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, February 23, 2024

organicgreendoctor: alzheimers news-get the diagnosis right

organicgreendoctor: alzheimers news-get the diagnosis right: ALZHEIMERS NEWS-GET THE DIAGNOSIS RIGHT it is important to get the diagnosis right kris kristopherson the singer songwriter actor was diagno...

alzheimers news-get the diagnosis right

ALZHEIMERS NEWS-GET THE DIAGNOSIS RIGHT

it is important to get the diagnosis right

kris kristopherson the singer songwriter actor was diagnosed with alzheimers and was placed on namenda and exelon
exelon is an aricept like medication in a patch you wear

later since he started having different symptoms and was not getting better he was diagnosed with lymes disease
he was placed on antibiotics and other lymes meds and has improved but has been left with various neurological and  muscular issues

he was having some arrhythmias and his cardiologist who was trained in a lyme disease area in the northeast united states thought he might have lymes disease
she was right

now in 2024 kris kristopherson would have be accurately diagnosed
he would have had labs memory testing mri and either a spinal tap for amyloid and tau or an amyloid pet scan that would have told his doctors he didnt have alzheimers
they would have gone in another direction in his diagnosis

he would have been spared the diagnosis and the unnecessary treatment with anti alzheimers meds
read his journey in this article 

soon in the next 5 years a blood test will be available for alzheimers biomarkers that will be as accurate as the spinal fluid tests and the amyloid pet scan
ie
a simple blood test will tell you this is not alzheimers or probably is alzheimers
if negative you may need to look elsewhere for another cause of your symptoms

other causes i have seen in folks who has reached out to me are depression medications alcohol or drug addiction old head injuries strokes sleep apnea anxiety to name a few

so
in 2024 you should be able to rule out or rule in alzheimers as a cause of your memory loss

the organicgreen doctor

Wednesday, February 21, 2024

organicgreendoctor: my story revisited #198-today is her birthday

organicgreendoctor: my story revisited #198-today is her birthday: MY STORY REVISITED #198-TODAY IS HER BIRTHDAY today she would have turned 102 years old this is her when she was younger she is my mother  s...

my story revisited #198-today is her birthday

MY STORY REVISITED #198-TODAY IS HER BIRTHDAY

today she would have turned 102 years old
this is her when she was younger
she is my mother 
she died in her mid eighties from alzheimers disease
in the final stages

she was a teacher early on and a preachers wife and a mother
later in her early 40s she finished nursing school and was a nurse for over 20 years

sometime in her mid to late 70s symptoms started
once she fell and hit her head
a ct scan showed she had a small head bleed and it was noted she also had brain shrinkage that turned out to be due to alzheimers disease
it was about that time she got her diagnosis of alzheimers and was started on aricept or donepezil
she lived at home her choice for awhile 
then moved to an apartment in a senior facility
then she moved to a long term facility where she remained until her death 
she died in the late stages of the disease

seeing her go through this was my first real experience up close with someone with the disease
i had treated patients in my office but when they ended up in a facility i didnt care for them anymore

with her progression i got to see what it was really like
then later my brother a year younger than me went down that same path

her experience and my younger brothers experience made me hyperaware of this disease showing up in me
i had this fear of it sneaking up on me like it did them and not realizing it
leaving me unaware trying to practice medicine
fearing i would harm someone if i got it

so
when i turned 60 i sought out a clinical trial that would monitor me on a regular basis
so
that if symptoms would start then i would stop practicing
the memory testing showed i had memory issues
so
i stopped practicing medicine at the age of 60

luckily i eventually got on aduhelm which removed all the amyloid plaque from my brain
the question is 
will it make a difference
we will know over the next 5-10 years
hopefully i will be spared those final stages

i know what can happen as the disease progresses since i have seen it up close in her and him
i just hope something else get me before it does

i will always remember her last part of  her journey
hoping i dont go there
but
i also remember her even more before she reached that point
as a mom a grandmother as a nurse
she was loved my all
she was a special person and we miss her today

i wish my grandkids could have got to know her

she was a special person
happy birthday mom
she is in our thoughts today

the organicgreen doctor

Tuesday, February 20, 2024

organicgreendoctor: is it worth it

organicgreendoctor: is it worth it: IS IT WORTH IT lets say you want to be a high school science teacher the pay when you finish will probably start out at around 50,000+- base...

is it worth it

IS IT WORTH IT

lets say you want to be a high school science teacher
the pay when you finish will probably start out at around 50,000+- based on where you get a job

most schools give you a teacher retirement usually full vested after 20 years but that can vary
most provide a 401k and some add a 457 plan that you can add money to and let it grow tax free
if your school you teach in doesnt pay into social security then you might not get any social security since it will be adjusted for the windfall elimination exemption or wep
you will want to teach in a school that pays into social security

if you are in high school looking for a career in high school teaching then you need to understand all of the financial stuff before you start teaching
most dont
most find out the hard way when they retire
most find out the hard way when they have to repay their school loans

here is one option
scenario a
here in santa barbara a high school graduates can attend santa barbara community college for two years 
they will pay no tuition fees books or other similar fees
they just need to provide room and board
so you could finish the two years with no debt
then you transfer to a 4 year school for your last two years
or
scenario b
you could attend for example a state school like the cal state system or the university of california system from day one
your cost at a school like the university of california at santa barbara would be about $150,000+ for tuition fees books other fees and room and board
at the cal state school it would be a little less
or
scenario c
looking at a well known private university their cost for 4 years of school is estimated to be around $280,000+

