who was this guy

WHO WAS THIS GUY

as i sat and watched the boston globes replays of the original blast
from the bomb at the boston marathon i noticed a elderly
gentleman in an orange top running and approaching the
finish line
then suddenly he is taken off his feet and seems to be moved
sideways some
he was down and in a later video you can see someone help him up
but initially he just laid there with people running around him
i thought maybe he had been hit by shrapnel from the bomb

i told my wife she
i wonder who that guy is and if he was hurt and if he managed
to finish the race since he was only a few feet from the finish line
the commentators never said anything about him
it would be tragic to have come so far in this race after 4+ hours
and have some terrorist defeat him so close to finishing

it seemed so obvious as i watched the original videos that this
man seemed to stand out from he other runners at the end
but
no one talked about him

well this morning when i logged onto my yahoo account there was
the still picture of him being blasted off his feet but
following the picture
was his story

his name is bill iffrig
he is 78 years old
he is from lake stevens washington
he was running his 3rd boston marathon
he was knocked off his feet by the concussive blast he said near the finish line
about 10 feet from finishing
he was momentarily stunned
a race official helped him up and
he walked across the finish line
then walked the half mile to his hotel
the only injury was a scraped knee

thats who that guy is
sounds like quite a fellah huh


my thoughts on all this
i bet this was done by our own homegrown terrorist
ive been concerned about things like this happening when
you read and hear the venomous things on the internet on tv radio and
even on facebook
yes i have had to befriend a few people

we may be more of a danger to ourselves than outside groups

it also made me think back to the late 60s after mlk was
assassinated and almost all the large cities in the united states
had rioting and burning going on so that every city seemed
to be afire
this was also partially the result of that same venomous rhetoric that we all
are seeing now
we may be reaping what we sow

my thoughts go out to those injured and to those families of those
who have died
innocently enjoying the marathon then to have it all taken away
by this

we have some healing to do and some introspecting to do

the organicgreen doctor

basketball

BASKETBALL
i watched a lot of basketball over the last few weeks
i especially enjoyed the march madness
only got one of the final four teams right
and didnt pick the winner
miami didnt make it

maybe ill just keep that miami choice for the nba championship game

sure enjoyed watching louisville play
that up tempo pressing game that you dont see as much as you
use to
ala razorbacks with rollin nolen when he won the whole thing
years ago then couldnt keep his mouth shut and got fired

the louisville guards were worth watching
it was amazing how they seemed to at will go through all the other
teams defense and seemed to score at will
those little guys didnt seem to get their shots blocked a lot

it also helped to have the big guy in the back to swat away balls
and play defense and to score when needed

yep those 3 will do well in the nba


then connecticut women are such a young team but they won
(so texas mens basketball that aint an excuse-a young team)
think dino is a good coach
its scary for the other teams as they will have the same team for the
next few years
especially now that brittany is out of the way

then in the nba ive been following the lakers all year and listening to
all the trash talk by the sports gods who said that the lakers would
have a losing team and wont make the playoffs

ticked kobe off is what they did
he was really kicking butt until last week when that pop happened
that achilles tendon sound

not sure how he was able to shoot the free throws afterwards

a few years ago while playing softball while rounding 3rd base i heard
that pop and watched as my foot seemed to dangle and wouldnt
respond to my trying to run
i did score however

two months on crutches then since that time my calf on that size is smaller
than the other
theres a long scar up my ankle where the achilles tendon is
i cant jump very high well i cant jump period
i cant run well either limited by that old achilles tendon tear

now kobe had his repaired and will start rehabbing it when he gets off crutches
will he loose calf mass
loose his ups
lose his burst of speed

i hope he does a better job of rehabbing than i did
if he doesnt
his career is over

sometimes its over anyway with an achlles injury
you lose a lot of the advantage you have over the other players
except of course
that will and determination he seems to have
time
it will tell

prediction
lakers will lose all their playoff games without kobe

then i watch the spurs
they just plod along and nobody notices they are there
then bam like emeril
they are in the playoffs and in the contention for the final game

go spurs go
however
like i said at the beginning
its miami winning it all


the organicgreen doctor

alzheimers symposium part 2

ALZHEIMERS SYMPOSIUM PART 2
i will present a talk on my story with possible alzheimers
at the alzheimers symposium at the mayborn center in temple texas
on tuesday april 30, 2013

here is the the link to register for the event

part 2
neurology visit

so i went to dallas to the neurology appointment with my wife
they asked that i get the following labs before i came to the appointment

labs to be done
cbc complete blood count
metabolic profile with electrolytes liver function tests kidney function tests
and glucose
vitamin b12 level
syphilis antibody test
hiv antibody test
tsh for thyroid function
urinalysis
mri scan of the brain
depression screen
neuropsychological testing or a good mental status exam
good history and physical

this is the list of lab tests and exams that you need to have done if you
are being evaluated for memory loss or dementia
anything less is not acceptable

