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, 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