so what do the students call you no matter where you go to school

ms jane smith my science teacher

the teacher who followed scenario a if they paid for all their schooling would owe probably around $30,000
the scenario b teacher could owe around $150,000
the scenario c teacher could owe $280,000

teacher a has school debt that would be like buying a new car
it would be much easier to pay off sooner than the others then they could buy a house have a family
maybe they can do investments in a 401k

teacher b and c would probably be paying on their school debt until their retirement
it may affect decisions like getting married buying a house having a family and where they can live
or do those other investments like the 401k

i read horror stories about folks who are teachers that owe over $300,000 in school debt
they might never get it paid off

luckily most folks live in communities where they can use community colleges to get their first years at a reduced cost or in our location no costs

eg years ago i left community college with no debt since i paid my own way by working
it did take 4 years to get my first two years in
my last two years was in the university of california system
i worked got grants and scholarships and took out some loans
i left school with a debt of about $3-5000 for my bachelor degree

after medical school since i followed scenario a my patients called me doctor
my friends who followed scenario b and scenario c their patients called them doctor

i left school with a debt of about $20,000
many of them had debts of $100,000+

is it worth it to go so far deep in debt for school
no 
not if its the expensive path

the organicgreen doctor

Thursday, February 15, 2024

organicgreendoctor: i am done and its gone

organicgreendoctor: i am done and its gone: I AM DONE AND ITS GONE that scan on the right is a positive amyloid pet scan all that red stuff throughout the brain is amyloid the scan of ...

Wednesday, February 14, 2024

i am done and its gone

I AM DONE AND ITS GONE


that scan on the right is a positive amyloid pet scan
all that red stuff throughout the brain is amyloid
the scan of the left is of a negative amyloid pet scan
there is no red out in the brain

in the theory of alzheimers the amyloid plaque that red stuff is deposited in the brain
it kills brain cells
later
tau protein tangles form which kills brain cells
later
inflammation sets up to kill more brain cells
these three what i call the trifecta of alzheimers kills brain cells
which causes what we see in our loved one as alzheimers

the approach now in 2024 is to attack each of the trifectas

first amyloid is now being removed with my drug aduhelm and the new drug leqembi and soon later this year another drug donanemab
all three are antiamyloid monclonal antibodies given as infusions 
soon they will be given as a shot you can give yourself
those studies will be out soon

if you can remove the measurable amyloid from the brain what effect does it have on the disease process
does it slow it down
does it stop it
does it make it go away
does it slow down the tau tangle accumulation
does it slow down the inflammation
does it really make a difference

here is what we know or think we know
they remove the amyloid plaques
folks memory decline stops or slows down

how long does the benefit last
will it really make a difference
well
we dont know
we will know in 5-10 years
just follow my story 
my journey over the next 5-10 year will the poster story for how well these drugs work

for me personally if i dont start getting more symptoms for another 5 years then i will be quite content with all my involvement in this study for the last 8 years

time well spent 

here is my story and where i am at today
i was diagnosed with mild cognitive impairment thats due to alzheimers disease
ny memory tests were intially abnormal 
my spinal fluid is abnormal for amyloid and tau levels 
i have the apoe 4/apoe 4 gene for late onset alzheimers
i have been on aricept or donepezil for 13 years
i have maintained my healthy habits

in 2015 i located information on aduhelm
in 2016 i started a several months evaluation for biogens aduhelm or aducanumab clinical trial
my amyloid pet scan was positive like that one above

in 2017 i started the biogen aduhelm study 
i received 18 months of placebo then 7 months of the real drug aduhelm
the study was abruptly ended
the restart was delayed by the pandemic
it was restarted as the embark aduhelm clinical trial
i then received 27 more infusions of aduhelm 
so i received a total of 34 monthly infusions of the real drug

recently the study was discontinued and aduhelm is being taken off the market
the company co owns leqembi which probably works better than aduhelm
they have decided to put all their emphasis on leqembi

yesterday day was my final day in the embark study 
the end of a 8 year journey which i never regret doing 
i had several hours of memory testing and a neurology exam and a final mri scan
the mri scan makes sure i havent had a brain bleed or other issues
all of my mris have been normal

here is where i stand now 13 years after my diagnosis
my initial amyloid pet scan was probably like that one above maybe not as severe as that one
the one done after the pandemic was still positive
i had had 7 real infusions but only two of those were the high recommended dose
in the embark study my next 27 infusions of aduhelm were the higher dose

the only problem i had was the onset of ocular migraines that started after my first high dose of aduhelm
it was bad enough i would have gone to the emergency room since i thought i was having a brain bleed
they stopped the infusions for a couple of months and did a series of mris to be sure there were no bleeds
the mris were all normal

i continued though to have ocular migraines once a month but over time they got less and less severe such that that the last few months of the study i didnt have any more headaches

having the apoe 4/apoe 4 gene put me at a higher risk for brain bleeds

i knew the risks and was willing to accept the risks

my last amyloid pet scan i had done 6 months ago shows that there is no measurable amyloid plaques left in my brain
my scan would look like the one on the left in the picture above

my memory tests done yesterday include a mmse and a moca test and others
both of these i can score as i go 
i got a 30 on both of them which is normal

my mri scan report will come through probably next week but i expect it to be normal

what do i do now
i wait
when the amyloid plaques reaccumulates in maybe 5-10 years i will need retreatment
my choice would be leqembi
it probably will be approved to be given at home as a shot 

i follow the research
two new anti tau drugs are being studied now
they are in clinical trials now
i dont qualify for these trials since my amyloid pet scan is now negative

a new antiamyloid pill is being studied
new antiinflammatory drugs for the brain is being studied
new drugs to alter the effect of the apoe 4 gene are being studied
new gene editing to alter the apoe 4 gene is being studied
there is more coming in the research world

if these come on the market i will probably take one of them

i stay on aricept
i continue to live healthy
i wait

so 
i am done and its gone
but
is it really gone
time will tell

the organicgreen doctor

Friday, February 9, 2024

organicgreendoctor: alzheimers news-changing your genetics

organicgreendoctor: alzheimers news-changing your genetics: ALZHEIMERS NEWS-CHANGING YOUR GENETICS what if i could change my genetics my choice would be to change my apoe 4 status or its effects what ...

