MY STORY-FINAL ANSWER PART THREE
well do i have alzheimers disease or dont i
remember you can only be definitely diagnosed at brain autopsy
the best that can be done before then is the diagnosis of
probable alzheimers disease
so my diagnosis is early mild cognitive impairment amnestic type
felt to be from probable alzheimers disease
this is based on
medical history of short term memory problems recognized by me
and documented on serial neuropsychological exams
a family history of alzheimers disease
other causes ruled out for memory loss
a positive apoe4/apoe4 gene for alzheimers (50-90% chance)
a low beta amyloid level in spinal fluid
research criteria would classify me as mild cognitive impairment
due to alzhiemers disease of intermediate probability
if i could see my pet scans and if they were positive the diagnosis
would be changed to due to alzhiemers disease of high probability
the new classifications for alzheimers disease are
preclinical-no symptoms
mild cognitive impairment-minimal to mild (thats me)
alzheimers disease-symptoms
these are the new classifications that are used in research only
studies are hoping to classify people earlier than before so
research can be done on these people
so far most research is on full blown alzheimers disease when
it may be too late to do anything
remember medications such as the aricept (donepezil) i am on
only controls symptoms but does nothing to control the disease
the goal is to find someone with no symptoms or minimal
symptoms and get them on a medicine or treatment that will
prevent this disease
thats where all the research is headed
now drugs are being tested and developed to do just that
eg when cholesterol was discovered to be related to arterial
disease drugs such as the statins were developed to treat people
with high cholesterol to prevent arterial disease ie heart attacks
years later
so is the goal for alzheimers research
these tests will be used to identify people early so they can
be started on medication to slow things down or prevent the
disease or to intensify preventative measures as below
when you are diagnosed with it now its too late to treat
on the alzheimers associatioin web site
http://www.alz.org/alzheimers_disease_stages_of_alzheimers.asp
there are the 7 stages of alzhiemers thats used to get a feel
for where a person is with the disease eg my mother was
in stages 6-7 and my close relative is in stages 4-5
i am in stage 2 of the disease
the stages can go fast or go slow
to get diagnosed you need a
medical history taken
mini mental state exam (mmse) as a screen test-i passed this part
blood work, mri or ct scan to rule out other causes of symptoms
if all are normal and there is still concern then consider a more
involved neuropsychological exam by a psychologist
i chose to get involved with research and
got a fdg-pet scan of the brain for glucose metabolism and
a beta amyloid pet scan of the brain
got spinal fluid analysis for beta amyloid and tau protein
got genetic testing and
am getting serial neuropsyhological exams
some of these are biomarkers that you will hearing a lot about
in the future and will be used to solidify the diagnosis better while
a person is alive
(100% diagnosis can only made at brain autopsy)
their use is not well defined by medicine yet but will be in the future
what can you do not to get alzheimers disease
in the future medications will be available
there is some evidence that doing those things that are preached to
us when we go to the doctor may make a difference in delaying or
some think may help prevent alzheimers disease
exercise-minimal 30 minutes of walking 5 days a week
diet-mediterannean diet of fish, fruits, nuts, vegetables, low fat diet, olive oil
controlling cholesterol levels
controlling blood pressure
controlling diabetes
maintaining a normal weight
good sleep habits
controlling stress
staying active mentally
socializing
treating depression
avoid drug and alcohol abuse
dont smoke
how is this affecting me
mentally
i have worried for years that i would get alzheimers disease
because of my strong family history
so ive handled this better because of this worry and because of my
knowledge as a physician and because of my involvement with a
research study and because i keep up closely with whats going on
with alzheimers disease
i have been screened several times for depression and i dont feel
depressed
financially
i have made a good income as a physician
my wife she and i have always lived conservatively and have
saved well for retirement and also have been able to help out
family members at times
we have little debt now
although i had to retire a few years before i wanted to we are doing
ok financially
i have a disability policy from my work that is suppose to pay if
i am not able to do my specific occupation as a family physician
this was suppose to start paying in april of this year but so far
they are dragging their feet paying off on my disability claim
i have to go to a neuropsychologist next month for an evaluation
(i have had 4 of these in the last 8 months)
family
its good my wife and i know as we are able to plan our lives now
we know whats coming we just dont know when
we are in the process of updating our will, our power of attorney,
our health care power of attorney, and our living wills
we i think enjoy each other more now
with more urgency i feel the need to make and continue contact
with family and friends and
with more urgency i feel the need to see some of those things i
have not seen or done ie my bucket list
my sons know where i am with all this and we plan to keep them
updated over time
my family members and friends know whats going on as most read
this blog daily
i have been and plan to continue to be open with what ever goes
on in my life with this disease as long as i can
i plan on trying to reach and educate as many people as possible
about this disease
remember
100 % of you will be affected by this disease in some way
it may break our health care system
in the group i worked with they have 250,000 patients
statistically the group should have 3000 patient with this disease
you cant avoid this disease its here for all of us to deal with
make a contribution to fighting this disease and give your
support through my walk to end alzhiemers team
organicgreendoctor.com or support your local walk to end
alzheimers at www.alz.org
coming up for me is my 2nd mri of the research study in 1 week
followed by the 6 month followup visit with the neurologist
an 8 hour neuropsychological exam and
the involvement with another research project making a video
with me as the patient for use by primary care doctors
demonstrating an in office mental neurological evaluation
i will be involved as the patient and also as my experience as
a family doctor
the organicgreen doctor
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 29, 2011
my story-final answer part three
Labels:
alzheimers,
alzheimers stages,
amyloid,
amyloid pet scan,
apoe 4,
aricept (donepezil),
fdg pet scan,
mild cognitive impairment,
my story,
walk to end alzheimers
Thursday, July 28, 2011
hurricanes a coming, bad bug, its so hot
HURRICANES A COMING
here it comes hurricane don
its headed our way
please give us those east side winds and rain
well take whatever rain it will give us
my rain water tanks are getting low so we need
some rain at least one inch please
have to rush as im laying down some new water
lines connecting some of my tanks together
guess i had better hurry up today and tomorrow
and get them done
BAD BUG
if you see this bug in your garden then youre in trouble
its called the silver blister beetle
it has cantheridin which can blister your skin
dermatologists use this to blister up warts
see my blog on my wife she and the blister beetles
at my 9/22/10 blog
these beetles can devastate your tomatoes, potatoes, peppers
very quickly
when you walk into the garden they all fall to the ground and
hide in the mulch where you cant see them
all you see is plants without any leaves
you know there bad when the chickens wont come anywhere
near them
bad bugs bad bugs except the larva do eat grasshopper eggs
so bad things can be good things at the same time
nonetheless will cover my plants with flour or kaolin clay to
clog their mouth pieces so they cant eat the plants
it usually works
ITS SO HOT
thanks sis for this
its so hot and dry in texas that
in longview that mosquitoes have been spotted carrying canteens
in lubbock the chicken farmers are giving the chickens crushed ice
so they wont lay hard boiled eggs
in lake palestine they caught a 20 lb catfish that had ticks on it
in bryan a fire hydrant was seen bribing a dog
and the baptists are sprinkling, the methodists are using wet wipes,
the presbyterians are giving out rain checks, and the catholics
are praying to turn the wine back into water
its so hot here ...
the organicgreen doctor
Wednesday, July 27, 2011
new middle, farmers, hurricane, fb musing
NEW MIDDLE
this debt limit crisis is making me fed up with politics
dont mess with our economy
both political parties are to blame
neither side should get a free pass on this
this is how washington doesnt work
the republicans have become too far to the right on issues and
the democrats are too far to the left
its the middle america that decides every election
they just seem to pick the lesser of two evils
always said we need a new party called the middle party
because thats where most of us are politically
the only problem is that this party would always dominate
the democrats and republicans as both would be always
out numbered
well apparently according to this article in the new york times
-make way for the radical middle-there is a new party
forming for the next election on the internet
the first state ballot they will be on is in california
could this be the start of that third party that we probably
need to balance out all those special interests that really
run things on both sides now
the website is called http://www.americanselect.org/
it may be a good start to a fresh approach to politics
FARMERS
its so hot and dry here now that we all are suffering from the
heat (my lower porch at 6 am was still warm from the day before
it already started out in the mid 80s in the cool of the early am)
the farmers are really suffering
some have even shut down production for the fall
they have to plant now for the fall season
tuff to do in this hot dry weather
support them at your farmers markets as much as possible
we dont want to lose them and have to totally depend on
whoever and wherever produces those veggies at the grocery store
HURRICANE
we need rain
our hope lies in a hurricane developing in the gulf
well that tropical wave has gone from yellow to red and
from a 10% chance to a 70% chance and is headed our way
hopefully it doesnt get diverted by that big high thats making
us all suffer
stay tuned
FB MUSING
thanks nm and ag for this one
be tender to the young, compassionate to the aged, and
tolerant to the weak as you will all three in your lifetime
the organicgreen doctor
this debt limit crisis is making me fed up with politics
dont mess with our economy
both political parties are to blame
neither side should get a free pass on this
this is how washington doesnt work
the republicans have become too far to the right on issues and
the democrats are too far to the left
its the middle america that decides every election
they just seem to pick the lesser of two evils
always said we need a new party called the middle party
because thats where most of us are politically
the only problem is that this party would always dominate
the democrats and republicans as both would be always
out numbered
well apparently according to this article in the new york times
-make way for the radical middle-there is a new party
forming for the next election on the internet
the first state ballot they will be on is in california
could this be the start of that third party that we probably
need to balance out all those special interests that really
run things on both sides now
the website is called http://www.americanselect.org/
it may be a good start to a fresh approach to politics
FARMERS
its so hot and dry here now that we all are suffering from the
heat (my lower porch at 6 am was still warm from the day before
it already started out in the mid 80s in the cool of the early am)
the farmers are really suffering
some have even shut down production for the fall
they have to plant now for the fall season
tuff to do in this hot dry weather
support them at your farmers markets as much as possible
we dont want to lose them and have to totally depend on
whoever and wherever produces those veggies at the grocery store
HURRICANE
we need rain
our hope lies in a hurricane developing in the gulf
well that tropical wave has gone from yellow to red and
from a 10% chance to a 70% chance and is headed our way
hopefully it doesnt get diverted by that big high thats making
us all suffer
stay tuned
FB MUSING
thanks nm and ag for this one
be tender to the young, compassionate to the aged, and
tolerant to the weak as you will all three in your lifetime
the organicgreen doctor
Tuesday, July 26, 2011
hurricane coming, poor willie, reverse planking, my nephew he-rainwater tank
HURRICANE COMING
could this be our relief from all this heat
this is a tropical wave that is drifting our way very gradually
hope the big high thats over us doesnt push it away from us
click on http://www.nhc.noaa.gov/ to see where its at
its only a 10% chance of developing but we all have hope
that it will progress
bring on the rain please
it is so hot and dry here that i have a cactus in the yard i planted last
year that is actually wilting
