Friday, July 31, 2020
organicgreendoctor: alzheimer news-this blood test may be the one
organicgreendoctor: alzheimer news-this blood test may be the one: ALZHEIMERS NEWS-THIS BLOOD TEST MAY BE THE ONE a lot of the well known alzheimers researchers are saying this this may be the one the test...
alzheimer news-this blood test may be the one
ALZHEIMERS NEWS-THIS BLOOD TEST MAY BE THE ONE
a lot of the well known alzheimers researchers are saying this
this may be the one
the test is called ptau217
217 is the location of a certain amino acid on the tau protein that correlates well with whether a patient will get or has alzheimers disease
in the theory of what happens in alzheimers disease
amyloid builds up in the brain forms plaques that kills brain cells
this happens first
then
later tau proteins that are found in the brains nerve cells get damaged and start to unravel
these tau proteins form tangles that also kill brain cells
amyloid shows up first then tau second
there are ways to diagnose alzheimers disease with some degree of certainty
when one dies they can autopsy the brain thats the 100% way to diagnose it
that doesnt really help though if your are dead
they use memory tests to look for memory loss compatible with alzheimers disease
they do a spinal tap for spinal fluid which then can be tested for amyloid levels and tau levels
they can do a amyvid pet scan for amyloid which will be positive if one has alzheimers disease
other things can make the amyvid scan positive also but if you have alzheimers it will be positive
they now can also do a tau pet scan
it was recently approved for use especially in research
i havent had the tau scan but i have had the other ones done
they all are positive
in the private world the amyvid pet scan is not covered by insurance
it costs $5000-$10000
my spinal fluid test cost over a $1000 and that didnt count the neurology visit and the spinal tap procedure costs
but
what if they could just draw blood and test it for ptau217
thats much easier
it probably will be alot cheaper
ive had two spinal taps and didnt necessarily enjoy them
ive had three amyvid pet scans which werent as bad as a mri but did require this space ship looking device to inject the radioactive stuff into my arm
yes
i would go for a blood test any day
a lot of well known researchers are excited about this test
i heard the head researcher on npr talking about the test this week
i called it a garage moment
i was listening to it as i pulled into my garage this week and then sat there in my car to hear the full interview
he was definitely optimistic about this new test
here is a link to a good news article on it
the researchers were able to autopsy brains of folks who died from alzheimers
the autopsies verified the diagnosis of alzheimers
they were able to then obtain old blood samples on these patients and tested them for ptau217 which were positive
they also went to colombia and tested folks there who have the positive gene for early onset alzheimers
if you have the gene you will almost 100% get alzheimers
their ptau217 tests were almost 100% positive
it apears the ptau217 is specific for alzheimers disease
it also may be used to differentiate alzheimers disease from other demetias like frontotemporal dementia eg
it seeems to be just as accurate as the amyloid scans and the spinal fluid for amyloid and tau
so
it appears that if this test works out it would be available in 2-3 years
it will first be used in the research world than later will be used in the private world for folks to have done
so
do you want to know if you have it or if you will get it when you are
40
or
50
or
60
or
? do you even want to know
planning for the future might be easier to do if you know
maybe you would want to retire earlier
maybe you would want ot get all you end of life stuff in order
maybe you would want to be more aggressive about your health care if you had knew
for me
i think had if i really had known at 40 or 50 i would have been even more aggressive about my diet and weight and blood pressure control and cholesterol control etc
it seems if this works out to be as good of a test as they think it will be that we all will one day have to decide
do you want to know
the organicgreen doctor
Thursday, July 30, 2020
organicgreendoctor: garden news-late summer plantings for the fall
organicgreendoctor: garden news-late summer plantings for the fall: GARDEN NEWS-LATE SUMMER PLANTINGS FOR THE FALL the tomatoes are coming in like crazy right now my garden really only needed 6 tomatoes but i...
garden news-late summer plantings for the fall
GARDEN NEWS-LATE SUMMER PLANTINGS FOR THE FALL
the tomatoes are coming in like crazy right now
my garden really only needed 6 tomatoes but i couldnt help myself so i planted 10 plants
the picture above is of sungolds i harvested yesterday
when i go back today to work in the garden there will be more waiting on me to pick
ms b and mr hudson loves the sungolds
they eat them like candy
if you pick at the peak of ripeness well they do taste like candy
now
i tend to pick mine early since varmints and birds like the real ripe ones so i let them finish ripening in the condo on that platter
the other prize tomatoes are these heirlooms
they were suppose to be a black krim and a cherokee purple
they look the same to me
i think they were mislabeled
anyway
they taste delicious
these i found hiding amongst my tomato jungle
the large ones are the size of a softball
i also call these sink tomatoes since when you bite into them or cut into them you better be over a sink
a few weeks ago we planted some beefsteak tomato seeds in small tiny pots
when they got bigger we transplanted or should i say i did into 4 inch pots
then after a few weeks they are ready for placement in the garden
i have found it hard to decide when to plant tomatoes here
so
i usually plant mine in mid march
this year the garden wants to try to plant some tomatoes now to see if we can get a good crop for the fall
late july august september and october are usually our warmest sunniest time which is just right for tomatoes
in may and june and now this year in july we get coastal fog to mid day then we get a nice sunny afternoon
that fog is rough on tomatoes
they tend to get fungal diseases
i removed all the onions from this bed
then i raked the bed out real good
we try not to till the beds
i added a couple of inches of real rich compost that we make ourselves
as i plant the tomatoes i added a little bit of organic fertilizer in the hole
this is what this 30 ft bed looks like when completed
hopefully mother nature will cooperate so we can have fall tomatoes
another thing i am going to try this week is something folks do in texas to get fall tomatoes
they cut back their indeterminate tomatoes this time of year to about 1 ft
the cut is just above a node that has a branch starting to grow
keep this watered and nurtured and sometimes they will produce fall tomatoes for you
in texas in the heat of the summer you have to use sunscreens to block the hot afternoon sun off of the tomatoes
ive not snipped off my indeterminates here yet but i plan to do that to one of my sungold indeterminate tomatoes
i also prepped beds for these acorn squash and butternut squash that the soup kitchens like to use for their soups
we do most of our plantings in the garden of veggies that the soup kitchens or food pantries like to have
as i was talking to someone yesterday as we looked out over the garden
you know j and i planted most of those veggies you see growing there
sometimes
i feel like i have an acre garden im taking care of
but
i really only have a small 400 square foot personal garden that i maintain for my wife she and me
thats all we need
later into the fall we will be planting kales leeks salad mixes chard cabbage broccoli etc in the main garden
all to be donated
so thats where i am doing my volunteer work at right now
i usually have the garden to myself when im there
if others are around we are all spread apart over the one acre garden
the organicgreen doctor
Wednesday, July 29, 2020
organicgreendoctor: my story revisited #51-scans and post visit and po...
