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

Thursday, June 20, 2024

organicgreendoctor: my story revisited #206-my story on my story

organicgreendoctor: my story revisited #206-my story on my story: MY STORY REVISITED #206-MY STORY ON MY STORY nine years ago i was asked to give an alzheimers talk at a senior expo in the area where i was ...

my story revisited #206-my story on my story

MY STORY REVISITED #206-MY STORY ON MY STORY

nine years ago i was asked to give an alzheimers talk at a senior expo in the area where i was in practice for 10 years
the talk was well attended
i gave the almost 50 minute presentation then answered questions for probably close to an hour

now when i look at what was on my slides
some things havent changed much
some have

the clinical trials i mentioned have been all completed
the a4 study showed after 10 years that infusions of solanezumab a monoclonal antibody didnt help at all
since then the monoclonal antibodies against amyloid plaques aduhelm leqembi and now donanemab has been approved for use in early alzheimers to slow down symptoms

the colombian study showed that these drugs didnt work in early onset genetic alzheimers disease

the bace inhibitor study showed that bace inhibitors didnt work but actually made things worse

the amyloid pet scan is routinely used now in a workup for alzheimers disease
medicare even pays for it as it also pays for these 3 new drugs

the alzheimers blood test is routinely used in clinical trials and will be coming to your doctors office soon to help diagnose alzheimers

if you look at that amyloid pet scan on the right side thats a positive amyloid pet scan
mine use to look like that in 2015 
but
in late 2023 my amyloid pet scan was negative like the one on the left side

who would have hoped for that when i was doing my presentation
the answer
me thats who
__________
09-22-2015
MY STORY
here is a link to information on the senior expo where
i will be doing a presentation on alzheimers disease today
at the bottom of the article is a few paragraphs
about my presentation

senior expo article

below are the slides from the talk
for those not attending
and
for those who did attend


slide one

slide two
slide three

slide four


slide five

slide six

slide seven

slide eight


slide nine

slide ten


slide 1 is a normal vs an alzheimers brain
total destruction has occurred
the theory is it starts with the bad beta amyloid accumulating then the
tau protein unravels resulting in brain cell death
it all starts in the underneath portion of the brain called the hippocampus
then spreads over the brain
what area of the brain thats affected determines what you see in
your loved ones

slide 2 is information on aricept (donepezil)

slide 3 is a list of tests that someone should have if they have memory loss
the ? ones are now available to private practice but are not paid for by
insurance
the last one the alzheimers blood test should be commercially available soon
its 90% accurate

slide 4 is the labs that are generally done
some providers add the homocysteine level since it may be associated
with an increased risk for alzheimers stroke and heart disease
i would add a ua in the elderly

slide 5 is an mri scan
this one shows a stroke

slide 6 is the new amyvid pet scan that highlights the beta amyloid
that accumulates in the brain
if you have alzheimers this test will be positive

slide 7 is the alzheimers graph that shows when things happen
as alzheimers develops
note that the bad beta amyloid and tau accumulates years before
symptoms develop

slide 8 is a list of things to do to slow down the disease
it is especially important to start as young as possible

slide 9 is a list of treatment research studies ongoing now
hopefully the treatments will be available in 5 years+

slide 10 is a reference list
the clinical best practices is a pdf file from the texas health department
on the recommended evaluation and treatment of memory loss

i look forward to the presentation today
hoping to give answers to those who cant get their questions answered
elsewhere
_________
the evaluation one does for memory loss hasnt changed much in nine years
exam history memory testing labs mri of the brain
now if needed an amyloid pet scan of the brain can be done to see if amyloid plaque is present in the brain 
it is the hallmark of alzheimers this amyloid plaque
soon in 2-3 years an alzheimers blood test will be done 
if its negative no amyloid scan is needed
if its positive an amyloid scan may be done to verify the diagnosis
then
if the disease is early enough treatment with leqembi or donanemab can be started to maybe slow things down

so we have made progress in the last 9 years
now
we need to make more progress in the next 9 years to treat tau tangles and inflammation in the brain

i wonder what i will be writing about in 9 years
hopefully more successes

the organicgreen doctor

Monday, June 17, 2024

organicgreendoctor: alzheimers news-here comes another one

organicgreendoctor: alzheimers news-here comes another one: ALZHEIMERS NEWS-HERE COMES ANOTHER ONE there will soon be three drugs that will remove amyloid plaque from the brains of alzheimers patients...

alzheimers news-here comes another one

ALZHEIMERS NEWS-HERE COMES ANOTHER ONE

there will soon be three drugs that will remove amyloid plaque from the brains of alzheimers patients 
doing this may slow down cognitive loss by about 30%
will removing this plaque make a difference
maybe

follow me over the next 10 years
if i am still doing this blog in 2034 then you know that removing amyloid plaque will have made a difference

in the theory of what happens with alzheimers
amyloid plaques accumulates first and kills brain cells
then
tau proteins in brain cells unravel forming tau tangles and kills brain cells
then
inflammation in the brain occurs as the body attacks this brain cell destruction and kills more brain cells

this is what happens in alzheimers

we now can remove amyloid plaque with three new antiamyloid monoclonal antibodies that bind to the plaques and removes them

the first drug to get approved was my drug aduhelm or aducanumab
i took 34 months of infusions which has removed all the measurable plaques in my brain as shown on an amyloid pet scan done last winter
will it make a difference
time will tell

aduhelm made by biogen and eisai was recently taken off the market since its sister drug leqembi works better and may have fewer side effects