alzheimers news-changing your genetics

ALZHEIMERS NEWS-CHANGING YOUR GENETICS

what if i could change my genetics
my choice would be to change my apoe 4 status
or its effects

what is apoe 4
it is apolipoprotein e that is involved in the metabolism of fats
it moves cholesterol around in the body
cholesterol is a good thing since it is used to make things like steroids in your body and is used to build or rebuild nerve cells
the right amount of cholesterol is a good thing
too much is a bad thing
like
causing heart disease or strokes or alzheimers

the apoe 4 gene is called the late onset alzheimers gene

there are 3 versions of apoe that you can inherit
apoe 2 which is good to have as it protects you somewhat from this disease
apoe 3 is sort of the half way one
apoe 4 increases your chance of heart disease stroke and alzheimers

if you get the apoe 4 apoe 4 version then your risk for alzheimers is increased by 10-20 times
2-3% of us have this version

you can counterbalance that apoe 4 apoe 4 gene by
 controlling your cholesterol throughout your life
along with doing all other things one should be doing
like
good blood pressure control
maintaining a normal blood sugar
maintaining a normal weight
eating a healthy diet like the mind diet
staying active mentally physically and socially
getting adequate sleep
avoiding stress
limiting alcohol
not smoking
and
doing all the other healthy things you need to do

then
what if
you could change that apoe 4 genes influence on your body
what if
you could be given a medicine to do that

well
this research from my alma mater the university of arkansas medical school has developed a new drug that might interfere with the effects of the apoe 4 gene
by doing so
it will counterbalance the effects of the apoe 4 gene
if it works then folks like me might not develop alzheimers disease

dont you just love science

also
this week
when you see someone picking their nose
say
stop or youll get alzheimers disease

some researchers think that by picking your nose a lot that you develop inflammation in the nose
the olfactory or smeller nerves are up in your nose
they have almost a direct line to the brain
the olfactory center in the brain is close to where alzheimers stats

neuroinflammation is part of what causes alzheimers destruction in the bran along with amyloid plaques and tau tangles

picking your nose causes neuroinflammation in the olfactory nerve
but
could that neuroinflammation cause alzheimers

well keep picking your nose and youll eventually find out

the organicgreen doctor

Wednesday, February 7, 2024

organicgreendoctor: my new workout equiptment and workout facility

organicgreendoctor: my new workout equiptment and workout facility: MY NEW WORKOUT EQUIPTMENT this picture showed up on facebook recently  i am not sure who to attribute it to this week i have been working on...

my new workout equiptment and workout facility

MY NEW WORKOUT EQUIPTMENT

this picture showed up on facebook recently 
i am not sure who to attribute it to

this week i have been working on a tool grant for our community garden
a lot of our tools are old real old and wore out
some are over 12 years old
some are broken
some are just wore out
some are bent 
some are missing parts
some lean to the left
some lean to the right
so
its time to replace them with new good quality stuff

so every tool in that picture above needs replaced

yes
we need some new outdoor workout equipment

i know folks who spend money on a gym membership
i spend mine on a community garden membership
around $30 a month for two plots
in return
i get access to all of this much as you want to use free exercise equipment
and lots of organic fresh vegetables and fruits
and a place to meditate 

i also monitor my steps on my iphone
on garden days i tend to get between 5000-10000 steps
add to that all that use of the garden exercise equipment 
keeps me healthy physically
and mentally

i may be in the best  physical shape i have been in since i moved here

plus we have a free vegetable and fruit bar
eg
yesterday i ate a couple handfuls of sweet peas off the vine
a  couple of satsuma oranges
several leaves of lettuce and kale and arugula
a couple of sprigs of broccoli
a couple of bananas from the banana trees
a couple of strawberries

man
you cant get any better exercise location than this 

and
its all outdoors

no wonder farmers live a long time

the organicgreen doctor

Saturday, February 3, 2024

organicgreendoctor: alzheimers news-it will be gone soon

organicgreendoctor: alzheimers news-it will be gone soon: ALZHEIMERS NEWS-IT WILL BE GONE SOON aduhelm or aducanumab is a monoclonal antibody that removes amyloid plaque from the brain removing this...

alzheimers news-it will be gone soon

ALZHEIMERS NEWS-IT WILL BE GONE SOON

aduhelm or aducanumab is a monoclonal antibody that removes amyloid plaque from the brain
removing this amyloid plaque may slow down alzheimers disease

i received 18 months of placebo followed by 34 months of aduhelm infusions in the biogen clinical trials i was doing


aarp

biogen along with eisai produced and marketed aduhelm
poorly i musts add

the problem is they tried to get it approved before all the final research was done to show whether it really worked well or not
my impression is that they tried to use some influence to get it approved too early
i also agreed as i have said several times including this time with my interview with the ny times

biogen had at least two studies ongoing
my study called embark and another one that the fda was requiring them to do to really show how well it worked

this week biogen stopped all clinical trials for aduhelm and have pulled it from the market
they are giving the rights back to its original company called neuroimmune who plans on developing it as a shot that can be given at home 

