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, October 16, 2019

organicgreendoctor: my story revisited 25-new guidelines another study...

organicgreendoctor: my story revisited 25-new guidelines another study...: MY STORY REVISITED 25-NEW GUIDELINES ANOTHER STUDY in 2011 the new alzheimers disease diagnostic guidelines were published the previous o...

my story revisited 25-new guidelines another study

MY STORY REVISITED 25-NEW GUIDELINES ANOTHER STUDY
Image result for organicgreendoctor
in 2011 the new alzheimers disease diagnostic guidelines were published
the previous ones were published in 1984
the link in the blog i wrote in 2011 is to the ny times which now requires you pay to access the article
also the link to the alzheimers association page on this has expired or is no longer available

here is a link to the guidelines from the national institute on aging nia and the national institute of health nih

there are 3 categories
preclinical     no symptoms but positive biomarkers
mild cognitive impairment mci     mild symptoms with positive biomarkers
alzheimers disease     worse symptoms with positive biomarkers

the biomarkers are spinal fluid analysis for amyloid and tau proteins and postive amyvid pet scan for amyloid

these biomarkers werent readily available in the private world back in 2011 but now they are
still insurances companies wont pay for them or for the genetic tests

my biomarkers were all positive
ie the spinal fluid for amyloid and tau levels were abnormal and my amyvid scan was positive for amyloid
eg to get in the biogen aducanumab i just finished you had to have a positive amyvid scan

in the article linked above and my blog back in 2011 the genetic testing for apoe 4 is discussed
just doing it without understanding what it means can cause folks to worry a lot

if you have the apoe 4 single gene you have an increased risk of getting late onset alzheimers at an increased risk of about 5 x
if you have the double gene apoe 4 then you have a 15-20x increased risk of developing late onset alzheimers

does this mean if you have apoe 4 gene you will get it
no
it will probably be based on how well a healthy life style you lead

i personally am glad i know i have it as it has made me be more aggressive in taking care of my health
plus
getting my early diagnosis has also made me be even more aggressive with my health
and
has helped force us to get all our long term and final plans done

thats the good things of knowing early

also a warning
be careful of getting this apoe 4 on your medical records
it may affect your ability to get long term insurance maybe disability insurance maybe life insurance and if they get rid of preexisting conditions you wont be able to get good health insurance ever
until you qualify for medicare

then i briefly mentioned my disability insurance
it would be almost 9 months after i had to retire for my private disability insurance to start
they had to prove that i had what they said i had
they got all my records but that wasnt good enough
so
they put me through an 8 hr neuropsychological exam
i guess trying to wear me down

my approach was to go in there and do the best i could
thats what i did
i eventually got my disability starting with back pay for 9 months
luckily my private disability wasnt taxable
but
when i was forced to apply for social security disability
well that was all taxable
since i got a check for 3 years of social security i got put into a much higher tax bracket
i received my private disability until i was 65 ie i got it for 5 years
my advice is to make sure you have disability insurance either where you work or buy it privately
dont expect to rely on social security disability
it can take 2-3 years to get it and its taxable
they make it hard for you to get it

this was all before the tax cuts that were passed with this administration
my tax rate i paid was much higher than most millionaires and billionaires pay now
doesnt seem right does it

then
i did one of several smaller research studies this one an online computer memory test
another one i did later was a video long distance neuropsycological test and later i did a sniff test to see if my ability to smell had been affected

XXXX

04-20-2011
NEW GUIDELINES
new guidelines came out yesterday in an article on the classification
of alzheimers disease
this is significant since the last time this was done was 1984

this article in the ny times on alzheimers guidelines does a good
job describing the new guidelines and why they are important

these guidelines were used when making my diagnosis
mild cognitive impairment amnesic type felt to be secondary
to alzheimers

the testing that is discussed in this article and the guidelines are
not all readily available but i have had them or will have them
this month

these guidelines are important as they will identify people early
with the disease
hopefully these will provide tools for family doctors to use to
identify people earlier
in my case it was good that i was identified so that i could plan
my life and that i stop practicing medicine before some harm
was caused as my disease progressed

