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

Monday, June 21, 2021

organicgreendoctor: covid 19-beware the delta

organicgreendoctor: covid 19-beware the delta: COVID 19-BEWARE THE DELTA whats the delta its known also as the india variant its what took over india when they thought they were doing so ...

covid 19-beware the delta

COVID 19-BEWARE THE DELTA

whats the delta
its known also as the india variant
its what took over india when they thought they were doing so good with the pandemic
its killed thousands of folks there
its now the dominant strain in great britain
here in the us its around 10% of the cases of covid 19
by the winter it will be the dominant variant
it is much more transmittable
which means it more easily infects folks then the original wild type
what this means for the unvaccinated folks in the us
since the vaccinated folks are protected by the vaccine
is
things you did over the last year will later this summer and fall get you infected
so far here in santa barbara none of the deaths from covid 19 have been vaccinated
they were all unvaccinated
thats whats happening across the us and the world

if you are unvaccinated you are vulnerable

the india or delta variant and other covid 19 infections are seeing an uptick in missouri arkansas mississippi and alabama since they have the highest unvaccinated folks in the us 
plus
they have a higher population of at risk folks

this delta variant is expected to spread across texas across the deep south to the coast of north carolina and south carolina
why
low vaccine rates
poor protective measures like masks distancing etc
larger numbers of high risk populations
its attacking younger folks the hardest and fastest

also they are seeing now and are expected to see more later this summer and fall and winter of all the upper respiratory illnesses like covid 19 flu parainfluenza rsv pneumonias
these attack the young and the oldest the most these non covid 19 infections
luckily most older folks are protected from covid 19 now

an aside here
not getting vaccinated will be decreasing it appears the numbers of republican voters across these southern states if the vaccination rates among this political party persists
a deadly form of voter suppression

biden has a goal of 70% of eligible adults to be vaccinated by july the 4th
right now he is around 67% plus or minus here in our county
hopefully as school approaches and when the 6 mo-12 year olds become eligible that number will get much better
maybe then we can reach that magic herd immunity 
sadly
that herd number will be achieved by infecting and killing hundreds of unvaccinated folks 
and
leaving thousands with permanent long term maybe forever disabilities
eg
i talked to a physician who had covid 19 last year when i think i had mine
he was mainly hit with neurological symptoms that persist even now a year ago

its not too late to get vaccinated
if you are not vaccinated you should wear a mask in high risk situations
you will probably catch the virus from kids and other unvaccinated contacts
these contacts are likely to have minimal or no symptoms

be ready later this summer and fall for the next surge of cases
how big it will be will be determined by 
how many more get vaccinated
how safe unvaccinated people are being
how many get ill from the covid 19

be safe and careful if you are unvaccinated

so what am i doing
i am vaccinated
i have a miniscule chance of catching covid 19
i probably can safely do what i want to do without being careful or wearing a mask
but
i wear a mask in places where its required
its a whiny thing to refuse to wear a mask
its so simple to place it on 
i carry one in my pocket all the time if im unmasked somewhere

if i was unvaccinated i would only wear a n95 mask and do it when outside
no matter what the guidelines are
it is mainly what will keep you from getting infected if you are around folks

thousands of nonbelievers in mask wearing and vaccinations died because of their beliefs
hundreds more will die as the year goes on especially this fall if we dont get more folks immune to this virus
we are doing this to ourselves
while the rest of the world is begging for vaccines
we are being the ugly americans again it seems

i wear a mask when i am around folks who are worried about catching covid 19
i would have no qualms about going to a concert or movie or restaurant or flying now

i will wear a mask if i am in situations this summer and fall and winter where i could catch a respiratory illness such as flu parainfluenza rsv pneumonia etc

so
beware the delta
its looking for someone to infect 

the organicgreen doctor

Friday, June 18, 2021

organicgreendoctor: alzheimers news-here is to a new start today

organicgreendoctor: alzheimers news-here is to a new start today: ALZHEIMERS NEWS-HERE IS TO A NEW START TODAY in this blog i wrote on wednesday about in 2017 the day before and the day after i got my firs...