now biogen and eisai are marketing the antiamyloid drug leqembi which probably works better than aduhelm and has full fda approval 
medicare even is paying for it also
it is also being researched to given at home as a shot where it may work just as well as infusions

biogen and essai decided to put all efforts and money into leqembi
it just got approved in china and may get european union approval this year

right now most agree its the one to use

soon to be approved will be donanemab which will be approved sometime this year
the two leqembi and donanemab will compete against each other

am i disappointed
no
i am glad its gone

am i glad i took it 
yes
since it probably removed all the amyloid from my brain

am i going to take something else
yes
probably leqembi when the amyloid plaques reaccumulate back in brain in the future
or
something else if it becomes available

since biogen is discontinuing the aduhelm studies and discontinuing aduhelm i plan to get them to release my final amyloid pet scan and my final tau pet scan so i will know where i am with my disease

i also would like to see my original amyloid pet scan i had done in 2016 when i started the aduhelm studies
and would like to see all the other ones i have had over the years i did the study

someone reached out recently for a spouse who was just diagnosed
it sounds like they has had a good workup and is probably going to have an amyloid pet scan which would solidify his diagnosis
then they will probably start aricept or donepezil to slow down symptoms
then
if it was me and i was early enough in the disease process
for me
i would seek out the leqembi infusions to potentially slow down the disease progression some
these infusions are not readily available in some areas 
you must though understand the risks of getting the infusions ie brain bleeds 
there are strict criteria for those who get on it

i was high risk for the brain bleeds since i am homozygous for apoe 4 ie i am apoe 4/apoe 4

the only problem i had with the infusions was the onset of ocular migraines that included a visual aura for 15-45 minutes then a headache for several days afterwards 
i have had none since my last infusion last year

we will know for sure in the next few years how well these antiamyloid drugs really work
they may work better than expected or not as well as expected

for me
speaking just for me
i would do it
i did do it
im glad i did
even
if it turns out it doesnt help much

im glad its gone and something is there to take its place

the organicgreen doctor

Wednesday, January 31, 2024

organicgreendoctor: colon cancer is on the rise in younger folks

organicgreendoctor: colon cancer is on the rise in younger folks: COLON CANCER IS ON THE RISE IN YOUNGER FOLKS american cancer society new guidelines   during my medical career of around 30 years i dont rec...

colon cancer is on the rise in younger folks

COLON CANCER IS ON THE RISE IN YOUNGER FOLKS

american cancer society new guidelines 

during my medical career of around 30 years i dont recall a patient under 50 who had colon cancer
a few years before i stopped practicing medicine the guidelines for screening for colon cancer was dropped down to 50

now the new guidelines are dropping down to 45
why
there is an increase in colon cancer in these younger folks

colon cancer is now the top cancer cause of death in men under 50
its second in women under 50 
breast cancer is first

in the 1990s it was the number 4th cause of death in this age group

why 
obesity 
excessive alcohol
processed foods
sedentary lifestyles
poor diet
i wonder if it could also be these two things below
some think exposure to chemicals in our diet and food may be contributing
makes me wonder about all those microplastic things that are getting in our bodies

so sorry especially guys 
its colon cancer screening at 45 now for you

the gold standard is a colonoscopy
the other options like that box of poop you send in to the lab are used by some but arent as accurate as the gold standard colonoscopy
if the poop box is positive you will have to have a colonoscopy

sorry guys
add this to the finger wave you need to be getting for your prostrate

the organicgreen doctor

Sunday, January 28, 2024

organicgreendoctor: alzheimers news-how to diagnosis and treat alzheim...

organicgreendoctor: alzheimers news-how to diagnosis and treat alzheim...: HOW TO DIAGNOSIS AND TREAT ALZHEIMERS IN THE FUTURE this prediction below of how to diagnosis and treat alzheimers disease is based on from ...

alzheimers news-how to diagnosis and treat alzheimers in the future

HOW TO DIAGNOSIS AND TREAT ALZHEIMERS IN THE FUTURE


this prediction below of how to diagnosis and treat alzheimers disease is based on
from being in alzheimers research studies 
from being treated with the antiamyloid plaque antibody aduhelm or aducanumab 
from reading hundreds of articles on alzheimers 
from attending and presenting at lots of alzheimers programs and seminars
from doing online interviews 
from interacting with numerous neurologists

when i was diagnosed in 2010
i saw a neurologist since my memory test in the adni 2 alzheimers research study was abnormal
i had a thorough neurological history and physical
i had the standard labs like cbc metabolic profile thyroid level vitamin b12 vitamin d3 and homocysteine level
i had an mri done that was normal

initially my diagnosis was based on my memory test and my strong family history of alzheimers
i was placed on aricept or donepezil to slow down symptoms
i have been on that for 13 years

later i had genetic tests that showed i did not have the early onset alzheimers gene
i did have the late onset alzheimers gene called apoe 4
i had the homozygous gene apoe 4 apoe 4 which increased my risk by 10-20 times

i also had a spinal tap for amyloid and tau which showed results compatible with alzheimers
later when i entered the biogen aduhelm treatment study my amyloid pet scan was positive
all these confirmed i had alzheimers 
most folks during that time and even today stop at the mri
there was no treatment back then except for the aricept or donepezil

now in 2024 if i had symptoms i would have the same workup except i wouldnt have the spinal tap
i would still do the genetic testing so my relatives would know its in our family genetically
then
i would do an amyloid pet scan that would confirm my diagnosis
medicare now pays for it and probably most insurances will eventually
then
in 2024 i would begin treatment with leqembi with bimonthly infusions for at least 18 months maybe longer
i would be looking around also to find clinical trials that was treating tau tangles in the brain
i would also take aricept or donepezil since the earlier you start the longer it works to slow down symptoms

