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, July 29, 2020

my story revisited #51-scans and post visit and post video and workup

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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
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
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
your diagnosis would be pretty accurate

now if the new blood test turns out to be accurate you can add that one
the diagnosis would probably be certain

we have come a long way in the last 10 years
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

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

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

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

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