alzheimers news-here is to a new start today

ALZHEIMERS NEWS-HERE IS TO A NEW START TODAY

in this blog i wrote on wednesday about in 2017 the day before and the day after i got my first infusion of biogens aducanumab drug that removes amyloid from the brain
i got 18 months of placebo and 7 months of the real drug aducanumab now called aduhelm
the study was stopped aburptly in 2019
its restart was delayed over a year because of the covid 19 pandemic

the plan is for me to get about 24 monthly infusions of aduhelm (aducanumab)
it will over that time remove all of the measurable on a amyvid amyloid pet scan amyloid that is in the brain 
leaving me with a negative amyvid pet scan in 2 years

the big question is
does it make a difference
will the amyloid all come back if the infusions stop
the answers will be made at the end of this 2 year study and the one that the fda is requiring biogen to do 
that required study could be 5-9 years long
so
we will know for sure how well it works when this is all done

there is controversy on whether this drug should have been approved

as i said in my new york times interview i think it should have been approved
and
so does this researcher dr stephen salloway who treated the first patient with aduhelm (aducanumab) and has treated over 65 patients with this drug for over 5 years
he has the most experience of anyone using this drug
he thinks it should have been approved and notices that it has made a difference in his patients who were treated
he has also noticed a decline since his patients were stopped for awhile during the studies pause

here is the link to an article where he is interviewed about using aduhelm (aducanumab) in these early alzheimers patients

so with all this in mind
we are off to ucla in a couple of hours 

we will zoom along the 101 down to the congested 405 to get there
on this mission today the traffic will not phase us at all

here is our schedule
see the neurologist for recheck on my status to make sure im good to go today
have the first visit memory testing done
have an ekg
have my vital signs taken
have blood drawn for blood count ie cbc blood chemistries urinalysis aducanumab serum level ie whats my aducanumab level to start with and an anti aducanumab antibody level
then
if all is clear
ill stick out my arm and get my iv 
then 
they will hang up a bag of aduhelm (aducanumab) at a low concentration i think this one will be 1 mg
over the next few months that will be gradually increased to 10 mg
why
there is a chance of some microbleeds called aria to happen 
its more likely to happen in folks like me who are apoe 4 apoe 4 positive
this aria usually resolve

i have had 7 of these infusions in the past and didnt have any aria on mri
and i have had plenty of mris
i will have several this year

the infusions in the past usually took 1 hour then you have to wait 30 minutes post infusion to leave

today from start to finish is about 5 hours +-
future infusion visits will take about 3 hours 

the trip down will take 2 1/2 to 3 hours
the trip back on a friday will take 3+ hours

folks its all well worth it

will i notice anything after the infusion 
nope no instant change 

the improvement in cognitive decline seen with this drug aduhelm (aducanumab) is a gradual slow one
ask me if i notice anything in 2 years

another reason i am glad to be able to get on this drug so early is that of all the 3000+- folks who have been put on this drug worldwide in these research studies i am probably the one who is the earliest in the disease process and may be one of those who could get the most benefit

so
if anyone is going to benefit from taking these aduhelm (aducanumab) infusions
it will be me

come on 
lets get going on his new journey
follow me along this journey 

im pumped
im ready

the organicgreen doctor

Wednesday, June 16, 2021

organicgreendoctor: my story revisited #91-ill say 1 down and 25 to go

organicgreendoctor: my story revisited #91-ill say 1 down and 25 to go: MY STORY REVISITED #91-ILL SAY 1 DOWN AND 25 TO GO it is interesting to read my old blog its like reading a journal someone might write out ...

my story revisited #91-ill say 1 down and 25 to go

MY STORY REVISITED #91-ILL SAY 1 DOWN AND 25 TO GO

it is interesting to read my old blog
its like reading a journal someone might write

out of the blue they called me on my birthday 4 years ago to let me know they could start the infusions of aducanumab now called aduhelm since its fda approved to be used in mci due to alzheimers and early alzheimers 

as i read my thoughts i wondered what i would feel in 2 days as i head to ucla to restart the aducanumab study that i was in 
i am due to get infusion one and then every 29 days after that i will receive another 25 infusions
at the end of these 100 weeks i will have gotten a total of 32 infusions of aduhelm (aducanumab)
plus i got 18 months of placebo

