organicgreendoctor: alzheimers news-will a skin biopsy tell you

organicgreendoctor: alzheimers news-will a skin biopsy tell you: ALZHEIMERS NEWS-WILL A BIOPSY TELL YOU no not a biopsy of the brain that doesnt sound good it seems ripe for something to go wrong like infe...

alzheimers news-will a skin biopsy tell you

ALZHEIMERS NEWS-WILL A BIOPSY TELL YOU

no not a biopsy of the brain
that doesnt sound good
it seems ripe for something to go wrong
like infection nicking a blood vessel hitting the wrong spot eg
 
now i had two spinal taps as part of the first alzheimers study i did called the adni 2 study
i had no problem but on the second one he did stick my nerve and i felt a bolt of lightning go down to my big toe but it quickly went away
i did say a four letter word when it happened
i had no problems afterwards

well my wife she did
she fainted and she wasnt even in the room when i got my spinal tap
she was in the waiting room
she required care not me
i even had to drive to the pet scanner since she was too woozy to drive

this last week i went to the dermatologist
i had a mole he wanted to biopsy so he removed it with a simple biopsy

i use to do them all the time
i used a punch biopsy
for this one you would use one the size of an ink pen opening
you know where the ink pen pokes through
my guess thats about 3 mm in diameter

now it may be possible to do a skin biopsy to tell if you have alzheimers disease

you just do a local injection to numb the area
use a punch to take out say a 3 mm piece of skin
then put a bandaid over it
done

the specimen would be sent to be read to see if you have alzheimers disease or parkinsons
your primary care doctor could easily do the biopsy
takes about 5 minutes to do

here is a review of the discern test by the american academy of neurology
they did skin biopsies on patients who had brain biopsies at autopsy
they found the discern skin biopsy was 95% accurate sensitivity and specificity

those with alzheimers have a 7 times increase in tau proteins in the skin biopsy
those with parkinisons have an 8 times increase in alpha synuclein proteins

now you still need a good neurological history and exam
some labs
memory testing
maybe an mri

then to definitively diagnose alzheimers you can do 
a blood test thats available in research but eventually will be available in private practice
a spinal tap checking for amyloid and tau levels in the spinal fluid-ouch
an amyloid pet scan to check for amyloid plaques and or a tau pet scan for tau tangles
or
maybe 
just just get a punch biopsy for a discern test 

the skin test sounds so easy 
the blood test is really a screen test for now
the spinal tap is accurate but many folks wont or cant get one
just dont bring your spouse

the amyloid pet scan is the definitive gold standard test and also gives you more information

then
the discern skin biopsy test will give you the answer also
plus medicare pays for it

last week i thought about this as the dermatologist was biopsying my mole
hey 
add an alzheimers skin test to that study i started to say to double check all my testing i have had done 
but 
no i didnt

physicians may use this test to decide if someone with memory issues really has alzheimers disease so they can decide if eg aricept or donepezil is needed
or
if my drug aduhelm or the new one leqembi or soon to be here donanemab would be administered
right now an amyloid pet scan is required first 

who would have thought a skin biopsy could verify you have alzheimers or parkinsons



join me for our santa barbara walk to end alzheimers on saturday october 14th
join us and or donate to our organicgreendoctor team 
or do your own local walk

the organicgreen doctor

organicgreendoctor: garden news-putting a faucet on a rainwater barrell

organicgreendoctor: garden news-putting a faucet on a rainwater barrell: GARDEN NEWS-PUTTING A FAUCET ON A RAINWATER BARELL this is a rainwater tank donated to the garden by my daughter in law she gave us two of t...