in the theory of what happens in alzheimers
amyloid plaques develop first
tau tangles then accumulate
inflammation then sets in 
all kill brain cells
the goal is to slow this down

where the tau tangles accumulate in the brain is where alzheimers is active in the brain
the goal in the future is to treat each separately 
like leqembi for amyloid
an antitau drug for tau tangles
an antiinflammatory drug for inflammation

doing all this should slow down the disease
adding of course all the healthy things one should be doing

so if you fast forward to 2030
if you are not having memory issues and have a strong family history of alzheimers you could have
your amyloid checked by a blood test as a screening test and then confirmed with an amyloid pet scan
your tau checked by a new blood test coming soon to screen you
if your memory test is normal and your amyloid and tau are positive 
you might then consider beginning treatment with an antiamyloid drug like leqembi or some newer one maybe a pill to start removing the plaques

this is called prealzheimers ie there is no memory loss but amyloid and tau in the brain are present in the brain

also they probably will be treating folks like this for tau with an antitau drug
the thinking is removing these will slow down or prevent alzheimers from developing

we are actually that close to doing this 
they are already doing it in clinical trials now

so 
when i was in my early 50s when my memory tests would have been normal had it been 2030 i probably would have done all of this had it been available

so
in 2030 if you have concerns for your memory 
you can do the workup i had in 2010 
then do the ptau blood test

if  positive then you probably have alzheimers and could proceed with an amyloid scan to make a definitive diagnosis 
then you could start with treatment with an antimyloid drug like leqembi and an antitau drug and maybe an antiinflammatory drug and probably aricept

if the blood test is negative you probably dont have alzheimers 

so
in about 5 years if you have memory issues you can go see your doctor and get an evaluation to include a blood test for amyloid and tau
if the blood test is negative you probably dont have alzheimers
if the blood test is positive you probably have alzheimers and will need more testing
then
if its alzheimers you will be able to get treatment to slow down the disease 

we are getting there its seems

the organicgreen doctor

Friday, January 26, 2024

organicgreendoctor: making lemonade out of lemons

organicgreendoctor: making lemonade out of lemons: MAKING LMEONADE OUT OF LEMONS this looks like a pretty southern california beach well when this picture was taken in 2018 no one was allowed...

making lemonade out of lemons

MAKING LMEONADE OUT OF LEMONS

this looks like a pretty southern california beach
well when this picture was taken in 2018 no one was allowed in the water here for months and months
this is goleta beach
i call it the dumping ground beach around here

In this blog in 2018 i wrote about this beach
it sits just south within walking distance of the university of california at santa barbara campus
which sits on a bluff above the ocean
i wrote a follow up blog also in 2018 
i also wrote this blog in 2023 when they dumped stuff there again

in fact below the bluffs is a popular place to surf 
there are always folks out their surfing
i think the surf breaks just right on some rocks
folks walk down a long stairway to the beach

this should be a great location for a beautiful beach this goleta beach

there is a pier just out of that picture above
you can see pictures in my old blog
its mainly used by fisherman and birds
it seems not maintained well the last time i was there

there also is a restaurant there that changed hands but has not been opened for quite some time
the bad winter storms that hit that area in recent winters had eroded the beach and damaged the restaurant so its had to be reinforced to withstand such attacks

then the beach got attacked several times not from storms or from winds but from muck and debris getting dumped there from other sites
mostly from the montecito area
you recognize that name
can you say oprah ellen prince harry and other well known folks 

when i was first there in 2018 after the mudslides they were digging deep holes and dumping truckloads of debris and muck in the holes for days it seemed
it smelled like a sewer
there are pictures in my old blogs

can you say contamination like sewage and whatever got washed down in all that muck
the beach was closed for months
it may still be

later when we had another flood and muck situation further south of this beach
they again dumped the debris and muck onto goleta beach
this time though
they pushed it out onto the beach and gradually built a sort of point

this left changes in the waves that has created some good surf waves there that the local surfers are surfing
the writer of this article about it recommended they call it the
dump truck point or some suggested oprahs point

now it seems the restaurant is getting rebuilt and hopefully reopened
this area so close to the university
it has a lot of potential
if
they would quit using it for a dumping ground for all that stinky contaminated muck

yes maybe it will be a lemonade beach one day
maybe they should call it lemonade cove or the lemonade point

the organicgreen doctor

Wednesday, January 24, 2024

organicgreendoctor: my story revisited #197-im not there yet

organicgreendoctor: my story revisited #197-im not there yet: MY STORY REVISITED #187-IM NOT THERE YET i find it hard to watch alzheimers movies like still alice or the one about glen campbell i guess b...

my story revisited #197-im not there yet

MY STORY REVISITED #187-IM NOT THERE YET

i find it hard to watch alzheimers movies like still alice or the one about glen campbell
i guess because it touches too close to home

in 2015 i had not started the aduhelm infusion study yet
it would be 2 more years before that happened
i sort of felt like i was looking down an abyss especially when i watched still alice and the campbell movie and listened to this song

my younger brother died about 2 years before i wrote this blog below
my older brother had been diagnosed with alzheimers disease and was placed on aricept and later nameda
he later was take off these meds and was told he didnt have alzheimers
his doctors fixed his heart issues and adjusted his medications and his memory and health improved
now 8 years later he does not have that diagnosis
note
i never write about family members unless i get their permission or their familys permission
like me
they feel like telling their stories may help others

when i was diagnosed in 2010 i really thought in 2024 i would be like glen campbell was in his video
but
i am not
_________

