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, July 19, 2024

organicgreendoctor: alzheimers news-new drug kisunia for early alzheimers

organicgreendoctor: alzheimers news-new drug kisunia for early alzheimers: ALZHEIMERS NEWS-NEW DRUG KISUNIA FOR EARLY ALZHEIMERS there are now 3 drugs approved by the fda to treat early alzheimers or mid cognitive i...

alzheimers news-new drug kisunia for early alzheimers

ALZHEIMERS NEWS-NEW DRUG KISUNIA FOR EARLY ALZHEIMERS


there are now 3 drugs approved by the fda to treat early alzheimers or mid cognitive impairment due to alzheimers

these drugs do not work in the genetic early onset alzheimers patients like those with the presenilin gene
they only work in later onset alzheimers like i have

in the theory of alzheimers amyloid plaque builds up and kills brain cells
later tau proteins unwind and form tau tangles in the nerve cells and kills brain cells
later inflammation occurs in the brain and kills brain cells

if you could remove the amyloid plaques or keep them from forming then maybe you could slow down the disease

antiamyloid monoclonal antibodies either prevent the amyloid plaques to form or remove them if they form

the 3 monoclonal antibodies against amyloid plaques are
aduhelm or aducanumab
leqembi or lecanemab
kisunia or donanemab

my drug i took for 34 months is aduhelm
they did a rocky introduction and tried to get approved before all the studies were done
even though it was approved for use it was eventually taken off the market since its sister drug made and marketed by the same company worked better
its sister drug is leqembi
aduhelm worked it just takes longer
after my 34 months of infusions my amyloid plaque is gone on my amyloid scan

leqembi works better and a little faster than aduhelm and with fewer side effects
although the side effects still happen ie aria or brain edema or brain bleeds
treatment is probably only for about 18 months
its given every 2 weeks as an infusion

the newest drug kisunia works faster and stronger
its given every month for about 12 months or until the amyloid pet scan is negative then its stopped
retreatment may be done when the amyloid reaccumulates
this could be 2-5+ years

kisunia seems to have more aria or edema or brain bleeds but it also seems to work better

those at worse risk for the bleeds are those like me with the homozygous apoe4 apoe4 gene
giving these drug in patients like me have to be done with great caution

how well do they work
at best expect a mid 20-mid 30% slowing in cognitive decline
im not sure what they means in regards to what you see in your affected love ones
the earlier the drug is started the better the results will be
i probably am one of the earliest to have been put on these drugs
so
i should get better results

all 3 of these drugs are being evaluated in patients who are have no symptoms
yes no symptoms
but they have positive amyloid plaques in their brain
they have normal memory tests
those studies should be reported in 3-5 years

these prealzheimers patients will probably get better results long term
eg for me i should have been treated in my 50s

so which would i chose
i am apoe4 apoe4 positive so i would have to be careful taking the kisunia since they use a more aggressive treatment
but they are given once a month

leqembi is given twice a month so thats a problem
they are working on giving it as an at home shot so you wont have to go to an infusion center
a real pain sometimes
they also are looking to change to monthly treatments at least for maintenance treatment

both of these leqembi and kisunia will need to be given intermittently to keep the amyloid from reaccumulating

I would probably chose leqembi because i am apoe4 apoe4

so 
you do your treatments
when the amyloid reaccumulates then you retreat at a maintenance dose

then
you will need tau tangles treated
drugs are now in clinical trials for that

a new drug is in trials that treats inflammation
i expect those to be available in 5 years
hopefully not too late for me

so would i 
yes i would take an antiamyloid drug now then when available take an inflammation drug and a tau drug
and
of course do all those healthy things should be doing all our lives
these healthy things have better long term results than any drug

the organicgreen doctor

Wednesday, July 17, 2024

organicgreendoctor: my story revisited #207-i still need my sleep

organicgreendoctor: my story revisited #207-i still need my sleep: MY STORY REVISITED #207-I STILL NEED MY SLEEP sleep is when the garbage can guys in your brain called microphages go into the brain and clea...

my story revisited #207-i still need my sleep

MY STORY REVISITED #207-I STILL NEED MY SLEEP


sleep is when the garbage can guys in your brain called microphages go into the brain and clean up all the debris left from the daytime
its thought one needs about 7-8 hours for that to happen
the debris accumulates if its not gotten rid up eventually becoming amyloid plaques which is what starts off the alzheimers disease cascade of events that kills brain cells
later tau proteins in the nerve cells unwind and form tangles which kills brain cells
later inflammation sets in and kills more brain cells
thats what happens in alzheimers disease

you need that sleep for the garbage can men to do their job to clean up all that stuff that accumulates

alzheimers disease and just getting old causes you to have affected sleep
then
add aricept or donepezil for alzheimers symptoms 
aricept can cause sleep disturbances

