welcome to the organic green doctor blog

i am a family physician who was diagnosed with
early mild cognitive impairment(mci) amnestic type on december 21, 2010
this is a precursor to alzheimers disease
because of this diagnosis i have opted to stop practicing medicine
this blog will be about my journey with this disease
please feel free to follow me along this path
i will continue blogging on organic gardening, green living,
solar power, rainwater collection, and healthy living
i will blog on these plus other things noted to be interesting

Thursday, June 20, 2024

my story revisited #206-my story on my story


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

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

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

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

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

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

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

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

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

senior expo article

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

slide one

slide two
slide three

slide four

slide five

slide six

slide seven

slide eight

slide nine

slide ten

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

slide 2 is information on aricept (donepezil)

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

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

slide 5 is an mri scan
this one shows a stroke

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

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

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

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

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

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

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

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

the organicgreen doctor

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