POOR WILLIE
willie nelson got busted for having 6 ounces of marijuana by a
border agent in el paso texas
originally the judge was going to just have him sing to them in
court and she would let him off
apparently that was unacceptable so the prosecutor decided a
$500 fine would be levied if he would plea guilty
now another judge decided said you cant do that and willie
has to be tried with the misdemeanor marijuana possession which
can carry up to a year in prison
now that would look bad wouldnt if willie locked up for a year
he just needs to go to california or colorado and go to a marijuana
clinic and get a prescription for marijuana to use for his chronic
wrist tendonitis
maybe that will keep him out of trouble
REVERSE PLANKING
here is my motherinlaw she doing a reverse planking on the
beach in nicaragua
you go girl
MY NEPHEW HE AND THE ROCK
go to this blog from september 2010 on my nephew trying
to get this limestone rock out of my rain water tank
http://www.organicgreendoctor.com/2010/09/my-niece-she-my-nephew-he.html
well the rock is still in my tank
my water level is low in my tanks so i pumped all the water
out of the tank with the rock
my nephew he may be coming in august to visit so ill leave
this tank empty until he gets here so he can go down in
the tank and remove the rock
last time he didnt complete the task
the organicgreen doctor
could this be our relief from all this heat
this is a tropical wave that is drifting our way very gradually
hope the big high thats over us doesnt push it away from us
click on http://www.nhc.noaa.gov/ to see where its at
its only a 10% chance of developing but we all have hope
that it will progress
bring on the rain please
it is so hot and dry here that i have a cactus in the yard i planted last
year that is actually wilting
POOR WILLIE
willie nelson got busted for having 6 ounces of marijuana by a
border agent in el paso texas
originally the judge was going to just have him sing to them in
court and she would let him off
apparently that was unacceptable so the prosecutor decided a
$500 fine would be levied if he would plea guilty
now another judge decided said you cant do that and willie
has to be tried with the misdemeanor marijuana possession which
can carry up to a year in prison
now that would look bad wouldnt if willie locked up for a year
he just needs to go to california or colorado and go to a marijuana
clinic and get a prescription for marijuana to use for his chronic
wrist tendonitis
maybe that will keep him out of trouble
REVERSE PLANKING
here is my motherinlaw she doing a reverse planking on the
beach in nicaragua
you go girl
MY NEPHEW HE AND THE ROCK
go to this blog from september 2010 on my nephew trying
to get this limestone rock out of my rain water tank
http://www.organicgreendoctor.com/2010/09/my-niece-she-my-nephew-he.html
well the rock is still in my tank
my water level is low in my tanks so i pumped all the water
out of the tank with the rock
my nephew he may be coming in august to visit so ill leave
this tank empty until he gets here so he can go down in
the tank and remove the rock
last time he didnt complete the task
the organicgreen doctor
Monday, July 25, 2011
thanks, rain, football,debt
THANKS
thanks for all the response to my recent blogs on my story-final
answer
thanks for those who have made donations to the walk to end alz
and have made commitments to their local walks to end alz
RAIN
we certainly need more of it here
its so dry and now its so hot-due to get to 105 here today
there is no rain in the forecast only continued heat
have noticed some browning of the leaves on some of the
trees on my property and in the area
have also had some loss of shrubs from the drought
our hope for rain this time of the year is usually for a
hurricane to hit the gulf and drive moisture up this way
so in texas lots of people are hoping for that hurricane
to form in the caribbean and head this way
we just want one that will move slowly across and hit
the texas gulf coast gently in an area where there is no
people living there and then send waves of rain over
us here in central texas
FOOTBALL
ok im ready for some football
glad that holdout is over with now
hopefully the players ok the agreement today
am going through football withdrawals already
cant wait until sunday afternoons arrive when we can
watch football and nap-those go together
DEBT
they still havent fixed the debt ceiling yet
they sure are mucking around with our financial system
have developed a new disrespect for the way our political
systems work or dont work
hope they get it all together this week and get it done
we need to decrease our spending and increase our revenues
just like you and i do every day
they have a week to get it done
the organicgreen doctor
thanks for all the response to my recent blogs on my story-final
answer
thanks for those who have made donations to the walk to end alz
and have made commitments to their local walks to end alz
RAIN
we certainly need more of it here
its so dry and now its so hot-due to get to 105 here today
there is no rain in the forecast only continued heat
have noticed some browning of the leaves on some of the
trees on my property and in the area
have also had some loss of shrubs from the drought
our hope for rain this time of the year is usually for a
hurricane to hit the gulf and drive moisture up this way
so in texas lots of people are hoping for that hurricane
to form in the caribbean and head this way
we just want one that will move slowly across and hit
the texas gulf coast gently in an area where there is no
people living there and then send waves of rain over
us here in central texas
FOOTBALL
ok im ready for some football
glad that holdout is over with now
hopefully the players ok the agreement today
am going through football withdrawals already
cant wait until sunday afternoons arrive when we can
watch football and nap-those go together
DEBT
they still havent fixed the debt ceiling yet
they sure are mucking around with our financial system
have developed a new disrespect for the way our political
systems work or dont work
hope they get it all together this week and get it done
we need to decrease our spending and increase our revenues
just like you and i do every day
they have a week to get it done
the organicgreen doctor
Friday, July 22, 2011
my story-final answer part two
MY STORY-FINAL ANSWER PART TWO
this is the part two of a three part blog on my story-final answer
this blog today will deal with the neurology visits, the medication
i am on, the research study im in, and the diagnostic tests that
have been done
next week the blog will be on what it all means for me and maybe
for you and your family
neurology visit
i met with the neurologist on december 21 2010
she interviewed me and my wife she
she also did a neurological exam on me
she reviewed the neuropsychological exam i had done-the one
where i did poorly on the short term memory portion
because i had a normal neuropsychological exam 2 years ago
followed by a abnormal neuropsychological exam 2 years later
because i had noticed problems with my memory over the last
few months and
because of my strong family history of alzhiemers disease in my
family-mother, father, a close younger relative and probably
numerous aunts and uncles
she felt and i agreed with her that i had early mild cognitive
impairment amnestic type probably from alzheimers disease
(remember alzheimers disease is only 100% diagnosed at autopsy)
she felt and i agreed with her that i should start on a medication
called aricept (donepezil)
i knew that medicine well
i had just written it for a patient of mine the day before as he
has mild alzheimers disease
my mother was on the same medicine and my close relative is
presently on it
so why do i need to be on this medicine
if what i have is due to alzheimers disease then it will progress
rapidly or may progress slowly but it will eventually progress to
the same awful end point
the medication aricept (donepezil) doesnt stop the disease process-
that deposition of amyloid in the brain and the unraveling of the tau
proteins in the nerve cell that may be the cause or end result of
alzhiemers-
it just marches on no matter what
the aricept (donepezil) inhibits acetylcholine esterase an enzyme
that breaks down acetycholine in the nerve cells
by inhibiting this enzyme the levels of aceylcholine stays elevated in
the nerve cells so what nerve cells remain work better
by taking the aircept (donepezil) the aceylcholine levels are kept
high and the brain works better
if you stop the aricept (donepezil) the acetylcholine levels drop and
the brain doesnt function as well
the bad thing is when you restart the aricept (donepezil) you dont
regain back to where you were
so it was decided that i take the medicine to maintain my status
where it was now rather than wait to see if my memory got worse
then start the medicine ie i would have lost ground that i could
never regain
so i have been on the medicine now for 7 months
the side effects are tolerable
it causes vivid dreams more than ive had in the past
it causes a figgidness especially in the morning time after i take it
i have to go outside and work or take a long walk
it also causes a restless leg like symptoms especially at night
it also interferes with sleep
both of these symptoms are relieved somewhat by taking a
childs dose of benadryl
i have not had any of the gastrointestinal symptoms that some
people have
so i have stayed on this medicine now and will stay on it until
it doesnt work anymore
at that time usually another medicine is added to the
aricept (donepezil)
when that will be i dont know
it could be in 1-3 years or 5 years or 10 years or never
i then underwent testing to rule out other treatable causes of
my memory loss
i had a complete blood count to rule out anemia, infection, leukemia,
a complete metabolic panel to rule out diabetes, electrolyte
problems, kidney disease, liver disease, a tsh level to rule
out hypothyroidism, a b12 level, a hiv test, a syphyllis test, hepatitis
screening, a urinalysis, and a sed rate to rule out inflammation--
all of these were normal
i had an ulrasound of the carotids to rule out blockage to the arteries
in the neck--this was normal
i also had a mri with and without contrast to rule out aneurysm,
tumors, strokes, circulatory problems, brain shrinkage, and
increased fluid in the brain--the mri was nomal
i was also screened for depression several times and i dont feel
depressed and the screens were negative for depression
after a few months on the aricept (donepezil) i did a followup
visit with the neurologist
i will see her every 6 months and will remain on the medication
i also was now able to enter the adni-2 (alzheimers disease
neuroimaging intitiative) study at the university of texas medical
school memory clinic since i was stable on the medication
this study is important as it may define how a person is
evaluated for alzheimers disease in the future with these tests
that i am having done
this time i was entered not in the normal control group but in the
early mild cognitive impairment group
the other groups are normal, late mild cognitive impairment
and alzheimers disease (aint there yet)
during the initial visit i had another neuropsychological exam,
a screen for depression, the same labs as above, and an
mri of the brain-the short term memory problems were still
present and the labs and mri were normal
i then had blood drawn for genetic tests and other dna and
rna tests-one of these genetic tests is for the apoe 4 genotype
which is known as the alzheimers gene
i underwent a spinal tap for amyloid protein (beta amyloid protein)
and tau protein-more about them later
i had a fdg (flurodeoxyglucose) pet scan which measures glucose
metabolism in the brain
in alzheimers disease the glucose metabolism slows and the fdg
pet scan shows early on in mild cognitive impairment a decreased
uptake in or near the hipppocampus on the undersurface of the
brain where memory occurs
above is a fdg scan that shows decreased uptake (the red color)
in mild cognitive impairment and in alzheimers disease
i also had a florbetapir f 18 pet scan which measures amyloid in the
brain-this is a research pet scan not available outside of research-
in mild cognitive there is an increase uptake in the hippocampus area
as the disease progresses (as more amyloid gets deposited) the
scan turns positive diffusely across the brain
this is a scan similar to the amyloid scan mentioned above
you can see the increased red amyloid deposition in alzheimers
disease vs a normal control scan
i will never see the reports of the labs, mris or the pet scan reports
as they are protected by the research study
that is part of the deal
i will have the pet scans and lumbar puncture every 2 years
i will have the mri at 3 mo 6 mo 12 mo 24 mo 36 mo 48 mo
i will also do neuropsychological tests, depression tests, and
blood work at each visit
i elected to have the apoe genotyping through my primary care
provider as i wanted to know the results
i felt like i was well versed on alzhiemers disease and understood
what the apoe tests mean and what limitations it has
the apoe gene is called the alzheimers gene although it is one of
several that may be associated with alzheimers
the apoe gene can be 2, 3, or 4
apoe 2 may be protective for alzheimers
apoe 3 may have milder degrees of alzheimers
apoe 4 i call it the sucky gene
a genotype of a single apoe 4 gene (heterozygous for you
science folks) carries a risk of 10-50 % chance of developing
azheimers disease
a genotype of double apoe 4 gene/apoe 4 gene (homozygous)
carries a risk of 50-90 % chance of developing alzheimers disease