the second drug is leqembi or lecanemab made by biogen and eisai which removes the amyloid plaques also but quicker than aduhelm and maybe will less side effects
its given as an every 2 weeks infusions
it may only need to be given for 12-18 months
its approved by the fda and medicare pays for it and the accompanying scans required ie amyloid pet scans and mri scans
its also will be soon probably approved to be given just once a month and maybe given as an injection at home

the third drug is donanemab which removes the plaques quicker than the other two but maybe with more side effects
it may be used only less than a year
this drug made by lilly just got fda pre approval and will receive full approval soon

the major side effect of these drugs are brain bleeds or aria or amyloid related imaging abnormalities
these aria can be just edema or they can be bleeds
it is more likely to happen in those with the homozygous apoe4 apoe4 gene
called the late onset alzheimers gene
that one  i have
i didnt have aria ie edema or bleed
i did develop ocular migraines manifesting as visual changes headache nausea 
the headaches would last for several days
the visual changes for up to an hour
these were strong at first but gradually become less intense
the drug was stopped for a couple of months until serial mris of the brain were normal
these headaches are resolved now that i am off the drug


so the biggest risk is these brain bleeds 
most that occurred resolved and didnt prevent folks from continuing treatment
there were a few deaths though from these bleeds

when i signed up for the aduhelm clinical trial the risks were spelled out on the consent forms
pages of paper work were signed it seemed every year i was on the study

i decided i was willing to take the chance since the potential outcome of a potential new treatment for alzheimers was significant
again
time will tell if it worked

probably most folks in the studies felt the same

so
would i take one of these drugs now if i was early in the disease
absolutely
i would maximize my health
i would take aricept of donepezil to slow down symptoms
i would seek treatment with either leqembi or the new one donanemab
probably leqembi especially if it goes injectable at home and just once a month
then
i would watch closely the new clinical trials with new drugs to treat tau tangles and inflammation
then
i would watch closely the research on when the amyloid reaccumulation would need to be treated
right now it may require periodic treatments with leqembi or donanemab 
hopefully something that can be done at home

so 
we are entering a new era of alzheimers treatment
we are just at the beginning 
sort of like they were with heart disease by treating cholesterol long before it caused problems
now we will be treating amyloid plaques and tau and inflammation long before alzheimers starts
maybe like with heart disease we can prevent the disease alzheimers from developing

i think thats the goal

for me
i am getting in on part of all this but probably will miss all the treatments coming down the pike
if my disease doesn't progress too fast or far i may make it to these newer future treatments

the organicgreen doctor
 

Thursday, June 13, 2024

organicgreendoctor: garden news-begetted another rainwater tank

organicgreendoctor: garden news-begetted another rainwater tank: GARDEN NEWS-BEGETTED ANOTHER RAINWATER TANK when i started gardening at our community garden 7 years ago we had no rainwater tanks i gradual...

garden news-begetted another rainwater tank

GARDEN NEWS-BEGETTED ANOTHER RAINWATER TANK

when i started gardening at our community garden 7 years ago we had no rainwater tanks
i gradually changed all of that

i looked around thinking why dont we save rainwater from falling off sheds and buildings and letting it flow down the garden to the creek to end up in the ocean
why cant we save some of it to use in our garden


i found 2 rainwater tanks that looked like these two online for a good price
i looked around and thought why dont i collect the rainwater off our two chicken coops
i found some old gutter and some old 2 in pvc pipe and guttered both chicken coops
and put a tank at the back of each coop to collect rainwater
then
my daughter in law give me these two tanks above to use in our garden
i hooked them up to the two tanks behind the coops
leaving us with 240 gallons of rainwater capacity
i added the grey tub to catch any overflow from our 4 tanks
we mainly use the water to water new plantings and to mix with fish emulsion when we do our twice a month feeding to our vegetables

then someone gave us three 60 gallon tanks 
i cleaned them up sanded and painted them 
i placed them under a shed out front and put a gutter and downspout to collect 180 gallons of rainwater
this water is used out front to water plants and to use in our greenhouse to water our new seedlings

now we have 420 gallons of rainwater capacity

with a 1 inch rain we collect 120 gallons of water
it takes 3 1/2 inches of rain to fill them up
this year they filled up multiple times since we had over 30 inches of rain
the average here is around 12 inches of rain

my wife she is always looking at freebie websites like buy nothing
last week she found this 50 gallon rainwater tank online for free
it is shown in the top picture above

in the picture above in the distance if you look closely you can see the 3 brown rainwater tanks sitting against the brown shed
i ran a water line from these tanks down to the new rainwater tank at the edge of my garden
a distance of about 50 feet
the tank sits lower then the tanks along the shed

we plan to use it to access the rainwater tanks on my side of the garden for myself and other gardeners
we i will use the rainwater to water in new plantings and mix up my fish emulsion seaweed molasses solution in our gardens

also in that picture there are two grow bags with dirt in them
this is dirt from my walkways which will be used in the main garden to help build up our beds
the front 2 grow bags have fava beans growing in them
they are a good cover crop and fix nitrogen in the soil
i will harvest some this year to cook since we have never cooked with them before

now over the last 20 years i have begetted several rainwater tanks to school gardens neighbors friends and habitat for humanity recipients
most of them are probably still being used

i feel like they are my children

the organicgreen doctor

Wednesday, June 12, 2024

organicgreendoctor: it was his birthday

organicgreendoctor: it was his birthday: IT WAS HIS BIRTHDAY waltdisney.org this is what donald duck looked like when he was first created this is from the website which chronicles ...