some people dont want to know but not me
it has made my life better knowing now (i have always feared it
would happen)
luckily i have disability insurance that should kick in soon to help
with my financial situation and i have long term care insurance
to cover long term care later in life and i have health insurance
(notice these need to be obtained before the diagnosis is made as
you cant get life insurance, disability insurance, long term care
insurance or health insurance with my diagnosis)

with these new classifications as more people are identified earlier
then more research can be done on those people with the
disease earlier than before

thats why the study im in now is important as they are looking at
people with normal cognition and with an early diagnosis like mine
now new drugs and new tests can be designed to attack this
disease
it wont help me but it may help you or your kids or my kids

full article if you are interested  is at
http://www.alzheimersanddementia.org/content/ncg

next week i have a mri then will do other tests later

ANOTHER STUDY
next week i will also be involved in another study in which the
university is developing an online neuropsychological test that
your family doctor or neurologist can order on you
you can go online and complete it then it is sent to a
neuropsychologist to interpret
the report is then sent to you doctor

hopefully this online test will make it easier to get tested

i will be taking the online version of the test for the study
they are doing but it may not be available to the general
public without a doctors order

if it becomes available i will blog about it

remember on these genetic tests eg huntingtons, alzheimers, etc
you dont want it done until you have all your insurances lined up as
you wont be able to get them once it is placed in your medical
records

XXXX



our santa barbara walk to end alzheimers is on saturday november 2, 2018
here is the link to my team and the walk site

click and donate and or join us
or
donate or join your local walk where you live

the organicgreen doctor

Tuesday, October 15, 2019

organicgreendoctor: a germy drink of water

organicgreendoctor: a germy drink of water: A GERMY DRINK OF WATER when i saw the article i thought of two things my billfold my cell phone i always keep my billfold in my fron...

a germy drink of water

A GERMY DRINK OF WATER
when i saw the article i thought of two things
my billfold
my cell phone

i always keep my billfold in my front pocket with my cell phone in the other pocket
several days a week i work in my garden
i dig holes
i move gallons of mulch around
i dig up compost
i make planting beds that are 40 ft long
so
i am around a lot of dust dirt compost
well it ends up sometimes in my pockets
surrounding my billfold and cell phone

occasionally
like last week
i emptied out my billfold
all my cards felt gritty like they had been at the beach
i had pockets of dirt and debris in the corners of the billfold
why
i could have planted a seed and there and it would have grown
so
i took alcohol swabs and cleaned it all out
i also wiped off each card to get all the grit off them
yes
they worked when i used them

then
off went my cover case for my cell phone
oh my
i had a great compost pile in there
it had definitely composted completely
so
i walked over to a houseplant and dumped the cell phone compost on it

i wiped it well with more alcohol swabs
the cell phone seemed to work better
i definitely could see and hear better

then
i looked over to my yetti water container i was given as a gift

it goes everywhere with me as i stay well hydrated all day

yes
it goes to the garden
yes
all that stuff that got on my phone seems to get on and around my water bottle

so
i took it all apart
i must say i did get a little nauseated
as
i took out my alcohol swabs and wiped the lid well
those white swabs well they went all black

yes i cleaned it for the above picture to spare you

black stuff on your food and water bottles means that stuff is black mold
it
cant be good to drink that stuff
then
i stuffed it separated in the dishwasher

later
i read this article on dirty water bottles being all germy
a swab of the sliding thing on the lid of a yetti bottle yielded  900,000 cfu thats
colony forming units per cubic centimeter
my lid is 5 centimeters wide so you can do the math
that folks is a lot of germs going down into my stomach

its enough to make you sick
just thinking about it

so
at least once a week take your water bottle apart
wash the lid with soapy water and if possible put the lid in the dishwasher
then
put the water bottle in the dishwasher

my lid gets calcium buildup so i soak it in a vinegar mixture to remove that white stuff

now
i can drink good clean water in my yetti water bottle
use a clean phone
put my money in a compost free billfold

im good now

the organicgreen doctor

Monday, October 14, 2019

organicgreendoctor: watch out for the zombied ones

organicgreendoctor: watch out for the zombied ones: WATCH OUT FOR THE ZOMBIED ONES in humans its called cjd disease or creutzfeldt jacobs disease or subacute spongioform encelphalopathy in c...