garden news-putting a faucet on a rainwater barrell

GARDEN NEWS-PUTTING A FAUCET ON A RAINWATER BARELL

this is a rainwater tank donated to the garden by my daughter in law
she gave us two of them

the problem was the faucets were missing
the holes for the faucets were predrilled
the problem was that the holes dont fit the faucet spigots commonly used for these tanks

i needed a hole drilled 1 1/4 inches

we now have 4 tanks that hold 60 gallons of water 
do the math that gives us 240 gallons
we catch the water off our two chicken coops off approximately 160 square feet of roof space
again doing the math a 1 inch rain will give us about 80 gallons of water each
it would take 3 inches of rain to fill up all four tanks

just think about all the water we are letting run out onto the street down the drain and out to the ocean

we use the water to mainly water new seedlings or new plantings or when we mix our fish emulsion for foliar feeding our veggies
 

now this tank has a narrow lid so i couldnt reach down and bolt down the spigot from the inside
at the coutnry n i use to use these large bulkhead parts
i was able to find this kit online with the spigot and bulkhead connection made for smaller tanks


it includes a string pipe tape spigot the bulkhead connection
the bolt that tightens it is a reverse one
its lefty tighty and righty loosy instead of righty tighty lefty loosy


the hole needed to be enlarged to a 1 1/4 inch hole so i used this bit attachment


i carefully drilled the hole since i was only enlarging the diameter by 1/4 inch


then i dropped the string down from the top of the tank then pulled through the string from the hole i had just drilled 
see that yellow string with one end on the ground and the other end hanging down from the top

then i reached in with my finger after dropping down the bulkhead piece over the string and pulled it through the hole


then i screwed on the bulkhead nut making sure i went lefty tighty not righty tighty
yes i did it wrong several times
its hard to break old righty tighty habits

then i removed the string

 i use to have to do this on my 3000 gallon tanks at the country n
so this one was easy peasy 


this what the end result is
hopefully its a leak free connection

this tank will be connected to the blue y connector to its neighboring tank
these two tanks are connected to tanks under the downspouts of the chicken coop
now all we need is more rain
sitting next to these two tanks is a 60 gallon tank that captures any overflow if the tanks fill up

we also have two  60 gallon tanks that we will connect to guttering off a shed in our front area
so
we will have 420 gallon capacity for rainwater collection eventually
yes i am infecting the garden with the rainwater collection virus or rwc virus for short

my rainwater brother who also was infected with the rwc virus would be proud of this
im sure he is looking down smiling at us


below is the flyer for our annual fundraiser for the garden


it is renaissance themed but not a fair
food and drinks and music will be scattered throughout the garden
plus you get to enjoy the beauty of our garden at sunset and dusk

please donate and or join us for the event

the organicgreen doctor

organicgreendoctor: my story revisited #188-it was much adu about some...

organicgreendoctor: my story revisited #188-it was much adu about some...: MY STORY REVISITED #188-IT WAS MUCH ADU ABOUT SOMETHING thats one of my former patients wearing our walk t shirt for our walk to end alzheim...

my story revisited #188-it was much adu about something

MY STORY REVISITED #188-IT WAS MUCH ADU ABOUT SOMETHING

thats one of my former patients wearing our walk t shirt for our walk to end alzheimers that year
it was i think the first walk we did after i was diagnosed 

some of my kid patients called me dr duck thus the i walk for dr duck t shirt

this patient is now in college sadly at texas am
i always encouraged him to go to the university of texas
he didnt listen to me

in 2015 when i wrote the blog about aducanumab or now called aduhelm or as i called it the adu drug
i had read an article in a medical magazine about aducanumab 

i wrote maybe it would be out in 2018 for use 
it turned out to be 2022 slowed by the pandemic and by a poor attempt to get it approved by biogen that delayed it and probably permanently stained this drug for use
more than likely leqembi and donanemab will be used in place of aducanumab

when i wrote that blog i had just finished 5 years of the adni 2 study and was waiting for a treatment study
i had my eye on the aducanumab study
it would be a year later when i would be accepted in the study then two years later when i started treatment with aducanumab or as it turned out the first 18 infusions were placebo 
i have had 34 infusions of aducanumab or aduhelm

thsi blog below gives some of the history of where the drug came from
 __________
05-29-2015
ALZHEIMERS NEWS-MUCH ADU
this is much adu about something
that may be a game changer in alzheimers treatment
if we are lucky it will available in 2018

