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

Friday, April 15, 2022

alzheimers news-there arent enough alzheimers specialists


what are alzheimers specialists

they are neurologists
geriatric psychiatrists

there is a limited supply of these alzheimers specialists in the united states
there are now over 6 million plus folks with alzheimers disease

that doesnt even count those folks who will be diagnosed earlier than ever before
many with mci or mild cognitive impairment due to alzheimers with be diagnosed early with the emphasis now on early diagnosis

this will produce a lot of folks needing to see these alzheimers specialists

there arent enough of them 

i predict that soon there will be a lot of testing in the primary care doctors office and probably in those do it yourself testing sites that will be doing these new testings for biomarkers in the blood that will tell you if you have the positive biomarkers for alzheimers meaning you will likely develop full blown alzheimers one day

as a review
in the development of alzheimers as the amyloid accumulates and the tau tangles start forming and as inflammation starts you will soon be able to measure that in the blood

the stages as alzheimers develops are
prealzheimers or prodromal alzheimers where there is no memory loss but these blood biomarkers will be positive
there are millions of these folks that will be diagnosed

mci or mild cognitive impairment due to alzheimers disease
these patients like me have mild memory issues with positive blood biomarkers

early alzheimers 
these patients have more advanced memory loss with the positive blood biomarkers

middle or mid alzheimers
these folks are early alzheimers patients who have developed worsening memory and other neurological problems

late alzheimers 
these alzheimers patients are advancing into the later and the downward course of the disease
the final step is death

who is going to diagnose and treat these patients
there arent enough alzheimers specialists

i make my neurology appointments a year in advance and dont dare try to change it
they are hard to come by

the only solution i see
the primary care physician

i understand its hard to have a lot of dementia or alzheimers patients in your practice
a busy family practice

i think if i was in practice now i could accurately evaluate diagnose and treat most alzheimers patients
the secret is to make an accurate diagnosis
this is so much easier to do then it was a few years ago
add the new blood biomarkers and the pet scans for amyloid then its easier to diagnose these memory patients

you could save the alzheimers specialists for the more difficult patients

we do this  now with heart disease hard to control hypertension hard to control diabetes hard to control lung disease hard to control depression and anxiety hard to control cholesterol to name a few diseases

eg i use to take care of a lot of childhood asthmatics and think i did a good job of managing their asthma
sometimes these patients reached a point where they needed a pulmonary specialists to manage their asthma

when i was in practice i wasnt good at taking care of alzheimers patients
i tended to refer them to neurologists for evaluation and treatment
if they werent too complicated many times the patient would return to me for medication management
ie aricept or donepezil

i might do some lab work but didnt really do much else except for ruling out abnormal labs and maybe doing a quicky clock memory test

i really did not know as much as i do now about alzheimers disease and its management
i began to learn more when my mom was diagnosed and later when my younger brother was diagnosed
that happened in the last years of my practice

it was after i was diagnosed with mci due to alzheimers disease
i began reading a lot more about alzheimers disease got involved in clinical trials and began doing alzheimers talks to groups

i began following the research and will read several articles on alzheimers disease each day
i read 10 articles this morning on alzheimers disease and read through two new clinical trials that are starting up

today if i was in practice i would do like i did with my asthmatic patients
i would diagnose and manage most of them myself
seeking out alzheimers specialists whenever i needed help with diagnosing or management of a patient

i would be able to take care of the majority of these patents and diagnose them with a high degree of accuracy

thats the solution here
is to train primary care providers to do what i would do if i was in practice

it could be done with educational outreach programs to retrain primary care providers to do more of the work and do it accurately 

here is a link to an article i read about this today that sparked me writing this blog
its a review from the 2022 dementia fact figures report from the alzheimers associations 

the solution is not training more alzheimers specialists since that will take years to do
the solution is to educate our primary care providers

they need a cookbook of alzheimers management 
a simple straight forward easy to follow guide

there arent enough alzheimers specialists to take care of the millions that are going to be diagnosed in the future

the organicgreen doctor

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