt remember your name
a long problem i have had for 30 years)
it appears that those subtle changes are present and those
changes will probably make me not want to work anymore
as they could interfere with my ability to practice medicine

I wonder if and when my mom noticed these changes
how long before we noticed her symptoms did this happen
to her

what about my close relative who was working
did he notice these changes months to years before
others noticed them
when did his wife notice them
when did they begin to interfere with his work

next the follow up to the neurology visit

the organicgreen doctor

Tuesday, May 21, 2019

organicgreendoctor: i knew it i knew it

organicgreendoctor: i knew it i knew it: I KNEW IT I KNEW IT I rarely if ever click on a website that floats across my facebook page unless its one that I recognize since you nev...

i knew it i knew it

I rarely if ever click on a website that floats across my facebook page unless its one that I recognize since you never know if its a Russian bot website or a virus website
this one was different I had to click on it and read it

after I read it
I said
I knew it I knew it
to myself

now I had noticed for a long time that when I went out into my garden and worked the soil and planted stuff and harvested stuff
it was like a moment of zen

I felt calm
I felt relaxed
I could hear the birds and even the bees when I stopped
I seem to lose whatever was bothering me that day

it was like a drug it seemed that I had taken as soon as I walked into the garden and started gardening on my garden plot

I know why

according to this article linked here there is a bacteria in the soil that has a prozac like effect if you get it on your hands and it gets into the skin
it can make you relax like prozac can since it may affect the serotonin level in your brain
as all gardeners know working in the dirt can make you happy

just the physical act of gardening makes you feel better
if you get your hands dirty you can get a dirt antidepressant treatment

yesterday after being waylaid from my mohs and more surgeries I was able to get in my garden to work the soil to weed out the weeds to tie up my climbing veggies to harvest beans and a tomato and greens and onions and clean up the garden
a rainstorm and windstorm had wrecked some havoc on the garden

when I finished
I stood in the middle of my garden
I faced the beautiful mountains
I looked at the beautiful blue sky
I took in a deep deep breath of fresh air
I exhaled slowly
I looked down at my dirty hands
I must say I felt quite relaxed

there is something about getting your hands in the dirt
it has to be true

the organicgreen doctor

Monday, May 20, 2019

organicgreendoctor: mohs and more

organicgreendoctor: mohs and more: MOHS AND MORE I hope that writing this blog will alert someone about a skin cancer they were ignoring or were not aware was a skin cancer ...

mohs and more

I hope that writing this blog will alert someone about a skin cancer they were ignoring or were not aware was a skin cancer

I have already had one person send me a picture after hearing of my recent experience with mohs surgery for my basal cell skin cancer

as I looked at the picture I thought im glad I did my post on it
the picture he sent was of a lesion on his face that looked like a basal cell skin cancer
I suggested he see a dermatologist to have this lesion checked

what I didn't tell him was how big the hole would be when they removed it
if done by a good skilled person the scar would not be too bad
at least he would be cured

now basal cell like he probably has and like the one that I had twice on my nose
doesn't metastasize like melanoma or like squamous cell skin cancer can do
it the basal cell instead just spreads slowly like a turtle sometimes all under the skin
where you cant tell its doing its destruction
that's what mine did
it was a turtle

last august I had this small speck of blood on my nose that went away the next day
I thought I had scratched my nose
I have sun damaged skin with some superficial blood vessels so I thought I had just scratched one of them
I take aspirin and take several supplements that thin the blood

then it did it again
I made an appointment to have it checked
then mr h got sick and I canceled putting it off
then later weeks later it did it again
it was the holidays
I put it off
then I had to have cataract surgery
then I put it off
then I had to have my cataract surgery redone
then I put it off
then my iritis flared up big time
then I put it off

it bled maybe 3 or 4 times but only for a day then it was gone
there was just normal looking skin on the nose
it bled again
ok I said you've put it off too long
you know this is just how it started two years ago when you had to have mohs surgery for basal cell cancer of the nose
of course this one was in a different part of the nose from where I had had the mohs surgery before
I knew it was  a different one

lucky the day I went in the nose had bled so it was easily marked for them to biopsy
they numbed the nose and took a 2 mm biopsy to be sure

that's procedure #1

I went ahead and scheduled the mohs surgery before the biopsy came back
yes the report was positive for basal cell
they numbed me up and did a biopsy
there was residual left
so they repeated this again and again and again and again and again
until it was all gone

that was procedure #2

what was left was a big ole hole I call the blowhole
my wife she calls it my pot hole
of course ms squeamish hasnt even seen what it looks like
I have spared her
I didn't want to pick her up off the floor

the next day
I saw a plastic surgeon  who said oh my
you have a big ole blowhole there

since you have all this scar tissue here is what I recommend
filet the nose those are my words not his like a fish and lift up the skin
then sit it back down and sew it in place to sit for a couple of weeks to increase the blood supply to the area
in two weeks you come back and will move that flap around to cover up your blowhole or pot hole as your wife she calls it

the defect is big and it is down into the cartilage of the nose so I think this will give you the best result
a skin graft wont work well since you have exposed cartilage
we could do a flap off your forehead and attach it over your blowhole or pot hole
I read about that one and saw pictures from the internet