my wife she handed me this magazine
i still get all these free magazines from when i
was in practice
i rarely read them
we just recycle them

i opened to this article on a new potential treatment
for alzheimers
now i briefly wrote about it once before but this
article went into more depths on its history and its
potential

if you have an interest in alzheimers treatment you
should take the time to read this article

previous treatment studies with antibodies didnt show good results
why
they treated people who were later in the disease process
many were way too late
they also when they went back and rescanned folks
they realized many didnt have the disease at all

now you can accurately predict who has the disease by
taking a good history
doing memory tests
doing mri scans
doing glucose utilization pet scans of the brain
(alzheimers patients lose the ability to absorb glucose
and it shows as blank areas on the pet scan)
doing spinal tap for beta amyloid and tau protein in the
spinal fluid
(beta amyloid decreases and tau increases in the spinal fluid
as the disease progresses )
then
a beta amyloid pet scan called amyvid can be done to show if it has
accumulated
it starts 15-20 years before symptoms start

now i have had all these tests so thats why im more certain
about my diagnosis of possible alzheimers disease

these werent all done in the other companies studies that failed

a company called biogen entered the picture

an european researcher isolated an antibody from healthy
older folks who were very mentally alert
that antibody was eventually called
aducanumab
adu for short

so in phase 1 studies they take a small number of volunteers
to try different doses on them and to look mainly for
side effects
if things look promising they go to phase 2
then
if that goes well to phase 3
phase 3 is more expensive to do as it uses more folks
in the studies
its the phase right before the fda approves the new drug

what they found in the phase 1 study of adu
was that the antibody seemed to work
folks got better on memory tests and scans showed
the bad stuff beta amyloid was being removed from the
brain
a+b=c

why was this working
they screened folks better so that they were more sure that
they were dealing with alzheimers patients
they treated folks who had not developed full blown disease
but had positive scans
this is called preclinical alzheimers
they also treated folks with early disease  who had mild symptoms
i am in between these two
which has prevented me from being in some of these treatment studies

now adu is on to phase 3 studies
these results should be out in a couple of years
if things go well
then adu may be on the market for you and me
in
2018

so this is much adu about something
a game changer
for me and others if it works
__________ 

now in 2023 folks are screened first with a blood test that fairly accurately tells you if you have alzheimers
then if you pass that screen test they do a amyloid pet scan to be sure
then treatment can began if there are no contraindications to treatment
there is no reason to do a spinal tap
the glucose metabolism pet scan isnt generally done any more since the amyloid pet scan is readily available and gives you more information

so in 2015 that article was much adu about something important in the alzheimers world


join me for our santa barbara walk to end alzheimers on saturday october 14th
join us and or donate to our organicgreendoctor team 
or do your own local walk

the organicgreen doctor

organicgreendoctor: leave mitch alone

organicgreendoctor: leave mitch alone: LEAVE MITCH ALONE wikepedia thats mitch mcconnell in a happier and younger looking photo he is now 81 years old he fell and hit his head and...

leave mitch alone

LEAVE MITCH ALONE

wikepedia
thats mitch mcconnell in a happier and younger looking photo
he is now 81 years old

he fell and hit his head and apparently had a concussion
he apparently recovered from this
then
he started staring off to some unknown spot
not responding to anyone 
then
suddenly he came back to life

now ive stared out before and my wife she has talked to me and i dont hear her
i was in a deep state thinking of something important
then i hear her talking and i respond to her

if she was a doctor she would say did you just have a petit mal seizure
or its called an absence seizure ie you are absent
click on the link to read about this one
its usually in kids
probably not what mitch had

leave him alone even if it was a petit mal or absence seizure
he would just need antiseizure meds and he would be fine
his testing could all be negative

or
he could have had a partial seizure
his testing could be negative
the treatment is antiseizure meds and he should be fine

or
he could have a tia or transit ischemic attack or ministroke
read the link to know more
his testing could be normal
the treatment is controlling risk factors and some would give him a baby aspirin to take