well i got screwed it looks like
i have the apoe 4/apoe 4 homozygous gene
ie i got it from each of my parents
i also opted to obtain spinal fluid for analysis of biomarkers for
alzheimers disease through my primary care provider
one of them is the beta amyloid protein
in alzheimers disease as the amyloid gets deposited in the brain
the amyloid levels go down in the spinal fluid
well i got screwed again as my beta amyloid protein is low in my
spinal fluid
the other test on the spinal fluid is the tau protein
its a protein thats found in the brain thats involved in the nerve cells
as this protein gets unraveled it gets phoshorylated and the p-tau
levels in the spinal fluids go up
well my levels were in the borderline level for alzheimers disease
here is a graph of my results
the left side of this graph is the beta amyloid level
the level is low
the horizontal side is the ptau level
the level is borderline
so i have a normal neuropsychological exam 2 years ago followed
by abnormal neuropsyhological exams showing short term memory
problems,
noticeable memory problems to me,
a strong family history of alzheimers,
a positive apoe 4/apoe 4 genotype,
a low beta amyloid in the spinal fluid and
a borderline level of p tau protein in the spinal fluid
all of these point to azheimers disease as the cause of my mild
cognitive impairment
if i could see the reports of the fdg pet scan and the amyloid pet
scan i would have an even more accurate picture of where i stand
next week in part three i will try to put all of this together and what
it means to me, my family and possibly to you
please support my team-organicgreendoctor.com-by donating to
it at my donor site or support your local walk to end alzheimers
at www.alz.org/walk/
the organicgreen doctor
this is the part two of a three part blog on my story-final answer
this blog today will deal with the neurology visits, the medication
i am on, the research study im in, and the diagnostic tests that
have been done
next week the blog will be on what it all means for me and maybe
for you and your family
neurology visit
i met with the neurologist on december 21 2010
she interviewed me and my wife she
she also did a neurological exam on me
she reviewed the neuropsychological exam i had done-the one
where i did poorly on the short term memory portion
because i had a normal neuropsychological exam 2 years ago
followed by a abnormal neuropsychological exam 2 years later
because i had noticed problems with my memory over the last
few months and
because of my strong family history of alzhiemers disease in my
family-mother, father, a close younger relative and probably
numerous aunts and uncles
she felt and i agreed with her that i had early mild cognitive
impairment amnestic type probably from alzheimers disease
(remember alzheimers disease is only 100% diagnosed at autopsy)
she felt and i agreed with her that i should start on a medication
called aricept (donepezil)
i knew that medicine well
i had just written it for a patient of mine the day before as he
has mild alzheimers disease
my mother was on the same medicine and my close relative is
presently on it
so why do i need to be on this medicine
if what i have is due to alzheimers disease then it will progress
rapidly or may progress slowly but it will eventually progress to
the same awful end point
the medication aricept (donepezil) doesnt stop the disease process-
that deposition of amyloid in the brain and the unraveling of the tau
proteins in the nerve cell that may be the cause or end result of
alzhiemers-
it just marches on no matter what
the aricept (donepezil) inhibits acetylcholine esterase an enzyme
that breaks down acetycholine in the nerve cells
by inhibiting this enzyme the levels of aceylcholine stays elevated in
the nerve cells so what nerve cells remain work better
by taking the aircept (donepezil) the aceylcholine levels are kept
high and the brain works better
if you stop the aricept (donepezil) the acetylcholine levels drop and
the brain doesnt function as well
the bad thing is when you restart the aricept (donepezil) you dont
regain back to where you were
so it was decided that i take the medicine to maintain my status
where it was now rather than wait to see if my memory got worse
then start the medicine ie i would have lost ground that i could
never regain
so i have been on the medicine now for 7 months
the side effects are tolerable
it causes vivid dreams more than ive had in the past
it causes a figgidness especially in the morning time after i take it
i have to go outside and work or take a long walk
it also causes a restless leg like symptoms especially at night
it also interferes with sleep
both of these symptoms are relieved somewhat by taking a
childs dose of benadryl
i have not had any of the gastrointestinal symptoms that some
people have
so i have stayed on this medicine now and will stay on it until
it doesnt work anymore
at that time usually another medicine is added to the
aricept (donepezil)
when that will be i dont know
it could be in 1-3 years or 5 years or 10 years or never
i then underwent testing to rule out other treatable causes of
my memory loss
i had a complete blood count to rule out anemia, infection, leukemia,
a complete metabolic panel to rule out diabetes, electrolyte
problems, kidney disease, liver disease, a tsh level to rule
out hypothyroidism, a b12 level, a hiv test, a syphyllis test, hepatitis
screening, a urinalysis, and a sed rate to rule out inflammation--
all of these were normal
i had an ulrasound of the carotids to rule out blockage to the arteries
in the neck--this was normal
i also had a mri with and without contrast to rule out aneurysm,
tumors, strokes, circulatory problems, brain shrinkage, and
increased fluid in the brain--the mri was nomal
i was also screened for depression several times and i dont feel
depressed and the screens were negative for depression
after a few months on the aricept (donepezil) i did a followup
visit with the neurologist
i will see her every 6 months and will remain on the medication
i also was now able to enter the adni-2 (alzheimers disease
neuroimaging intitiative) study at the university of texas medical
school memory clinic since i was stable on the medication
this study is important as it may define how a person is
evaluated for alzheimers disease in the future with these tests
that i am having done
this time i was entered not in the normal control group but in the
early mild cognitive impairment group
the other groups are normal, late mild cognitive impairment
and alzheimers disease (aint there yet)
during the initial visit i had another neuropsychological exam,
a screen for depression, the same labs as above, and an
mri of the brain-the short term memory problems were still
present and the labs and mri were normal
i then had blood drawn for genetic tests and other dna and
rna tests-one of these genetic tests is for the apoe 4 genotype
which is known as the alzheimers gene
i underwent a spinal tap for amyloid protein (beta amyloid protein)
and tau protein-more about them later
i had a fdg (flurodeoxyglucose) pet scan which measures glucose
metabolism in the brain
in alzheimers disease the glucose metabolism slows and the fdg
pet scan shows early on in mild cognitive impairment a decreased
uptake in or near the hipppocampus on the undersurface of the
brain where memory occurs
above is a fdg scan that shows decreased uptake (the red color)
in mild cognitive impairment and in alzheimers disease
i also had a florbetapir f 18 pet scan which measures amyloid in the
brain-this is a research pet scan not available outside of research-
in mild cognitive there is an increase uptake in the hippocampus area
as the disease progresses (as more amyloid gets deposited) the
scan turns positive diffusely across the brain
this is a scan similar to the amyloid scan mentioned above
you can see the increased red amyloid deposition in alzheimers
disease vs a normal control scan
i will never see the reports of the labs, mris or the pet scan reports
as they are protected by the research study
that is part of the deal
i will have the pet scans and lumbar puncture every 2 years
i will have the mri at 3 mo 6 mo 12 mo 24 mo 36 mo 48 mo
i will also do neuropsychological tests, depression tests, and
blood work at each visit
i elected to have the apoe genotyping through my primary care
provider as i wanted to know the results
i felt like i was well versed on alzhiemers disease and understood
what the apoe tests mean and what limitations it has
the apoe gene is called the alzheimers gene although it is one of
several that may be associated with alzheimers
the apoe gene can be 2, 3, or 4
apoe 2 may be protective for alzheimers
apoe 3 may have milder degrees of alzheimers
apoe 4 i call it the sucky gene
a genotype of a single apoe 4 gene (heterozygous for you
science folks) carries a risk of 10-50 % chance of developing
azheimers disease
a genotype of double apoe 4 gene/apoe 4 gene (homozygous)
carries a risk of 50-90 % chance of developing alzheimers disease
well i got screwed it looks like
i have the apoe 4/apoe 4 homozygous gene
ie i got it from each of my parents
i also opted to obtain spinal fluid for analysis of biomarkers for
alzheimers disease through my primary care provider
one of them is the beta amyloid protein
in alzheimers disease as the amyloid gets deposited in the brain
the amyloid levels go down in the spinal fluid
well i got screwed again as my beta amyloid protein is low in my
spinal fluid
the other test on the spinal fluid is the tau protein
its a protein thats found in the brain thats involved in the nerve cells
as this protein gets unraveled it gets phoshorylated and the p-tau
levels in the spinal fluids go up
well my levels were in the borderline level for alzheimers disease
here is a graph of my results
the left side of this graph is the beta amyloid level
the level is low
the horizontal side is the ptau level
the level is borderline
so i have a normal neuropsychological exam 2 years ago followed
by abnormal neuropsyhological exams showing short term memory
problems,
noticeable memory problems to me,
a strong family history of alzheimers,
a positive apoe 4/apoe 4 genotype,
a low beta amyloid in the spinal fluid and
a borderline level of p tau protein in the spinal fluid
all of these point to azheimers disease as the cause of my mild
cognitive impairment
if i could see the reports of the fdg pet scan and the amyloid pet
scan i would have an even more accurate picture of where i stand
next week in part three i will try to put all of this together and what
it means to me, my family and possibly to you
please support my team-organicgreendoctor.com-by donating to
it at my donor site or support your local walk to end alzheimers
at www.alz.org/walk/
the organicgreen doctor
Labels:
adni-2,
alzheimers,
amyloid,
apoe 4,
aricept (donepezil),
fdg pet scan,
florbetapir f 18,
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my story,
tau
Thursday, July 21, 2011
what time is it, super duct tape, tomorrow
WHAT TIME IS IT
so when you ask what time is it the answer may be
different according to what clock you are looking at
if you are looking at a clock that runs off electricity
and reads 1200 when it needs reset eg when the electricity
goes off it may be different now
the government is now jacking with your time
they want to adjust the frequency of the electric current
it seems that the frequency of the electric waves are used
to determine the time
if the frequency of the electric waves are adjusted it makes
the electric grid more efficient
but it messes up the time the clock reads
in the east the time may be off as much as 20 minutes a year and
in texas it will be about 8 minutes
the time on computers and the internet will be accurate
so your plug in clocks, appliances and your coffee maker will be
8-20 minutes faster
apparently the use of renewable energy affects the frequency of
the electric current as it is not always on eg when its cloudy the
renewable energy from the sun drops off and the frequency of
the current is affected
somehow this doesnt seem the right thing to do does it
maybe that could use that extra time on fixing our financial
problems
SUPER DUCT TAPE
so supermans birth kryptonian father was jor-el
he was played by marlon brando in the christopher reed
superman movie
in the movie he wore a silver suit that reflected light
well when we were in the dreier museum in santa barbara he had
the original suit wore by marlon brando in the movie
we were able to take pictures and to actually touch it
it was made of reflective duct tape
the flash makes it glow
think this is the best use and most impressive use of duct
tape ive seen so far
TOMORROW
tomorrow will post a blog on part two of my story-final answer on
my neurology visits, the tests ive done, the study im in
the organicgreen doctor
so when you ask what time is it the answer may be
different according to what clock you are looking at
if you are looking at a clock that runs off electricity
and reads 1200 when it needs reset eg when the electricity
goes off it may be different now
the government is now jacking with your time
they want to adjust the frequency of the electric current
it seems that the frequency of the electric waves are used
to determine the time
if the frequency of the electric waves are adjusted it makes
the electric grid more efficient
but it messes up the time the clock reads
in the east the time may be off as much as 20 minutes a year and
in texas it will be about 8 minutes
the time on computers and the internet will be accurate
so your plug in clocks, appliances and your coffee maker will be
