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, May 11, 2022

my story revisited #136-do your forms


link to my lecture
this picture i ran across this morning online
its taken from a lecture i gave on alzheimers disease in 2016
it was in the time when i was being evaluated for the biogen aducanumab study that i was eventually approved to be in  

the video is about an hour long
i talked about alzheimers research that was ongoing at that time

now 6 years later
the bace inhibitor studies didnt pan out as they made things worse
the insulin nasal spray is only now getting started
the solanezumab didnt work either
the a4 study is just now finishing up and results should be available soon
the aducanumab study well we all know about that one
it got approval amongst some controversy
medicare says they will pay for only if its in a research study 

in my old blog below i review the paperwork that an elder lawyer suggested
i had an old will from the mid 1990s that needed to be updated
it would be 5 years before we got ours redone
it took the pandemic and me thinking i was going to die to get ours all finished

we did all these below including a trust
the trust was mainly to save taxes on our deaths to prevent probate costs

we chose someone who does mainly elder law and whom we saw lecture several times at the alzheimers symposiums

update on biogen aduhelm or aducanumab study called embark that i am in
another infusion in two weeks
a tau pet scans in about 3 weeks
an all day memory testing in 4 weeks
a mri in about 6 weeks

so far no side effects
so far no memory issues

it doesnt really matter how old you are
you should have these things done
dont wait until its to late
it becomes harder and more expensive to take care of things

yesterday i went to the second annual alzheimers symposium
in temple texas
its the one that i gave a presentation to on my story with
possible alzheimers disease last year
this years focus was on the caregivers

the first presentation was given by an elder lawyer

his first topic was guardianship
you dont want to have to do this
as its expensive and the control of your or your family member is
under the control of the court system

he said avoid this if possible
the best way is to be prepared
by having all the forms and documents mentioned below
done correctly
and there will be no guardianship
you dont want some lawyer or judge having to ok checks for
you or our loved one

the younger you do all of this the better
one speaker a bioethicist from california is the caregiver for
her brother who was in a car accident and now has a head injury

without the paperwork being done ahead of time
a guardianship may have to be done

if you do all this right he said then you get to determine guardianship

do a medical power of attorney or power of attorney for health care
put one person in charge with alternative persons if that one is not
capable or able

unless i piss my wife she off royally i have her as my medical power of
attorney with my sons listed as backup
my wife she and i have had discussions about what i dont want

side bar another speaker the bioethicist showed a graph of what
physicians dont not want done if their health is terminal like with
alzheimers or cancer etc
100% said no cpr-the survival rate for cpr in these situation is 0%
most said no cpr no ventilation no dialysis no surgery
no invasive testing no feeding tube no antibiotics no iv hydration
but >90% said they wanted pain medication
the two lowest was iv hydration and antibiotics at 60%

we must know something you guys dont

after practicing for >25 years i would say 100% no to all of those
things especially cpr and ventilation

if it happens to me as i get demented i plan to come back
and haunt the heck out of whoever did it to me

now im not talking about right now as im in great health
except for that alzheimers cloud thing hanging over my head

do a hippa release form 
if you havent ever got pissed off when you try to get information
on a family member you may not understand how important this
one is

he suggested to not use the one from the hospital but get one
on line that covers things better

without one you may be shut out of your spouses medical
information if they become incapacitated

do a directive to physicians or living will
make sure this thing has things like no feeding tube no cpr no ventilation
no chemotherapy etc if you become incapacitated with a terminal disease
dont let others wonder what you would want

if things get complicated or if the doctors or hospitals screw up or
if another family members doesnt agree
this and the other forms are so important in overriding their objections

do an out of hospital dnr form
he suggested to google it and use a printed out form
without this if the emt paramedics come to your home or
to the nursing home etc they might do all that stuff that drs dont
want them to do to themselves
hopefully flashing that form in front of them will stop them

do a durable power of attorney
this gives someone and he recommended picking one person
with backups if that person is not able to do it
this gives them the right to do your financial and legal stuff when
you are incapacitated
and can prevent you from having to go to court for guardianship to
do your loved ones financial and business stuff

he recommended the durable power of attorney be updated every
few years as some banks etc will not recognize one eg that is
15 years old

he also suggested a living trust but not everyone agrees with
this recommendation
this one provides another layer of protection

some of these things can be done without an attorney
but some need their input

interesting was that the attorney i used for my will etc
was at the conference since she has become more involved
with elder law
since her dad had alzheimers disease and she learned
first hand what mistakes could be made and prevented

i plan to pull out all my documents this week and review them
i know that i plan to add more specific details to my directive
to physicians or living will
i dont have an out of hospital dnr
my hippa form is not a more involved one
i am not sure if i will do a living trust
i plan to seek other counsel on that one

be sure and use forms specific for your state as each states laws
may be different

so dont wait to get all this done
wait to long
a local judge and lawyer will make the decisions for you
not your love ones
i did all these except i didnt do the cpr since i feel like i right now am a good candidate for cpr
when my dementia worsens i want my no cpr form done and tattooed on my chest
not everyone needs a trust
if not sure consult a lawyer

dont let the state decide what happens to you and your estate

the organicgreen doctor

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