organicgreendoctor: my story revisited #51-scans and post visit and po...: MY STORY REVISITED #51-SCANS AND POST VISIT AND POST VIDEO AND WORKUP when i was diagnosed with mild cognitive impairment that turns out t...
my story revisited #51-scans and post visit and post video and workup
MY STORY REVISITED #51-SCANS AND POST VISIT AND POST VIDEO AND WORKUP
when i was diagnosed with mild cognitive impairment that turns out to be due to alzheimers disease it raised concern and awareness in all my siblings
one my younger brother was in the throes of alzheimers disease when i was diagnosed
each of the siblings had testing done with their primary care doctor or a neurologist
some had in office memory testing and some had a neuropsychological exam so they would have a baseline for them to refer to in the future if needed
two siblings were given the moca test by me
i gave them a copy of the results so they could show it to their primary care doctors if needed
so they all got good baseline studies
more than one also had an mri of the brain
so they had all the baseline studies that one would do to test ones memory and look for other causes
tiday you might consider doing the amyvid pet scan that detects amyloid in the brain even before symptoms start
today there is an article about a new blood test thats 2-3 years away that will detect if you will get alzheimers years before it happens
now we just need a treatment
we are getting closer hopefully the aducanumab or the ban2401 will slow it down
time will tell
when i wrote that blog i had just had my 6mo neurology visit my visits for the adni2 study a few hours of taping of a video that ut southwestern did on my wife she and me
the video is linked here
at that time they still had to come out to our country n to interview us and videotape the place
the video is 4 minutes long but the taping was over 3 hours long
i had done all of the three scans mentioned in the blog that day
the amyvid pet scan the glucose metabolism pet scan and the volumetric mri
my amyvid as i found out to get into the aducanumab study was positive
my glucose metabolism pet scan was negative
my volumetric mri was normal
ie
i am early in the disease as those will become abnormal eventually
today if you have a complete workup for memory loss you
have a good history and exam
do screening labs
do an in office memory test like the moca test
if its abnormal you do a full neuropsychological exam
do an mri if indicated
then
if you arent sure of the diagnosis and you are willing to pay for the amyvid pet scan you would do an amyvid pet scan
then
your diagnosis would be pretty accurate
now if the new blood test turns out to be accurate you can add that one
then
the diagnosis would probably be certain
we have come a long way in the last 10 years
___________
01-27-2012
SCANS
i tried to post a beta amyloid pet scan of a patient with
mild cognitive impairment yesterday on facebook
that would not post so im posting it here
the red stuff is not suppose to be there
this is actually from a patient with alzheimers disease
but a patient with mild cognitive impairment who has
advanced some will look similar to this
that red stuff is beta amyloid
thats what is thought to be the cause or the end result
of whatever is causing alzheimers disease
if we can stop this deposition of the beta amyloid in the
brain or remove it early with meds or a vaccine then we
will be getting somewhere in the prevention and cure and
treatment of the big A
this is a glucose metabolism pet scan
the red stuff in this scan is suppose to be there
its radioactively labelled glucose
the more the merrier
in mild cognitive impairment its reduced
and in the big A its even reduced more
the brain cells that are damaged cant metabolize
glucose well so they start dying
the other scan that is done is the volumetric mri
on the right is a normal beta amyloid scan with a normal
volumetric mri (vmri)
on the left is the abnormal beta amyloid with the red stuff
and just below this is an abnormal volumetric mri
with an increase size to the ventricles in the middle that looks
like a bird in flight and the decrease in the hippocampal area
on the under surface of the brain
-the hallmarks of early alzheimers disease or mild cognitive impairment
these then are the three scans that i am aware of that are used
in working up alzheimers disease or cognitive problems
the beta amyloid scan is only available in research centers but will
be available elsewhere in the next two years if the fda approves it
the volumetric mri and the glucose metabolism pet scan can be done
at many radiological centers now
i hope this is helpful to those of you that have asked about them
POST VIDEO
taping the video was fun
dang sure was a lot of retakes
i hate to see what it would be like to do a movie
the video staff taped an interview with me then with the doctor
i see doing an office visit with me then with the research director
doing an intake interview with me and then with the testing person
doing part of the neuropsychological testing (asked them to do
the part that i could do correctly)
this will eventually be on their new updated website
i will post it when its all completed
POST VISIT
i am sure they hate to see doctors as patients
i know i hate being one
theres no changes in my medications and will do
a follow up in 6 months
so not much to report
WORKUP
a close relative of mine has decided to undergo an evaluation
mainly as a baseline for future reference
the relative took the article that was written about my situation
to the doctors visit
she is now having an evaluation done that sounds like its everything
that should be done to evaluate someone
this is probably a good idea since
the relative is probably at a higher risk than most people because of
our shared genetic history
remember most cases of alzheimers ARE NOT genetic
it just happens that it probably is in our families genes
the earlier this is picked up
the earlier medication and preventative stuff can be done (we all should
be doing those things anyway)
the medications can delay things for awhile
it gives us time with our families
and in my case i savor each day
which i may not have been doing if i didnt know
___________
yes i have savored each day the last 8 years since i wrote this
i feel lucky to still be able to enjoy life each day
the organicgreen doctor
when i was diagnosed with mild cognitive impairment that turns out to be due to alzheimers disease it raised concern and awareness in all my siblings
one my younger brother was in the throes of alzheimers disease when i was diagnosed
each of the siblings had testing done with their primary care doctor or a neurologist
some had in office memory testing and some had a neuropsychological exam so they would have a baseline for them to refer to in the future if needed
two siblings were given the moca test by me
i gave them a copy of the results so they could show it to their primary care doctors if needed
so they all got good baseline studies
more than one also had an mri of the brain
so they had all the baseline studies that one would do to test ones memory and look for other causes
tiday you might consider doing the amyvid pet scan that detects amyloid in the brain even before symptoms start
today there is an article about a new blood test thats 2-3 years away that will detect if you will get alzheimers years before it happens
now we just need a treatment
we are getting closer hopefully the aducanumab or the ban2401 will slow it down
time will tell
when i wrote that blog i had just had my 6mo neurology visit my visits for the adni2 study a few hours of taping of a video that ut southwestern did on my wife she and me
the video is linked here
the video is 4 minutes long but the taping was over 3 hours long
i had done all of the three scans mentioned in the blog that day
the amyvid pet scan the glucose metabolism pet scan and the volumetric mri
my amyvid as i found out to get into the aducanumab study was positive
my glucose metabolism pet scan was negative
my volumetric mri was normal
ie
i am early in the disease as those will become abnormal eventually
today if you have a complete workup for memory loss you
have a good history and exam
do screening labs
do an in office memory test like the moca test
if its abnormal you do a full neuropsychological exam
do an mri if indicated
then
if you arent sure of the diagnosis and you are willing to pay for the amyvid pet scan you would do an amyvid pet scan
then
your diagnosis would be pretty accurate
now if the new blood test turns out to be accurate you can add that one