i have ocular migraines which can be a version of a tia
i take a baby aspirin once a day in case it its a tia
i also had a complete workup for this

the head injury he had could have triggered the staring spell if its a partial seizure
or
he might have just been bored and was thinking about walking his dog in the park
or
like me i just stare sometimes in the garden and look up at the mountains above the garden enjoying the peace and quiet

nah
it wasnt that one
my guess its a partial seizure triggered from his head injury

if he came into my office with these symptoms i would refer him to a neurologist for a workup which would include 
a good thorough neurological and medical history and exam
some screening labs
an ekg
an eeg
an mri
maybe a carotid ultrasound

more than likely all these would be negative except for the history 
luckily a neurologist would have access to the videos of him staring

the diagnosis would probably be a partial seizure
the cause head injury 
the treatment  would be no treatment or antiseizure meds
then
leave him alone
quit picking on him for his age his gerontocity

like trump and biden you dont ask their age you ask are they doing their job
now i dont like the job that trump or mitch are doing but they seem ok to me
the same with biden

now with biden his speech issues are from a lifetime of problems with stuttering and his gait is from a peripheral neuropathy 
none means he cant do his job

so back to mitch 
leave him alone
hopefully he has had a complete workup and his folks arent lying about it 
you have to watch what they say 
eg
they said there is no evidence of any problem
no sorry 
we saw his staring off into space for a few seconds
twice
my money is on a partial seizure

leave him alone
let him do his job
if you dont like the job he is doing them vote him out of office

the organicgreen doctor

organicgreendoctor: garden news-bane of our existence

organicgreendoctor: garden news-bane of our existence: GARDEN NEWS-BANE OF OUR EXISTENCE this pretty white flower growing in our garden is called bindweed or wild morning glory i call it the bind...

garden news-bane of our existence

GARDEN NEWS-BANE OF OUR EXISTENCE

this pretty white flower growing in our garden is called bindweed or wild morning glory
i call it the bind of our existence
or 
morning gory

this plant will last in your garden up to 20 years
its roots can go deep in the ground to around 10 feet or more
break the roots off and they grow new plants
its almost impossible to remove them
no
its impossible to remove them
they will spread up to 6 ft
they grow around surrounding plants and tangle them up choking them out
thus the term bindweed

if you saw the biggest little farm they talk about bindweed
they had a huge problem in their orchards
they used sheep which kept the bindweed chewed down to the ground
that wont work in our garden since the sheep or goats would love all our veggies too much

once you got bindweed you got bindweed forever
you cant dig it out

we have spent endless volunteer hours hoeing this stuff
it has to be hoed every 3 weeks

our large pathway down and around one side of our garden is 120+ feet long
it is covered with the bindweed

we tried laying down cardboard and covering it with mulch
that lasts for almost a year then it eventually breaks through the cardboard

you could use that r word stuff but we are organic

here is the innocent looking bindweed just starting up
leave it there and it will take over
forever

so i would call it a forever weed

here is another bane of our existence
its bermuda or some here call it crab grass
arkansas texas folks its bermuda
it ranks up their with the bindweed as our biggest nuisance

if i had to chose from getting rid of bindweed or gophers
i would say bindweed since at least you can catch a few gophers
well maybe they are just as bad on second thought


here is the first part of the pathway which is about 40 feet long
i laid down a double layered heavy landscape fabric that is 6 feet wide
stapled heavy with landscape staples on the edge


then we placed a real thick layer of mulch over the fabric
those bags there on the left are donated soil amendments from our local home improvement center that i will put on the bed to the left when i redo it


here is the second part of the walkway that is about 80 feet long showing some mulch laid down over the landscape fabric


here is the finished product on that second side

we have done this in front of my garden plot 3 years ago and it is still working to block this bind of our existence

this should save us hours of weeding for a few years

now
what to do about those gophers
i plan to rewatch caddy shack to see what bill murray did

below is the flyer for our annual fundraiser at the garden


it is renaissance themed but not a fair
food and drinks and music will be scattered throughout the garden
plus you get to enjoy the beauty of our garden at sunset and dusk

please donate and or join us for the event

the organicgreen doctor

organicgreendoctor: my story revisited #187-things have changed some

organicgreendoctor: my story revisited #187-things have changed some: MY STORY REVISITED #187-THINGS HAVE CHANGED SOME thats me talking at the conference 8 years ago at texas state university i talked for about...

