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, January 12, 2022

my story revisited #119-i dont like this gene


when i see the word gene i think of two things 
my friend gene
the apoe 4 gene
the first one i like 
the second one i dont like

the first one has the advantage of being a life long friend since medical school
the second one has no advantage at all that i know of

the bad gene puts me at risk for developing alzheimers disease
i have two bad genes the apoe 4 genes not my friend gene that puts me at a more increased risk for developing alzheimers
granted the other gene and i did some things together that probably wasnt good for our health like eating too much bbq and too much crawfish and shrimp and at times too much beer
we missed a lot of sleep during medical school and residency and in our medical practices
the good gene had very little influence on my diagnosis
the bad gene had a big contribution to my diagnosis

the good gene is a friend forever
the bad gene is an enemy forever

the good gene and i are friends and we were both southerners
we were both married with kids
we liked to fish
we liked country music 
in fact he introduced me to willie nelson music

we were opposite though
he was from texas and i was from arkansas
he was an avid longhorn fan and i was an avid arkansas fan
he was the opposite of me on the political leanings
he was opposite of me on religion
he was a pathologist and i was a family physicians
we were opposites in many ways but similar in others

but he was a good gene and is still is

i met the good gene when i was around 28
i met the bad gene when i was 60
i wish i hadnt met the bad gene
im glad i met the good gene

now this bad gene is coming back to be an issue with me
since i now have mci due to alzheimers disease
also the bad gene has put me at a higher risk for having microbleeds in my brain as i get the higher dose of aduhelm 
i receive these infusions monthly in biogens embark aduhelm study 
i have now received the maximum monthly dose 
my last mri over a month ago was normal 

in the last two weeks i started having headaches that lasted over 3 weeks without any explanation except for a possible microbleed or aria from taking aduhelm

i have now been headache free for almost 5 days
yesterday i had a mri of the brain to rule out a microbleed or aria
the mri has to be sent to biogen to read and review to decide if i had a microbleed
that will take about 4 days before i know

if its a microbleed the infusions will be paused until the mri is normal then i would restart the infusions

if there is no microbleed then i go in a week for an antiaduhelm antibody test
if it is ok
then i will resume my infusions in early february at my next scheduled infusion date
i would miss only one infusion

my guess is that i did not have a microbleed and that i will move ahead as scheduled next month

one of my best friends name is gene
one of those forever friends
i could write a lot about him and things we did
but then he would have to write about things i did
then i would write about things he did
well you can see where thats going
nothing good might come of that

im writing about another gene
thats the apoe4 gene and i guess this all could apply to
other genes like eg huntingtons disease

first the apoe4 gene
if you have a double version or
a homozygous version ie the apoe4/apoe4 version
you have an increased chance of developing alzheimers
a 10-30? times chance of developing the disease the late onset
version of alzheimers disease
<6% of us have this combo
up to 25% of you have the singe version of apoe4

so theres a lot of you 25 of 100 of you who read this have
this apoe4 gene
a fairly common gene wouldnt you say

some of you with the apoe4/apoe4 gene will not get alzheimers

so its not one of those 100% genes
like huntingtons disease
like the dominant genes for alzheimers that some get
you get the gene you get the disease
100% guaranteed
(see the colombian alzheimers study)

with eg cystic fibrosis if both parents have a cystic fibrosis gene
then the child has a 25% chance of getting the gene
if the child gets the double gene they have a 100% chance of getting the disease
1 in 30 white folks carry this gene

with the apoe4 gene the double gene apoe4/apoe4 you have a
10-30% chance of maybe getting late onset alzheimers disease

why am i writing about this

i had a lengthy conversation with someone a young someone in
their thirties who got tested you know those things you see on tv
where they swab your cheek and its sent in and then
back comes results that has no real good accompanying explanation
of what that means what it really really means for that particular person

i felt ready when i was tested
i was mentally ready to be tested
i was 60 and had just been told i had mild cognitive impairment amnestic
type that could turn out to be alzheimers disease
based on changes on mental status evaluation over a 3-5 year time period
things i had noticed in my daily life
a strong strong family history of alzheimers disease
so i wanted as much information as possible to help me make decisions
on my personal situation moving forward

i was ready so i was tested
it was though one of those surreal moments when i opened that
letter and read the results
even then i didnt understand what it really all meant like i do now

a positive test with the history above is not a good thing

now move to this person i had the talk with

they have a real strong family history in grandparents and uncles
now i was tested by a real reputable lab that my neurologists used
this person was tested by that lab that advertises on tv that the fda
is trying to shut down

but i dont doubt though that this persons apoe4 test wasnt correct
what was missing was what does it really really mean
the lab where i was tested will not test cause you want it tested
it has to be ordered by someone who feels its necessary and can
appropriately counsel you on what it really really means

so what does this mean for this thirty year old
it means that this person has a 70% chance that this person will not get
alzheimers disease
but im sure this person is locked in on the 30% risk the person was given

the odds are
1 in 1 you will die of something
1 in 7 you will die of heart disease
1in 7 cancer
1 in 28 chronic lower respiratory disease
1 in 108 moving vehicle accident
1 in 340 assault by firearm

1 in 5 is the lifetime risk of developing alzheimers disease in women
1 in 10 for men
(women live much longer than men so they are more likely to get it)

so in summary for this person
i wouldnt have been tested without counseling first
this person could have a 1 in 5 chance of getting alzheimers without the
apoe4 gene
the apoe4/apoe4 gene increases this some
that xx gene a female has increases the chance almost as much as the apoe4 gene

there are so many things that factor in to someone getting this disease
it appears that for the apoe4/apoe4 gene combo it may not be
as important eg as

controlling ones blood pressure
getting exercise
not smoking
having moderate alcohol intake
sleeping normal
controlling anxiety and depression
being happy
staying mentally active
eating a mediterranean diet of less red meat  eat fish fruits nuts veggies
olive oil and whole cereal foods

so be careful of being tested for these different diseases
make sure you are ready if you are going to be tested
make sure you get the appropriate counseling
if you are positive for things like huntingtons or the dominant gene
for alzheimers eg
make sure you have your life planned out
with life insurance disability insurance and maybe long term care insurance
thanks to obamacare health insurance wont be an issue

you wont be able to get any of these after these diagnoses are on
your official medical records
(now in 2022 there are some laws to protect from the insurance companies)
that includes the apoe4/apoe4 gene results

so testing for those gene things should not be taken lightly
do genetic counseling first
the only gene i want to have to be associated with in the future
is my old friend
do put some thought before you get genetic testing for diseases
make sure you understand what it means if the test is positive

ill take the good gene anytime

the organicgreen doctor

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