8-20 minutes faster
apparently the use of renewable energy affects the frequency of
the electric current as it is not always on eg when its cloudy the
renewable energy from the sun drops off and the frequency of
the current is affected
somehow this doesnt seem the right thing to do does it
maybe that could use that extra time on fixing our financial
problems
SUPER DUCT TAPE
so supermans birth kryptonian father was jor-el
he was played by marlon brando in the christopher reed
superman movie
in the movie he wore a silver suit that reflected light
well when we were in the dreier museum in santa barbara he had
the original suit wore by marlon brando in the movie
we were able to take pictures and to actually touch it
it was made of reflective duct tape
the flash makes it glow
think this is the best use and most impressive use of duct
tape ive seen so far
TOMORROW
tomorrow will post a blog on part two of my story-final answer on
my neurology visits, the tests ive done, the study im in
the organicgreen doctor
Wednesday, July 20, 2011
buford, rain yes, data, fb musing
BUFORD
so this is buford wyoming population of 1
its the highest town between ny and san francisco on i80
its also the smallest town in the us with its on zip code
the mayor said the town meetings were interesting
he always gets his way
maybe well visit there on our wyoming tour next summer
RAIN YES
was awaken from a noon time nap by the rain falling on our
metal roof
thats a great feeling lying in bed and listening to that rain
fall on the roof
made me want to go back to sleep
we have a rain chain that is about 15 feet long and its so
relaxing to sit on the top deck and watch the rain water
move downwards along the chain to our rain water tank
we are getting low on our rainwater here
but considering the drought we are in we are doing ok
we have enough water now for about 2 months
hopefully well get some rain by then
the 1/4inch we had yesterday and the 1/4 inch we had
last week helped out some
have reduced watering anything except my garden
its interesting to see what plants are surviving this
drought without any supplemental water
they are mostly all native plants
salvia greggi, turks cap, rosemary, 4 nerve daisy, blackfoot
daisy, oregano, zexmenia, sage, germania, shrimp plant,
knockout rose, orchid tree, texas persimmon, texas plum,
trumpet vine, lavender, sun flowers, gregs mist flower,
texas hibiscus, butterfly bush, cedar sage are just some
that are doing well in this drought
whatever survives after this drought is what ill keep around
more rain please
DATA
so in the us the cell companies are 80% full in their data capacity
now they will start charging us more for our data use
since we live so far out we have to use either a satellite system or
use a cell phone data plan
we chose the verizon cell phone data plan as it allows the computer
to run slightly faster
well now every month we get this message that we are
exceeding our data limit on the computer usage
we dont download much on the computer because of the speed
knew they would eventually stick it to us
now they are
on our smart phones we have unlimited data and wont get hit
with the extra charge
or so they claim
FB MUSING
thanks ag for this
greatness is obtained by our willingness to serve others
the organicgreen doctor
so this is buford wyoming population of 1
its the highest town between ny and san francisco on i80
its also the smallest town in the us with its on zip code
the mayor said the town meetings were interesting
he always gets his way
maybe well visit there on our wyoming tour next summer
RAIN YES
was awaken from a noon time nap by the rain falling on our
metal roof
thats a great feeling lying in bed and listening to that rain
fall on the roof
made me want to go back to sleep
we have a rain chain that is about 15 feet long and its so
relaxing to sit on the top deck and watch the rain water
move downwards along the chain to our rain water tank
we are getting low on our rainwater here
but considering the drought we are in we are doing ok
we have enough water now for about 2 months
hopefully well get some rain by then
the 1/4inch we had yesterday and the 1/4 inch we had
last week helped out some
have reduced watering anything except my garden
its interesting to see what plants are surviving this
drought without any supplemental water
they are mostly all native plants
salvia greggi, turks cap, rosemary, 4 nerve daisy, blackfoot
daisy, oregano, zexmenia, sage, germania, shrimp plant,
knockout rose, orchid tree, texas persimmon, texas plum,
trumpet vine, lavender, sun flowers, gregs mist flower,
texas hibiscus, butterfly bush, cedar sage are just some
that are doing well in this drought
whatever survives after this drought is what ill keep around
more rain please
DATA
so in the us the cell companies are 80% full in their data capacity
now they will start charging us more for our data use
since we live so far out we have to use either a satellite system or
use a cell phone data plan
we chose the verizon cell phone data plan as it allows the computer
to run slightly faster
well now every month we get this message that we are
exceeding our data limit on the computer usage
we dont download much on the computer because of the speed
knew they would eventually stick it to us
now they are
on our smart phones we have unlimited data and wont get hit
with the extra charge
or so they claim
FB MUSING
thanks ag for this
greatness is obtained by our willingness to serve others
the organicgreen doctor
Tuesday, July 19, 2011
destructo kid, lost money, funny comment
DESTRUCTO KID
if you have a kid did you ever wonder why the house is a mess or
even worse if you have more kids than that
we had 8 kids in our family so can imagine what our house use to
look like
here is 4 hours of play time put into a 2 minute video
this guys busy
LOST MONEY
so recently saw this website www.unclaimed.org
you can go there and see if you have any unclaimed money laying
around in some bank or in some state treasury
so i plugged in my name and there was $100 that had been left
after the final closing of our house that we sold in austin several
years ago
why couldnt they find me
they had my name ss# phone numbers at work and at home
so it had sat there for several years with me getting no notification
so i filled out the form and in a few weeks i got my check for $100
you might want to check it out
FUNNY COMMENT
so i get comments on my blogs every day via the comment section,
facebook, this blogs email, and my personal email
people are so witty at times
recently i posted a blog on the effect of holding your cell phone to
your ear and there being an increased glucose metabolism in that
part of the brain
obesity causes a problem with glucose metabolism also so
she wrote so thats why my butt is so large as i keep my cell
phone in my back pocket then she wrote
maybe ill buy me a shirt with two front pockets and put cell
phones in both of them
the organicgreen doctor
if you have a kid did you ever wonder why the house is a mess or
even worse if you have more kids than that
we had 8 kids in our family so can imagine what our house use to
look like
here is 4 hours of play time put into a 2 minute video
this guys busy
LOST MONEY
so recently saw this website www.unclaimed.org
you can go there and see if you have any unclaimed money laying
around in some bank or in some state treasury
so i plugged in my name and there was $100 that had been left
after the final closing of our house that we sold in austin several
years ago
why couldnt they find me
they had my name ss# phone numbers at work and at home
so it had sat there for several years with me getting no notification
so i filled out the form and in a few weeks i got my check for $100
you might want to check it out
FUNNY COMMENT
so i get comments on my blogs every day via the comment section,
facebook, this blogs email, and my personal email
people are so witty at times
recently i posted a blog on the effect of holding your cell phone to
your ear and there being an increased glucose metabolism in that
part of the brain
obesity causes a problem with glucose metabolism also so
she wrote so thats why my butt is so large as i keep my cell
phone in my back pocket then she wrote
maybe ill buy me a shirt with two front pockets and put cell
phones in both of them
the organicgreen doctor
Monday, July 18, 2011
us soccer, hacked, thanks
US SOCCER
that was one of the best soccer games i have ever watched
it was enjoyable to watch the womens soccer world cup
they dont do all of the whining and faking and fouling that the
mens soccer teams do
there wasnt any dirty stuff going on
there were very few yellow or red cards
the refereeing was good
you know the refereeing is good when you dont notice them
during the game
granted the us had more than enough chances to win and
out played japan most of the game
but in soccer the team that wins may not always be the best
team or the team that plays the best game
maybe japan was destined to win after what happened to them
with the tsunami that hit japan
many of their players were directly affected by the tsunami
they lost several friends and family members
this us soccer team is now better known because of this
world cup
names like hope, abby, christie, alex, and megan replace names
like mia, brandi, michelle, and julie
yes well remember this team
it will be a long 4 years until the next world cup
still would like hope solo for a daughterinlaw
HACKED
could it be that hacking voice mail and cell phones could bring the
murdock dynasty down
think he touched a nerve there
go to this site www.komando.com to learn how to protect your
voice mail from being hacked
the biggest problem is people either dont have one or have a
weak password on their voice mail that makes it easy to hack
no 12345 is a bad one as is 000000
remember as time goes on our cell phones will be our pocket
books and our purses with all our credit cards, bank information,
addresses, and phone numbers all stored on the phones
some one can access all that with out even stealing the phone
thats scary
strengthen that password today
dont let murdochs crew get you
THANKS
thanks to all of you that read and responded via comments,
facebook, email and phone calls to my story final answer part one
blog on friday
this friday the blog will cover all the tests that have been done and
my neurology visits and the studies im involved in
the organicgreen doctor
that was one of the best soccer games i have ever watched
it was enjoyable to watch the womens soccer world cup
they dont do all of the whining and faking and fouling that the
mens soccer teams do
there wasnt any dirty stuff going on
there were very few yellow or red cards
the refereeing was good
you know the refereeing is good when you dont notice them
during the game
granted the us had more than enough chances to win and
out played japan most of the game
but in soccer the team that wins may not always be the best
team or the team that plays the best game
maybe japan was destined to win after what happened to them
with the tsunami that hit japan
many of their players were directly affected by the tsunami
they lost several friends and family members
this us soccer team is now better known because of this
world cup
names like hope, abby, christie, alex, and megan replace names
like mia, brandi, michelle, and julie
yes well remember this team
it will be a long 4 years until the next world cup
still would like hope solo for a daughterinlaw
HACKED
could it be that hacking voice mail and cell phones could bring the
murdock dynasty down
think he touched a nerve there
go to this site www.komando.com to learn how to protect your
voice mail from being hacked
the biggest problem is people either dont have one or have a
weak password on their voice mail that makes it easy to hack
no 12345 is a bad one as is 000000
remember as time goes on our cell phones will be our pocket
books and our purses with all our credit cards, bank information,
addresses, and phone numbers all stored on the phones
some one can access all that with out even stealing the phone
thats scary
strengthen that password today
dont let murdochs crew get you
THANKS
thanks to all of you that read and responded via comments,
facebook, email and phone calls to my story final answer part one
blog on friday
this friday the blog will cover all the tests that have been done and
my neurology visits and the studies im involved in
the organicgreen doctor
Friday, July 15, 2011
my story-final answer
MY STORY-FINAL ANSWER
i have the unique opportunity of telling my story as a physician who
has treated alzheimers patients, as a family member who dealt with
close relatives with the disease and now as a patient who may have
been diagnosed early enough that i can give unique observations
on this terrible disease
so its been a long 8 months since i was diagnosed with early mild
cognitive impairment amnestic type thought to be from alzheimers
alzheimers is a diagnosis that can only be 100% made by brain
autopsy when a person dies
i hope to reach as close as possible to 100% while i am alive with
what is available in modern medicine although some of the tests
are only available in research studies
i had to quit practicing medicine which was what i loved to do
i enjoyed going to work every day
i had just got real good at what i do
i will do a three part series every friday for the next three fridays
on my story
today will be on the history of what happened to me
next friday will be all the test results and how they are used
then the third friday will be what all this means for me and for
you
here goes
