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, June 2, 2023

organicgreendoctor: alzheimers news-its almost official

organicgreendoctor: alzheimers news-its almost official: ALZHEIMERS NEWS-ITS ALMOST OFFICIAL a quick review  what happens in the development of alzheimers is amyloid accumulates in plaques in the b...

alzheimers news-its almost official


a quick review 
what happens in the development of alzheimers is
amyloid accumulates in plaques in the brain killing brain cells
tau proteins in the brain cells unwind and forms tau tangles killing brain cells
inflammation sets in killing brain cells

the anti amyloid drugs bind to the amyloid plaques to remove them
by doing so it slows down the alzheimers process
this slows cognitive decline

there are 3 anti amyloid drugs that will get approval for use by the end of this year
my drug aduhelm which i have had 30 monthly infusions is approved already but is limited to research only unless you want to pay for it yourself
leqembi will get full approval by the fda next month
donanemab will probably get full approval later in the year

cms or medicare and medicaid has said that once a drug gets full approval that it will pay for it

these drugs will soon be available to all of you to take in a matter of months
there will be strict criteria for who can get it

you have to have mild cognitive impairment from alzheimers or early alzheimers
diagnosed by an amyloid pet scan or by a spinal tap for amyloid and tau
in the future blood tests will do this

then if you meet the health and age requirements you can get it

the biggest risk factor is having the apoe 4 gene or even more risk is the homozygous apoe 4 gene like i have
it puts you at a higher risk of microhemorrhages in the brain or major bleeds
anticoagulation is another risk factor also eg being on coumadin
there will be multiple other risk factors also

you if you get treatment will be monitored closely for bleeds ie mris of the brain

if you have one of these diagnoses of mci or early alzheimers you may qualify for early treatment to maybe slow down the disease

i feel like that the earlier you start treatment the longer effect it will have on slowing down the disease

if this had been available in 2010 i would have gotten on it and received 13 years of treatment so far
this would potentially slow down the disease some 
could it allow me to see ms b graduate from high school
but i have will only have gotten 4 years of treatment when i end my study next year

the treatment with one of these 3 drugs will probably be done until the measurable amyloid plaques are gone from the brain
some maintenance dose will be given long term
eg it might be once twice three times four times a year
it probably will be based on what the amyloid pet scans show

some folks including me feel like that by removing the amyloid you also slow down the tau tangles and the inflammation 

new drugs to attack the tau tangles are starting to be studied now
as are new drugs to attack the inflammatory process that happens also

i could easily be on two other drugs 
one to attack the tau tangles
one to attack the inflammation that ensues

the secret will be to treat this all as early in the process as possible

there are studies like the ahead study ongoing now and looking for volunteers that will identify folks with amyloid in the brain who have no symptoms
they will be treated with one of these drugs before symptoms start
this is where the treatment will eventually be done

its like treating cholesterol
you treat the cholesterol in your middle age to prevent a stroke hearty attack or alzheimers disease later in life

for me
i will finish my embark aduhelm study next year 
i will follow the research on which of these works the best and has the fewer side effects
i will get regular maintenance dosing to keep my amyloid plaque levels down
when the anti tau drugs become available i will take those also
i will
control my cholesterol with a statin
control my blood pressure with a drug if i need it
stay active mentally physically socially
get adequate sleep
eat a well balance diet like the mind diet
avoid stress anxiety 
stay happy
maintain a normal weight
avoid excessive alcohol
avoid smoking

new treatment centers will pop up everywhere to give these infusions
so they should be available eventually everywhere
instead of kidney centers we will have brain centers

hopefully all of this will slow down the disease

the organicgreen doctor

Wednesday, May 31, 2023

organicgreendoctor: my story #178-then and now

organicgreendoctor: my story #178-then and now: MY STORY #178-THEN AND NOW these pictures above are of amyloid pet scans of the brain form the phase 1 aducanumab study from nature on the l...

