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