i of course would prefer to have gotten 18 more months of aducanumab

at the end of this study more will be known about how well this really works
then
this study could be extended
or
if it seems the aduhelm may be working i can change to the private world outside the research world and continue the infusions here locally

this gives me and the scientific world time to figure out whether to continue them or not

i will get based on the price thats proposed about $112,000 worth of infusions plus about 6 memory testings multiple neurological evaluations multiple mris of the brain and several amyloid pet scans and lots of labs

the cost to me is $0
well just some of my time and effort

its worth it to be able to get it early before it goes to market
it puts me a few months ahead of getting treated

now 
heres hoping it works to slow the disease down
_________

03-23-2017
ALZHEIMERS NEWS-ITS MY DAY
today is my birthday
i have had a lot of birthdays
the 40th one was memorable
yes i got black stuff and got my yard trashed
i got all those over 40 jokes

then
came number 50
yes i got the aarp stuff in the mail

then
came the number 60
i told my wife she
i just want a quiet one
have people leave me alone
no harassment please
i got enough at age 40 and 50

after my 60th birthday
our life was humming along pretty good
we had no idea what would be coming along
in about 9 months
our lives would change

kabam
there was the diagnosis
that diverted our future to where it is today
an uncertain one

now
i have got a lot of presents over the years
some well most have been good ones
but
yesterday
well
i got the best birthday present ever

my phone rang
hi
this is the alzheimers disease center at ut southwestern
we have an opening tomorrow at our infusion center
do you want to start your aducanumab infusions tomorrow

i didnt even hesitate a second
we have made receiving these infusions our priority
yes
ill be there
early

im ready
to get this show on the road
the sooner the better

for those who dont know
aducanumab is an antibody that attacks the bad beta amyloid
that accumulates in the brain
beta amyloid is thought to be the substance that causes alzheimers disease
if you remove it
the alzheimers disease may be stopped or at least slowed down

i will be one of the first to get this stuff at the alzheimers center

everyone knows the drug humira
its advertised on tv all the time
its used for diseases like rheumatiod arthirits ulcerative colitis
crohns disease and other connective tissue diseases
its given as shots under the skin usually every 2 weeks
its an antibody against a protein that causes the inflammation in
these diseases
its generic name is adalimumab

my drug
aducanumab
my birthday present today
works similarly
but
the protein it attacks is the bad beta amyloid in the brain

this drug aducanumab
is the best hope that we have right now to slow this disease down
this study i am in will determine if it works or not
my reading and my hope is that it will

so
i am ready
to get the best birthday present ever today
it must be a sign
getting it today on my birthday
i believe
i believe
its a good sign


03-24-2917
ALZHEIMERS NEWS-1 DOWN 47 TO GO
i did it yesterday
i got my birthday present
as i wrote the best ever

as i drove the 3 hours trip i did a lot of contemplating
thinking about this 6 year long journey that i have been on
hoping it will last a long long time before its all over

i thought how lucky i am to be this far along
and not have worsening memory loss

during that time this last 6 years
i lost my brother from the final stages of this disease
had my older brother get diagnosed with it

i thought maybe just maybe i am the lucky one
getting an opportunity that they didnt get
to really really slow this down

i am honored to be in this trial
knowing that if its successful as it might be
that it could be a game changer for me
and all my relatives behind me
to have a chance to avoid this awful disease

thats how close we are to finding a treatment
its right now today not off tens of years from now
for me and my family it started yesterday

yesterday the day for the rest of our lives

lets getter on is what i muttered under my breath
i arrived yesterday early of course to the infusion center
its located in this building at the university of texas southwestern
medical center
i walked up to this desk where the busy infusion center is
there sits this guy called santa claus
he is the receptionist
everyone calls him that
since he looks like santa claus
and
plays one at christmas
nice as you would expect santa claus to be
nice first person to interact with

then there was some snafu
we may have to reschedule
some protocol has to followed exactly right
i was the first one starting this study there
some special approval had to done by some god in massachusetts
or somewhere back east at biogen

we may need to reschedule if you dont want to wait
nope i said
im staying until this gets settled
ive waited too long and this may mean too much to me and my family
i just want to get this thing done
getter done i mumbled under my breath