Tuesday, June 11, 2024

it was his birthday

IT WAS HIS BIRTHDAY

waltdisney.org
this is what donald duck looked like when he was first created
this is from the website which chronicles his journey

when i was a kid my rainwater brother and i would try to talk like donald duck as we watched saturday morning cartoons on tv
until my mom would kick us outside to paly all day

over time i got better at talking like donald duck 
such that you could mostly understand what i was saying in donald duck language

last sunday donald duck turned 90
he doesnt look that old does he

he was started to be a side kick for mickey mouse
he donald was more aggressive and well sort of moody and grumpy
he also had a donald duck temper
which i have but it doesnt manifest itself very often
when it does i become a dr jekyll mr hyde person
once i would have murdered someone if i could have gotten my hands on them
lucky for them i was 20 miles away on the phone with them

i noticed as i was seeing kids in my medical practice that that they liked when i talked to them like donald duck
some even called me dr duck

i still have signs that were given to me by patients that says dr duck on them

when patients would go to disneyworld or disneyland they would bring back pictures with donald duck or a donald duck souvenir doll or a signed donald duck autograph
they proudly gave them to me when they came in to the office

before i retired someone built this shadow box for some of my donald duck characters
thanks dc and mc
now i had boxes of them to chose from
these are the ones that made the cut
most were given to me by patients and by my motherinlaw

the rest were either donated or sold as fundraiser when we moved
one person bought a lot of the donald duck stuff at our moving sale

i still do my donald duck voice for my grandkids
they are use to it and dont enjoy it as much as they did when they were younger
my younger son does a donald duck voice so his kids are use to it
his son is practicing his voice regularly so maybe he will carry on the donald duck voice tradition

in my practice i would use the voice to calm down my young patients 
sometimes they would quieten down and allow me to examine them

i did find though that younger kids less than one didnt usually appreciate donald duck as much as when they got older

now
i talk to the kids in the preschool next door to our community garden in my donald duck voice and whenever we do a tour of younger kids in the garden
one thing they all say is 
do it again do it again

i use to have patients cry when they left my office
whats wrong mom asked
he didnt talk like donald duck

some would tell mom
im sick i need to see dr duck

so
happy belated birthday donald
your voice has entertained hundreds of kids via my voice over the years

thank you for the inspiration

the organicgreen doctor


Thursday, June 6, 2024

organicgreendoctor: my vehicles over the years

organicgreendoctor: my vehicles over the years: MY VEHICLES OVER THE YEARS the first car i owned was this blue ford my younger brother and i went 50/50 on it we bought it from an old gentl...

my vehicles over the years

MY VEHICLES OVER THE YEARS

the first car i owned was this blue ford
my younger brother and i went 50/50 on it
we bought it from an old gentleman who hardly drove it
one foggy morning on my way to work a black angus bull walked in front of me destroying the front of the car
it cost him his life

i hadnt thought about this car until i saw this list of the worst cars to own
i looked at the top five 
ive owned some of those 
lexus and toyotas and accura
we now own two toyotas

i looked at the bottom 12
guilty
ive owned some of those
volkswagen chrysler chevrolet dodge ford
chrysler was ranked #1 worst for 2024 

after my 55 ford i bought a ford maverick
drove it two years
then a motorcycle for a year
then a ford falcon which i bought from a friends grandmother for very little and drove it for 6 years
then a ford pickup that was an old forest truck
i drove it for 4 years through medical school
then i bought a ford ranger pickup 
i called it my residency truck
i drove it for another 7 years
i willed it to a friend who used it for his ranch truck
later he traded it to a contractor for some driveway asphalt work on his ranch

my wife she owned a yellow volkswagen bug she owned when we got married
one cold snowy day in northwest arkansas she was driving slowly and a large truck which was racing with another truck hit her and my son head on on a hill
they both survived
my wife she had multiple body bruises and my son sustained multiple head lacerations and a broken arm
the car was demolished
it had been a reliable car up to that point

during medical school we bought a car for the family a chevrolet chevette
we called it the shove it
it was a badly made car
no more chevrolets after that one
next we bought a chevrolet nova which was really a toyota car
we drove it for several years and gave it to our son when he started driving
then we switched to a minivan either a chrysler or a dodge
nowadays we would have bought a toyota or honda van

it was after all that we only drove toyotas accura or lexus
one of our best cars was a toyota echo 
at one time i had one and my wife she had one
it got great gas mileage and never had any problems

later my wife she drove a toyota yaris which gets about 40 miles per gallon
we have owned it now for 15 years
i now drive it for my vehicle
it is a hatchback so i call it my truck

in the early 2000s i decided i needed a farm truck
i heard my friend was unloading a truck a ford f150 that his son drove but gave it up
i contacted him to see if he wanted to sell it to me
it had just been traded it in to a dealership in dallas
i called and they still had it
i flew up to dallas and bought the truck and drove it home

when we moved to santa barbara in 2017 i gave it to our friend for her farm truck
its still going strong even though its 25 years old
i must admit i severely abused it while i had it
it had scrapes dents bruises all over it
it was a true beat up farm truck
it was one of the best vehicles ive owned 

we also owned a toyota corolla which was wrecked
its a long story 
we replaced it with a new one 

so looking back 
my favorite vehicle was my ford falcon
although i enjoyed my old forest ford truck and my black ford f150