two years ago i applied for long term care insurance because of my
family history of alzheimers
my mom had severe alzheimers and died from complications of the
disease
she had an infected toe that she and no one else noticed
from that she got gangrene of the leg and died after that
my dad was spared the merciless trip of alzheimers by dying from
a heart attack
looking back he had mild to moderate alzheimers but never was
officially diagnosed (i know this because of a genetic test i had)
a close relative of mine has moderate alzheimers now
he is a year younger than i am
his disease is what worries me the most as i feel like i may be
following down the path he is taking
for the long term care insurance i had to undergo a 30 minute
neuropychological exam by an examing nurse and had no problem
with any of the questions
i eventually got the long term care insurance and plan to maintain it
during my lifetime
if i had waited until all this had happened i would not have been able
to get the long term care insurance today
(nor could i get new health insurance, life insurance, medical
malpractice, or a disabiltiy policy ie im uninsurable)
a year later because of the family history of alzheimers i wanted to
enter an alzheimers research study or see a neurologist to follow
me on a regular basis
i had started to notice problems at this time although they were
quite subtle and not noticeable to patients, family members,
fellow workers or fellow doctors
i had started to have problems with doing prescriptions especially
when having to calculate doses and if the patients prescriptions
got complicated
i compensated by using caution, triple checking everything and
being backed up by the computer, a good nurse and by the pharmacy
i had started to have problems remembering the interactions of
medications but this again was helped with our computer system
and by using standard forms for office visits
i also started to have some problems remembering seeing patients
when they would return for followup visits
i know you cant remember seeing every patient and remember
everything about a visit but
i had several times when i saw patients for illnesses that i should
have remembered but absolutely did not recall seeing them
i found this surreal and very disturbing
but at no time did i put my patients at jeopardy
i became very cautious and did a good job of documenting the visit
when i saw patients
i also had to take a continuing medical education course for my
malpractice insurance to get a 15% discount on my premiums
when i read the material and then took the test i only made a 30%
on the test
i was given credit for taking the test but again i was very disturbed
by my failure to retain the material
this was about the same time i went to see the memory clinic at the
university of texas southwestern medical school in dallas
after talking to the research associate the plan was i would enter a
alzheimers research as a normal control subject
i discussed with the research associate what i was wanting to do
was to be in the alzheimers research study so i could be monitored
if i had or developed a problem i would know
if that happened i would quit practicing medicine for fear of
causing harm to my patients
my wife she and i went to the clinic
we met with the research associate who interviewed us in
separate rooms-i answered some questions better than my wife
she did
i then under went a complete neurological exam by one of the
staff neurologists
he also interviewed my wife she when i went in for my neuro-
psychological exam
on the 3 hour neuropsychological exam
i did ok on most of the material
however the parts that delt with short term memory was a problem
for me
i knew for sure when i took that exam that i had a problem
this was quite disturbing to me
after the test i discussed it with the research assoicate who told
me oh know everyone says that
i knew i had a problem
on the trip home i discusssed all this with my wife she
that week i dumbed down my practice, slowed down my practice,
referred out any complicated patients, tried to get out of doing
urgent care, and scheduled more time off
a few weeks later i got a call from the research associate who told
me i was turned down for the study because i failed the short term
memory portion of the neuropsychological exam
it was recommended i see a neurologist for an evaluation
next week ill do part two which will be on the neurology visits,
all the test results, and the research study then
in part three i will try to put it all together as to what it means
to me and my wife she and my family and what it may mean
to you in regards to alzheimers disease
please support my team-organicgreendoctor.com-for the
austin walk to end alzheimers at my team page
or support a local walk in your area at www.alz.org/walk/
we need your support to help end this disease
the organicgreen doctor
i have the unique opportunity of telling my story as a physician who
has treated alzheimers patients, as a family member who dealt with
close relatives with the disease and now as a patient who may have
been diagnosed early enough that i can give unique observations
on this terrible disease
so its been a long 8 months since i was diagnosed with early mild
cognitive impairment amnestic type thought to be from alzheimers
alzheimers is a diagnosis that can only be 100% made by brain
autopsy when a person dies
i hope to reach as close as possible to 100% while i am alive with
what is available in modern medicine although some of the tests
are only available in research studies
i had to quit practicing medicine which was what i loved to do
i enjoyed going to work every day
i had just got real good at what i do
i will do a three part series every friday for the next three fridays
on my story
today will be on the history of what happened to me
next friday will be all the test results and how they are used
then the third friday will be what all this means for me and for
you
here goes
two years ago i applied for long term care insurance because of my
family history of alzheimers
my mom had severe alzheimers and died from complications of the
disease
she had an infected toe that she and no one else noticed
from that she got gangrene of the leg and died after that
my dad was spared the merciless trip of alzheimers by dying from
a heart attack
looking back he had mild to moderate alzheimers but never was
officially diagnosed (i know this because of a genetic test i had)
a close relative of mine has moderate alzheimers now
he is a year younger than i am
his disease is what worries me the most as i feel like i may be
following down the path he is taking
for the long term care insurance i had to undergo a 30 minute
neuropychological exam by an examing nurse and had no problem
with any of the questions
i eventually got the long term care insurance and plan to maintain it
during my lifetime
if i had waited until all this had happened i would not have been able
to get the long term care insurance today
(nor could i get new health insurance, life insurance, medical
malpractice, or a disabiltiy policy ie im uninsurable)
a year later because of the family history of alzheimers i wanted to
enter an alzheimers research study or see a neurologist to follow
me on a regular basis
i had started to notice problems at this time although they were
quite subtle and not noticeable to patients, family members,
fellow workers or fellow doctors
i had started to have problems with doing prescriptions especially
when having to calculate doses and if the patients prescriptions
got complicated
i compensated by using caution, triple checking everything and
being backed up by the computer, a good nurse and by the pharmacy
i had started to have problems remembering the interactions of
medications but this again was helped with our computer system
and by using standard forms for office visits
i also started to have some problems remembering seeing patients
when they would return for followup visits
i know you cant remember seeing every patient and remember
everything about a visit but
i had several times when i saw patients for illnesses that i should
have remembered but absolutely did not recall seeing them
i found this surreal and very disturbing
but at no time did i put my patients at jeopardy
i became very cautious and did a good job of documenting the visit
when i saw patients
i also had to take a continuing medical education course for my
malpractice insurance to get a 15% discount on my premiums
when i read the material and then took the test i only made a 30%
on the test
i was given credit for taking the test but again i was very disturbed
by my failure to retain the material
this was about the same time i went to see the memory clinic at the
university of texas southwestern medical school in dallas
after talking to the research associate the plan was i would enter a
alzheimers research as a normal control subject
i discussed with the research associate what i was wanting to do
was to be in the alzheimers research study so i could be monitored
if i had or developed a problem i would know
if that happened i would quit practicing medicine for fear of
causing harm to my patients
my wife she and i went to the clinic
we met with the research associate who interviewed us in
separate rooms-i answered some questions better than my wife
she did
i then under went a complete neurological exam by one of the
staff neurologists
he also interviewed my wife she when i went in for my neuro-
psychological exam
on the 3 hour neuropsychological exam
i did ok on most of the material
however the parts that delt with short term memory was a problem
for me
i knew for sure when i took that exam that i had a problem
this was quite disturbing to me
after the test i discussed it with the research assoicate who told
me oh know everyone says that
i knew i had a problem
on the trip home i discusssed all this with my wife she
that week i dumbed down my practice, slowed down my practice,
referred out any complicated patients, tried to get out of doing
urgent care, and scheduled more time off
a few weeks later i got a call from the research associate who told
me i was turned down for the study because i failed the short term
memory portion of the neuropsychological exam
it was recommended i see a neurologist for an evaluation
next week ill do part two which will be on the neurology visits,
all the test results, and the research study then
in part three i will try to put it all together as to what it means
to me and my wife she and my family and what it may mean
to you in regards to alzheimers disease
please support my team-organicgreendoctor.com-for the
austin walk to end alzheimers at my team page
or support a local walk in your area at www.alz.org/walk/
we need your support to help end this disease
the organicgreen doctor
Labels:
alzheimers,
my story,
walk to end alzheimers
Thursday, July 14, 2011
sugar on the brain, debt limit, usausaus, series
SUGAR ON THE BRAIN
if you are someone who talks a lot on the cell phone
with it stuck in your ear then you may not want to
read the rest of this blog
one of the tests that i had done and will have every year
for the next 5 years is a pet scan that measures glucose
(one of the sugars) metabolism in the brain
they give you a radioactive labeled glucose that is given
intravenously then they do the scan
areas with abnormal or increased activity show up
so they had people hold the cell phone up to the ear and
turn it on but not talk on it or listen to anything on it
(that must have been real hard for people to do-its like
putting crack in front of a crack addict and telling them not
to use it)
and then measured brain glucose metabolism with a mri or
a pet scan
(wonder if they picked up anyone with early alzheimers)
what happens is that the part of the brain where the cell
phone antenna sits is the area that had the increased glucose
metabolism which shows that the radio frequency waves do
affect the brain activity
this cant be good for you
makes you want to use a hands free phone huh
just dont let it sit in your lap
more research is needed to be done to see what effects
long term this could have
there are millions of people they could test
they could start first with my wife she
DEBT LIMIT
just raise the dam debt limit and be done with it
makes me want to vote all of the representatives and senators
out right now
its a good thing this is not an election year
moodys is looking to down grade the us government rating from
their triple a rating
if this happens it will be devastating to our economy
just raise the debt limit-it has to be done
but do your cuts (start with their salaries first maybe 10%)
but you have to raise taxes some way too
it seems both sides are out of touch with reality
in the real world we all cut our expenses but also look for
other sources of revenue to help our bottom line
why cant the us government do the same
sure hope the biggest holder of our debt doesnt get pissed off
or we will all be speaking chinese
lets get er done please
USAUSAUSA
so in soccer sometimes the team that plays the best game doesnt
always win
thats what happened yesterday with the us womens world cup
soccer game with france yesterday
france out played the usa until the last few minutes when the
usa suddenly came alive and scored two quick goals
this team has the karma and are now in the final game on
sunday against japan (i wanted them to play sweden for
a rematch)
hope solo is now the poster player for this team
go usa beat japan
SERIES
starting tomorrow i will write a three part series on my trip
with alzheimers
it will be posted over the next 3 fridays
tomorrow
how it all happened and when i was diagnosed