06-30-2015
ITLL BE ME
last night my wife she and i watched the movie
about glen campbells farewell tour
ill be me

Image result for glen campbell's movie ill be me
there were parts
well lots of it that were difficult to watch

everyone needs to watch this movie
it shows you what its like to have this disease
and
how inside that brain there is still things that
functioned well
and
could be called up for use

over the last five years as ive learned more and more
about alzheimers disease
i have seen it first hand with my mother and my younger brother
and now with my older brother and to some degree with
my father
i was amazed at how well glen campbell was able to
perform on stage singing his songs
and
doing a decent job
yes it was a struggle on his last concert

so knowing what i know now
i realize he was in a more advanced stage
of the disease during the tour

that explains his rapid decline since the concerts
as he had hit that rapid decline
that fall off the cliff that occurs in the later stages

lucky for us he did his final concert and album
before he got to the cliffs edge

i watched with tears in my eyes
as i saw him record his last song
and doing it well

alzheimers disease does strange things
the music seemed to awake something in his brain
from some deep crevice
that defied the stage of the disease he was in

amazing is what i muttered under my breath
as he sang that final song
im not gonna miss you
even though he couldnt carry on a conversation
when the words came out they didnt always make sense
didnt know his family
couldnt dress himself
couldnt find the bath room
was inappropriate whatever that means when he ate

it was good to watch his family and friends
tolerate his behaviors
just going with the flow
not arguing with him
even during the concerts
as he sang a song twice
or sang a different song than planned

thats the way to handle patients
just go with the flow

i didnt find this movie as disturbing as
still alice
but
i was still misty eyed through much of the movie

especially as i watched him and his speech
and his behavior
it reminded me so much of my younger brother
as he progressed with the disease

then
it did bother me a lot
as i realized
itll be me
one day
_________
so why am i not like glen campbell in that video now in 2024

i was diagnosed early
thats the number one reason i am better

i had a thorough medical workup
in 2024 in my opinion that includes a good medical exam and history
a good memory test like the moca or a full neuropsychological exam if indicated
labs like a cbc a metabolic profile thyroid level vitamin b12 and maybe vitamin d3
some would add a homocysteine  level
a mri to rule out other causes of memory loss like stroke tumor scar tissue etc
ai is now being used to read mris of the brain and can diagnose early mri changes in the brain

then if indicated one needs either a spinal tap for analysis for amyloid and tau
or
an amyloid pet scan 
if you have alzheimers these will be positive

soon within 5 years you can do blood work that will tell you if you have it

then you should know if you have it
so 
here is what you do

maintain your health
eat a mind diet or equivalent one
maintain normal blood pressure cholesterol blood sugar and weight
stay active mentally socially and physically
avoid alcohol use or limit its use
dont smoke quit if you do
treat anxiety depression sleep issues
avoid stress
get adequate sleep
stay busy mentally physically socially 
most newly diagnosed with mci or alzheimers disease get put on medication like aricept or donepezil

so far all these healthy things mentioned above works better than any of the newer drugs to slow down and prevent alzheimers when you are younger

look for treatment studies or probably in the next few years they will treat folks before symptoms start
that is happening in studies now

if you are diagnosed with it consider taking leqembi or donanemab infusions as long as you understand its limitations and potential side effects

so
im not there yet
but
i know it will be me eventually

i have bought some time it seems

the organicgreen doctor

Tuesday, January 23, 2024

organicgreendoctor: i choose neither and test them both

organicgreendoctor: i choose neither and test them both: I CHOSE NEITHER AND TEST THEM BOTH the hill if it was up to me neither of these guys would be on the ballot this year for president its time...

i choose neither and test them both

I CHOSE NEITHER AND TEST THEM BOTH

the hill
if it was up to me neither of these guys would be on the ballot this year for president
its time for us to move on to the next generation
the majority of americans feel the same way
there is a good chance one of these if not both of them wont be around anymore by 2028

yes its time 

one is 78 and the other is 82
in 2028 one will be 82 the other would be 86

yes we need the next generation to take over
when i look around at both sides there are plenty of good candidates
lets go for those folks this time
some fresh ideas
with a different outlook on what needs to be done

ive read a lot about memory testing these guys
one boasts of passing his memory test
he took the moca test in the past and according to him he passed it
got all of them right
the other guy im not sure if he did one or not

the moca test stands for minnesota cognitive assessment test
the gold standard memory test is the full neuropsychological test
the moca test is the standard test commonly used in the office setting to test memory
it takes about 30-30 minutes to take
if you have memory issues it should show up on this test
you cant fake or cheat on the test
if there is a problem 
it will show up

now i have taken a moca test at least once a year since 2010
some years i have take two some years three some years four
i have even administered the test to folks
so 
im fairly familiar with the moca test

there are 30 items on the test
a score of 27-30 is normal
i score from 28-30 on mine 
of course initially when i was diagnosed my scores went lower 
in the mic or mild cognitive impairment range
they have since returned to normal

in the last 12 months i have had 3 of them
i will have another one in 2 months

so 
i sort of know what i am talking about

my guess is that both of these guys will be in the normal range of 27-30
neither will get a perfect score of 30

what i propose is both take a moca memory test administered by a reputable independent tester chosen by both
if either of them score below 27-30 range
then they agree to drop out of the race

if they both score in the normal range then lets all stop talking about them being memory impaired

then
all presidential candidates should volunteer to take the moca memory test
if they fail the they should drop out

then
all presidents should take the test each year
if they fail then they resign and let the vice president take over

yes
lets test them both

the organicgreen doctor

Thursday, January 18, 2024

organicgreendoctor: what is it

organicgreendoctor: what is it: WHAT IS IT mercyone.com i know a lot of folks with a cough or nasal congestion  i see a lot of folks online with these symptoms is it covid ...