then
the diagnosis would probably be certain
we have come a long way in the last 10 years
___________
01-27-2012
SCANS
i tried to post a beta amyloid pet scan of a patient with
mild cognitive impairment yesterday on facebook
that would not post so im posting it here
the red stuff is not suppose to be there
this is actually from a patient with alzheimers disease
but a patient with mild cognitive impairment who has
advanced some will look similar to this
that red stuff is beta amyloid
thats what is thought to be the cause or the end result
of whatever is causing alzheimers disease
if we can stop this deposition of the beta amyloid in the
brain or remove it early with meds or a vaccine then we
will be getting somewhere in the prevention and cure and
treatment of the big A
this is a glucose metabolism pet scan
the red stuff in this scan is suppose to be there
its radioactively labelled glucose
the more the merrier
in mild cognitive impairment its reduced
and in the big A its even reduced more
the brain cells that are damaged cant metabolize
glucose well so they start dying
the other scan that is done is the volumetric mri
on the right is a normal beta amyloid scan with a normal
volumetric mri (vmri)
on the left is the abnormal beta amyloid with the red stuff
and just below this is an abnormal volumetric mri
with an increase size to the ventricles in the middle that looks
like a bird in flight and the decrease in the hippocampal area
on the under surface of the brain
-the hallmarks of early alzheimers disease or mild cognitive impairment
these then are the three scans that i am aware of that are used
in working up alzheimers disease or cognitive problems
the beta amyloid scan is only available in research centers but will
be available elsewhere in the next two years if the fda approves it
the volumetric mri and the glucose metabolism pet scan can be done
at many radiological centers now
i hope this is helpful to those of you that have asked about them
POST VIDEO
taping the video was fun
dang sure was a lot of retakes
i hate to see what it would be like to do a movie
the video staff taped an interview with me then with the doctor
i see doing an office visit with me then with the research director
doing an intake interview with me and then with the testing person
doing part of the neuropsychological testing (asked them to do
the part that i could do correctly)
this will eventually be on their new updated website
i will post it when its all completed
POST VISIT
i am sure they hate to see doctors as patients
i know i hate being one
theres no changes in my medications and will do
a follow up in 6 months
so not much to report
WORKUP
a close relative of mine has decided to undergo an evaluation
mainly as a baseline for future reference
the relative took the article that was written about my situation
to the doctors visit
she is now having an evaluation done that sounds like its everything
that should be done to evaluate someone
this is probably a good idea since
the relative is probably at a higher risk than most people because of
our shared genetic history
remember most cases of alzheimers ARE NOT genetic
it just happens that it probably is in our families genes
the earlier this is picked up
the earlier medication and preventative stuff can be done (we all should
be doing those things anyway)
the medications can delay things for awhile
it gives us time with our families
and in my case i savor each day
which i may not have been doing if i didnt know
___________
yes i have savored each day the last 8 years since i wrote this
i feel lucky to still be able to enjoy life each day
the organicgreen doctor
Tuesday, July 28, 2020
organicgreendoctor: be prepared for the flu this year
organicgreendoctor: be prepared for the flu this year: BE PREPARED FOR THE FLU THIS YEAR picture of flu virus from cdc you know what would be bad this year is to get the covid 19 and also the...
be prepared for the flu this year
BE PREPARED FOR THE FLU THIS YEAR
picture of flu virus from cdc
you know what would be bad this year is to get the covid 19 and also the flu
so far there is no vaccine for covid 19
yet
there may be in early 2021 or if we are lucky late late 2020
but if it does become available it may be awhile before most of us can get it
its not the case though with the flu shot
it is usually readily available for everyone to access
this would be the year to be sure and get your flu shot
if you were to get both of those infections together most of us will not do well
so
dont take a chance
get your flu shot this year
i know i know its early but september will be here before you know it
now
i usually wait until early october to get my flu shot
early enough to prevent an early case of the flu but late enough so the flu shot will last into the spring
i was looking at some covid 19 graphs the other day listing all the countries who have covid 19
of course the us was number one
no distinction to be proud of i might add
but
down at the bottom was a graph of the flu outbreaks in the southern hemisphere thats happening now
remember
its their winter there
they get the flu first then it heads our way
the graph was as flat as a fritter
why
guess
why
people are wearing a mask
people are social distancing
people are washing their hands or using disinfectants a lot
these are the same thing that also slows down transmission of the flu
so
its working down in the south world
it should work here also
add
a flu shot to that mix and you should be well protected from getting the flu
anyone coming around mr hudson has to have a flu shot and all their other immunizations updated
doing all these things protect people like mr hudson but also all the vulnerable folks like grandparents new babies pregnant folks immunosuppressed folks diabetics etc
so
keep doing those covid 19 things we all should be doing
get your flu shot this fall
protect your loved ones
protect yourself
then
get that covid 19 immunization when it becomes available
its not too early to be thinking about all this
the flu shots should be here in september
get yours
ill get mine
we all will be protected
the organicgreen doctor
picture of flu virus from cdc
you know what would be bad this year is to get the covid 19 and also the flu
so far there is no vaccine for covid 19
yet
there may be in early 2021 or if we are lucky late late 2020
but if it does become available it may be awhile before most of us can get it
its not the case though with the flu shot
it is usually readily available for everyone to access
this would be the year to be sure and get your flu shot
if you were to get both of those infections together most of us will not do well
so
dont take a chance
get your flu shot this year
i know i know its early but september will be here before you know it
now
i usually wait until early october to get my flu shot
early enough to prevent an early case of the flu but late enough so the flu shot will last into the spring
i was looking at some covid 19 graphs the other day listing all the countries who have covid 19
of course the us was number one
no distinction to be proud of i might add
but
down at the bottom was a graph of the flu outbreaks in the southern hemisphere thats happening now
remember
its their winter there
they get the flu first then it heads our way
the graph was as flat as a fritter
why
guess
why
people are wearing a mask
people are social distancing
people are washing their hands or using disinfectants a lot
these are the same thing that also slows down transmission of the flu
so
its working down in the south world
it should work here also
add
a flu shot to that mix and you should be well protected from getting the flu
anyone coming around mr hudson has to have a flu shot and all their other immunizations updated
doing all these things protect people like mr hudson but also all the vulnerable folks like grandparents new babies pregnant folks immunosuppressed folks diabetics etc
so
keep doing those covid 19 things we all should be doing
get your flu shot this fall
protect your loved ones
protect yourself
then
get that covid 19 immunization when it becomes available
its not too early to be thinking about all this
the flu shots should be here in september
get yours
ill get mine
we all will be protected
the organicgreen doctor
Monday, July 27, 2020
organicgreendoctor: this isnt going to end well
organicgreendoctor: this isnt going to end well: THIS ISNT GOING TO END WELL mr hudson update he is tentatively scheduled for discharge from the hospital tomorrow thats two weeks later...