my story #178-then and now


these pictures above are of amyloid pet scans of the brain form the phase 1 aducanumab study from nature
on the left is the scans when the study was started
on the right is the scans 1 year after treatment

that red stuff is amyloid 
the first one on the right is a placebo patient after one year
i was a placebo patient after 18 months
my amyloid pet scan probably looked like this after those 18 monthly infusions of saline
it would be full of the red stuff

then i got the real drug 
so far i have had #30 aducanumab or aduhelm infusions
my amyloid pet scan i will be getting in two weeks should look like the 10 mg/kgm  one
ie there should be no red stuff showing up

below i wrote a blog to ms b my granddaughter of around 3 at that time 

i wrote 
ms b look over at that chair 
if this stuff works then i will be sitting in that chair when you can read this
if it doesnt work then that chair will be empty

well 6 years later today as she reads this it looks like that chair has me sitting in it


now ms b
i hope when you read this
well my guess is that you will probably be around 10-15 years old
when you first read this
as you sit on the couch with your laptop or your whatever is being
used then
as you read this blog today
i hope you will be able to look over at the easy chair in your
living room
there sitting in that easy chair will be me
ill look at you
ill understand
i we made it

you see ms b
i have or may have alzheimers disease
i hope by the time you read this
you will know a lot about the disease
we should have a good treatment or maybe a cure
when you read this

today ms b
your gma and i make the drive up to ut southwestern in dallas
a 3.5 hour drive
i drive up there
your gma drives home

today we are going there to get a scan
called the amyvid pet scan
its a scan that will show the beta amyloid if its there
hopefully you will know a lot about this disease and
will understand what this means

a quick summary
i have a strong family history of alzheimers disease
i have a gene apoe 4 that puts me at risk for getting alzheimers disease
i have abnormal levels of beta amyloid and tau protein in my
spinal fluid which is associated with alzheimers disease
i had a normal memory tests 8 years ago then 3 years later
it was abnormal

so i probably have alzheimers disease
i take medicine called aricept donepezil for it
i am aggressively doing healthy things to help
i need one more thing
i need the final picture the final piece of the puzzle
the amyvid pet scan for the beta amyloid

if its positive
well i got it that alzheimers disease

the good thing though is that if this thing is positive
like i expect it to be
then i qualify for the aducanumab study

i then will receive monthly infusions that has a chance to slow it down
if we are lucky stop it in its tracks

so ms b
todays important to us

so ms b
as you read this look over at the chair
if its empty
this stuff didnt work
if i am sitting over there smiling at you
this stuff worked
 yesterday i had a tau pet scan at ucla
i was there for about 5 hours
i have had 3 of these 
i have one more to go next year at this time in this study

if i could see it i could tell where the alzheimers was active in my brain allowing me to predict where my symptoms would show up first

next week i have a day long of memory testing and neurological exams and end the day with a mri of the brain

looking back i feel like it was a good decision to be in this study

this week i can sit in ms b and mr hs living room and they will look over and ill be there

the organicgreen doctor

Tuesday, May 30, 2023

organicgreendoctor: censorship at its worst

organicgreendoctor: censorship at its worst: CENSORHIP AT ITS WORST npr.org i remember watching her read her memorable poem over 2 years ago tearing up some as she read it i knew that t...

censorship at its worst



i remember watching her read her memorable poem over 2 years ago
tearing up some as she read it
i knew that this was a reading of a poem that will be remembered well in history 

it was maya angelouish
it was shown and read in schools and homes across the country
i wanted my grandkids to read it and watch her reading of it when they got old enogh to read
ms b was there 2 years ago
i want her to know who amanda gorman is
her generations maya angelou

i watched her read it this morning and read along as she read it
i said
is in there that needs censored by that elementary school in florida

this is censorship at it worst

take the time to reread this historical poem and watch her reading of it

whats wrong with us

every generation has its lifetime poet or author
my generation the baby boomers have maya angelou as its lifetime poet or author
other generations had robert frost
i can still hear maya angelou as she so eloquently read her poems
leaving a lasting impression on my brain and in my heart