watch out for the zombied ones

WATCH OUT FOR THE ZOMBIED ONES
in humans its called cjd disease or creutzfeldt jacobs disease or subacute spongioform encelphalopathy
in cows its called mad cow disease
in deer its called chronic wasting disease or zombied deer

in humans cjd disease it can be inherited or from eating contaminated cattle or use to the cannibals would get in as they ate human brains infected with these prion or proteins that caused the infection or disease
it is found in 1 in a million folks worldwide
its one the causes of dementia
the most common form of dementia is alzheimers then vascular then mixed then parkinsons then lewy body then frontotemporal then eventually cjd disease

its not treatable things go fast real fast when a person gets it
its one of the most terrible of the dementias to get
the person can be here today and almost gone tomorrow

in these prion diseases a protein thats found starts folding itself causing the infection and symptoms in the brain and the nervous system

there have been reports of it being transferred via surgical instruments from harvesting pituitary glands where growth hormone was extracted
the growth hormone would have been contaminated if obtained from an infected person by the prions
the person given this growth hormone would be infected
as a medical student i use to harvest the pituitary glands from cadavers at autopsy
yes i wore gloves and mask and surgical protective gear
the practice of taking growth hormones from human pituitary glands is no longer done

it can take years for the disease to show up in humans

now
eg mr hudson gets daily shots of growth hormone but his growth hormone is grown in the lab
so no mr hudson isnt at risk

then
some surgical instruments not cleaned well enough could transfer the prion during brain surgery
thats not likely to happen today


mad cow disease in cattle occurred from feeding sheep brains to cattle as feed
if a sheep brain was contaminated with the prion the cattle could get mad cow disease
if a human ate this contaminated beef they could potentially get cjd disease or in this case
mad cow disease


now to the zombied deer thing
deer get cjd infections and its called zombied deer or more accurately chronic wasting disease
or cwd
these deer look all wasted looking and lose their fear of humans

here is an excellent article from the cdc on chronic wasting disease

Image result for cdc chronic wasting disease
cdc.gov
here is the map of the infections from this disease

its presently found in 26 states

as its now deer hunting time in many of these states
my advice is you be careful of eating the deer you are hunting
if you arent sure if your deer is sick or not you can have it tested

if the deer is sick dont eat it
remember
cooking the meat doesnt
i  repeat it doesnt
kill the prion
it still can be transmitted by eating the meat

in deer unlike in mad cow disease seen in cattle it mainly affects the meat

Image result for cdc chronic wasting disease
here is a picture of a zombied deer with chronic wasting disease from wikipedia.org

now the chances of getting cjd from eating meat from a chronic wasting diseased deer
is small if at all
it is theoretically possible though

if you get this prion disease you are done for for sure

dont take the chance
be careful

deer meat or venison is usually one of the healthiest meat to eat

the organicgreen doctor

Friday, October 11, 2019

organicgreendoctor: alzheimers news-a lot of questions were answered y...

organicgreendoctor: alzheimers news-a lot of questions were answered y...: ALZHEIMERS NEWS-A LOT OF QUESTIONS WERE ANSWERED YESTERDAY yesterday as we zoomed down to the los angeles area for our early memory loss c...

alzheimers news-a lot of questions were answered yesterday

ALZHEIMERS NEWS-A LOT OF QUESTIONS WERE ANSWERED YESTERDAY
Image result for organicgreendoctor
yesterday as we zoomed down to the los angeles area for our early memory loss conference i reviewed my set of answers to the questions from the moderator
i for awhile sort of zoned out as i floated back to daydreaming about the last 9 years
a lot of reflection happened during that 2 hour trip

when i arrived i was ready to answer questions
i laid the 4 pages of answers i had written down by my chair as i set on the panel with a couple
he a later mci patient or maybe an early alzheimers patient
she a caregiver
i liked the couple as one way they handled the situation was with comedy and laughter
but i must say as i looked at her when she was talking you could see even though she would smile the sadness in her eyes and face and the fatigue in  her body
and
they are just at the beginning

fyi yes we got out of the los angeles area before the fires started and are today safe in santa barbara

one question was asked of all 3 of us that stood out in my memory
is there something good that came out of knowing our diagnosis early
we all three said the same
NO
what we meant was there is no good in finding out you have alzheimers disease
as most folks that have been exposed to alzheimers before they know what the diagnosis means