this isnt going to end well
THIS ISNT GOING TO END WELL
mr hudson update
he is tentatively scheduled for discharge from the hospital tomorrow
thats two weeks later than expected
his mom says she can tell he is ready to leave since he is tired of getting messed with
ie blood draws ivs shots meds ultrasounds lots of specialists etc
if he could talk im sure he would say
i wanna go home
after a week he was doing great
the new kidney was working great
then
he spiked a high fever for a few days
a septic workup was done which lead to 2 antibiotics an antifungal and an antiviral to be given iv
he had lots of testing and lots of labs
when his fever persisted he had a ct scan done which the contrast used stunned the new kidney
his bun and creatinine climbed up but the new kidney responded well and is almost now back to normal
the ct scan was normal
then
his picc line developed a blood clot in it
he had to go on iv blood thinners ie heparin to prevent the clot from dislodging nad going to the lungs
he did several days of iv heparin
the picc line was removed
then
yesterday reevaluation showed the blood clot was now gone
the heparin and his body removed it
thank goodness
now he has to take 6 weeks of anticoagulation therapy ie coumadin or warfarin
so
on tuesday he is where he should have been 2 weeks ago
he is happy playful and ready for discharge
they will remain in los angeles after discharge for 4-6 weeks since he has to have frequent transplant clinic visits each week for awhile
its been a long long journey but finally its coming to a end
i have been thinking a lot about kids going back to school this fall
my thoughts
everyone just needs to take a covid year off
all the schools need to be virtual schools this year
next year hopefully there will be less of an outbreak due to more herd immunity and hopefully a vaccine to protect us all from this awful highly contagious disease
recently i wrote this blog titled should schools open
my answer then was no
my answer now is even more of a no
in texas many schools will be virtual at the beginning then after a few weeks will then go live
in florida schools are told to open
in california the schools are all going to be virtual all year
so californa said done decision made now lets figure out how to best do virtual school
those who decide to start live will probably all end up virtual anyway
these three states may end up being worse than new york was at its peak
here is what is going to happen in those states florida and texas
the kids will go back to school
there is absolutely in those states with the outbreaks as bad as it is that they can safely have those kids return to school
wear a mask maybe they will keep them on and not be touching them all day
safely distance thats not going to happen
wash or disinfect their hands a lot
it only takes a few seconds for them to recontaminate their little hands
if one of them has the germ it will be spread to the other kids to the teachers the principal the secretaries the custodial folks the librarian the cooks and the chef etc
it will be spread
guaranteed to happen one hundred percent
then
these infected folks will take it home to
their immunosuppressed family members like pregnant folks new babies grandparents great grandparents aunts uncles relatives with high risk diseases like hypertension heart disease diabetes asthma emphysema arthritis that suppresses the immune systems transplant patients like mr hudson etc
we arent like the other countries that have safely returned to schools
they did what needed to be done to control their outbreaks
we here in the us seemed to not have the will power socially and politically it takes to control this covid outbreak
we failed and they didnt
we cant endanger our kids and their families this way
now ms b was not going to go to school anyway this year
the transplant folks had requested that she be home schooled for at least 6 months
this was before the covid 19 outbreak occurred
so
now she will be in virtual school with the rest of her kindergartner class this year
that is the only safe way to do this for schools this year
if they dont
mark my word
nothing good is going to come of this
the organicgreen doctor
mr hudson update
he is tentatively scheduled for discharge from the hospital tomorrow
thats two weeks later than expected
his mom says she can tell he is ready to leave since he is tired of getting messed with
ie blood draws ivs shots meds ultrasounds lots of specialists etc
if he could talk im sure he would say
i wanna go home
after a week he was doing great
the new kidney was working great
then
he spiked a high fever for a few days
a septic workup was done which lead to 2 antibiotics an antifungal and an antiviral to be given iv
he had lots of testing and lots of labs
when his fever persisted he had a ct scan done which the contrast used stunned the new kidney
his bun and creatinine climbed up but the new kidney responded well and is almost now back to normal
the ct scan was normal
then
his picc line developed a blood clot in it
he had to go on iv blood thinners ie heparin to prevent the clot from dislodging nad going to the lungs
he did several days of iv heparin
the picc line was removed
then
yesterday reevaluation showed the blood clot was now gone
the heparin and his body removed it
thank goodness
now he has to take 6 weeks of anticoagulation therapy ie coumadin or warfarin
so
on tuesday he is where he should have been 2 weeks ago
he is happy playful and ready for discharge
they will remain in los angeles after discharge for 4-6 weeks since he has to have frequent transplant clinic visits each week for awhile
its been a long long journey but finally its coming to a end
i have been thinking a lot about kids going back to school this fall
my thoughts
everyone just needs to take a covid year off
all the schools need to be virtual schools this year
next year hopefully there will be less of an outbreak due to more herd immunity and hopefully a vaccine to protect us all from this awful highly contagious disease
recently i wrote this blog titled should schools open
my answer then was no
my answer now is even more of a no
in texas many schools will be virtual at the beginning then after a few weeks will then go live
in florida schools are told to open
in california the schools are all going to be virtual all year
so californa said done decision made now lets figure out how to best do virtual school
those who decide to start live will probably all end up virtual anyway
these three states may end up being worse than new york was at its peak
here is what is going to happen in those states florida and texas
the kids will go back to school
there is absolutely in those states with the outbreaks as bad as it is that they can safely have those kids return to school
wear a mask maybe they will keep them on and not be touching them all day
safely distance thats not going to happen
wash or disinfect their hands a lot
it only takes a few seconds for them to recontaminate their little hands
if one of them has the germ it will be spread to the other kids to the teachers the principal the secretaries the custodial folks the librarian the cooks and the chef etc