finally after awhile it all got cleared up

back i went
nice nurse
nice receptionist
nice neurologist
it helps to have nice medical personal taking care of you
when you are dealing with the unknown
dealing with a terminal illness
i remembered as i watched them start my infusion and draw my blood
their patients are the ones that dont usually fair well
its their diagnoses

below thats the brown bag stuff hanging on the pole
the stuff thats either fake stuff or the real deal
the real deal for me please
me
i thought as i watched them hook all this up
i want to be the exception for them
i want to be a success result

the only thing i noticed as i got my infusion was
that i tasted salt on my tongue and i got real thirsty
dont know if thats a good sign or not
when it comes to whether or not i am in the placebo group
or not

if i get headaches get confused have some dizziness
then theres a good chance i got the real deal stuff
however not everyone has side effects
i am at higher risk for side effects since i have the apoe 4/apoe 4 gene
this gene put me at an increased risk for getting alzheimers disease

prior to getting the infusion i had a memory test done
for some reason i noticed that i did better on it than usual
it may be because i have had it done so much
i can anticipate the answers before they ask the questions
however
they for this study do a variety of memory tests
most of which i havent done before
which make them more accurate

so
i finished my infusion without any effects
now
i return each month to do the same thing all over again
except
i dont have to wait around the extra hour or so like i did
this time
in and out in an hour or so each time

i decided i can deal with whatever problems pop up
for
in the end it may be all worth it

i scheduled my next infusion date on 4/20
i did that date on purpose
its in case you dont know is marijuana day

why pick that day
well
there is a lot of research that needs to be done on the ingredients
in marijuana
they appear to be useful in the treatment of neurological diseases
like alzheimers
however
the federal government severely limits the research that needs to
be done on these marijuana ingredients

in my contact with folks affected by these diseases
they are using marijuana
obtaining it from states where its legal
using strands that have the potential to help

its sad that good scientific research cant be done
to find things like this that may help

its my small way of protesting our governments restrictions
on this research

but
hopefully if this aducanumab stuff works for me
i wont have to get involved with using any 420 stuff

next
a month of waiting
then
round two

keep following me on this journey
i am hoping the end result will be a good one
if it is
there may be hope for a lot of people
__________
you can bet ill do a lot of daydreaming as i head down to ucla
i probably wont have the same degree of excitement i did on that first infusion 4 years ago
but
there will be excitement nonetheless

another memorable day in the fight to slow down the disease

the organicgreen doctor

Tuesday, June 15, 2021

organicgreendoctor: do dreams come true

organicgreendoctor: do dreams come true: DO DREAMS COME TRUE this picture was from a blog i wrote a couple of years ago about my dreams called  monsters under the bed i think this d...

do dreams come true

DO DREAMS COME TRUE

this picture was from a blog i wrote a couple of years ago about my dreams called 
monsters under the bed
i think this dream was triggered by looking at our closet which you can see in the dark picture above
if you look closely at that pictures you can see them

i have written about my aricept dreams i have which are induced by the aricept (donepezil) 
these dreams are usually quite vivid but usually are not that disturbing
usually i can scare off the monsters or whatever is trying to get me on that particular night
usually i can yell our or throw a pillow at them and they will go away

eg throwing a pillow at the closet scared those monsters away from our room

the dream i had two nights ago didnt have monsters in it
well in a way it was a monster
the alzheimers disease monster

i have wondered a lot over the last 10 years about what were my mother and my younger brother thinking as they slid into the alzheimers abyss
did they know they were slipping away 
or
was it so slow that they didnt realize it
or
did they reach a point where thinking those things dont happen anymore

alzheimers has been on my mind a lot the last few days since i was interviewed for the ny times article and since the aduhelm (aducanumab) was approved for the treatment of early alzheimers and since i have been reactivated in the aduanumab study so that i get my first infusion in this study in 3 days
a lot of people have asked me questions about all it

i  have been thinking a lot about alzheimers and what i will be like in the near future

i wrote this blog to ms b called thank you for letting me into your world so she can read it when she graduates from high school in 12 years since i probably wont be cognitively aware or alive when she graduates