I started aricept as soon as i was diagnosed in 2010 and have been on it for 14 years 
it may be one reason by symptoms have not gotten worse
a study showed if started early those patients have a slowing of symptoms and also tend to live longer than those not given the med

i chose to get on it and i am glad i did

the big problem i have is it interferes with my sleep so that i only get 5 hours of sleep at night
so
i add on a nap in the afternoon for 1-2 hours
this gives me my 7 hours so those garbage men can do their job

if i skip my nap i still only sleep 5 hours 

this needing 7-8 hours a day applies to all of us
those garbage guys not finishing their jobs every night can lead to a lot of damage in your brain over your lifetime

so
in my old blog i was explaining to ms b why i need more sleep
__________
09/23/2015

DEAR MS B-SLEEP

you may not notice this yet
but
when you go down for a nap after lunch
so do i

now you do it cause your full and you are
afastagrowing
to fast i might add
you need your growth rest
growing can tire you out

now i take a medicine called aricept (donepezil)
well one day youll understand why
when you ask why im not around for your
high school graduation

this stuff is a sleep disturber
it lets me only get a few hours sleep a night
usually 5 hours
so
i compensate with that afternoon nap
without it im afraid i wouldnt function well

now ms b ive tried going without it
and
i gain my lost sleep hours back
i would just stay off it
but
im not sure what may happen if i did

i might not know who you are
i might be further along in this process im
undergoing
further than i realize

so i dont wont to take that chance
of stopping the aricept so i can get more sleep

now this stuff does make for some vivid dreams
sometimes
almost real when i wake up

usually they are not disturbing
but
occasionally they are though

now we have enjoyed facetiming with you
you can see your little eyes focus on us
as we talk
yes you seem to like my donad duck voice
and
the whistling i do
something i learned in caring for babies during
my career

now that facetiming with you
and
that ad on tv of those zombies deciding to run after
that guy

well it all came together in a dream
those zombies in that ad
they were after me
running me down they were

i fell onto the floor
huddled down
closed my eyes

then ms b
it got quiet
guess i made them go away
i slowly opened my eyes
there you were ms b
with those eyes and that smile
you were sitting up
leaned forward
you looked just like you did on facetime
you leaned in real close
and
gave me this wet slobbering kiss on my cheeks

ms b i instantly woke up
ms b
believe it or not
but my cheek was soaking wet
and
i didnt wipe it off

thanks

maybe ill just stay on that stuff
__________
ms b is now old enough to read my old blogs
maybe ill get her to read this one so she will understand why i nap every afternoon

i am doing better because
i was diagnosed early
i was started on aricept or donepezil earlier than most folks
i was and am aggressive with my health 
ie
i get adequate sleep
i eat healthy ie the mind diet
i maintain a normal blood pressure cholesterol and glucose
i have a normal weight ie a normal bmi of 23
i stay active mentally socially and physically
i avoid stress as much as i can
i dont smoke or drink
i meditate by gardening
i took 34 months of aduhelm which removed all the measurable amyloid plaque from my brain

for now that is the prescription for fighting this disease
the earlier you start the better chances you are to be successful

in the future there are more meds that will remove tau tangles and treat inflammation and prevent amyloid from forming 

you might start by getting enough sleep
you will feel better every day if you do

the organicgreen doctor

Saturday, July 13, 2024

organicgreendoctor: garden news-a days harvest

organicgreendoctor: garden news-a days harvest: GARDEN NEWS-A DAYS HARVEST i am in the throes of harvesting daily from my 400 square foot garden our weather here has finally started to war...

garden news-a days harvest

GARDEN NEWS-A DAYS HARVEST

i am in the throes of harvesting daily from my 400 square foot garden

our weather here has finally started to warm up some into the daytime temperatures in the 70s
with nighttime in the low 60s
we also are having less fog but still have some early morning fog
this fog sets things up for fungus and powdery mildew especially on tomatoes squash and cucumbers

in my garden i have 8 tomatoes planted
sweet 100s sungold pink boar black krim cherokee purple celebration early girl
one i think was mislabeled as it looks more like a green zebra

earlier in the late spring our tomatoes in my garden and the main garden got what looks like a black mold or it could be a bacterial or viral infection that killed a lot of leaves and stunted the first crop of tomatoes
i treated it with a solution of watered down 3% peroxide that may have helped 
i also treated the powdery mildew with a powdered milk baking soda aspirin liquid soap solution that has controlled the mildew
i also treated the tomato plants with a fish emulsion seaweed molasses feeding 
the tomatoes have seemed to be now putting out bigger better and more tomatoes
the warmer drier weather also has helped