maybe my toyota yaris im driving now would be my newest favorite one even though its now 15 years old
it has handles to roll up the windows which my grandkids love a key a real key all the doors are manual and its a stick shift
i like a roll down window in case i run into a body of water
i can roll the window down and swim out without worrying like you do with an electric window
this yaris will probably be the last one i will own
so im enjoying it

so we have owned a variety of cars over the years
several were replaced due to car wrecks 
others just got too old

if i do have to buy another one for me i plan on getting an electric car or truck
but im hoping my yaris will last as long as i do

the organicgreen doctor

Friday, May 24, 2024

organicgreendoctor: garden news-its hard to grow a tomato here sometimes

organicgreendoctor: garden news-its hard to grow a tomato here sometimes: GARDEN NEWS-ITS HARD TO GROW A TOMATO HERE SOMETIMES this is a picture of my first tomatoes of the year these are early girl tomatoes they a...

garden news-its hard to grow a tomato here sometimes

GARDEN NEWS-ITS HARD TO GROW A TOMATO HERE SOMETIMES


this is a picture of my first tomatoes of the year
these are early girl tomatoes
they are now about the size of an apple

it can be tricky growing tomatoes here in santa barbara

these early girl tomatoes started as a seed planted in our greenhouse back in mid january
then they were transplanted into a 4 inch pot
later as they grew they were bumped up to a gallon pot until they were ready to plant in the garden

sometime in later march they were planted in the ground
the soil was prepped by adding 3-4 inches of compost to the soil then an organic fertilizer was added
this was forked into the soil 
in the planting hole worm compost was added 
then i used a mixture of fish emulsion seaweed molasses to water in the plantings
every 15 days i fertilize again with this mixture
to encourage blooms i sometimes use hasta gro fertilizer in place of my fish emulsion mixture
then
i am at the mercy of the weather

our biggest problem here is the may grey and the june gloom 
this year it started in april and last year it ended in july

what happens is we get fog and clouds so we get a marked reduced amount of sun
it almost causes a seasonal affective disorder or sad for both the gardener and the plants

after some early blooming there are no new ones mainly because of the lack of sun
the heavy moisture makes mildew and other fungal diseases a problem on tomatoes squash cucumbers potatoes and other veggies

last year most folks tomatoes did not fare well around here
the only ones that did well for us was those early girl tomatoes in the picture above

right now our vines look ok
they are nice and green with a few flowers
i will add the hasta gro next week hoping to stimulate flowering so we can get some tomatoes

i also do a monthly watering on the leaves of a milk baking soda aspirin liquid soap mixture that seems to prevent the mildew on our veggies

if we start getting more sunshine our tomatoes will take off and produce
if we keep this gloomy grey weather we wont get many tomatoes

gardeners in the south where there has been too much rain have had their tomatoes drown
others have had storms with its heavy rains wind and hail destroy theirs

at least here we have plants growing good 
we just need some warmth and sunshine

this is my first tomato an early girl
i  picked it early and will let it ripen in our kitchen
i didnt want to loose that first tomato to some varmint or some disease
my wife she has promised to let it ripen good before she we eat it

we plant early girls in our main garden since they always seem to produce

in my garden plot i have room for 8 tomatoes
i planted 
2 early girls
1 celebration
1 black krim it may have been mislabeled since it looks like a green zebra instead
interesting since we had no green zebra seeds
1 cherokee purple
1 pink boar
1 sweet 100
1 sungold

if the sun cooperates we should have enough tomatoes to eat donate and store
if the sun doesnt cooperate then well we will be sad

in our main garden for donation 
we grow a row of early girls and a row of celebration
we also grow a row of mixed tomatoes
sweet 100 sungold yellow pear moneymaker pink boar celebration moskovich and glacier
a total of about 50 tomato plants
all will be donated to those in need
if we get enough sunshine

its a gamble sometimes to grow tomatoes
but
if successful its all worth it 

you win some you lose some
i like winning

the organicgreen doctor

Thursday, May 23, 2024

organicgreendoctor: alzheimers news-it could be me

organicgreendoctor: alzheimers news-it could be me: ALZHEIMERS NEWS-IT COULD BE ME last week dr sanjay gupta did a show on alzheimers disease on cnn on new approaches to evaluating and treatin...

alzheimers news-it could be me

ALZHEIMERS NEWS-IT COULD BE ME

last week dr sanjay gupta did a show on alzheimers disease on cnn on new approaches to evaluating and treating and preventing the disease
yes
prevent the disease
maybe 40% of cases could be prevented

now if you get the early onset gene like presenilin you are doomed you will get it 
not much slows it down 
yet

if you are in the alzheimers world take the time to see his special on cnn called the last alzheimers patient 
and read this article about what he showed in his special

basically because of a family history of alzheimers disease he saw a preventative neurologist for an evaluation
he underwent extensive testing luckily showing no genetic risks on his gene test and normal memory or cogitive testing
his vitamin b12 was low and his homocysteine level was elevated which can easily be corrected by taking vitamin b12 and folate

in the cnn special he also followed several people who were predisposed to alzheimers or were in the early stages of the disease
five years later all of them were either the same or had gotten better
why
exercise
healthy diet like the mind diet 
socially active
mentally active
supplements for  any abnormalities like the low b12 or high homocysteine levels
aggressively controlling your weight cholesterol blood pressure blood sugar levels
getting adequate sleep
meditating 