my story revisited #187-things have changed some

MY STORY REVISITED #187-THINGS HAVE CHANGED SOME

thats me talking at the conference 8 years ago at texas state university
i talked for about 20 minutes then let folks asked me questions
mainly questions they couldnt get answers to
i like doing these q and a sessions better than just talking

a lot of what i recommended hasnt changed in 8 years
except
now we can diagnose alzheimers with more certainty 
and
we know better what to do to prevent it
and
now we have treatments that if they are started early may slow it down some
ie
my drug aduhelm or leqembi or soon donanemab

this week as i got my #34 infusion of aduhelm at ucla i talked a long time with the head neurologist of the study i am in and i also talked a lot with the nurse that day who cared for me

in one year i have decisions to make about my future care
i have asked for permission to access my final amyloid pet scan so i can have documentation of my amyloid plaque status in my brain
i may need that when i try to get treated again with an antiamyloid drug
my guess is that once the amyloid plaque reoccurs in my brain then i will need retreated
or
i might need to be on some type of maintenance dose each year

i am leaning towards using leqembi since it will probably be given as a self administered shot in the future so i can give it myself when the time comes

plus there are antitau tangle drugs being studied in clinical trials now that will probably be on the market in time to help me

plus a lot of work is being done using antiinflammatory drugs also since inflammation is a big issue after alzheimers starts
one drug is a multiple sclerosis drug that treats inflammation in those patients
it may be used in alzheimers eventually to treat the neuroinflammation
those are already fda approved and would be used off label

so i am on the edge of accessing this as i age
hopefully my disease doesnt kick in before that access happens

wish i could have discussed all of this with them that day 8 years age
__________

04-20-2015

LINKS END
last friday i think i could have answered questions from
the audience all afternoon
and
they would have kept on asking me questions 

here are some links i promised to post today

first
for the lady whose husband may be experiencing some
memory loss

here below is a link to a pamphlet in the form of a pdf file
there explains dementia and what workup and treatment
should be done for this disease

the texas dept of health came out with clinical guidelines
for evaluating and treating dementia and memory loss
click on the far right pdf file

also here is a brief summary of what will be put in the
algorithm for evaluation of a patient for memory loss
that will eventually be available to all the primary care
providers in the state
the gold standard to be followed for evaluation of memory
loss

the first thing you need to do is go to this link
21 question questionnaire
answer the questions about your husband
score the answers
this gives you a good idea of where his memory loss is
copy this form off
take the answered and scored form with you when you
and he go to the doctor
yes dont let him go by himself

also make a written list of what you and he have noticed
to give to the doctor

he should have a good thorough medical history taken
and a good examination
looking for causes of memory loss
like
old head trauma  excessive alcohol   depression   anxiety
stress   sleep disorders like sleep apnea or restless legs
medications side effects   drug abuse   poor controlled
blood pressure or cholesterol   lack of exercise
obesity   diabetes    family history etc

then a memory in office test is done
they may do
a minicog test-3 words are named then you are asked to
draw a clock and put the time on a clock then you are
asked to recall the 3 words
if you dont do well on this one the patient may be more advanced

most neurologist will do a standardized test
the best to use is the moca test
its more sensitive for picking up early memory loss
eg i didnt do well on this one at my first evaluation

if the score on this one isnt normal
the full neuropsychological test should be done
administered by a psychologist or neuropsychologist
its the gold standard of memory tests

then
labs
almost all neurologists do these
cbc   metabolic profile(electrolytes, kidney and liver function and
glucose levels)   tsh for thyroid function   b12 level   vitamin d level
others would add
folate   homocysteine level(elevated levels may be associated with
stroke heart attack and alzheimers disease)   lipid profile hiv
my b12  and vitamin d levels were low
my homocysteine level was elevated