what is it

WHAT IS IT

mercyone.com

i know a lot of folks with a cough or nasal congestion 
i see a lot of folks online with these symptoms

is it
covid
is it
flu
is it 
rsv

if you older like i am or are immunocompromised or have a chronic disease that puts you at risk
knowing what you have may be important

here are some symptoms i found in this article that are common to all three of these

fever chills
cough
runny nose
body aches
headaches
sore throat
fatigue
nausea with covid and flu
diarrhea with covid and flu

a common cold can have similar symptoms also but not the gi stuff

you can prevent all three of these by getting your
flu shot
covid shot
rsv shot

now the shot may not totally prevent you from getting ill with these
but
they can prevent you from getting bad sick especially if you are high risk

if you get tested early enough you can get treatment 
tamiflu for flu
paxlovid for covid
if you wait too late to start the drugs they dont work
probably around 3 days

the biggest risk if you are high risk is pneumonia
the ultimate risk is death

also at risk are pregnant females and young children
kids with asthma are at risk also
pregnant females can get the rsv shot at around 34 weeks to protect themselves and their newborn infants
high risk babies can get a rsv antibody shot
pregnant females should have covid and flu shots also
pregnant females have a drop off in their immune system that makes them vulnerable to these infections

it can be hard sometimes as a doctor to tell the difference between these three infections since there is overlap of symptoms

you can
test yourself at home with a covid test
get a flu test at your providers office
start treatment asap if either of these are positive to slow down the symptoms

get your flu or covid or rsv shots if you havent had them yet
the traveling yall all did recently and now being trapped inside with all this bad weather will spread the germs around to everyone

one problem is the vaxxination rate for all three of these is lower than normal 

its the vulnerable we are worried about

we worry about giving these to our grandkids but what my wife she and i have found is we should be worried about giving it to our grandparents who are probably more vulnerable to these infections

get your vaxxines
get tested
get treatment if positive
seek medical care if your symptoms get worse
dont spread it to others 

the organicgreen doctor

Tuesday, January 16, 2024

organicgreendoctor: alzheimers news-i want to see too

organicgreendoctor: alzheimers news-i want to see too: ALZHEIMERS NEWS-I WANT TO SEE this is the video of the episode called the master of the mind on 60 minutes from this weekend several folks s...

alzheimers news-i want to see too

ALZHEIMERS NEWS-I WANT TO SEE

this is the video of the episode called the master of the mind on 60 minutes from this weekend
several folks sent me a message about it
i will admit as i was watching it yesterday 
well
i cried real tears
and
got chills and chill bumps
and
since i watched it right before i did my afternoon nap 
i couldnt hardly go to sleep
i did
but it wasnt a restful sleep

as i worked in my garden by myself for a couple of hours 
i did a lot of thinking about all of this


this is a photo from the cbs news 60 minutes episode called master of the mind

before i started aduhelm or aducanumab in 2016 my amyloid pet scan looked like this
probably not as much since from what i  could tell im not as far along as those who were in the study that the program was about
but still my scan was reported as being positive

if you watch the episode
if you are anywhere near the alzheimers world you should take the time to watch the video
it will give you some hope for where treatment is heading
you will see them show the original amyloid pet scan with all that red stuff
which is amyloid plaque
the plaques are part of what causes alzheimers disease
then
they show the amyloid plaques all that red stuff has been blasted away by opening up the blood brain barrier with ultrasound on a specific area of the brain after receiving an infusion of aduhelm or aducanumab

on the follow up amyloid scan you even you non medical people can easily see the plaques are gone

when they showed that follow up amyloid pet scan 
well
thats when i lost it and started crying

i even said out loud to myself

want
to 
see

what i meant was i want to see my amyloid pet scans
all 5 or 6 of them
i want to know
where i am at

i am not allowed to see my scans though since they are protected from viewing
i have though requested i get to see them after the study is concluded

now i received 35 infusions of aduhelm or aducanumab over 35 months
over that time the aduhelm or aducanumab should have removed all of the measurable plaque from my brain

so if i could see my last amyloid pet scan done this summer
it would look like the one they showed on the big ole screen after the patients got the ultrasound blast and the aduhelm or aducanumab
the area that was spot treated showed all of the plaque was gone on the scan

on my scan it should show that all the amyloid plaque throughout my brain is gone ie none could be measured
if i could line all my scans up in a row you could see the progression of the removal of the amyloid plaques

there was some hope since the one patients wife noticed he had not gotten worse since he was treated and had improved slightly

thats what i am hoping with my treatment
that i dont get worse and maybe improve

seeing it on the screen like they should make it more real

yes
i want to see too

the organicgreen doctor

Saturday, January 13, 2024

organicgreendoctor: i dont know if i can do it

organicgreendoctor: i dont know if i can do it: I DONT KNOW IF I CAN DO IT this is my yeti cup that i drink my water from right now i drink filtered water from the faucet soon though i mig...