doing this in five years they all improved or at least stayed the same

now 
you like dr gupta can be proactive
if you want to know more about your risk
check your apoe4/apoe4 status
consider checking you amyloid status in the near future when the new labs become available
consider early treatment when it gets approved by the fda to be used in patients with prodromal or prealzheimers 

all 6 million of the folks with alzheimers now were prodromal or prealzheimers about 20 years before their symptoms started
what if they could have be treated 20 years ago
what if they we had maximized their health

what if my mother been treated in her early 60s
what if my younger brother been treated in his late 40s
what if i could have been treated in my early 50s instead of my late 60s early 70s

could we have added 10 years or more of good health to their our lives
i think so
we are getting closer to treating folks early before symptoms start to allow them more time to work be with their family and live their lives

as i watched the cnn special on the last alzheimers patient
i turned to my wife she and said
you know i could have been on that special

these new treatments and the ones coming right behind them are just the beginning
soon in 10 years you will be treated with these medications to slow down or to prevent alzheimers
as long as 
you do those healthy things i mentioned above and that they mentioned in the special

it is me

the organicgreen doctor

Thursday, May 9, 2024

organicgreendoctor: alzheimers news-homozygous apoe4 gene is not good

organicgreendoctor: alzheimers news-homozygous apoe4 gene is not good: ALZHEIMERS NEWS-HOMOZYGOUS APOE 4 GENE IS  NOT GOOD an article was published in nature medicine linked here about the apoe4/4 homozygous gen...

alzheimers news-homozygous apoe4 gene is not good

ALZHEIMERS NEWS-HOMOZYGOUS APOE 4 GENE IS  NOT GOOD
an article was published in nature medicine linked here about the apoe4/4 homozygous gene for alzheimers disease
i have the homozygous apoe4/4 homozygous gene called the late onset alzheimers gene

this ny times article written by the same person that interviewed me about the aduhelm clinical trial i was in did an excellent job of writing about the nature medicine article

we are only talking about 15-20% of the cases of alzheimers

in 2010 i had my blood drawn for alzheimers genetic studies
it showed i was apoe4/4 or homozygous
i had very mild symptoms that have since resolved such that now 14 years later my memory is normal for my age
at that time my spinal tap showed amyloid and tau levels that were compatible with alzheimers disease
5 years later when i had my amyloid pet scan for amyloid plaques it was positive
6 months ago or 14 years later after receiving 34 months of aduhelm the antiamyloid monoclonal drug my amyloid pet scan is now negative for amyloid plaques

in this article mentioned above they say we should be classifying apoe4/4 patients as having a distinctive genetic disease ie alzheimers disease caused by the apoe4/4 gene

a gene for the early onset alzheimers disease causes alzheimers early on in all of the patients that inherit that gene

this apoe4/4 gene called the late onset gene it appears if you have the double version or the homozygous version 
you will at the age of 55 have positive biomarkers for alzheimers in the brain
by 65 you will have amyloid plaques in the brain at close to 100%
you will get alzheimers probably 10 years before those from other causes get it except for those with the early onset gene
3% of the population have the apoe4/4  gene
it represents about 20% of the cases of alzheimers disease

if you just have the apoe4 single gene your risk is increased close to 2-3 times
this represents 50% of those with alzheimers

so
it seems 
if you have the apoe4/4 gene you will get alzheimers and get it sooner than those who have other causes
your amyloid scans will be positive in your 50s and early 60s
thats when the new treatments need to be given before too much plaque builds up

now before you get the leqembi or donanemab infusions to remove the amyloid plaques you have to have your apoe4/4 gene tested
if its positive you have to be monitored closer for bleeds and symptoms
some infusions centers will not give you the infusions of these new drugs if you are apoe4/4 positive
others will give it

i got all my infusions even though i was apoe4/4 positive
they eased up to the maximum dose over time and did frequent mris of the brain looking for edema and bleeds

once when i had a real bad ocular migraine and more smaller ones for several months they stopped the meds and did serial mris
i had no bleeds

thank goodness i was in a clinical trial where they had strict protocols to follow

so what does this all mean
the apoe4/4 gene is a distinct genetic gene that causes late onset alzheimers just as the early onset gene like presenilin and others cause early onset alzheimers

if you have the  apoe4/4gene you will close to 100% get alzheimers
if you get the early onset gene you will 100% get alzheimers 

having the apoe4/4 gene is more ominous now that we know this

this is being widely discussed in the alzheimers world
not all agree but my guess it will be fully accepted eventually

but should you get tested
well read my last blog on this linked here
for me i would
for others they wouldnt
my view is it scares you to take care of your health and to be looking for treatments as it comes available
for me
i feel like i was destined to be in the full throws of alzheimers by now
luckily im not yet
why
healthy living
aricept or donepezil early on in my disease
getting 34 infusions of aduhelm to remove amyloid plaques in a clinical trial

add all those things up and this is why i am able to write this blog 14 years later

the organic green doctor

Monday, May 6, 2024

organicgreendoctor: alzheimers news-risk gene for late onset alzheimer...

organicgreendoctor: alzheimers news-risk gene for late onset alzheimer...: ALZHEIMERS NEWS-RISK GENE FOR LATE ONSET ALZHEIMERS DISE ASE the risk gene for late onset alzheimers is called apoe 4 about 25% of americans...