later all the tests ive had and their results and then
what it all means for me and for you
the organicgreen doctor
if you are someone who talks a lot on the cell phone
with it stuck in your ear then you may not want to
read the rest of this blog
one of the tests that i had done and will have every year
for the next 5 years is a pet scan that measures glucose
(one of the sugars) metabolism in the brain
they give you a radioactive labeled glucose that is given
intravenously then they do the scan
areas with abnormal or increased activity show up
so they had people hold the cell phone up to the ear and
turn it on but not talk on it or listen to anything on it
(that must have been real hard for people to do-its like
putting crack in front of a crack addict and telling them not
to use it)
and then measured brain glucose metabolism with a mri or
a pet scan
(wonder if they picked up anyone with early alzheimers)
what happens is that the part of the brain where the cell
phone antenna sits is the area that had the increased glucose
metabolism which shows that the radio frequency waves do
affect the brain activity
this cant be good for you
makes you want to use a hands free phone huh
just dont let it sit in your lap
more research is needed to be done to see what effects
long term this could have
there are millions of people they could test
they could start first with my wife she
DEBT LIMIT
just raise the dam debt limit and be done with it
makes me want to vote all of the representatives and senators
out right now
its a good thing this is not an election year
moodys is looking to down grade the us government rating from
their triple a rating
if this happens it will be devastating to our economy
just raise the debt limit-it has to be done
but do your cuts (start with their salaries first maybe 10%)
but you have to raise taxes some way too
it seems both sides are out of touch with reality
in the real world we all cut our expenses but also look for
other sources of revenue to help our bottom line
why cant the us government do the same
sure hope the biggest holder of our debt doesnt get pissed off
or we will all be speaking chinese
lets get er done please
USAUSAUSA
so in soccer sometimes the team that plays the best game doesnt
always win
thats what happened yesterday with the us womens world cup
soccer game with france yesterday
france out played the usa until the last few minutes when the
usa suddenly came alive and scored two quick goals
this team has the karma and are now in the final game on
sunday against japan (i wanted them to play sweden for
a rematch)
hope solo is now the poster player for this team
go usa beat japan
SERIES
starting tomorrow i will write a three part series on my trip
with alzheimers
it will be posted over the next 3 fridays
tomorrow
how it all happened and when i was diagnosed
later all the tests ive had and their results and then
what it all means for me and for you
the organicgreen doctor
Labels:
alzheimers,
cell phones and glucose,
debt limit,
soccer
Wednesday, July 13, 2011
hope for the future, cursive done for, fb musings
HOPE FOR THE FUTURE
well now there is hope for the future
its hope solo the goalkeeper for the us womens soccer team
this is a picture of her making the save in the shootout of the game
against brazil
what a save
what a great game
one of the best soccer games ive seen
lets support them as they play france today at 1030 am cdt
on espn
go usa usa usa
sure would like her for a daughter in law
so yes there is hope for the future
CURSIVE DONE FOR
so it looks like cursive handwriting in the schools are done for
as most states dont require it to be taught
man i wished i could have gone to school in this day and time
all of the times i suffered with handwriting (and those who tried to
read it)
its not because im a doctor that i cant write correctly
i fit the perfect stereotype of the doctor who has bad handwriting
just ask the nurses that have worked with me for years and those
pharmacists that interpreted my prescriptions for the patient
now that is no more
of course i cant print worth a dam either
in my office i would write backwards for the kids on my exam
table paper to entertain the kids
they could look at the back side of the paper to read it or hold
it up to a mirror to read it
but some of them couldnt read it even then
(funny thing was my writing was better when i wrote backwards)
the computer and keyboarding has been a great saver for those of
us who have the disability of bad godawful handwriting
know the nurses and pharmacists and other doctors sure
appreciated it when i used it to do my notes and prescriptions
on the computer
now those kids wont be tortured by teachers and others berating
them for their poor writing (i got many a bad grade in handwriting
during my school years)
guess this is progress
FB MUSINGS
thanks cs for this one
thought of this when thinking of the packing we did for our two
recent trips
when preparing for a trip lay out all of your clothes and all of your
money
then take half the clothes and twice the money
yep found this to be so true
the organicgreen doctor
well now there is hope for the future
its hope solo the goalkeeper for the us womens soccer team
this is a picture of her making the save in the shootout of the game
against brazil
what a save
what a great game
one of the best soccer games ive seen
lets support them as they play france today at 1030 am cdt
on espn
go usa usa usa
sure would like her for a daughter in law
so yes there is hope for the future
CURSIVE DONE FOR
so it looks like cursive handwriting in the schools are done for
as most states dont require it to be taught
man i wished i could have gone to school in this day and time
all of the times i suffered with handwriting (and those who tried to
read it)
its not because im a doctor that i cant write correctly
i fit the perfect stereotype of the doctor who has bad handwriting
just ask the nurses that have worked with me for years and those
pharmacists that interpreted my prescriptions for the patient
now that is no more
of course i cant print worth a dam either
in my office i would write backwards for the kids on my exam
table paper to entertain the kids
they could look at the back side of the paper to read it or hold
it up to a mirror to read it
but some of them couldnt read it even then
(funny thing was my writing was better when i wrote backwards)
the computer and keyboarding has been a great saver for those of
us who have the disability of bad godawful handwriting
know the nurses and pharmacists and other doctors sure
appreciated it when i used it to do my notes and prescriptions
on the computer
now those kids wont be tortured by teachers and others berating
them for their poor writing (i got many a bad grade in handwriting
during my school years)
guess this is progress
FB MUSINGS
thanks cs for this one
thought of this when thinking of the packing we did for our two
recent trips
when preparing for a trip lay out all of your clothes and all of your
money
then take half the clothes and twice the money
yep found this to be so true
the organicgreen doctor
Labels:
cursive,
fb musings,
hope for the future
Tuesday, July 12, 2011
garden stuff, solar planking
GARDEN STUFF
ok its hot and dry out there
but now is the time to plant some things for the fall garden
this week will plant my fall tomatoes and my fall squash to
include zuchinni, yellow squash and spaghetti squash
will plant these from 4 inch pots to get them a head start
in this weather
will also summer over some of my tomatoes that are producing
well and are not diseased and are a type that will continue
producing in the fall eg sweet 100s, juliet
the beds were prepared before hand by adding 4 inches of
compost and an organic fertilizer or composted chicken manure
the plants will be planted and watered in well with a seaweed
solution and then they are mulched well
each plant is put in a wire cage which is covered with a
shade cloth to block the oppressive heat from the plant
as the weather gets nicer will remove the shade cloth
(hope that is sooner than later)
the plants are watered daily until well established then are
watered with a drip irrigation system that sits under the mulch
any bare or unused garden beds are overseeded with black
eyed peas as a cover crop and as a source of food
(just add cornbread)
it is also about the time to plant eggplant and peppers as they
do the best in the fall
i usually just keep my spring peppers and eggplants going
through the summer as they will produce some during the heat
but will usually take off again once the weather cools
(our fall gardening here is the best time to garden)
be sure and give your shrubs and trees supplemental water
in this drought we are having
be careful working in the heat
garden in the early morning or late evening
wear a hat and
drink plenty of water
good luck
SOLAR PLANKING
so will do green planking by planking my solar panels
the organicgreen doctor
ok its hot and dry out there
but now is the time to plant some things for the fall garden
this week will plant my fall tomatoes and my fall squash to
include zuchinni, yellow squash and spaghetti squash
will plant these from 4 inch pots to get them a head start
in this weather
will also summer over some of my tomatoes that are producing
well and are not diseased and are a type that will continue
producing in the fall eg sweet 100s, juliet
the beds were prepared before hand by adding 4 inches of
compost and an organic fertilizer or composted chicken manure
the plants will be planted and watered in well with a seaweed
solution and then they are mulched well
each plant is put in a wire cage which is covered with a
shade cloth to block the oppressive heat from the plant
as the weather gets nicer will remove the shade cloth
(hope that is sooner than later)
the plants are watered daily until well established then are
watered with a drip irrigation system that sits under the mulch
any bare or unused garden beds are overseeded with black
eyed peas as a cover crop and as a source of food
(just add cornbread)
it is also about the time to plant eggplant and peppers as they
do the best in the fall
i usually just keep my spring peppers and eggplants going
through the summer as they will produce some during the heat
but will usually take off again once the weather cools
(our fall gardening here is the best time to garden)
be sure and give your shrubs and trees supplemental water
in this drought we are having
be careful working in the heat
garden in the early morning or late evening
wear a hat and
drink plenty of water
good luck
SOLAR PLANKING
so will do green planking by planking my solar panels
the organicgreen doctor
Monday, July 11, 2011
thisll make u mad, hope for the future
THISLL MAKE U MAD
if you or anyone you know have ever had gout you know how
bad it hurts
many people would take colchicine several times a day when the
gout attack would start and this would help shut down the attack
and help the pain
you would go to the pharmacy and as this medication has been
around for years and was generic you would pay about $0.04 a
tablet
so a days worth of colchicine would cost about $0.24 a day to
treat this acute gout flare up
i have written lots of prescriptions over the years for the colchicine
as it usually worked well in most patients
the biggest side effect was diarrhea if you took too much
diarrhea vs god awful pain is a tolerable side effect
so 21 companies use to make this stuff
so now this is where the consumer screwing by the fda, congress and
those bad guy drug companies come into the picture
so theres a rule or law that an old drug that has not been officially
tested and approved for its use by the fda can be given a exclusive
patent for a few years if its tested and approved
colchicine has been used for gout for 2500 years
its like patenting ginger for nausea
so here comes the screwing
the fda gave the pharmaceutical company url pharma exclussive
rights for 3 years to make and sell colchicine under the brand
name of colcrys
for the price of $5 a pill
thats up to $30 a day for treatment for an acute gout attack
3 10s vs a quarter
remember some biblical characters probably took this drug
all this cost was justified because of the expense of doing testing
on 180 people-yea sure
first it was the banking loan industry now its the big pharma
gouging us all again
so now congress is upset over this
excuse me
you passed the dam law in the first place
are you stupid or what
whats next aspirin
HOPE FOR THE FUTURE
am always running across teenagers who are talented and provide
a lot of hope for the future
my wife she works at a local high school where your kids go
if they get into some trouble at school
some of those kids are real talented
they just have screwed up homes if they have one or screwed
up lives
she sees the best in all of them
and looks for it
she is always discovering a child who is talented in writing, art,
music,or singing and the school they came from has no idea how
talented the student is
thought of her and some of her students when i saw this video
my wife she has a video of one her students singing happy birthday
to her and it reminded me of this video
the girl from her school has a beautiful voice and you can just feel
her soulful feeling as she sings to my wife
this a video off youtube that has gone viral
wonder if this girl knows how good this is
she is the hope for the future
dont give up on a kid
the organicgreen doctor
if you or anyone you know have ever had gout you know how
bad it hurts
many people would take colchicine several times a day when the
gout attack would start and this would help shut down the attack