i am harvesting cherokee purple black krim early girl and maybe a green zebra with the boar and celebration not producing much yet
i do have a lot of growth and flowers on the tomatoes with a lot of green tomatoes on them so there is hope for more tomatoes
those we are harvesting especially the cherokee purple and black krim are delicious

in my garden i only planted french beans called emerite
if i had room i would plant more varieties like kentucky wonder or blue lake
we are getting this much like in the picture above about every other day
i plant my green beans in 6 packs then transplant them into the garden
at the time i do the transplants i also plant seeds in the ground
then i also later plant more in 6 packs for later transplanting
this gives me 3 waves of green beans for the year

we eat green beans every day and what is left over we freeze in quart bags for later use in soups beans stews or casseroles

i have 3 varieties of squash
tatume a mexican squash that likes hot weather
i try to pick it small and use it like a zucchini squash
its the green squash in the picture above
if it gets large i will donate it to the garden for use by the organic soup kitchen
i have yellow squash that is producing every day and a zucchini that produces every day
i had to replant the zuchinni as a gopher chewed the stem underground

we freeze a lot of squash for future use

i also have harvested my asian cucumber 
normally cucumbers are hard to grow here because they get the powdery mildew so bad
so far so good this year

greens we harvest frequently are 3 kales collards arugula and malabar spinach
i mix these with amaranth purslane and a grocery store lettuce mix for salads

the kales and spinach are used in soups beans stews and casseroles

i have basil we use to make our pesto with nuts garlic olive oil and parmesan cheese

we have 5 different peppers jalapeno bell sweet banana shishito and poblano
we have eggplants and okra planted but they are just now kicking in now that its warmer

i planted a lot of fava beans in my growbags
i plan to save the seeds for cooking
i have never grown them to eat as i usually grow them as a cover crop to fix nitrogen in the soil
i also have purple eyed peas growing in grow bags 
i soon will be planting some carrots in my garden

so all of this produce makes enough for the two of us to eat from the garden almost every day and to save some by freezing for future use and for donating to others and to donate to our community garden

its amazing what you can grow in 400 square feet

the organicgreen doctor



Wednesday, July 10, 2024

organicgreendoctor: alzheimers news-i have no tattoo

organicgreendoctor: alzheimers news-i have no tattoo: ALZHEIMERS NEWS-I HAVE NO TATOO   thats right i dont have a tattoo on my brain but he does dr daniel gibbs a retired neurologist wrote in hi...

alzheimers news-i have no tattoo

ALZHEIMERS NEWS-I HAVE NO TATOO 

thats right
i dont have a tattoo on my brain but he does
dr daniel gibbs a retired neurologist wrote in his blog a tattoo on my brain and in his book with that name and now with a documentary with that name
he got a tattoo on his brain
i did not

he is a retired neurologist 
i am a retired family physician
we both retired due to our diagnosis
mci or mild cognitive impairment due to alzheimers disease

he in homozygote for apoe4 ie he is apoe4 apoe4
making him high risk for getting alzheimers diseaes
i have the same apoe4 apoe4 gene

we both entered the biogen aduhelm or aducanumab study receiving monthly infusions of aduhelm
after a few infusions he developed a massive brain bleed that almost killed him
thought to be due to the infusions of aduhelm 
its a risk that is explained to you when you sign the permits
i read it like he probably did and probably like him i accepted the risks

after months of rehab he eventually returned back to where he was when he started the aduhelm
he now will not qualify for any new treatments

why did he bleed
having the homozygous apoe4 apoe4 put you at risk for brain bleeds
these patients like he and i can get deposits of amyloid in the walls of blood vessels so when the aduhelm or the new drugs leqembi or the new drug donanemab are given they tear the plaques off the blood vessels which can cause brain bleeds
thats what happen to him
he almost died

now i didnt have brain bleeds or edema called aria or amyloid related imaging abnormalities
i did have bad headaches with visual aura that would incapacitate me for 15 minutes to an hour after i got my highest dose of the drug
these headaches lasted several days and over time became less and less intense
after stopping the aduhelm at the end of the study my headaches resolved and have not returned
knock on wood

his mri shows iron deposits where he had bleeds
he calls them a tattoo on his brain

my mri is normal and shows no tattoo on my brain

his amyloid pet scan which you can see in his documentary has gradually progressed over the last few years
this matches his decline he notices as he talks about in the documentary