it will be spread
guaranteed to happen one hundred percent
then
these infected folks will take it home to
their immunosuppressed family members like pregnant folks new babies grandparents great grandparents aunts uncles relatives with high risk diseases like hypertension heart disease diabetes asthma emphysema arthritis that suppresses the immune systems transplant patients like mr hudson etc
we arent like the other countries that have safely returned to schools
they did what needed to be done to control their outbreaks
we here in the us seemed to not have the will power socially and politically it takes to control this covid outbreak
we failed and they didnt
we cant endanger our kids and their families this way
now ms b was not going to go to school anyway this year
the transplant folks had requested that she be home schooled for at least 6 months
this was before the covid 19 outbreak occurred
so
now she will be in virtual school with the rest of her kindergartner class this year
that is the only safe way to do this for schools this year
if they dont
mark my word
nothing good is going to come of this
the organicgreen doctor
Friday, July 24, 2020
organicgreendoctor: alzheimers news-moca test back in the news
organicgreendoctor: alzheimers news-moca test back in the news: ALZHEIMERS NEWS-MOCA TEST BACK IN THE NEWS thanks to trump the moca test is back in the news the moca stands for montreal cognitive asse...
alzheimers news-moca test back in the news
ALZHEIMERS NEWS-MOCA TEST BACK IN THE NEWS
thanks to trump the moca test is back in the news
the moca stands for montreal cognitive assessment test which is used for someone whom you have concerns that they are having memory loss
why was he having the moca test done
it doenst measure ones intelligence or iq or whether one has a psychiatric diagnosis like anxiety or depression or schizophrenia or narcissism or psychopathic personalities or other psychiatric diagnoses
if you know someone who has taken the test its usually done for a reason memory loss
i have had the test done probably 20 or more times
it is one of the memory tests that alzheimers research studies use to monitor study participants
each year when i see my neurologist she administers a version of the moca test
it gives her a feel for where i am with my disease
each time i get a different version of the moca test but the principles are the same
the moca test is sensitive for picking up someone who has mild cognitive impairment
if you have alzheimers it will not be normal
if used as a screening tests for memory loss and its abnormal then a full neuropsychological exam is done to verify the diagnosis
my initial moca test i did almost 10 years ago was abnormal
abnormal enough that it lead me to discontinue practice and get started on the drug aricept a month later
a few years ago the neurologist laid out my moca test scores over several years for me to see
you could see where i was at a mild cognitive impairment level that went lower for awhile then gradually overtime return back to a normal level and has remained there for the last several years
why is mine normal now
the aricept (donepezil)
the healthy living things i do
control of my blood pressure and cholesterol
maybe the few months of iv aducanumab i received
my last several moca tests have had a perfect score as trump calls it of 30
im glad he had a normal score since i wouldnt wish alzheimers disease on anyone
it doesnt mean though that a person doesnt have a psychiatric or personality problem if the score is normal though
the designer of the moca test said this in the washington post recently
“it’s not meant to measure IQ or intellectual skill in any way. If someone performs well, what it means is they can be ruled out for cognitive impairment that comes with diseases like Alzheimer’s, stroke or multiple sclerosis. That’s it.”
i have administered the test personally to several people over the years
you can miss three things on the test and still be in the normal range ie you dont have to be perfect
i once missed two things and still got a normal score
the range is 27-30 for normal
i worry about all this talk about the moca test and maybe misunderstanding on how its used
its such an important tool in following ones memory loss and for helping make the initial diagnosis
i would prefer it not be in the news so folks dont go and read the moca test which if you arent careful will make its use not as accurate
so
i also have a perfect moca test now but i didnt initially
but now
i am on aricept
i have a diagnosis of mild cognitive impairment due to alzheimers
i have received iv aducanumab to remove amyloid from the brain and hope to continue its use
so
remember
just because the moca test is normal doesnt mean things are ok up in your brain
the organicgreen doctor
thanks to trump the moca test is back in the news
the moca stands for montreal cognitive assessment test which is used for someone whom you have concerns that they are having memory loss
why was he having the moca test done
it doenst measure ones intelligence or iq or whether one has a psychiatric diagnosis like anxiety or depression or schizophrenia or narcissism or psychopathic personalities or other psychiatric diagnoses
if you know someone who has taken the test its usually done for a reason memory loss
i have had the test done probably 20 or more times
it is one of the memory tests that alzheimers research studies use to monitor study participants
each year when i see my neurologist she administers a version of the moca test
it gives her a feel for where i am with my disease
each time i get a different version of the moca test but the principles are the same
the moca test is sensitive for picking up someone who has mild cognitive impairment
if you have alzheimers it will not be normal
if used as a screening tests for memory loss and its abnormal then a full neuropsychological exam is done to verify the diagnosis
my initial moca test i did almost 10 years ago was abnormal
abnormal enough that it lead me to discontinue practice and get started on the drug aricept a month later
a few years ago the neurologist laid out my moca test scores over several years for me to see
you could see where i was at a mild cognitive impairment level that went lower for awhile then gradually overtime return back to a normal level and has remained there for the last several years
why is mine normal now
the aricept (donepezil)
the healthy living things i do
control of my blood pressure and cholesterol
maybe the few months of iv aducanumab i received
my last several moca tests have had a perfect score as trump calls it of 30
im glad he had a normal score since i wouldnt wish alzheimers disease on anyone
it doesnt mean though that a person doesnt have a psychiatric or personality problem if the score is normal though
the designer of the moca test said this in the washington post recently
“it’s not meant to measure IQ or intellectual skill in any way. If someone performs well, what it means is they can be ruled out for cognitive impairment that comes with diseases like Alzheimer’s, stroke or multiple sclerosis. That’s it.”