now after you find out
you have to deal with it
so
we all three are dealing with it
in our own way

i think we all three agree that its good to know early
you have time to be ready when things get worse
in my case i might be able to do things that slows it down a lot
well that i think has already happened
we and i are under no illusions here
we and i know that things are going to get worse and never better

we answered questions from the audience and the moderator for over an hour
yes this the first time i didnt tear up
i must admit i tend to stay away from the parts that make me tear up choke up sometimes cry

the other three lectures were on

legal preparation you need to have like these things
will
power of attorney for health care
power of attorney for finances
living will
polst dnr no cpr forms
hipaa forms
advance directive
maybe a trust

if you dont know what some of those are just highlight them and do a google search
if you have all of these done your kids grandkids and other heirs will love you for it

my wife she and i have most of them but we plan to meet this fall with an elder lawyer
yes its hard to say that but we are now elder we just dont feel that way
to discuss and update and put all of it together so we will have a folder that says
open when we die

another lecture was on having a healthy balance while living with the disease
this also applies to caregivers
and
the rest of you

she talked about your wellness wheel with these 7 spokes
faith life   connect with the world and others
movement   exercise walk garden get outside vacuum dance etc this all increases blood flow to the brain
work   volunteer contribute to the world and others improve your health improve your numbers like weight blood pressure cholesterol blood sugar
emotional   cope with life stresses meditate get enough sleep relax and breathe
nutrition   eat healthy like the mediterranean diet or mind diet google these diets drink adequate water
family and friends   foster social networks give and receive support

then the last lecture was from a clinical and behavior neurologist and researcher from ucla who happens to be the neurologist i see for my private care and for the research studies i am doing

first let me say that after listening to her talk i realize how much i really know about this all since i practiced medicine  i am a patient with the diagnosis i am a research subject  i blog about alzheimers at least twice a week  i read at least 5-10 articles on alzheimers each day
so
it all has sunk in into my shrinking brain and thankfully at this point it is all staying there

i dont know that i learned much new today
but
what i heard really really reinforced what i already know

one thing that i and the other two medical speakers warned was
dont start taking vitamins and supplements without discussing it with your medical provider
you also can go to webmd.com and plug them into their drug interaction checker
eg i plugged in cbd and aricept (donepezil) to see if there was an interaction
there wasnt

here is my take

there is not a treatment or cure for the disease
yet
a ton of research is being done right now slowly getting us to the treatment and cure
if you want to do something so you dont get alzheimers the consensus is
exercise
eat a good healthy diet like the Mediterranean diet or mind diet
get adequate sleep
avoid stress treat anxiety and depression
be care with some medications that may make you have memory loss eg chronic use of xanax or bladder pills or maybe antihistamines

they dont know about cbd or thc since the research hasnt been done on it since the government wont let them do the research that needs to be done
eg cbd has great antiinflammatory properties
besides amyloid accumulation and tau protein damaging the brain cells neuroinflammation happens to finish off the brain cells
so
if we can treat the neuroinflammation that would be good
cbd might be one of several drugs to do that
the research needs to be done

possibly a blood test could be available as soon as two years to tell if you have alzheimers disease going up in your head
it will be like the cholesterol test
get the cholesterol test if bad treat your cholesterol to prevent heart attacks and strokes and maybe alzheimers disease
so
you may be alble to get an alzheimers blood test in a few years
if its positive
what do you do
well sorry there is no treatment or cure
but
you can do those spoke things on that wheel and you may be able to reduce your chances of it progressing or worsening real fast by as much as 60%

having mci or mild cognitive impairment due to alzheimers disease where you have had all the definitive tests like memory testing positive spinal tap for amyloid and tau that show abnormal levels and or an amyvid pet scan thats positive pretty well makes its certain that you have alzheimers disease
and
may benefit from taking aricept (donepezil) early on

this slows down symptoms for awhile but sorry it doesnt treat the disease
warning was of course as i have written about this before and talked about before if you have been on the aricept (donepezil) for awhile and you just stop it
sorry you will digress to where you would have been had you not taken it
then
if you restart it
sorry again
thats your new baseline that you will be working from
ie
you wont get better again

