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, August 5, 2020

alzheimers news-what to do if you have memory issues

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yesterday i spent an hour with a couple where one of them was having memory issues
a friend had contacted me and asked if i would talk to them
i did via zoom and the phone
they lived on the east coast

afterwards i told them i would write a blog today so that others who might need the information i told them would be able to read what i told them
it might help someone

if you have memory issues you should be evaluated
make an appointment with your primary care provider or a specialist like a neurologist only for one reason memory loss
this is especially important if you see your primary care provider who may try to focus on something else thats wrong with you
make appointment for memory loss only 
let that be the total focus of the office visit

do not go by yourself
most providers like a family member to interview
eg they request my wife she come to my neurology visits

write down what issues you have
write down all the medications you take either prescriptions or over the counter otc including any herbal supplements

the provider should take a thorough history and examination looking for reasons for memory loss 
eg anxiety depression uncontrolled blood pressure uncontrolled cholesterol medications sleep apnea morbid obesity lack of exercise uncontrolled diabetes old head injuries chemical exposures etc

they usually do labs like a complete blood count cbc a complete metabolic profile that checks things like your electrolytes your liver functions your kidney functions a vitamin b12 level a folate level a homocysteine level a vitamin d3 level
these are the ones most folks check although some dont check the homocysteine level
an elevated homcysteine level may be associated with an increased risk for heart disease stroke or alzheimers disease although some doctors dont agree with that it does

then an in office memory test should be done 
a simple clock test might be ok if its grossly abnormal 
if its normal that doesnt mean anything
a better in office memory test is the moca test like trump says he took
if its normal thats good
if its abnormal then 
you might consider doing a full neuropsychological exam which is usually done by a psychologist or a neuropsychologist
its the gold standard memory test

sometimes even thought he moca test is normal and there is still concern for the memory loss then they may go ahead and do the neuropsychological exam anyway

they might do an mri scan of the brain
if someone has memory issues this is usually done
the mri looks for brain shrinkage old strokes old trauma cysts masses vascular abnormalities etc 

when one has had all of these tests done usually the medical provider can come up with an accurate diagnosis

usually all of the tests i mentioned above are covered by health insurance 
there are some that one can have done that will improve the accuracy of the final diagnosis
health insurance doesnt pay for them

an amyvid pet scan to show the amyloid plaques in the brain 
if you have alzheimers it will be positive
if its negative you dont have alzheimers disease
there are a few other neurological diseases that make the amyvid pet scan positive
but usually they are evident in all the testing above

a spinal tap for amyloid levels and tau levels in the spinal fluid
alzheimers patient have a certain ratio of those two

so if you have all of these tests done you will know as certain as one can in 2020 if you have alzheimers disease

it is important that anything that is discovered in the evaluation be corrected
sometimes correcting these may improve ones memory
if you have sleep apnea it needs to be treated 
any anxiety or depression should be adequately treated
diabetes and blood pressure and cholesterol should be controlled
obesity should be addressed 
you should strive for a normal bmi or body mass index
regular exercise is important 
social interaction with others are important
mental exercise is important like reading writing playing chess doing word games etc
keep that brain active
eat a healthy diet like the mind diet
dont smoke 
limit your alcohol intake
avoid stress

if you are diagnosed with alzheimers disease or mild cognitive impairment and are given aricept (donepezil) or namenda (memantine) then i would take it
these drugs may slow down the symptoms some

i think i am doing so well now because i did all of those healthy things above and am taking the aricept (donepezil)

then finally 
consider getting into an alzheimers research study
type in alzheimers disease
select the state you live in 
you should find what alzheimers research studies are available in your area

here is a scientific study just published looking at these things to do that might help
warning this is a scientific study so if you arent a science person 
click on this review article that summarizes what they found

good luck on having your memory evaluation
there is a cause for it 
it should not be ignored 

the organicgreen doctor

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