a cbc complete blood count checks for anemia or a low white count

a metabolic or chemistry profile checks the electrolytes for a low or high
sodium or potassium which can cause memory loss
abnormal liver tests
abnormal kidney tests the bun and creatinine which is elevated
if you have kidney failure

a glucose which can detect diabetes

a vitamin b12 level
if you have a low b12 level you can have problems with memory

syphilis antibody test
you can have latent syphilis that shows up as later in life in the
central nervous system and cause dementia

hiv antibody test

tsh for thyroid function
thyroid stimulating hormone will detect hypothyroidism or low thryoid
which can cause depression and memory loss

urinalysis to check for blood or protein in the urine

a depression screen
depression can cause memory loss

a mri of the brain
this is looking for increased fluid in the brain shrinkage or atrophy of the brain
brain tumors or masses or cancer old scar tissue evidence of stroke
aneurysms or white matter hyperintensities which can be associated with
an increased incidence of dementia
they are looking for something treatable

a neruopsychological test the gold standard for evaluation or a
good mental status evaluation in the office as  a screening test
the mmse test misses me but a mocha a more involved test picks up
some subtle changes on me that would make a physician want to do more
testing with the gold standard neuropsychological test

then a good history and physical examination looking for something in the
exam that would explain the memory loss

so i saw the neurologist who looked at my neuropsychological test and
my lab tests and mri scan that were done and did a history and exam

she said
dr nash
you have early mild cognitive impairment amnestic type
(short term memory loss) that is earlier than what we usually see
and it may be due to alzheimers disease

here why
you had a normal mental status exam three years ago with your long term
care insurance and now using the same test you have an abnormal result
and other short term memory tests are abnormal

your labs and scans show a normal evaluation for other treatable causes of memory loss

you have a very strong family history of alzheimers disease
mother father brother cousin aunts and uncles grandparents

you put this all together and it says possible alzheimers disease
(later other tests done point towards this diagnosis also)

i think you should consider getting on the medication aricept (donepezil)
i had read enough about my diagnosis and knew thats what i wanted to do

aricept (donepezil)
is an acetycholineterase inhibitor
it raises the acetylcholine levels in the brain and makes the brain and nerve
cells work better

it does not treat slow down or prevent the disease
it only delays the symptoms

one neurologists told me that 1/3 get better on it
1/3 stay the same
1/3 dont get better

so 2/3 of those that start it stay the same for a while or improve
near 100% of those who dont take it dont get better

the earlier you start the aricept (donepezil) the longer it seems to work
it however will get to the point where it doesnt work any more
as the disease just marches on

the side effects of the medicine is related to the elevated acetylcholine
the first month you take as i found out is when the side effects are the worst
they get better however over time

i have had most of the side effects
i get insomnia that is worse if i take it before bedtime
my brother took his however at bedtime and never had any sleep problems
i take it in the morning after breakfast to counter the nausea that occurs
and to help with the insomnia
i also snack some in the morning to keep the nausea at bay

i have the most vivid dreams those aricept dreams
the kind when you wake up you want to go back to sleep so you
finish them
they are never bad ones just pleasant ones

i have restless sleep
i get restless during the morning not long after i take it
which gets better as the day progresses as does the nausea

i get severe leg cramps when i sleep
the kind that get you up out of bed
they are worse if i have done a lot of exercise

i get blurry vision about 2-3 hours after i take it but that goes away
fairly quickly
it was worse the first month but now is better

warning
if you or a family member is on this medicine dont abruptly stop it
without talking to their doctor
eg if i were to discontinue this medicine i might drop down to the level
i would have been without the medicine and if i restart it
i might not ever return back to the same cognitive level i was at

other drugs used in alzheimers are
exelon which works similar to aricept
it also comes in a patch form which helps with the nausea

namenda works differently that the other two
its usually used as an add on medicine when things start getting worse or if
there is problems taking the other two

recent studies have shown that using the aricept and namenda together at
the beginning of the diagnosis may be helpful
eg
pat summitt started on those two meds when she was first diagnosed

so she wrote that prescription for aircept and handed it two me
a surreal moment as i had just 24 hours before written the same prescription
handed it to a patient and his daughter and reviewed those same side effects

i was not accepted in the normal control group of the
alzheimers disease neuroimaging initiative study
but was told after i was on the aricept (donepezil) for 3 months that i
could reenter the study in the early mild cognitive impairment group

i never returned to work
i went on short term disability then later on long term disability

once i was diagnosed i became uninsurable
no life insurance no disability insurance no health insurance no long term
care insurance no malpractice insurance

luckily i had those all in place before the diagnosis was made

so put a lot of thought into getting this evaluation
you need to be ready
soically psychologically and economically ready
if you are not ready it can be devastating

next friday april 19 i will blog on
alzheimers symposium part 3
the alzheimers disease neuroimaging initiative

the organicgreen doctor