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

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

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