so
for me
if i were to stop my medication my aricept (donepezil) i might digress to where i would have been had i not take the drug
eg
i might not be able to write this blog do my finances do the shopping maybe drive maybe not travel not be able to plan our trips and other things i enjoy doing
and
if i stopped it the medicine and later restarted it i would not be not better than what i wrote in the last sentence
i would just keep sliding down that slippery slope to oblivion

i already knew all this before i heard the lecture
i more than most really understand
so
as i told the audience i put up with the drugs side effects like sleep problems and stomach issues

why dont we have treatment or cure for this disease
well
like i said yesterday when asked if i had some last words for the folks in the audience

there are two reasons
one

volunteers like me
to do the studies that need to be done
some criteria for the studies are strict so they may have to evaluate a lot of folks to get enough for the studies
eg the biogen aducanumab study was like that

money
we need more money for research from the federal government
remember you are going to be affected by this disease
you cant avoid it
you will eventually be paying for it in taxes as the cost outpaces our defense budget and possibly the whole us budget

we need donations from nongovernmental sources
so
donate and join our walks against alzheimers disease
there are walks in your area
in texas its
alzheimers texas
alzheimers association
here in the los angeles area its
alzheimers greater la 
they sponsored the event yesterday

find yours and donate
again
we cant afford not to

remember
memory loss is not part of aging


our santa barbara walk to end alzheimers is on saturday november 2, 2018
here is the link to my team and the walk site

click and donate and or join us
or
donate or join your local walk where you live

the organicgreen doctor

Thursday, October 10, 2019

organicgreendoctor: my story revisited-adni 2

organicgreendoctor: my story revisited-adni 2: MY STORY REVISITED 24-ADNI 2 almost 9 years ago after being on the aricept (donepezil) for at least 3 months and being stable they allowed...

organicgreendoctor: my story revisited-adni 2

organicgreendoctor: my story revisited-adni 2: MY STORY REVISITED 24-ADNI 2 almost 9 years ago after being on the aricept (donepezil) for at least 3 months and being stable they allowed...

organicgreendoctor: my story revisited-adni 2

organicgreendoctor: my story revisited-adni 2: MY STORY REVISITED 24-ADNI 2 almost 9 years ago after being on the aricept (donepezil) for at least 3 months and being stable they allowed...

Wednesday, October 9, 2019

my story revisited-adni 2

MY STORY REVISITED 24-ADNI 2
Image result for organicgreendoctor
almost 9 years ago after being on the aricept (donepezil) for at least 3 months and being stable they allowed me to reapply to be in the adni 2 study alzheimers disease neuroimaging initiative 
not in the normal control
but
in the early mild cognitive group of the study
no treatments would be done
only diagnostic studies that ended up defining what kind of workup is done for someone with dementia

if you ask alzheimers researchers what is the most important alzheimers study ever been done they would say its the adni studies

i did almost 5 years of this study before i took time off then decided that i would only do treatment studies that would show some promise in slowing this disease down for me
i did the 25 months of the biogen aducanumab study using aducanumab as a potential treatment
it was stopped last april
i now have to wait unitl march 2020 before i can enter a new treatment study

in the first two years of this adni 2 study my memory slowly got worse before it started getting better

why
im hoping it from taking the aricept (donepezil) and aggressively taking care of my health

if you had told me when i wrote that old blog that i would be sitting here today 9 years later writing this blog
well
i wouldnt believe you

whatever the reason
ill take it

there is the adni 1 then later my study the adni 2 and now there is a new adni 3
i will not be doing the adni 3
adni 3 linked here is also only diagnostic testing

as i was writing the two old blogs below i wasnt optimistic for my future


XXXX

04-18-2011
ADNI-2
today i start my alzheimers research study called adni-2
alzheimers disease neuroimaging intiative-2 is an extension of
the adni-1 study

this study will look at normal controls (thats the category i was
going to be in when all this mess ive got myself into started)