alzheimers news-risk gene for late onset alzheimers disease

ALZHEIMERS NEWS-RISK GENE FOR LATE ONSET ALZHEIMERS DISEASE

the risk gene for late onset alzheimers is called apoe 4
about 25% of americans carry the single gene apoe 4
this makes them at a 3-5 times increased risk for developing late onset alzheimers disease
about 3% of americans carry the double gene or homozygous gene apoe 4/apoe 4
this makes them at a 10-20 times increased risk for developing late onset alzheimers disease

this is probably why i have mild cognitive impairment due to alzheimers disease
i am apoe 4/apoe 4

the apoe 4 gene affects lipid transports in the brain
think cholesterol and fats

add family history high blood pressure and high cholesterol to my risk factors
thats why i got it

should you be tested for apoe 4 
yes
no
maybe

yes
if you are like me and want to know where you are with your brain status
i wanted to know as much as i could about where i stand so i can decide what to do with my life
i tested apoe 4 amyloid pet scans for amyloid a spinal tap for amyloid and tau
so
i know i have it and can use statistics to see when it will totally take me over
probably if i am lucky in my late 70s or early 80s
unless of course all the healthy stuff i am doing and the fact that aduhelm removed all the amyloid plaque from my brain may slow it down more

no
if you will have increased anxiety about knowing
getting it a positive apoe 4 gene can reek havoc on obtaining life insurance and long term care insurance and probably disability insurance
some think it might affect getting hired for jobs such as high cognitive ones 
if its done on the record on your health records it is there forever
some people pay out of pocket to have it done and not let it be entered in their medical records
the problem in having it done and not understanding what it means can cause a lot of stress
but
for me
i wanted to know

maybe
knowing will incentivize folks to better take care of their health
doing all the healthy things one should do
this doing all the healthy things can actually neutralize if you will the effects of having the apoe 4 gene
not doing anything about your health if you carry the gene increases the odds you will get alzheimers disease and it will be sooner and worse for you

i read about folks that were tested and it created lots of anxiety in their lives when they found out they were positive

note i got my long term care insurance a few years before i was diagnosed and tested for amyloid plaques and apoe 4 status
i also already had life insurance already
i also had health insurance already
i had disability insurance that ended up paying for 6 years until i reached 67
if it wasnt for the obamacare rules i would be uninsurable if i was not on medicare
if they change the obamacare rules on preexisting conditions then i wouldnt be able to get insurance if i was not on medicare

so would i do it when i was younger
back when i was 50 i probably wouldnt have since i didnt really understand what it meant
now i do
i didnt have my long term care then but did have life insurance health insurance and disability insurance

now i would not only get my apoe 4 gene test but would try to be tested for amyloid plaques asap
watching closely all the research treating folks with amyloid plaques and no symptoms with the new monoclonal antibodies leqembi and donanemab 
right now that early treatment is only being done in clinical research

soon within 2-5 years a blood test just as accurate as the amyloid pet scan will be available
if its positive an amyloid pet scan or a spinal tap will be used to verify the blood test

soon a treatment for tau tangles in the brain and inflammation in the brain will be available
hopefully i wont be to far gone to get those treatments

medicine will be treating amyloid plaques to prevent alzheimers like they do cholesterol levels now to prevent heart attacks and strokes later in life

so if i was 50 now
i am talking about me knowing what i know now
i would get my apoe 4 gene tested since i undertand what it really means
it doesnt mean you get alzheimers but you are at an increased risk for it
i would get an amyloid blood test when it becomes available
if its positive i would do an amyloid pet scan to be sure
then if it was available for this prealzheimers i would start treatment with leqembi or donanemab
if not available yet i would seek a clinical trials treating prealzheimers or asymptomatic patients

then
i would do all the healthy things 
avoid polluted areas to live
dont smoke
dont drink or limit drinking
avoid stress and control anxiety ans depression 
get adequate sleep
eat a mind diet
listen to music
stay active physically socially mentally
meditate or do relaxing things
control cholesterol blood pressure blood sugars and weight

later when it becomes available i would seek out tau tangle and inflammation treatment 

i predict in 10 years many of you will be doing this when you get in your 50s
why not start all the healthy living and start you kids doing healthy living on the day they are born

i plan to repeat this advice on a regular basis since new people start reading my blog each week
i want them to know what we all know
i want to reinforce all of this to the rest of you

so start now

the organicgreen doctor



Friday, May 3, 2024

organicgreendoctor: garden news-hope for the future

organicgreendoctor: garden news-hope for the future: GARDEN NEWS-HOPE FOR THE FUTURE every time i work with youth groups i think there is still hope for the future i felt this way after working...

garden news-hope for the future

GARDEN NEWS-HOPE FOR THE FUTURE

every time i work with youth groups i think there is still hope for the future
i felt this way after working with ws a boy scout who needed to do a project for his eagle scout requirements
he wanted to do garden beds so he reached out to our gardens

now i have helped put several raised beds in school gardens using two layers of concrete blocks
when finished they are there forever until the beds are disassembled 
wood eventually rots

i spoke once with two organic gurus in austin about how safe these were to use in an organic garden
they both said they were safe
the old cinder box had products that could be toxic
concrete blocks are just concrete

so he agreed to do the raised beds in our kids garden which has really been neglected and left to not do much with since the pandemic
i had planned to do one by myself and our volunteers
but him doing it for his project was a win win for us

he did all the  planning and purchasing materials after we reviewed the site and i sent him videos and materials on using concrete blocks for the project

our biggest delay since we started planning on this months ago was the bureaucracy of the boy scouts
every change we made or they recommended had to be reapproved by a line of folks
it felt like at times we were dealing with our local government approval district which takes forever around here to get a project approved