i have administered the test personally to several people over the years
you can miss three things on the test and still be in the normal range ie you dont have to be perfect
i once missed two things and still got a normal score
the range is 27-30 for normal
i worry about all this talk about the moca test and maybe misunderstanding on how its used
its such an important tool in following ones memory loss and for helping make the initial diagnosis
i would prefer it not be in the news so folks dont go and read the moca test which if you arent careful will make its use not as accurate
so
i also have a perfect moca test now but i didnt initially
but now
i am on aricept
i have a diagnosis of mild cognitive impairment due to alzheimers
i have received iv aducanumab to remove amyloid from the brain and hope to continue its use
so
remember
just because the moca test is normal doesnt mean things are ok up in your brain
the organicgreen doctor
Thursday, July 23, 2020
organicgreendoctor: garden news-more tomatoes and pumpkins and beans
organicgreendoctor: garden news-more tomatoes and pumpkins and beans: GARDEN NEWS-MORE TOMATOES AND PUMPKINS AND BEANS mr hudson update he should have be discharged a week ago but he is still there yes whe...
garden news-more tomatoes and pumpkins and beans
GARDEN NEWS-MORE TOMATOES AND PUMPKINS AND BEANS
mr hudson update
he should have be discharged a week ago but he is still there
yes when you look at him he looks fine
he is mostly happy and playful
there have been some bumps in the road
fever thought maybe due to infection requiring a course of iv meds
problems with his picc line that will require him to be in the hospital until next week
his kidney meanwhile keeps working good and is not why he is still there
i think he is ready to go home
these are a quart of christmas lima beans pictured above that ms b picked herself then she shelled them later
now if i can get her to taste them when i cook them
if you cook them they have a ham like flavor
ms b loves the garden
in these pandemic times she enjoys being in the garden checking things out
yesterday it was just her and i and my wife she in the acre garden
i wont let her in the garden unless we are the only gardeners there
she is only allowed to play in my garden area or the orchard
of course she is allowed to visit and feed the chickens
so
i filled a 5 gallon bucket halfway full of compost then dumped it into a flat container
she spent a long time digging through the compost to find worms and roly polies and treasures
when we first moved here she wouldnt touch a worm
now
she will proudly pick them up with her bare hands to show them to you
it is nice to see her have an appreciation and love for the garden
i did have eleven tomatoes in my garden
thats more than i should have in a garden my gardens size
so nature thinned them out for me
the winds blew over one tomato a my sisterinlaw tomato
it had gotten so loaded with tomatoes the weight and the wind just tumped it over
so
i harvested all the tomatoes many of them were still green
i placed the green ones on a platter to ripen on their own to see if that would work
my wife she took some for fried green tomatoes
then i took out one tomato plant that was not producing well
then
yesterday i found my early girl tomato all fallen down i presume also from the wind and the weight of all those tomatoes
so
i harvested the ripe ones for eating now
i harvested the green ones and placed them covered with newspapers in cardboard boxes to ripen on their own
when i lived in texas i did that every year right before the first frost
those tomatoes were as good as vine riped tomatoes
we will see how well these tomatoes do in a few weeks
you can only eat so many fried green tomatoes right
this week one of our volunteer projects was to plant our fall pumpkins
usually each fall the garden does a program for hundreds of elementary kids to come through for a two hour program
this year because of the covid 19 pandemic the program wont happen
but
we plan to raise the pumpkins for folks to see and enjoy
later
we will probably have a pumpkin sale of the pumpkins we grow
there is always plenty of safe things to do in the garden
i commonly garden with no one else there or if they are present we tend to work in different parts of the garden
i always of course wear a mask
the organicgreen doctor
he should have be discharged a week ago but he is still there
yes when you look at him he looks fine
he is mostly happy and playful
there have been some bumps in the road
fever thought maybe due to infection requiring a course of iv meds
problems with his picc line that will require him to be in the hospital until next week
his kidney meanwhile keeps working good and is not why he is still there
i think he is ready to go home
these are a quart of christmas lima beans pictured above that ms b picked herself then she shelled them later
now if i can get her to taste them when i cook them
if you cook them they have a ham like flavor
ms b loves the garden
in these pandemic times she enjoys being in the garden checking things out
yesterday it was just her and i and my wife she in the acre garden
i wont let her in the garden unless we are the only gardeners there
she is only allowed to play in my garden area or the orchard
of course she is allowed to visit and feed the chickens
i filled a 5 gallon bucket halfway full of compost then dumped it into a flat container
she spent a long time digging through the compost to find worms and roly polies and treasures
when we first moved here she wouldnt touch a worm
now
she will proudly pick them up with her bare hands to show them to you
it is nice to see her have an appreciation and love for the garden
i did have eleven tomatoes in my garden
thats more than i should have in a garden my gardens size
so nature thinned them out for me
it had gotten so loaded with tomatoes the weight and the wind just tumped it over
i harvested all the tomatoes many of them were still green
i placed the green ones on a platter to ripen on their own to see if that would work
my wife she took some for fried green tomatoes
then i took out one tomato plant that was not producing well
then
yesterday i found my early girl tomato all fallen down i presume also from the wind and the weight of all those tomatoes
so
i harvested the ripe ones for eating now
i harvested the green ones and placed them covered with newspapers in cardboard boxes to ripen on their own
when i lived in texas i did that every year right before the first frost
those tomatoes were as good as vine riped tomatoes
we will see how well these tomatoes do in a few weeks
you can only eat so many fried green tomatoes right
usually each fall the garden does a program for hundreds of elementary kids to come through for a two hour program
this year because of the covid 19 pandemic the program wont happen
but
we plan to raise the pumpkins for folks to see and enjoy
later
we will probably have a pumpkin sale of the pumpkins we grow
there is always plenty of safe things to do in the garden
i commonly garden with no one else there or if they are present we tend to work in different parts of the garden
i always of course wear a mask
the organicgreen doctor
Wednesday, July 22, 2020
organicgreendoctor: my story revisited #50-another neurology appointment
organicgreendoctor: my story revisited #50-another neurology appointment: MY STORY REVISITED #50-ANOTHER NEUROLOGY APPOINTMENT when wrote that blog over 8 years ago i wasnt sure what i would be like in 2020 if y...