and help the pain
you would go to the pharmacy and as this medication has been
around for years and was generic you would pay about $0.04 a
tablet
so a days worth of colchicine would cost about $0.24 a day to
treat this acute gout flare up
i have written lots of prescriptions over the years for the colchicine
as it usually worked well in most patients
the biggest side effect was diarrhea if you took too much
diarrhea vs god awful pain is a tolerable side effect
so 21 companies use to make this stuff
so now this is where the consumer screwing by the fda, congress and
those bad guy drug companies come into the picture
so theres a rule or law that an old drug that has not been officially
tested and approved for its use by the fda can be given a exclusive
patent for a few years if its tested and approved
colchicine has been used for gout for 2500 years
its like patenting ginger for nausea
so here comes the screwing
the fda gave the pharmaceutical company url pharma exclussive
rights for 3 years to make and sell colchicine under the brand
name of colcrys
for the price of $5 a pill
thats up to $30 a day for treatment for an acute gout attack
3 10s vs a quarter
remember some biblical characters probably took this drug
all this cost was justified because of the expense of doing testing
on 180 people-yea sure
first it was the banking loan industry now its the big pharma
gouging us all again
so now congress is upset over this
excuse me
you passed the dam law in the first place
are you stupid or what
whats next aspirin
HOPE FOR THE FUTURE
am always running across teenagers who are talented and provide
a lot of hope for the future
my wife she works at a local high school where your kids go
if they get into some trouble at school
some of those kids are real talented
they just have screwed up homes if they have one or screwed
up lives
she sees the best in all of them
and looks for it
she is always discovering a child who is talented in writing, art,
music,or singing and the school they came from has no idea how
talented the student is
thought of her and some of her students when i saw this video
my wife she has a video of one her students singing happy birthday
to her and it reminded me of this video
the girl from her school has a beautiful voice and you can just feel
her soulful feeling as she sings to my wife
this a video off youtube that has gone viral
wonder if this girl knows how good this is
she is the hope for the future
dont give up on a kid
the organicgreen doctor
Friday, July 8, 2011
alzheimers myths, ouch thanks duct tape, walk to end alzheimers
ALZHEIMERS MYTHS
here are the last 3 myths from caring.com
7 dads alzheimers will make him an aggressive and angry
person and he will lash out at us
this disease affects people differently
some people become more reserved and timid
some people will feel frustrated or angry at times
perhaps from being in a new environment or from being
embarrassed
8 alzheimers disease is reversible
the sucky thing is its not reversible
early on a person may function well for years then
have a rapid decline
there is not way to cure it or reverse it
the medications im on only slows the disease symptoms down
but the disease process just marches on unabated
9 there is no bright side to an alzheimers diagnosis
i agree
it gradually robs your brain and your personality and can cause
a considerable drain emotionally and financially on those who
provide the care
many families reconnect after the diagnosis
they realize nows the time
there wont be another time to get to know the person, get
family history, get information from old photographs, etc
looking back with my mom we missed out on obtaining
information on the past
lucky the older siblings remember a lot from her younger
days from talking with her and being with her
seize the moment
OUCH THANKS DUCT TAPE
so had a great photo from the dreier museum of a unique use
of duct tape
that will be saved for later after the event of yesterday
i have gotten behind on cleaning up my property this spring
because of all the wedding journey stuff and because of the
weekend larrys party and because of the heat and because
was waiting for the late blooming wildflowers to finally go
to seed before i mowed and weed eated
yesterday as i worked outside in the heat i was bending over
working on my water pump as i hooked it up to pump water
to my garden rainwater tanks
i was on my knees and felt fire ants in my drawers
on my left side
dang they hurt bad
so i squashed them by patting my gloved hand on my left
buttocks
as i continued to work those fire ants kept biting me
dang thought i killed all them
so eventually i took off my gloves
called my wife she and
dropped drawers right there in the yard
(the advantage of living in the country with no neighbors nearby)
my wife she started laughing
she wanted to take pictures of me in my work boots and old
dirty filthy stained work shirtt and old floppy hat and
with my drawers laying on the ground
wouldnt let her do it though
dang those fire ants
so my wife she says you got cactus stuck on your butt
i didnt think it was funny but she sure did
(guess thats payback for all the snake stories huh)
so she went inside and got a roll of duct tape
glad im not a hairy butt guy
she rolled the duct tape in a circle and removed most of the
cactus stickers with the duct tape
she rolled the tape across the area and also put on strips and
ripped them off real fast
think she enjoyed this too much at my expense
eventually i replaced my undies and shorts with cactus sticker free
ones and went back to work
add that to the use of duct tape
WALK TO END ALZ
we still need donations for the organicgreendoctor.com team for the
walk to end alzheimers in october here in austin
you may make donations and or join my team or
find a local walk to end alzheimers in your area
it may be the only disease that 100% of you will affected in
some way
go to our walk to end alzheimers team page to join or donate
the organicgreen doctor
Labels:
alzheimers myths,
duct tape,
walk to end alzheimers
Thursday, July 7, 2011
fb musings, haboob
FB MUSING
i read facebook every day
its a good way to keep up with whats going on in the world
and with friends and family
so many people are so witty
and can give one liner wittisms
here is one from a regular contributor to wittisms
so her priest tells a joke every week
so a man goes to a doctor
later the doctor calls in the wife and told
her that the man needed some rest and peace
here was some sleeping pills
she asked when does she give them to him
the doctor says you dont give them to him
they are for you
guess what sex laughed and what sex didnt
HABOOB
so this haboob hit phoenix yesterday
a haboob is a sandstorm
they occur in arab countries
it hit phoemix yesteday as a result of a rainstorm that hit the area
it was 50 miles long at one point
it affected the electricity, it affected traffic, and it really
screwed up plane traffic in phoenix
planes were grounded for several hours
well my younger son he flew in to phoenix but was stuck there
that afternoon and evening
it must be a sign as he was to be on the same flights we were on
when we had our flight fun last week
he waited in the same waiting areas we did until the storm went
through and the air traffic got cleared to leave
at least he didnt have to board that plane three times like we did
can you imagine how gritty your eyes and teeth would be in a
storm like that
and how dirty your hair would feel
and just think if all the dusting you would have to do after that
storm left
maybe thats why i dreamed this vivid dream last night about
vacuuming up a large amount of dirt out of the carpet and
stopping up my wife shes vacuum cleaner (now its mine)
thanks aricept(donepezil) for the dream
(a side efffect of the medication)
the organicgreen doctor
i read facebook every day
its a good way to keep up with whats going on in the world
and with friends and family
so many people are so witty
and can give one liner wittisms
here is one from a regular contributor to wittisms
so her priest tells a joke every week
so a man goes to a doctor
later the doctor calls in the wife and told
her that the man needed some rest and peace
here was some sleeping pills
she asked when does she give them to him
the doctor says you dont give them to him
they are for you
guess what sex laughed and what sex didnt
HABOOB
so this haboob hit phoenix yesterday
a haboob is a sandstorm
they occur in arab countries
it hit phoemix yesteday as a result of a rainstorm that hit the area
it was 50 miles long at one point
it affected the electricity, it affected traffic, and it really
screwed up plane traffic in phoenix
planes were grounded for several hours
well my younger son he flew in to phoenix but was stuck there
that afternoon and evening
it must be a sign as he was to be on the same flights we were on
when we had our flight fun last week
he waited in the same waiting areas we did until the storm went
through and the air traffic got cleared to leave
at least he didnt have to board that plane three times like we did
can you imagine how gritty your eyes and teeth would be in a
storm like that
and how dirty your hair would feel
and just think if all the dusting you would have to do after that
storm left
maybe thats why i dreamed this vivid dream last night about
vacuuming up a large amount of dirt out of the carpet and
stopping up my wife shes vacuum cleaner (now its mine)
thanks aricept(donepezil) for the dream
(a side efffect of the medication)
the organicgreen doctor
Labels:
aricept (donepezil),
fb musings,
haboob
Wednesday, July 6, 2011
weather, flight fun
WEATHER
its so hot here this summer with the heat and the drought that
even the cactus are wilting
FLIGHT FUN
i dont like to fly
its not a fear of flying or
flight anxiety its just that
i get severe motion sickness so i have to take medicine
to prevent the motion sickness
so
as we left santa barbara at 1200 noon i took my pill that dissolves
in my mouth (thats the one that got all wet on the walk to the
airport when i left on the trip as we had a shower and i got soaked
walking from the parking lot to the terminal and found a dissolved
pill in my pocket which made for a fun flight that day)
well it happened again
not a wet pill but time caused my last flight to be a nauseating problem
heres the story
we left late and barely got to the phoenix airport in time to catch
our connecting flight home
my wife she and my motherinlaw she waited at the first plane
waiting for our unchecked luggage in a hot runway walkway
(why dont they just check those dam things for free and be
done with it)
i dashed ahead and found the gate our transfer flight was leaving
from and held my ground at the check in desk waiting for those
two ladies
they made it barely as they were going to close the doors on us
cant they be nicer as it was their fault we were late
(as it turned out i should have just taken my time)
we all got on the plane and waited and waited in a semihot plane
how come they cant let air blow out of those little holes in the
ceiling while you are just sitting there
finally they closed the door and backed out of the terminal and
headed back to the runway then
sorry folks one of the air conditioners is out (think i had already
figured that out) and in this hot weather we
can either fly too warm or go back to the terminal and get it fixed
i voted for fixing the ac in that 113 degree phoenix weather
so we all unloaded with our bags, waited for the unchecked
luggage,and set up camp in the terminal
we watched as they worked on the plane and as they started up
the plane great bellows of smoke came out of the motors
that didnt look good
not sure i want on that plane
after a few hours there was an announcement
the plane cant be fixed
we are looking for a new plane for us to fly
but you have to go to a new gate
of course we were at 2 and had to go all the way to the last gate
which was in the 20s number
and we waited
finally after a few hours they said we have a plane and pilots
lets board
yes finally after several hours
we all got on the plane
got all loaded up
by now i met my fellow passenger and found out all about her
after all we had been sitting by each other several hours by now
we met the people next to us and in front of us
we all became friends before all this was over with
so we took off ok
my fellow passenger next to me must have partied too much
in vegas as she slept the whole time on this flight
joke was on her though
hahahhahahahahah
after an hour or hour and a half the pilot came on the intercom
thats not good
well we have a mechanical problem and we are going back
to phoenix
that sucks gosh we should have been almost all the way to
austin by now
then later he came back on in a more serious tone and said
we have had a problem with one of the landing gears coming back
up and we have had to fly in circles around phoenix since we left
to burn off fuel so we could land
the other landing gears have came down ok
so why do they have to burn off all that fuel before we land
i did not want to ask
but i could sure read between the lines
so here we go
burned off all that fuel huh
at least we werent told to bend forward and put our heads down
as we approach the landing
my fellow passenger woke up and was
getting ready to get off the plane in austin
almost didnt have the heart to tell her we were in phoenix
(now that would have been funny if we had just let her get off
without her knowing she was not in austin)
boy was she shocked when i told her the truth
so here we go again
we got off the plane (thank goodness it was a good landing)
waited to get our unchecked baggage again that should have