my amyloid pet scan since i got 34 months of aduhelm shows no amyloid plaque
my amyloid pet scan has gone from positive to now negative for amyloid plaque

his amyloid pet scan is red throughout
my amyloid pet scan is now red free

the question is if he had been able to complete the full treatment like i did would he be able to do all those things he was doing when he had his bleed
would it make a difference

for me my memory i feel and those around probably feel the same is the best its been over the last 14 years since i have been diagnosed

my moca memory test are now normal
i usuall score 29-30 on my moca test
orginally i scored a 25
for those who are familiar with the test

he scores at 22 which is probably early alzheimers disease vs previously he was mci

to be political here if both biden and trump took the moca test they would more than likely not score in the normal range like i do

the moca test is being mentioned a lot in the media right now
maybe some test like that should be required for the public to know about our politicians especially our presidents

when i scored a 25 and was diagnosed i chose to stop practicing medicine because in my occupation i knew what that meant
the same would be for an air traffic controller a pilot a general or a president

thats not for me to decide 
it for us as a society to decide

im just glad i have no tattoo on my brain like dr gibbs has

if you are in the alzheimers world i recommend you 
read dr gibbs interiview in the jama or journal of the american medical association
watch his new documentary linked here
we watched it on paramount tv

when i watched the documentary it was surreal
i watched his wife the new caretaker as she seemed to be in pain emotionally
it was hard to watch
i first watched it alone and later watched it with my wife she
yes i cried since i realized that would be me some time in the future
hopefully not soon

since for me i know thats where i am headed 
how soon i dont know
but
i am enjoying each day i have gardening being with my grandkids and family writing and doing all the things i enjoy doing

yes
i dont have a tattoo
im glad i dont

addendum
in a recent posting on the dementia website being patient they reposted part of my interview i did with them about being in clinical trials
it is liked here

the organicgreen doctor


Monday, July 8, 2024

organicgreendoctor: happy anniversary mr hudson

organicgreendoctor: happy anniversary mr hudson:   HAPPY ANNIVESARY MR HUDSON this is an artist rendering of mr hudson in his first year of life a quick review of his story almost 6 years a...

happy anniversary mr hudson

 HAPPY ANNIVESARY MR HUDSON

this is an artist rendering of mr hudson in his first year of life
a quick review of his story

almost 6 years ago he was born in kidney failure and heart failure due to obstruction of his kidneys in utero
this obstruction was relieved right after birth but the damage was already done to his kidneys
soon a few days after delivery his heart failure resolved and his kidney function gradually improved but it never reached normal

he spent close to 2 months in the nicu until he grew enough and could eat enough to go home

over the next two years his kidney function waxed and waned and mostly waned so that weeks before his kidney transplant their function worsened to the point where it was either do kidney dialysis or do a transplant

a search for a live donated kidney was done
several relatives stepped forward and both parents and also a distant relatives wife psf
as it turned out the distant relatives wife was the best kidney match
later through some ancestry sleuthing it was determined that she actually had some long distance ancestry match to our family


here is him not long before his transplant
he was in advanced kidney failure
trying to get to 20 lbs so he would be big enough to accept an adult kidney
all of this happening in the middle of the covid pandemic
his first attempt for a transplant day was canceled due to the pandemic
months later they opened up for transplants again 

a wealthy donor from here provided her a jet to fly psf from the east coast to the west coast so she would not get covid on a commercial flight

when the go for it was given it was not soon enough
mr hudson was on the throes of having to do dialysis
then
the greenlight was given to proceed

a crowdfunding site for pediatric transplants provided a source to raise money to be used for mr hudsons expenses beyond insurance coverage and is available for his use throughout his lifetime
it is used to pay for all the expenses not covered by insurance
this funding is available for all pediatric transplants
now 4 years later its being used some

the donor psf flew to los angeles via private jet safely and on that day 4 years ago she heroically gave mr hudson one her kidneys
her surgery was quick
his surgery took several hours
the new kidney kicked in immediately inside mr hudson
this kidney functioned well ie his creatinine level which was at the dialysis level gradually decreased to a normal less than 1 level and has remained there since 
mostly

we have found out that mostly is common with kidney transplants
more below on that

after a week in the hospital with plans for discharge he spiked a fever which eventually was figured out to be a blood clot in his right upper arm from his pic line
he had to undergo over a week of iv heparin to dissolve the blood clot and a week of iv antibiotics

eventually after over 2 weeks he got to go home

the outward physical response was amazing
he went from a lethargic 2 year old to a typical energetic toddler

we all want to thank psf mr hudsons kidney angel
how it must feel to know that you made it possible for a young child to live and thrive with the donation of your kidney

