happy 15th anniversary

HAPPY 15TH ANNIVERSARY

this picture was taken the year i retired
i retired at 60 on december 22 2010 because i was diagnosed with mild cognitive impairment that is due to alzheimers proved over time with diagnostic tests and memory tests
i cried and was sad for a period of time
however
today on my 15th anniversary of having to retire because of my diagnosis and having to stop doing what i was lucky to do for my career
well
today 15 years later i am having a happy anniversary 

why
i am still alive
my last several memory tests are normal
i see and feel no decline today minus what is expected of a 75 year old

15 years ago if you had asked me where would i be in 2025 i would say i would be dead now from alzheimers after spending some time in a long term care facility
but
i didnt and im alive 

so
i am happy today on my anniversary

the blog i wrote below was to my patients when i retired
__________
12/22/2010

LAST DAY-THANKS 
this my last day to work as a physician
always considered myself lucky to have been able to
do in life what i wanted to do since i was a middle schooler

in high school i was able to work in a local hospital in the
summer on weekends and during holidays
our family was poor so not only did i get financial benefit from
working but i also was exposed to a lot in the hospital setting
it made me know that i wanted to be a family physician

during college i worked as a emergency room technician
on weekends, weeknights, and holidays
this also gave me financial support but also exposed me to
different doctors and different emergency situations

i was accepted to medical school but never wavered on what
kind of doctor i wanted to be
a family physician

i was accepted to a family practice residency
after completing my residency i owed the federal government
three years to work at an approved federal underserved area

i was able to create with some help a site in  the small
town near where i grew up       i  worked there for three years
although traumatic at times it was a learning experience that i
carried through out my career

after fulfilling my three year obligation and after sustaining a
large financial hit from my involvement with the local clinic
i was recruited to the area where i am working now
thanks to my medical school friend for helping me out in
my time of need

i have worked for 25 years as a family physician
i always wanted to be one

now it is time i have to quit not because i want to but
because a genetic health problem has risen its nasty head
and because of this will have to discontinue what i like to do

i do not ever dread going to work every day
feel like i have now just gotten good at what i do

realize that patients dont necessarily need all of the new
medications we have, the new tests we can do or need
the newest treatments available

they do better if you just listen to them, pat them on the
shoulder, be kind to them and be their advocate when
they need it

i have honed my skills in taking care of kids over my career so
that many of the kids have felt comfortable seeing me and look
forward to seeing me to get a sticker or sucker, hear my
duck voice, or have me joke with them
that part i will miss a lot

thanks to all my patients in the past for allowing me to fulfill
my dream of being a family physician
i hope i have done you a good job

thanks to my wife she for putting up with me during
my quest for my career
know she found hers

love yall
the organicgreen doctor
__________

this last week i have responded to two people who reached out about their memories

one was a younger person with memory issues

another was a 70 year old with early alzheimers who wanted to know more about early diagnosis and ask for my thoughts on her evaluation and treatment
i spent an hour and a half with her and her husband

one thing i did was tell them my story using it as vehicle to talk about alzheimers and its treatment and their future

when i got home after talking with the couple i thought a lot about my story

here is a short version

in 2019 i applied for long term care insurance and passed a 30 minute memory interview having answered all the nurses questions correct
i would say it was close to the moca memory test

i received my long term care policy
luckily i bought the best i could buy with a cost of living adjustment
if i had waited a year i would not have received my long term care insurance because of my diagnosis

when i turned 60 i volunteered for the adni 2 or alzheimers disease neuroimaging initiative 2 to be in the normal control group
i wanted to be monitored annually and if i developed problems i would stop practicing medicine

my mother and younger brother died from alzheimers and my father probably had it when he died
multiple grandparents and aunts and uncles and cousins had it

when i took the neuropsychological exam for memory it was found i had memory loss greater than it should be for my age and degree of education
i felt the abnormalities when i was taking the exam
i cried later

i saw a neurologist who put me on aricept or donepezil which i have taken for 15 years
i stopped practicing the day i saw the neurologist

my initial moca test score was a 25 which is in the mild cognitive impairment range
it now is in the normal range of  29-30 for the last several years

as part of my evaluation i had a spinal tap for amyloid and tau that was compatible with alzheimers
i later had one of several amyloid pet scans tor amyloid that were positive for amyloid
my last one a year ago after treatment was negative for measurable amyloid plague
my genetic test was positive for the apoe4 apoe4 gene
the late onset alzheimers gene
it puts you at a 10+ times increase for getting alzheimers
luckily you can overcome that if you control your lipids blood pressure sugar weight eat correctly the mind diet and do other healthy things such as stay active mentally physically and socially get adequate sleep control any mental health issues such as stress anxiety or depression avoid alcohol abuse and dont smoke

my vitamin b12 was below normal as well as my vitamin d3
i take supplements to correct these
my homocysteine level was elevated so i take supplements to correct this
my cholesterol and blood pressure was elevated so i take meds to control this 
my moca memory test was low at 24 but gradually over a few years it returned to normal

why
the aricept and all the healthy things i was doing and maybe the aduhelm infusions mentioned below and some good luck

the adni study is the most important alzheimers study ever done
its all diagnostic studies
sadly you dont usually get the results since its a blind study 

around 2017 i was accepted in the aduhelm clinical trial
i took 52 monthly infusions
the first 18 were placebo and the last 34 were the real drug aduhelm
aduhelm is a moncolonal antibody against amyloid 
my initial amyloid pet scan was positive for amyloid plaque
i was given that result before i started the study 
my final amyloid pet scan showed no measurable amyloid plaque 

so the aduhelm did its job it removed the amyloid plaque

it was take off the market since its manufacturer also makes leqembi which does the same thing but better

i have had multiple amyloid pet scans and tau pet scans and the new alzheimers blood test
except for the first and the last amyloid pet scan i didnt get the results

i wish i had them since they would be usefully in planning my future care

It will take 5-10 years for the amyloid to reaccumulate so i will probably need to receive treatment with a drug like leqembi to keep the amyloid from reaccumulating
and
wait for new drugs that are in clinical trials now

my kids and grandkids and nephews and nieces will have access to these drugs probably before alzheimers starts up

we have come a long way in 15 years

another thing i did was i freely talk about my diagnosis with anyone that will listen to me

i have been interviewed by the new york times washington post the financial times bloomberg and local newspapers in the austin area and here in california

i have been on alzheimers panels at ucla usc texas state greater alzheimers los angles the local alzheimers association and numerous churches and  memory centers
my favorite is to do q and a with the audiences

i seem to be able to give them answers they cant seem to get 

so 
today 
on my 15th anniversary 
it will be a happy one

the organicgreen doctor