then
a mri should be done to rule out explanations for memory loss
like stroke old head trauma tumors too much fluid in the brain
brain shrinkage etc

after this complete evaluation then your husband should know
why he has memory loss
and
then can be told what he can do to help

other things to consider if further workup is desired but they
are not usually covered by health insurance are
the beta amyloid scan amyvid that shows if he has the bad
stuff beta amyloid built up in the brain

spinal tap for beta amyloid and tau proteins
these protein levels are abnormal in alzheimers disease

hope this is useful
anything less than this for workup of memory loss is
not acceptable

also
for the others who asked
if you go on your computers
not on your smartphone
go to my blog
at the top are links to
a video my wife she and i did for the
alzheimers center
a newspaper article form the austin american statesman
a newsletter from the alzheimers center at ut southwestern dallas

thanks for attending the dementia and aging conference
and
for asking such good questions
__________
now most of those tests are being done when a workup for memory loss is done
soon a blood test will be done before an amyloid pet scan is done or a spinal tap which no one likes to have done
this blood test will be fairly accurate
if its negative you are unlikely to have alzheimers disease
if its positive you probably do but an amyloid pet scan or spinal tap for amyloid and tau will solidify the diagnosis

then treatment will be offered
maintain a healthy lifestyle as i have mentioned multiple times in the past
also get started on aricept or donepezil
consider taking one of the antiamyloid drugs 
right now leqembi and aduhelm are approved
i know i would have had they been available in 2010 when i was diagnosed

so we have made progress in the last 8 years



join me for our santa barbara walk to end alzheimers on saturday october 14th
join us and or donate to our organicgreendoctor team 
or do your own local walk


the organicgreen doctor

organicgreendoctor: ALZHEIMERS NEWS-BLANK STARESwhen i write about bla...

organicgreendoctor: ALZHEIMERS NEWS-BLANK STARESwhen i write about bla...: ALZHEIMERS NEWS-BLANK STARES when i write about blank stares i dont mean like the one that mitch mcconnel did twice my guess those are parti...

ALZHEIMERS NEWS-BLANK STARES

when i write about blank stares i dont mean like the one that mitch mcconnel did twice
my guess those are partial seizures no one will just say that

in the alzheimers world especially if you have had a loved one with the disease
you know what a blank stare is

my mother had them
my younger brother had them
im sure i will one day also
its part of the disease

even now when i catch my self staring and daydreaming i think
is it my time
sometimes when my wife sees me staring and daydreaming i think she thinks that too

jay allen is a former voice contestant who sings and writes country songs


this first video is an interview he did with the tennessean about his mother who either had early onset alzheimers or early alzheimers

early onset is usually genetic and hits people in their 50s or early 60s
sometimes even earlier in the 30s or 40s

early alzheimers is the first stage of late onset alzheimers after mild cognitive impairment

she eventually died from the disease

he tells the story of how he came to write his alzheimers song blank stares
all the money it has raised has been donated to alzheimers organizations

watch this video above first to get the story and the feelings 
then watch and listen to the song below

hopefully it doesnt make you cry like it did me

we head down to ucla today for a 4 hour conference on alzheimers where the latest and future alzheimers research will be discussed
many in the audience will be clinical trial participants and their loved ones

it seems strange to me as i sit across the table with folks who are in the studies
i sometimes feel guilty when i am at these events since i am dong so well and so many of them are more advanced in their disease

since i keep up with the research i know a lot of what they will present but i do learn new things though

the trip is always worth it

i do a lot of blanks staring later when i am by myself after these conferences
maybe tomorrow morning ill listen to jay allens blank stares video as i blank stare

next week its back down to ucla for aduhelm infusion #33 with 9 more to go


join me for our santa barbara walk to end alzheimers on saturday october 14th
join us and or donate to our organicgreendoctor team 

the organicgreen doctor