i dont know if i can do it

I DONT KNOW IF I CAN DO IT

this is my yeti cup that i drink my water from
right now i drink filtered water from the faucet
soon though i might have to change that

now the ultimate water we ever had was when we lived at the country n
we drank rainwater
the ultimate water

the rainwater ran though two sediment filers
one smaller one and one real large
then it went though a large carbon filter
then it passed through a ultraviolet filter which sterilized it

it didnt really have a taste like our present water does
nor did it have a smell

it was just well unless you have drank it before you dont know what its like to drink
i guess you could drink it as it falls from the sky like you do a snowflake on your tongue

washing dishes and washing clothes and showering and shampooing your hair
its the ultimate water to use

the same for drinking rainwater

alas
we are stuck with bottled water or filtered water
so
we compromise for convenience and cost
we drink filtered water from the tap

now califonnia made it ok to use toilet water and the local water folks are going to reuse toilet water to add to the drinking water
you mean theyre going to dilute it out some so it wont taste bad
doesnt sound good to me

the only other state to do this is colorado
is this a liberal or blue thing to do 

california is generally drought city
water is precious
wastewater has been used for a long time
just not as drinking water

some resorts use it to make snow
you mean like dirty snow
ill never eat snow again
farmers even use it on their crops
does that mean their crops are organic since they use wastewater
like we use chicken manure and steer manure in our gardens

i thnk of all the things i have dumped in a toilet 
no pun there
over the years
i admit i dont dump any extra stuff down there anymore

then think of what folks put in there
clorox vinegar draino medications vitamins drugs 
well you name it its dumped down there

im not sure they can really get all that stuff out of there before it reaches my faucet

here is an article on all this
dont take my word for it
read and decide if you want to drink this toilet water

here locally 
they probably will do this 
they also get some water from the ocean from desalination
just think what gets dumped in the ocean sewage oil chemicals you name it
they get water from two reservoirs
they get water from wells
they if they need it can get water from the states canals system
which they dont usually have to access

what i dont understand is why they dont mandate more rainwater collection in this state
heck
in our community garden we have 420 gallons of water we collect off our sheds
thats over 430 gallons that would end up in the ocean
what if more folks did that
then figured out how to make it drinkable

i guess though what will happen is we will end up with toilet water mixed in with all our other water

i guess thats progress

i might have to start drinking richards rainwater

the organicgreen doctor

Wednesday, January 10, 2024

organicgreendoctor: my story revisited-dont judge her

organicgreendoctor: my story revisited-dont judge her: MY STORY REVISITED-DONT JUDGE HER if you are going to read this old blog you need to read the article linked in the old blog it is from the ...

my story revisited#196-dont judge her

MY STORY REVISITED #196-DONT JUDGE HER

if you are going to read this old blog you need to read the article linked in the old blog
it is from the ny times and you may have to pay for it
here is a link to a summary of that article that gives you the gist of what the original article was about
click here to read that summary

this is a make you think article about what you would do

i look at my mothers alzheimers course and my younger brothers course and i think what point during my disease would i want to be euthanized

this person in the ny times article did it while she was cognitively intact enough to do it
that means
she had more living to do 
she could have gotten more time with her loved ones
sorry
i cant do that
i want to extract all the time i can be cognitively aware with my grandkids my wife she my sons and daughter in laws my brothers and sisters my friends my relatives my garden and more

when my senses are not sensing those things anymore
then thats the time
__________

05-15-2015
ALZHEIMERS NEWS-LAST DAY
if my amnestic mild cognitive impairment does as it
is expected to do
progress to full blown alzheimers disease
could i or should i or would i
choose my last day

my cousin about my age posted online on facebook
this article
the last day of her life from the nytimes magazine

i know she must think about all this a lot
since like me
her mom and dad both died with dementia
she watched them dwindle away
as did all her dads siblings
including my mother who was a sister to her dad

we all know what that final course is like
i saw it first hand in my mother and my younger brother
it was so difficult to see them in those final stages
with all the health issues that that entails
almost cruel it seemed

so i think about this a lot
and
i have thought about this a lot
and
this article just makes me want to pause a minute
and
think about this article

could or would or should i plan something like this

now ive seen on tv these specials on euthanasia
where folks are allowed to legally end their life
now i will admit though that it seemed some of
those folks had more living to do
but
there were many whose time had come
cant we let them die with some dignity at the time
and place of their choosing

now i watched still alice the movie about the
college professor who had alzheimers disease
she planned hers out
even got the drugs set aside in a drawer
with the instructions on her computer on how to
do this final episode of her life

the problem was she couldnt understand
and
follow the directions

i look at my mothers disease progression
and
my younger brothers progression
and
i think at what point would be the point to
do this final episode of my life

i think of times in their disease
and
think definitely before them
then
at earlier times
no definitely not yet

so timing is the problem
for you see i plan to extract all i can out of this
final journey
but
when no more can be extracted
then
its time

but
am i going to be like still alice where ive waited
too late

i think this person in this article was a brave brave
person
to do what she did
she left on her own terms
before the final deep despondent for everyone involved
heart wrenching loss of humanity decline
occurs

now
i know thats the thing to do
i would want it that way
but
scheduling it seems to be the problem

i want to be remembered as a good family doctor
a good husband
a good father
a good grandfather

an advocate

a volunteer
an organic gardener
and
not as a shriveled up shell of myself at the end
both physically and mentally

take a moment
read this article
dont judge
_________
when i wrote that blog 8 years ago i really thought i would be further along in my disease such that i wouldnt be writing this blog today
you never know do you

when was that time for my relatives
i could go see them and they recognized me and would smile
maybe not then
for me that would not be the time

the last time i saw them they didnt know me at all
both were bedridden

when im bedridden that would probably be the time
but
then 
i wouldnt be the one that makes that choice

my suggestion is when its time let me go peacefully
let nature tkes its natural course
just dont intervene to stop mother nature


the organicgreen doctor