all of this was on my mind two nights ago

i dreamed i had stopped practicing medicine because of my diagnosis
that part is true i did 
once diagnosed and placed on the alzheimers drug aricept (donepezil) i felt like i should not be practicing medicine so i stopped practicing and retired my medical license

since then my memory has improved gradually over the last 10 years so i feel like i could be practicing now
no i dont plan to do that 

so
all this thinking about that made me have this dream

i was working in the clinic in my dream where i was in practice
one thing i had given up was my dea number which allowed me to write certain prescriptions
but i was practicing and still writing those prescriptions when i needed to for patients care
now this is in my dream not in real life

then
in my dream my memory had deteriorated so that i got lost trying to go to the clinic
when i got to the clinic i couldnt find the office i worked in 
i couldnt remember the names of the doctors i worked with 
i couldnt remember patients or fellow employees

as usual i woke up before i was able to finish my dream

i wondered where it was heading had i not woke up
i would like to have it continued so i could find out more

this dream has stuck with me the last few days since i feel like i got an insight into what its going to be like when my memory fades
its probably what my mother and my brother felt as their memory faded away

it felt like when i had a concussion and i was talking crazy like and the memories after that concussion are real fuzzy

so 
thats where i am this morning with this dream
it gave me an insight to what it may be like

im afraid this is a dream that i will remember as long as i can remember things

oddly
its not really a disturbing dream
it was an almost calming one
its ok i said to myself as i woke up 

so
do dreams come true

some probably do 

the organicgreen doctor

Monday, June 14, 2021

organicgreendoctor: covid 19-what to do if you are unvaccinated

organicgreendoctor: covid 19-what to do if you are unvaccinated: COVID 19-WHAT TO DO IF YOU ARE UNVACCINATED here are some latest numbers on how many people are vaccinated where you live now these numbers ...

covid 19-what to do if you are unvaccinated

COVID 19-WHAT TO DO IF YOU ARE UNVACCINATED

here are some latest numbers on how many people are vaccinated where you live
now these numbers are for total population not just vaccine eligible adults

it seems to me this is the number we need to be following
vaccinated of total population
unvaccinated of total population 

46% in santa barbara vaccinated vs 54% unvaccinated

what that means is over half of the folks you encounter here are unvaccinated

28.1% vs 71.9% in mississipi
41 vs 59 in florida
32.1 vs 68 in arkansas
37.4 vs 62.6 in texas
32.7 vs 67.3 in tennessee 
39.8 vs 60.2 in kentucky 
33.8 vs 66.2 in georgia
35.6 vs 64.4 in missouri
32.2 vs 67.8 in louisiana
49.3 vs 50.7 in new york
45.6 vs 50.4 in california

you can add probably between 20-30% to those vaccinated numbers to get an estimate of how many folks are probably immune to getting the infection

80% immunity is probably about where we ought to be to really drop that curve down close to zero

so
if you live in 
california that means about 65-75% are immune
mississippi that means about 48-58% are immune
texas that means about 57-67% are immune
arkansas that means about 52-62% are immune
etc etc

right now in most places the numbers of infections are down
eg here they are way down
some states like texas are starting to see an uptick in cases
the uk variant is the dominant strain
the india variant is approaching 10% and will become the dominant strain by the fall
it is much more contagious

its expected that this fall when the respiratory infections like the flu parainfluenza rsv bacteria pneumonia start their uptick
so will covid 19

those areas will low vaccine rates and those areas with high risk populations like those states mentioned above across the south will be hit the hardest

so in many of these states around 65-75% of those you encounter will not be vaccinated
ie for every 100 people you encounter 60-70 arent vaccinated

hopefully when we start vaccinating the kids less than 12 we will see those numbers get much better
remember kids dont usually get that sick with covid but they can transmit it 

so in some places this fall after that age group is vaccinated we might be approaching some degree of immunity across our populations

so what to do if you are unvaccinated

if you are in those medically vulnerable categories you need to be real careful
or
if you are around vulnerable folks you also need to be also careful for them

you should wear a mask when you are in situations that are risky
like
inside where the ventilation is poor or it feels risky
outside if you can be away form large groups of folks you would be ok
to be safe wear your mask
if you go to church inside wear a mask while there
if you get together inside with unvaccinated folks wear a mask
if you get together inside with vaccinated folks you might be ok if you dont wear a mask
if you go to school wear a mask
if you go to work inside wear a mask