so now
enter amanda gorman
this generations lifetime poet
the harvard graduate national youth poet laureate 
she also like maya angelou has left a lasting impression on my brain and in my heart

i want ms b and mr h and mr n to know who she is and to appreciate her artistry
listen to what she wrote 
listen to her read those words
follow what she wrote
for us all to make our lives better

she spoke so eloquently even though she started her life with a speech impediment
she overcame that as she also overcame a lot in her life
to be
the next lifetime poet or author of this generation

i sat down and watched the video below of her speech
as she spoke
i read the words that are posted below her video
to make it easier to appreciate what she is saying

this is the answer to what ails us as a society 
this twenty-two year old gives us the road map to the future
its up to us to follow it

ms b read and enjoy

click this link to the video if it doesnt show on your feed 

the hill we climb


When day comes we ask ourselves,

where can we find light in this never-ending shade?

The loss we carry,

a sea we must wade

We’ve braved the belly of the beast

We’ve learned that quiet isn’t always peace

And the norms and notions of what just is

Isn’t always just-ice

And yet the dawn is ours before we knew it

Somehow we do it

Somehow we’ve weathered and witnessed

a nation that isn’t broken

but simply unfinished

We the successors of a country and a time

Where a skinny Black girl

descended from slaves and raised by a single mother

can dream of becoming president

only to find herself reciting for one

And yes we are far from polished

far from pristine

but that doesn’t mean we are

striving to form a union that is perfect

We are striving to forge our union with purpose

To compose a country committed to all cultures, colors, characters and conditions of man

And so we lift our gazes not to what stands between us

but what stands before us

We close the divide because we know to put our future first

we must first put our differences aside

We lay down our arms

so we can reach out our arms to one another

We seek harm to none and harmony for all

Let the globe, if nothing else, say this is true:

That even as we grieved, we grew

That even as we hurt, we hoped

That even as we tired, we tried

That we’ll forever be tied together, victorious

Not because we will never again know defeat

but because we will never again sow division

Scripture tells us to envision

that everyone shall sit under their own vine and fig tree

And no one shall make them afraid

If we’re to live up to our own time

Then victory won’t lie in the blade

But in all of the bridges we’ve made

That is the promise to glade

The hill we climb

If only we dare

It’s because being American is more than a pride we inherit,

it’s the past we step into

and how we repair it

We’ve seen a force that would shatter our nation

rather than share it

Would destroy our country if it meant delaying democracy

And this effort very nearly succeeded

But while democracy can be periodically delayed

it can never be permanently defeated

In this truth

in this faith we trust

For while we have our eyes on the future

history has its eyes on us

This is the era of just redemption

We feared at its inception

We did not feel prepared to be the heirs

of such a terrifying hour

but within it we found the power

to author a new chapter

To offer hope and laughter to ourselves

So while once we asked,

how could we possibly prevail over catastrophe?

Now we assert,

How could catastrophe possibly prevail over us?

We will not march back to what was

but move to what shall be

A country that is bruised but whole,

benevolent but bold,

fierce and free

We will not be turned around

or interrupted by intimidation

because we know our inaction and inertia

will be the inheritance of the next generation

Our blunders become their burdens

But one thing is certain:

If we merge mercy with might,

and might with right,

then love becomes our legacy

and change our children’s birthright

So let us leave behind a country

better than the one we were left with

Every breath from my bronze-pounded chest,

we will raise this wounded world into a wondrous one

We will rise from the gold-limbed hills of the West,

we will rise from the windswept Northeast

where our forefathers first realized revolution

We will rise from the lake-rimmed cities of the Midwestern states,

we will rise from the sunbaked South

We will rebuild, reconcile and recover

and every known nook of our nation

and every corner called our country,

our people diverse and beautiful will emerge,

battered and beautiful

When day comes we step out of the shade,

aflame and unafraid

The new dawn blooms as we free it

For there is always light,

if only we’re brave enough to see it

If only we’re brave enough to be it.”

amanda gorman

our hill may be higher to climb than we realized
dont let a few ruin it for the rest of us

enjoy her writings ms b

the organicgreen doctor