I said I don't want that one unless I just have to

I went with what he did as I described above
next week I go in to have the 4th step done to close up my blowhole

so I did procedure #3 to filet my nose and sew it in place
I will have procedure #4 to move that flap over the blowhole

the worst parts beside the initial pain was having to stay down for a few days and he requested that I don't do any gardening
I thought to myself that's not going to happen but I kept it to myself

Im telling you all this stuff so that maybe you can learn a lesson at my expense so that this doesn't happen to you

if you see a lesion that bleeds looks too dark or youre worried get it check
if it needs biopsied
get it done and don't wait

if you wait to fix it it can get more complicated like mine did the second time
the first mohs I had done took one biopsy then a simple flap with repair
I went in as soon as I saw it on my nose

this time
it took me over 6 months before I went it
all the work and lost time doing what I like to do I have had to deal with

my advice
don't wait

the organicgreen doctor

Friday, May 17, 2019

organicgreendoctor: my story revisted 6

organicgreendoctor: my story revisted 6: MY STORY REVISITED 6 each year on December 22nd I go back and reread the blog I wrote on that day about my last day of practicing medicine...

my story revisted 6

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each year on December 22nd I go back and reread the blog I wrote on that day about my last day of practicing medicine
I read in the early morning before dawn all by myself
I pause as I read it thinking of that day and what it meant to me and my patients and my family

yesterday I reviewed the blog I wrote that day
I was by myself
it was late afternoon
I stopped and cried
as I do each year when I read this blog

its like reading your own obituary sort of
like you've died but you get to read it

when I wrote this blog it was the day I went up to the university of texas southwestern alzheimers center in dallas to meet with the neurologist to go over my neuropsychological memory test and to make a decision for my future

I knew as I wrote in earlier chapters the last few weeks that while I was taking my memory test
I knew that I now had it
the alzheimers disease

about 2-3 weeks later I go the phone call
dr nash
it appears you have short term memory loss thats greater than it should be for your age and your degree of education
we recommend you see a neurology for an evaluation
if you see one of our neurologists we would like labs and an mri first

I chose to be seen by a neurologist there

so over the next month as I saw patients I knew that was probably the last time I would see them
I tried to get my practice ready for my not returning after my neurology visit
I refilled patients prescriptions early
I stopped seeing new patients
I had patients come in early for physicals and well child check and rechecks

the last day I worked
I had a nurse bring in her child for his two year old exam as the clinic closed that day
he was the last patient I saw in my medical career

as I was leaving that day the clinic supervisor stopped me
looked at me
you arent coming back are you

I said to myself
this is it


LAST DAY-THANKS  this my last day to work as a physician
I always considered myself lucky to have been able to
do in life what i wanted to do since i was a middle schooler

in high school i was able to work in a local hospital in the
summer on weekends and during holidays
our family was poor so not only did i get financial benefit from
working but i also was exposed to a lot in the hospital setting
it made me know that i wanted to be a family physician

during college i worked as a emergency room technician
on weekends, weeknights, and holidays
this also gave me financial support but also exposed me to
different doctors and different emergency situations

i was accepted to medical school but never wavered on what
kind of doctor i wanted to be
a family physician

i was accepted to a family practice residency
after completing my residency i owed the federal government
three years to work at an approved federal underserved area

i was able to create with some help a site in the small
town near where i grew up       
I worked there for three years
although traumatic at times it was a learning experience that i
carried throughout my career

after fulfilling my three year obligation and after sustaining a
large financial hit from my involvement with the local clinic
i was recruited to the area where i am working now
thanks to my medical school friend for helping me out in
my time of need

i have worked for 25 years as a family physician
i always wanted to be one

now it is time i have to quit not because i want to but
because a genetic health problem has risen its nasty head
and because of this I will have to discontinue what i like to do

i do not ever dread going to work every day
i  feel like i have now just gotten good at what i do

I realize that patients dont necessarily need all of the new
medications we have, the new tests we can do or need
the newest treatments available

they do better if you just listen to them, pat them on the
shoulder, be kind to them and be their advocate when
they need it

i have honed my skills in taking care of kids over my career so
that many of the kids have felt comfortable seeing me and look
forward to seeing me to get a sticker or sucker, hear my
duck voice, or have me joke with them
that part i will miss a lot

thanks to all my patients in the past for allowing me to fulfill
my dream of being a family physician
i hope i have done you a good job

thanks to my wife she for putting up with me during
my quest for my career
I know she found hers

love yall

the organicgreen doctor