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 26, 2019

my story revisited 11

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after i was diagnosed with mild cognitive impairment amnestic type and placed on aricept generic donepezil i was not allowed in the normal control group of the adni 2 or alzheimers disease neuroimaging initiative study
later after being stable on the drugs for three months i was placed in the mild cognitive impairment wing of the adni 2 study
i was in the adni 2 study for 5 years
they wanted an intial mri so i would be ready for the study and for diagnostic reasons for my neurologist
i have had a lot of mris done over the last 8 1/2 years in the two long studies i have been in 
i think its well over 10 but you know after a while you quit counting

now as part of these studies you dont get the results
for some reason i would get copies sent to me of some of the mri reports
unlike the amyvid pet scans done in the study which i never got an official written report 
i know that mine all are normal except for two specks of white matter hyperintensities which are small white specks that are associated with an increased risk for stroke and dementia
when these are seen on folks mris its a warning sign to the patient and to their doctors

no doctor told me that i found out by reading research papers on these white spots
thats one of the reasons i got more aggressive with my blood pressure control and my cholesterol control 
doing what i could to not get any more
there is a number for some reason off the top of my head this morning its 7 that means your risk is even greater for these events stroke and dementia to occur
i jumped right on a statin drug and my pressure drug and improved my diet and improved my exercise and kept my weight under control

now when they do these mris for memory issues they are looking for explanations for why a person had memory loss
my mom had diffuse cerebral atrophy or brain shrinkage that was compatible with alzheimers disease
she also had a small subdural hematoma from a fall that cleared on its on
my younger brother with his first mri had changes compatible with alzheimers disease
another close relative had brain shrinkage of their frontal and temporal lobes 
these explained all their memory issues

other things they look for is too much fluid in the ventricles of the brain like what happens in the babies that have hydrocephalus
if this normal pressure hydrocephalus can be discovered in adults it can be potentially be treated with shunting of the fluid from the brain like they do in the babies
in some of these patients their memory and neurological symptoms almost totally resolve

other things to find on mri are strokes masses like cysts or aneurysms or tumors or old scars like from trauma or like that lady in the news lately who had a tapeworm cyst
many of these are treatable
if an old stoke is seen then preventative measures can be started like cholesterol and blood pressure measurements maybe aspirin or other drug therapy

so on all my mris the only thing that is found are those two white matter hyperintensities that havent changed but are just sitting there warning me to 
take care of my health to maybe prevent more and maybe slow down the alzheimers thing some

now after the initial mri then i would have more tests 
some i was able to duplicate in the private world
the genetic blood tests for early onset alzheimers genes and the late onset gene apoe 4
the spinal fluid analysis for amyloid and for tau proteins levels of which become abnormal in alzheimers disease

here is what i wrote 8 plus years ago about that first of many mris i would have

as i read these old blogs i realize how much i didnt know and i realize how much i have learned in the last 8 plus years


i have my mri today as part of my workup
it will be looking for other causes of this disease
such as infection, stroke, abnormal masses, etc that
could be treatable
then the diagnosis might be mci nonamnesic type
that would be nice
then the chances of progression would be about 20-30%
vs the sucky 50-80% of what i have

also there are certain changes on the mri that are seen with
alzheimers and may be found on me in the early stages of
this disease like changes in the part of the brain called the
hippocampus where alzheimers starts
or increases in the size of the ventricles of the brain
or shrinkage in the cortex of the brain

if it is normal then that doesnt mean i dont have mci amnesic type
it just means that changes havent shown up on mri yet

i will give the report of the scan on this blog when i get it

in february i will probably have a lumbar puncture for the
research study i am it     
i will have some of the fluid sent off
to a lab to test for tau and amyloid proteins which are proteins that are
found in abnormal levels in alzheimers patients
i will also have dna analysis to see if i carry the genes for
this disease

these tests by themselves dont make a diagnosis but like a
lot of things in medicine when added together they will make the
diagnosis more likely

later on
i will have a pet scan done which will show even better
any changes that may occur in the brain

also when i enter the studies i will have all these tests
on a regular basis as they follow me during the study
except i will not receive the results since i had to sign a waiver

the worse test i may have to have again this year and annually
is the neuropsychological testing
this is where they pick up abnormalities by asking questions
doing drawings etc
i think i would rather have the lumbar puncture instead

but its important since the neuropsychological testing shows how well the brain is
functioning in real time

the organicgreen doctor

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