remember out of the 500+- who die each day with covid 19 in the us very few if any were vaccinated ie they are unvaccinated
if you are unvaccinated you are at risk
if you are vaccinated you are probably not at risk

so
what am i doing
i wear my mask leaving my condo and if i go to a store or a crowded situation or to the garden 
i am really not worried about getting infected since the chances are close to zero
but i know its not zero but close
i know i probably dont need to wear a mask at all
i have noticed though that in some places people dont feel comfortable with you not wearing a mask
wearing a mask is no big deal for me
this weekend while in the community garden by myself i kept my mask on since i realized it has been protecting my face from sun exposure for the last year 
i may keep wearing it for that reason
man i dont wont any more mohs surgery on my nose and face
we no longer wear a mask around hudson
i think he enjoys seeing our faces again

i also might continue wearing a mask through this winter to protect myself from getting sick from all the other respiratory illnesses that may come back this year with a vengeance

so
if unvaccinated
wear a mask 
keep your distances unless you are around vaccinated folks
most of those you encounter during the day are unvaccinated
if you can get your vaccine unless you medically cant
wash your hands
remember it will be your family and friends that give it to you
think carefully about whether you need to travel
if you are vulnerable because of your health be even more careful

remember 
this virus will be coming back stronger this fall and will only infect those who are unvaccinated or who are not immune
how bad it will be will be determined by how many of the rest of yall get vaccinated

i know we will celebrate this fall when ms b and mr hudson get vaccinated then our family will be fully protected

so if unvaccinated be careful

its sad to see those death numbers each day in the us
all of them could have been protected

the organicgreen doctor

Friday, June 11, 2021

organicgreendoctor: alzheimers news-here we go again

organicgreendoctor: alzheimers news-here we go again: ALZHEIMERS NEWS-HERE WE GO AGAIN this is me standing outside the ucla building that houses the pet scanner where i had my amyvid pet scan fo...

alzheimers news-here we go again

ALZHEIMERS NEWS-HERE WE GO AGAIN

this is me standing outside the ucla building that houses the pet scanner where i had my amyvid pet scan for amyloid yesterday
this is the scan that will show how much amyloid i have left up in my brain
some of it was removed thats the amyloid not the brain when i did those 7 months of infusions of aduhelm (aducanumab) before the biogen aducanumab study was halted
how much was removed and has remained gone will show up on this scan
that will be my new starting point when i restart my infusions of aduhelm (aducanumab)

amyloid accumulates in the brain over years and is the first part of the alzheimers disease process followed then by tau protein accumulation then followed by inflammation

aduhelm (aducanumab) attacks just the amyloid and over time removes most of that that can be seen on an amyvid or amyloid pet scan

so yesterday i got my new baseline amyvid pet scan

heres how its done


they start an iv on you



then they inject you with this radioactive material that binds to the amyloid in the brain
you have to wait about 30-50 minutes after the injection before the scan is done


they then put you in this pet scanner 
its much quieter than a mri and is less confining
the scan takes about 25 minutes
then you are done 


if the scan is negative it will look like the one on the left
however
if its is positive it will look like the one on the right

my guess if some of my amyloid was removed and not replaced since my last infusion that my amyvid pet scan will look halfway between the two 
ie
the scan may show some clearing of some of the amyloid

alas i will never see the scan or be given the results

im ok with that
my goal is to get my infusions of aduhelm (aducanumab)

so
in 3 weeks i go back to get a tau protein pet scan in that same pet scanner except i will be injected with a radioactive material that this time binds to tau tangles in the brain
this tells the researchers how bad the alzheimers is 
it appears that aduhelm (aducanumab) may also remove some of the tau tangles

alas again i will not see those results

then 
finally 
the moment we have been waiting for for over 2 years
in 1 week
i go back to ucla
i restart my monthly infusions of adhelm (aducanumab) for at least 24 weeks as part of a continuation of the biogens aducanumab study i was in  

i have followed the research and understand the controversy with this drug and i understand its limitations
but
like the others in the alzheimers world it gives us some hope

i must say we be stoked to get started

the organicgreen doctor