well we finally got approval
ws got all his materials
he got all his friends and family to help with the project
i along with another volunteer helped also
i helped since i had done these before


this is the site where we were building our beds

first we raked down the beds to make them as level as possible
we then add gopher wire that fits under the concrete blocks
gophers love this part of the garden
we have limited our gardening in this spot because of the gophers
wheres bill murray when we need him       


we started in one corner using our first block which we leveled perfectly and used it to work off from to make sure the rest of the beds were level and even

we then  used the first bed to determine where we placed the other two beds so things would be symmetrical

when the beds were all done with two levels of blocks we used rebar in each corner and some along the sides to help hold the bricks in place


this is the finished beds
the two on the right are about 10 ft long and 4 ft wide
the one on the left is 8 ft long and 4 ft wide

we decided not to fill it with commercial garden soil but instead we made our own soil 
sort of lasagna style
so first we added two layers of cardboard


then we added a layer of limbs old plants waiting to be chipped up by our chipper
then a layer of mulch was added
then a layer of chicken compost from our chicken coop that has been composting for a year
then a layer of garden soil that i had dug up from my garden plot
then a layer of unfinished compost form our large compost pile
then a layer of my garden soil
then another layer of our unfinished compost


then in the holes in the concrete blocks we filled half of the blocks with my garden soil then the top half with eb stone organic raised bed soil


then to top off the bed we added about 6 inches of eb stone raised bed soil which has all the ingredients you need to get plants growing
until
all the lasagna breaks down 
into real real rich soil

in the concrete block holes we will plant strawberries along one side of the beds
on the other side we will put some flowers and herbs and veggies like onions carrots and beets

in the beds we will plant for the summer green beans a yellow pear tomato sweet 100 tomato sungold tomato french beans dino kale red russian kale curly kale cucumelon baby cukes swiss chard and red pepper

this fall we will plant sweet peas along with broccoli kale chard beets carrots lettuces and other veggies

when it is all planted i will post a picture of it when the veggies mature

ws and his friends were a delight to work with
they worked hard

maybe we will call this the hope for the future kids garden

the organicgreen doctor

Thursday, April 25, 2024

organicgreendoctor: garden news-flowers in our garden

organicgreendoctor: garden news-flowers in our garden: GARDEN NEWS-FLOWERS IN OUR GARDEN at our community gardens we have a front meadow that we use for seasonal events in the spring we either le...

garden news-flowers in our garden

GARDEN NEWS-FLOWERS IN OUR GARDEN

at our community gardens we have a front meadow that we use for seasonal events
in the spring we either let it just grow with whatever seeds are planted by nature
or it will be planted with oats or with wildflowers
this year we let it just grow
we have oats lots of sunflowers bachelor buttons some weeds some flowers i dont know what they are and 
these beautiful bright red poppies that stand out as you drive up to park
they are scattered throughout the meadow
ok i scattered some red poppy seeds in different places the last two years
these are some of the progeny from last years poppy flowers

flowers are real important in the garden as they provide a source of food for bees
lots of bees 
these bees help to pollinate our vegetables and our fruit trees

most of our plot holders plant flowers in their garden beds
i accept whatever nature plants in my garden supplementing it with flowers like sunflowers and marigolds
marigolds eg are a good trap plant for insects especially near tomatoes
so i plant them in my tomato beds

in my garden nature has planted lots of calendula and borage so far


these are orange poppies that are everywhere in our garden
we  never have to plant them they just show up
we usually leave them where they grow unless they are in the way


these purple flowers are sweet peas
they are in a plot just as you enter our garden
you can smell them before you reach the gate
they make great flower arrangements for the home

those white flowers are fava bean flowers
we grow them usually as a cover crop as they fix nitrogen in the soil
some folks save the bean seeds and eat them
we usually save the seeds to keep our seed supply up for our cover crop plantings


this blue flower is a borage
its flowers are edible 
they are a brilliant blue
bees just go crazy over this one 
it stays covered with bees all day long


this is a poppy also
i forgot the name of it
it is in the garden plot of a gardener who grows a lot of lowers for her dyeing classes

those yellow flowers in the background are calendula
we never have to plant those either
they are everywhere in the garden



this big ole sunflower just popped up in our front area near the greenhouse
it so far is about 8 foot tall
i had to stand up on a large picnic table to take this photo
we let the birds eat the seeds 
we save a few seeds for our plant sales and for planting in our garden and we give some away at the annual santa barbara seed swap each year


recently a borage popped up with white flowers
i guess a mutation occurred
i prefer the blue ones since thats my favorite color
the bees dont care


this is a bush nasturtium 
the leaves and flowers are edible


this is dryers chamomile
its used in the gardeners dyeing classes

we also let some of our vegetables like cilantro lettuce arugula some kale and broccoli to go to seed ie they will flower
it provides more food for the bees

when you walk up to our gardens right now you see all these beautiful different colors growing throughout our gardens
you will see lots of bees some hummingbirds and just now are seeing some butterflies

so if you garden
be sure and grow flowers in your garden
your bees will love it 

i know ours do

the organicgreen doctor

Wednesday, April 24, 2024

organicgreendoctor: my story revisited #205-the future is brighter

organicgreendoctor: my story revisited #205-the future is brighter: MY STORY REVISITED #205-THE FUTURE IS BRIGHTER when i spoke last year at the santa barbara walk to end alzheimers i mentioned there was hope...