my story revisited #50-another neurology appointment
MY STORY REVISITED #50-ANOTHER NEUROLOGY APPOINTMENT
when wrote that blog over 8 years ago i wasnt sure what i would be like in 2020
if you had asked me i would have probably said that i would be in the throes of early alzheimers disease no longer driving no longer doing my blog no longer traveling no longer doing our finances no longer doing those things that folks usually do every day
well
here i am 8 years later still doing all those things
sorry i dont even try to look 10 years ahead now
the covid 19 pandemic has changed all of that
i still write my blog regularly
we have no plans to travel until the threat of the covid 19 is all gone
i realize that our traveling days may be done for
you can read in the old blog posted below that we were staying busy
we traveled several times a year to california to visit our family and did several summer trips including our annual family reunions and trips to the western us eg grand canyon southern utah etc
i was about to start a several years course of volunteering for habitat for humanity and for meals on wheels
my how covid 19 has stopped all that
we try to limit our exposure to the virus as much as we can
our lives stay busy though
i try to go to my garden every day especially during the veggie growing season
keeping my shadow in the garden every day
i also volunteer at least 3 days a week in the community garden for 2-3 hours at a time
this has helped me rebuild my stamina back
eg
i recently was able to haul mulch in a larger container up a steep hill several times the other day
not long ago i couldnt even go up the hill once without a container
we spend more time helping out with or grandkids than in the past since mr hudson requires a restricted environment and limited exposure to people
my volunteer time with the alzheimers organizations has stopped for now
so even though the covid 19 has changed what we all do a lot we stay busy
i have recovered a lot from being sick this spring and am getting closer to where i was presickness
we have a new normal now
we have learned to live with it
im just glad to be alive and able to function as a normal cognitive person
something when i wrote that blog below i didnt think i would be still writing my blog today
________
01-22-2012
ANOTHER NEUROLOGY APPOINTMENT
well its time again
i have to go back for my 6 month follow up with the neurologist
this visit i dont mind
its usually in and out
how you doing
tap tap on the knee
refill the prescription
see you in 6 months
its been 15 months since ive been officially diagnosed with
mild cognitive impairment amnestic type
thought to be possibly due to alzheimers disease
only time will tell for sure if thats accurate
during that 15 months i may have noticed a subtle change but on
all those neuropsychological tests ive had over that time period
there has been no significant changes
thats like a cancer patient getting a negative pet scan
its reassuring
but as i know this can remain stable for awhile then take off
like it has with my younger brother
he sure has progressed during these last 15 months
he has gone from driving himself to now not driving himself
not getting himself dressed and requiring 24/7 monitoring
i think about him a lot and wonder if ill be like him and when
the decline will happen
but i have to continue to move forward and accept the fact that
i really dont know what will happen
only time will tell
i am doing all the things you and someone like me needs to do to
prevent or slow down the disease
exercise, control blood pressure,control lipids, maintain my weight,
stay mentally active, socialize, and take my dam donepezil (aricept)
i am afraid to stop it because i know it could be the one thing that is
slowing this disease down for awhile before it eventually takes off
if i stop it i could see a more rapid decline in my status
so i plan to continue it despite the side effects
at least its now a cheap generic
i and my wife she are trying to get things done now in this early time
as we dont know what will happen
we have a lot of travel plans and this is the year we are getting all our
financial and legal ducks in a row
we have paid off our house and our cars and this next month
we should be totally debt free
maybe ill call the dave ramsey show so i can scream were debt free
on his radio show
we enjoy each other more now than we ever have before
and know to savor each day as it happens
ive continued doing this blog and spend a few hours on it everyday
i also walk 3-4 miles a day and have taken up hiking trails in this area
sorry ive missed some of the beauty around here over the last 10 years
ive also started a habitat for humanity project that i plan to follow
through to completion
ok so im going to learn some skills i can apply to the redo of my old barn
i will start tomorrow delivering meals on wheels in this area
this is something ive wanted to do
my mother always looked forward to those meals and those
brief interactions with the person that delivered the meal
i have tried to read a real paper newspaper a day and read several
online news websites every day
i also read a book every day if possible
ok my stack is kinda high in my to read stack
i havent made the kindle transformation yet
i like the feel of a book and love to dog ear those pages
but know i will eventually have to give in and use one
i stay busy maintaining my 10 acres here at the country n and
my organic garden
i will never get all this stuff done that needs to be done here
but its fun trying
so i hope in the next 15 months that things will not progress any
that will be good news for my wife she and i
stay tuned
_________
here is hoping for a few more years of good health
the organicgreendoctor
when wrote that blog over 8 years ago i wasnt sure what i would be like in 2020
if you had asked me i would have probably said that i would be in the throes of early alzheimers disease no longer driving no longer doing my blog no longer traveling no longer doing our finances no longer doing those things that folks usually do every day
well
here i am 8 years later still doing all those things
sorry i dont even try to look 10 years ahead now
the covid 19 pandemic has changed all of that
i still write my blog regularly
we have no plans to travel until the threat of the covid 19 is all gone
i realize that our traveling days may be done for
you can read in the old blog posted below that we were staying busy
we traveled several times a year to california to visit our family and did several summer trips including our annual family reunions and trips to the western us eg grand canyon southern utah etc
i was about to start a several years course of volunteering for habitat for humanity and for meals on wheels
my how covid 19 has stopped all that
we try to limit our exposure to the virus as much as we can
our lives stay busy though
i try to go to my garden every day especially during the veggie growing season
keeping my shadow in the garden every day
i also volunteer at least 3 days a week in the community garden for 2-3 hours at a time
this has helped me rebuild my stamina back
eg
i recently was able to haul mulch in a larger container up a steep hill several times the other day
not long ago i couldnt even go up the hill once without a container
we spend more time helping out with or grandkids than in the past since mr hudson requires a restricted environment and limited exposure to people
my volunteer time with the alzheimers organizations has stopped for now
so even though the covid 19 has changed what we all do a lot we stay busy
i have recovered a lot from being sick this spring and am getting closer to where i was presickness
we have a new normal now
we have learned to live with it
im just glad to be alive and able to function as a normal cognitive person
something when i wrote that blog below i didnt think i would be still writing my blog today
________
01-22-2012
ANOTHER NEUROLOGY APPOINTMENT
well its time again
i have to go back for my 6 month follow up with the neurologist
this visit i dont mind
its usually in and out
how you doing
tap tap on the knee
refill the prescription
see you in 6 months