its been 4 years now since he had his transplant
there have lots of ups and downs
mostly ups though
some downs though have been scary

the worst was 18 months ago
mr hudson has to take immunosuppressant drugs that keeps his body from attacking his kidney
the problem is that makes him susceptible to more infections than most kids his age
it mostly doesnt slow him down 

during christmas time 18 months ago he got sick with a stomach bug that left him with a viral infection that he couldnt clear out
he lost a lot of weight and at one point his electrolytes were messed up that required a 5 day icu admission
this admission as i sat in the icu room with him one day i thought as i cried he is going to die and they arent going to be able to save him
he though has great kidney doctors that worked hard to make him better

he survived that admission and has mostly done well since then but recently had the infection return again
he recently spent 6 days in the hospital with pneumonia and dehydration again and had to have a kidney biopsy
he again lost a lot of weight
but
since that admission he has regained all his weight and is eating enough for 3 kids
the biopsy shows the kidney rejection is under control

he has to have iv immunogloublin called ivig infusions monthly for 6 months
these are antibodies to fight infection that many of yall donate when you donate blood that also fights rejection of the kidney 
he also has to receive an infusion of an rheumatoid arthritis drug that suppresses his immune system which helps keep him from rejecting his kidney
the ivig helps fight off infections he normally would resist

none of this really slows him down
he played tball during all of this and loves baseball now
if you saw him at the park or the swimming pool or at school you would never know anything was going on with him

he still has to take in an adult amount of water each day
he cant drink enough so he uses a gtube to supplement his oral liquid intake
eventually when he gets bigger that can be removed

so
as of yesterday he is a happy healthy playful 5 year old soon to be a kindergartner who loves baseball swimming playing with friends star wars and all thinks little boys love

he is our miracle boy
psf is our miracle kidney donor
she gave him life and will always be in our hearts for what she did

you go mr hudson
enjoy life

the organicgreen doctor 

Monday, July 1, 2024

organicgreendoctor: my head is itching

organicgreendoctor: my head is itching: MY HEAD IS ITCHING wikipedia i read the wikipedia article linked above on the head louse and then read the washington post article on the ...

my head is itching

MY HEAD IS ITCHING

wikipedia

i read the wikipedia article linked above on the head louse and then read the washington post article on the rise of lice since the pandemic
if you are in the lice in your head world read that post article

after a few minutes my head started to itch real bad
the more i looked at the pictures and read the articles the more my head itched
now writing this my head is on fire

i may have to go wash my hair and put on some vaseline and brush it real good

apparently lice is on the uprise since the pandemic
it apparently dropped off during the pandemic since we werent mingling around with each other especially the school kids

now we they are 
some think its also because of the increase in selfies we now take
putting our heads together to smile and take our photo

those little varmints will jump from one head to the other

if you are an elementary school teacher you are very familiar with lice

it knows no social boundaries 

according to this article much of the old over the counter treatments dont work well
and many of the topical stuff that is applied doesnt work
like mayonnaise, vinegar, rubbing alcohol melted butter dont work
maybe vaseline or petroleum jelly works maybe

whatever treatment is done has to be repeated in 7-9 days since any nits or eggs left will hatch during that time
if vaseline is used it needs to be combed out real well then washed away which may be hard to do 

essential oils work somewhat such as rosemary pennyroyal eucalyptus marjoram but doesnt get them all
you have to be careful using them

there are now lice clinics that will treat lice
they are fairly successful but expensive
they treat comb then retreat comb and repeat as needed

a new drug called natroba is available by prescription 
i looked at the ingredient
spinosad

i recognize that since it is an organic pesticide we use in the garden to treat insects like caterpillars slugs and pill bugs
i have pellets and liquid that i use some in my garden

i looked up how much a bottle of the natroba 0.9% spinosad would be as a prescription
$300
a bottle at the nursery about $20

the problem is i couldnt find anything that said it was safe to use garden 0.5% spinosad on lice in a kid
im sure someone thought of that after going to the pharmacy to shell out $300

man now my head is itching so bad i think im going to the garden and spray spinosad on my hair and maybe my hat
and
repeat it in 9 days

so how would i treat lice if i had it
after reading these articles i would cut my nails real close
wash my hair
apply vaseline liberally and comb comb comb all those nits out of my hair
probably treat with something like otc meds or if rich enough i would get some natroba to use
then repeat it all in 9 days
maybe repeat again in another 9 days
or
just make an appointment with one of those lice clinics and let them do all the work

anything to get my head to quit itching

did your head start itching too

the organicgreen doctor