my story revisited #205-the future is brighter

MY STORY REVISITED #205-THE FUTURE IS BRIGHTER


when i spoke last year at the santa barbara walk to end alzheimers i mentioned there was hope for the future for alzheimers patients
when i wrote the blog below in 2015 there was hope 
now that hope is brighter

instead of guessing if one has alzheimers and instead of doing a spinal tap to find out for sure or doing an amyloid pet scan for amyloid plaques real soon a blood test will be used instead as part of the workup with a high degree of accuracy to help diagnose alzheimers 

that spinal fluid result in the blog below is my spinal fluid test for amyloid and tau
that * shows i am just at the borderline of being positive for alzheimers disease in 2010
i was in the mild cognitive impairment stage which correlates with my neuropsychological memory tests

my amyloid pet scan if i had it done in 2010 would have been positive
in 2024 my amyloid pet scan is negative after taking 34 months of aduhelm

then in 2015 the antiamyloid antibodies were just entering the initial phase of clinical trials
i was two years away from starting aduhelm an antiamyloid infusion that removes amyloid plaque from the brain
now leqembi and soon donanemab which both work better than aduhelm are or will be available for treatment only in the early or beginnings of the disease
if you wait too long they dont help

now in clinical trials available in many alzheimers research centers they are giving an antitau drug that removes the tau tangles from the brain

we have made progress since 2015
by 2030 we will be diagnosing using blood tests and will probably be treating alzheimers with 3 types of drugs
antiamyloid drugs
antitau drugs
antiinflammatory drugs

this trifecta will probably slow down the disease
__________
09-04-2015

ALZHEIMERS NEWS-A BRIGHTER FUTURE
i think thats true
the future is brighter than it was 5 years ago
progress has been made

as i am preparing for two large presentations on alzheimers disease
i stopped
and
contemplated how much things have changed in the
last 5 years
and
how much potential there is for the future
for
those with memory loss due to alzheimers disease

when i was diagnosed with amnestic mild cognitive impairment
that may be due to alzheimers disease five years ago
it was sort of overwhelming
i could only think of what it was like as my mother and
younger brother were at my stage
they probably werent as aware like i am of the problem
and
what the future held for them
an awful one

all i could think was what course they had
and
how bad it was for the family and friends and
for themselves

i worried a lot about my future
my wife she and i our future
what it would be like

now as i look back and can look forward
i feel more hope
and
thats important
hope

personally i feel better both physically and mentally
my cholesterol and blood pressure are under good control
my weight and physical conditioning is under good control
my diet is the best its ever been
i take a boatload of supplements that have been implied
to help slow things down but not definitely proven to help
yet
i stay very active socially mentally and physically
i drink red wine each night and 2-3 cups of coffee each morning
both may help
i dont sleep well at night 5-6 hours of sleep is all i get
but
luckily since im retired i am able to do an afternoon nap
which helps immensely
maybe we all should be doing this
im happy and contented
i still take aricept (donepezil) and plan to continue it long term
and
i am afraid to stop it as i might deteriorate some with my memory
if do

then
looking forward
for myself and others

memory issue folks can now get a very thorough evaluation
done
so that they will know why they have memory loss
and
if its alzheimers disease
by
a good history and physical
labs for anemia chemistry abnormalities like electrolytes kidney
and liver functions and glucose vitamin b12 vitamin d folate
homocysteine levels which are associated with an increased
risk of alzheimers stroke and heart attacks
thyroid levels
these lab abnormalities are all treatable
Image result for alzheimer's memory test
bloomberg.com

memory tests easily done in the office and online
mri scans
genetic tests for dominant alzheimers and for apoe 4 gene

Image result for spinal fluid for beta amyloid and tau protein organicgreendoctor.com
spinal fluid analysis for the bad beta amyloid and tau protein

Image result for amyvid pet scan
amyvid pet scan of the brain for the presence of beta amyloid
if yours is positive there is a good chance you will get or now have
alzheimers disease
Image result for alzheimer's blood test
coming soon within maybe 2 years a blood test that may be
90-100% accurate in telling you if you got it or not

so soon
like now you can find out if you have it if you have symptoms
but
some of the tests arent covered by insurance

then once diagnosed
if not sooner
get your self motivated to do those things to stay healthy
get on medicine like aricept as it may slow down symptoms
but at times the side effects suck big time
then
look into the future
as
real soon
there may be a pill called a bace inhibitor that you take
and or
a vaccine given as a regular infusion
both if  they are proven to help
will prevent or slow down the disease
you will be able to take them long term

so
i see hope in the future for myself my siblings
and
those of you affected now or soon to be
__________
the most important thing to be doing to prevent or slow down alzheimers is prevention
its number one
do all those healthy things mentioned above
then
get diagnosed early maybe even before symptoms start
then seek treatment 
as time goes on more and more treatments will be available

i probably will be at a stage in the disease where i will be able to receive treatment with antitau drugs or antiinflammatory drugs before my disease takes off

note the bace inhibitor drugs mentioned in the old blog above didnt work 
in fact they made things worse

i dont do all of the supplements i use to take
i only take those based on abnormal labs
eg b12 folate vitamin d

i aggressively treat my cholesterol and blood pressure
note i am off blood pressure meds since i stopped drinking caffeinated coffee
i eat a mind diet mostly 
i stay active mentally physically and socially

join us in helping to fight this disease
we have a much brighter future ahead

the organicgreen doctor