its been 15 months since ive been officially diagnosed with
mild cognitive impairment amnestic type
thought to be possibly due to alzheimers disease
only time will tell for sure if thats accurate
during that 15 months i may have noticed a subtle change but on
all those neuropsychological tests ive had over that time period
there has been no significant changes
thats like a cancer patient getting a negative pet scan
its reassuring
but as i know this can remain stable for awhile then take off
like it has with my younger brother
he sure has progressed during these last 15 months
he has gone from driving himself to now not driving himself
not getting himself dressed and requiring 24/7 monitoring
i think about him a lot and wonder if ill be like him and when
the decline will happen
but i have to continue to move forward and accept the fact that
i really dont know what will happen
only time will tell
i am doing all the things you and someone like me needs to do to
prevent or slow down the disease
exercise, control blood pressure,control lipids, maintain my weight,
stay mentally active, socialize, and take my dam donepezil (aricept)
i am afraid to stop it because i know it could be the one thing that is
slowing this disease down for awhile before it eventually takes off
if i stop it i could see a more rapid decline in my status
so i plan to continue it despite the side effects
at least its now a cheap generic
i and my wife she are trying to get things done now in this early time
as we dont know what will happen
we have a lot of travel plans and this is the year we are getting all our
financial and legal ducks in a row
we have paid off our house and our cars and this next month
we should be totally debt free
maybe ill call the dave ramsey show so i can scream were debt free
on his radio show
we enjoy each other more now than we ever have before
and know to savor each day as it happens
ive continued doing this blog and spend a few hours on it everyday
i also walk 3-4 miles a day and have taken up hiking trails in this area
sorry ive missed some of the beauty around here over the last 10 years
ive also started a habitat for humanity project that i plan to follow
through to completion
ok so im going to learn some skills i can apply to the redo of my old barn
i will start tomorrow delivering meals on wheels in this area
this is something ive wanted to do
my mother always looked forward to those meals and those
brief interactions with the person that delivered the meal
i have tried to read a real paper newspaper a day and read several
online news websites every day
i also read a book every day if possible
ok my stack is kinda high in my to read stack
i havent made the kindle transformation yet
i like the feel of a book and love to dog ear those pages
but know i will eventually have to give in and use one
i stay busy maintaining my 10 acres here at the country n and
my organic garden
i will never get all this stuff done that needs to be done here
but its fun trying
so i hope in the next 15 months that things will not progress any
that will be good news for my wife she and i
stay tuned
_________
here is hoping for a few more years of good health
the organicgreendoctor
Tuesday, July 21, 2020
organicgreendoctor: how risky is it to go to an event where you live
organicgreendoctor: how risky is it to go to an event where you live: HOW RISKY IS IT TO GO TO AN EVENT WHERE YOU LIVE georgia tech risk assessment tool mr hudson update he should have been discharged a we...
how risky is it to go to an event where you live
HOW RISKY IS IT TO GO TO AN EVENT WHERE YOU LIVE
georgia tech risk assessment tool
mr hudson update
he should have been discharged a week ago
however
since he developed fever he has had to stay an extra week
it has been an up and down week for mr hudson this last week
initially his fever responded to the antiinfectives then it returned yesterday
although as a low grade temp that as of last early evening went away
we are awaiting this mornings report
if he can stay afebrile he may get to be discharged later this week
he felt better yesterday
here is crossing our fingers
one of the common ways the covid 19 gets spread is via group get togethers
like
weddings
anniversaries
birthdays
funerals
sunday church
etc
one person can come into that group and in some cases infect the whole group
in some cases causing the death of some of the vulnerable members
like parents and grandparents
then
from there it spreads out into the community
if you think you will attend one of these events think twice about it
remember vulnerable doesnt just mean grey headed folks
its asthma obesity hypertension pregnancy crohns ulcerative colitis arthritis like lupus rheumatoid chemo patients etc
many of whom are young
georgia tech did an assessment map
you can put in the number that will be at the event
slide over to its counties location
it will give you a percentage risk that at least one person will be at that event with covid 19
so
i pretended i was going to a wedding where 25 people would be there
i looked at places where i have lived
where i went to college in riverside ca 62% note the nearby county is 98%
where i live now in santa barbara 58%
where i went to medical school in little rock 51%
where i get my infusions in los angeles 61%
where i grew up in southern arkansas 20%
where i was in practice in texas 73%
where i lived at the country n 49%
there are places in hot spots that are over 90%
here is the link to the assessment map accessed by clicking here
slide in your number that will be there
put your cursor over the county where the event will be
that number gives you an idea if you should go
may answer without seeing it is
dont go
and
that person there wont give you the covid 19
so
be safe
wear a mask outside your home
keep your distance from other people
wash those hands
the organicgreen doctor
georgia tech risk assessment tool
mr hudson update
he should have been discharged a week ago
however
since he developed fever he has had to stay an extra week
it has been an up and down week for mr hudson this last week
initially his fever responded to the antiinfectives then it returned yesterday
although as a low grade temp that as of last early evening went away
we are awaiting this mornings report
if he can stay afebrile he may get to be discharged later this week
he felt better yesterday
here is crossing our fingers
one of the common ways the covid 19 gets spread is via group get togethers
like
weddings
anniversaries
birthdays
funerals
sunday church
etc
one person can come into that group and in some cases infect the whole group
in some cases causing the death of some of the vulnerable members
like parents and grandparents
then
from there it spreads out into the community
if you think you will attend one of these events think twice about it
remember vulnerable doesnt just mean grey headed folks
its asthma obesity hypertension pregnancy crohns ulcerative colitis arthritis like lupus rheumatoid chemo patients etc
many of whom are young
georgia tech did an assessment map
you can put in the number that will be at the event
slide over to its counties location
it will give you a percentage risk that at least one person will be at that event with covid 19
so
i pretended i was going to a wedding where 25 people would be there
i looked at places where i have lived
where i went to college in riverside ca 62% note the nearby county is 98%
where i live now in santa barbara 58%
where i went to medical school in little rock 51%
where i get my infusions in los angeles 61%
where i grew up in southern arkansas 20%
where i was in practice in texas 73%
where i lived at the country n 49%
there are places in hot spots that are over 90%
here is the link to the assessment map accessed by clicking here
slide in your number that will be there
put your cursor over the county where the event will be
that number gives you an idea if you should go
may answer without seeing it is
dont go
and
that person there wont give you the covid 19
so
be safe
wear a mask outside your home
keep your distance from other people
wash those hands
the organicgreen doctor
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