(many of you know who have read my blogs that i entered this
study to be a normal control but flunked the initial
neuropsychological test in the short term memory department and
was not allowed in on the adni-2 normal group

from there a trip to the neurologist landed me on aricept and
a decision to stop my medical practice because of the fear of
causing harm)

other categories are early mild cognitive impairment-thats my group
late mild cognitive impairment and alzheimers disease

we will all be followed for 54 months with 
blood work,

neuropsychological tests
(thats the one that caught me and i hate taking it. its like taking a test 
where you dont know the material and you know you are going to flunk it. 
its like taking a test you havent studied for and not knowing the answers. 
its like a bad dream.  i dread it more than the spinal tap)

a spinal tap to assess amyloid and tau protein-both are elevated in alzheimers,
mris, a pet scan to look at radioactively labeled amyloid, and a
pet scan to look at radioactively labeled glucose which shows
how well the brain is actively functioning

these tests and data are sent to a central place usually ?ucla for
developing a data base that research will study sometimes for
years
sometimes a cell line is developed if a significant finding is made
maybe mine could be called the togd gene

also included in this study i will sign a permit that will allow an
autopsy of my brain when i die so they can compare what they
see in my brain at my death with what they saw on the scans and
neuropsychological tests
the final diagnosis of alzhiemers is made only on autopsy

will this study help me
no
but it may help my kids, grandkids, you or your family
remember you will be affected by this terrible disease in some way

there is no drug testing in this study
there is only the scans and lab studies that are not readily available
outside the research system

problem is ill never know what my results will be
as all the test subjects are identified by numbers and the results go
into this research black hole never to be seen by me or the other
people in the study

ill remain on my aricept until it doesnt work anymore
there has not been any worsening of my condition
i have gotten adjusted to my meds and have few side effects
i have lost those great dreams i was having
guess ill have to get netflix now

tomorrow i will blog on anything new after by initial visit
at least i dont have to repeat that damn neuropsych exam this time

04-09-2011
ADNI-2
well i think i made it into the study
i will know later this week
if the labs are ok then i should be a go for the study

i get to start with a mri since its the hardest to get scheduled 
then
i will follow up with a day of neuropsychological exams-thats the one
i dont like to do as its frustrating since some of the short term
memory parts i have trouble with


i did a minimemory one yesterday and had some difficulties with some of
the short term parts again but did not seem worse than what i
had done in november of 2010
the next neuropsychological test will be more involved than the
sucky one i had to do that got me in this mess im in now

my wife she has to go back with me when i have the spinal tap done
i still would rather have that than the neuropsych test
she also has to be interviewed more extensively about me for this
study (hope she doesnt tell any family secrets)

then i go back again to have the 2 pet scans done

these will be my baseline studies for this almost 5 year study
with the probability that it will last longer if funding is available

so my disease process will be monitored closely over this
period of time
i feel lucky since my wife she and i wont have to be guessing
where i am with my disease as we will have objective data
to look at

my close relative with the disease has progressed over the last few
years
for him and his wife and his family and his doctors its harder to
know where he is with his disease and when to have him stop
driving and doing other things that could harm himself and others

with this study the evidence will be there for my wife she and i and
my family to see so we can make those decisions more easily

this study is an important national study that will probably define
how a patient gets evaluated and monitored for alzheimers

now if they could just find a prevention and a treatment of this
disease

i have realized that once the diagnosis of alzhiemers is made the
treatment is easy as there is only a few choices and they dont
really affect the course of the disease they just slow down the
symptoms some
the biggest problem in treating alzheimers is a social one
that most people are not ready for
we werent with my mother

as i do each test although usually i may not get a full report i will
know how im doing 
i will blog on it each time

in late summer i will have back all my genetic and spinal fluid
results and will post them on this blog and will explain what it
all means

hopefully all of this will help someone when they or their family
members get this disease
it will affect you in some way eventually


XXXX

so here i am below almost 9 years later like an old timex watch
i am still ticking doing my talks doing all the things that i like to do

sort of
waiting for that other shoe to fall
hopefully i can keep that shoe on for awhile


i will be on an alzheimers panel at the valley presbyterian hospital in van nuys california on thursday october 10 2019
i will on the panel that day with other people diagnosed with alzheimers
each person present with their spouse will represent different stages of the disease

what do we think about all this is what we want those in the audience to hear

here is the link to the conference


our santa barbara walk to end alzheimers is on saturday november 2, 2018
here is the link to my team and the walk site

click and donate and or join us
or
donate or join your local walk where you live

the organicgreen doctor