been checked
and waited in the waiting area
we were told after a while that they were looking for a plane and for
new pilots (guess we wore the other ones out)
so we waited some more
then after a few more hours an announcement was made
we have a plane and pilots but we are leaving at a new gate
thats right back all the way to where we started
(if you have been to phoenix you know the distance from gate 1
to gate 20s is a long way)
we made it to the gate and waited and waited then finally we
all boarded the plane
as we took off i realized my motion sickness pill had worn off and
it was in my unchecked baggage that was in the belly of the plane
so i took deep breaths of cool air and drank ginger ale to make
it to austin
hey thats how i started this wedding journey week
so i got to meet a young girl from austin who is going to chef school
who is also working as a chief assistant in a large hotel near austin
there is hope for the future
we met a schoolteacher who was flying in to meet her husband in
austin as he was flying in from atlanta on his way to where he
teaches college
they will have a short night together as we got in at 200am
then there was the lady who was over medicated or over alcoholed
who began crying after the first plane mishap and they would not
let her back on the plane
she may be the lucky one as she may not remember any of this
what an interesting day it was
and an interesting end to our great wedding journey week
so dont expect me to fly anywhere for awhile
so i did kiss the floor of the terminal when i finally arrived here
the organicgreen doctor
its so hot here this summer with the heat and the drought that
even the cactus are wilting
FLIGHT FUN
i dont like to fly
its not a fear of flying or
flight anxiety its just that
i get severe motion sickness so i have to take medicine
to prevent the motion sickness
so
as we left santa barbara at 1200 noon i took my pill that dissolves
in my mouth (thats the one that got all wet on the walk to the
airport when i left on the trip as we had a shower and i got soaked
walking from the parking lot to the terminal and found a dissolved
pill in my pocket which made for a fun flight that day)
well it happened again
not a wet pill but time caused my last flight to be a nauseating problem
heres the story
we left late and barely got to the phoenix airport in time to catch
our connecting flight home
my wife she and my motherinlaw she waited at the first plane
waiting for our unchecked luggage in a hot runway walkway
(why dont they just check those dam things for free and be
done with it)
i dashed ahead and found the gate our transfer flight was leaving
from and held my ground at the check in desk waiting for those
two ladies
they made it barely as they were going to close the doors on us
cant they be nicer as it was their fault we were late
(as it turned out i should have just taken my time)
we all got on the plane and waited and waited in a semihot plane
how come they cant let air blow out of those little holes in the
ceiling while you are just sitting there
finally they closed the door and backed out of the terminal and
headed back to the runway then
sorry folks one of the air conditioners is out (think i had already
figured that out) and in this hot weather we
can either fly too warm or go back to the terminal and get it fixed
i voted for fixing the ac in that 113 degree phoenix weather
so we all unloaded with our bags, waited for the unchecked
luggage,and set up camp in the terminal
we watched as they worked on the plane and as they started up
the plane great bellows of smoke came out of the motors
that didnt look good
not sure i want on that plane
after a few hours there was an announcement
the plane cant be fixed
we are looking for a new plane for us to fly
but you have to go to a new gate
of course we were at 2 and had to go all the way to the last gate
which was in the 20s number
and we waited
finally after a few hours they said we have a plane and pilots
lets board
yes finally after several hours
we all got on the plane
got all loaded up
by now i met my fellow passenger and found out all about her
after all we had been sitting by each other several hours by now
we met the people next to us and in front of us
we all became friends before all this was over with
so we took off ok
my fellow passenger next to me must have partied too much
in vegas as she slept the whole time on this flight
joke was on her though
hahahhahahahahah
after an hour or hour and a half the pilot came on the intercom
thats not good
well we have a mechanical problem and we are going back
to phoenix
that sucks gosh we should have been almost all the way to
austin by now
then later he came back on in a more serious tone and said
we have had a problem with one of the landing gears coming back
up and we have had to fly in circles around phoenix since we left
to burn off fuel so we could land
the other landing gears have came down ok
so why do they have to burn off all that fuel before we land
i did not want to ask
but i could sure read between the lines
so here we go
burned off all that fuel huh
at least we werent told to bend forward and put our heads down
as we approach the landing
my fellow passenger woke up and was
getting ready to get off the plane in austin
almost didnt have the heart to tell her we were in phoenix
(now that would have been funny if we had just let her get off
without her knowing she was not in austin)
boy was she shocked when i told her the truth
so here we go again
we got off the plane (thank goodness it was a good landing)
waited to get our unchecked baggage again that should have
been checked
and waited in the waiting area
we were told after a while that they were looking for a plane and for
new pilots (guess we wore the other ones out)
so we waited some more
then after a few more hours an announcement was made
we have a plane and pilots but we are leaving at a new gate
thats right back all the way to where we started
(if you have been to phoenix you know the distance from gate 1
to gate 20s is a long way)
we made it to the gate and waited and waited then finally we
all boarded the plane
as we took off i realized my motion sickness pill had worn off and
it was in my unchecked baggage that was in the belly of the plane
so i took deep breaths of cool air and drank ginger ale to make
it to austin
hey thats how i started this wedding journey week
so i got to meet a young girl from austin who is going to chef school
who is also working as a chief assistant in a large hotel near austin
there is hope for the future
we met a schoolteacher who was flying in to meet her husband in
austin as he was flying in from atlanta on his way to where he
teaches college
they will have a short night together as we got in at 200am
then there was the lady who was over medicated or over alcoholed
who began crying after the first plane mishap and they would not
let her back on the plane
she may be the lucky one as she may not remember any of this
what an interesting day it was
and an interesting end to our great wedding journey week
so dont expect me to fly anywhere for awhile
so i did kiss the floor of the terminal when i finally arrived here
the organicgreen doctor
Tuesday, July 5, 2011
gardening, hot dogs, drownings
GARDENING
here is some of my potato harvest from yesterday
notice the duck planking
its safer having the duck plank instead of me
well eat these taters over the next few weeks
we store them in our pantry
and eat them as we need them
after we (i) dug the taters out of the bed
we (i) put down a 4 inch layer of barn yard compost
and put down some pure chicken manure compost
which is rich in nitrogen made from our chickens productions
this was then worked into the soil well then the area
was covered with a layer of newspapers
this then was covered with layers of mulch
i use pine straw
this will be allowed to 'ripen' until next spring when i plant
my spring garden
probably will plant tomatoes or onions in this bed as i rotate
my beds every year when possible to cut down on the
risk of disease transmission
we (i) also planted some amaryth and lambs ear in my wife shes
salad garden
these are plants that you can eat the leaves in your salads
the hotter it gets the better it grows
we (i) have to water them 2-3 times a day while the seeds are
germinating and growing
we also add malabar spinach which loves the hot weather
also added to our salads in the summer are arugula and pursalane
and swiss chard
all of these like hot weather and are all good together with our
maters and onions and basil in our salads
so this is whats in our summer seasonal salad garden
in a couple of months it will time to start the fall and winter
salad gardens with lettuces, spinach, and salad mixes so
we can have salads from our garden all year round
i watch what the local farmers are selling at the farmers market
each season and i try to grow what they are growing
figured they had already figured this out and they knew what
would grow in this area
also in this area its time in the next 2 weeks to plant your fall
tomato crops
remember the fall may the best time to grow tomatoes
some nurseries will have transplants available
you must provide shade and water for them to get them
through this hot weather
i use shade cloth i get from the local nursery but you can use
anything to provide the shade
HOT DOGS
so that guy ate 62 hot dogs in 10 minutes
that 6 dogs a minute
(i have trouble eating one hot dog)
thats 20000 calories in 10 minutes
thats enough calories for a month
bet he had a bad night and a real bad day today
what people will do for $10000
the black widow won the womens contest by eating
40 dogs in 10 minutes
she a short skinny girl
wouldnt want to have to take her out to eat
will admit it was hard to watch them eat all those dogs
this year i got nauseated watching it
so i dvred for a later viewing
DROWNINGS
weve seemed to have more drownings this summer than usual
maybe more people are swimming because of the oppressive
heat
please be careful
no more this summer
the organicgreen doctor
here is some of my potato harvest from yesterday
notice the duck planking
its safer having the duck plank instead of me
well eat these taters over the next few weeks
we store them in our pantry
and eat them as we need them
after we (i) dug the taters out of the bed
we (i) put down a 4 inch layer of barn yard compost
and put down some pure chicken manure compost
which is rich in nitrogen made from our chickens productions
this was then worked into the soil well then the area
was covered with a layer of newspapers
this then was covered with layers of mulch
i use pine straw
this will be allowed to 'ripen' until next spring when i plant
my spring garden
probably will plant tomatoes or onions in this bed as i rotate
my beds every year when possible to cut down on the
risk of disease transmission
we (i) also planted some amaryth and lambs ear in my wife shes
salad garden
these are plants that you can eat the leaves in your salads
the hotter it gets the better it grows
we (i) have to water them 2-3 times a day while the seeds are
germinating and growing
we also add malabar spinach which loves the hot weather
also added to our salads in the summer are arugula and pursalane
and swiss chard
all of these like hot weather and are all good together with our
maters and onions and basil in our salads
so this is whats in our summer seasonal salad garden
in a couple of months it will time to start the fall and winter
salad gardens with lettuces, spinach, and salad mixes so
we can have salads from our garden all year round
i watch what the local farmers are selling at the farmers market
each season and i try to grow what they are growing
figured they had already figured this out and they knew what
would grow in this area
also in this area its time in the next 2 weeks to plant your fall
tomato crops
remember the fall may the best time to grow tomatoes
some nurseries will have transplants available
you must provide shade and water for them to get them
through this hot weather
i use shade cloth i get from the local nursery but you can use
anything to provide the shade
HOT DOGS
so that guy ate 62 hot dogs in 10 minutes
that 6 dogs a minute
(i have trouble eating one hot dog)
thats 20000 calories in 10 minutes
thats enough calories for a month
bet he had a bad night and a real bad day today
what people will do for $10000
the black widow won the womens contest by eating
40 dogs in 10 minutes
she a short skinny girl
wouldnt want to have to take her out to eat
will admit it was hard to watch them eat all those dogs
this year i got nauseated watching it
so i dvred for a later viewing
DROWNINGS
weve seemed to have more drownings this summer than usual
maybe more people are swimming because of the oppressive
heat
please be careful
no more this summer
the organicgreen doctor
Monday, July 4, 2011
fourth, highlights
FOURTH
todays the fourth of july
i know its all about picnicing and fireworks (not here
this year as all the fireworks are cancelled because of the
severe drought)
but today is the day the declaration of independence was
approved by congress on july 4, 1776
most of us havent read it and know most politicians
either havent read it or they definitely dont remember
its contents
maybe we should all take the time and read it again
be safe today
enjoy the day
remember why we have this holiday
HIGHLIGHTS
the highlights of our recent wedding week were
of course just being in santa barbara think-divide our temps
here in texas by 50% and those are the temps
sure would feel good today
seeing the dreier museum and holding babe ruths bat
priceless
and of course all of the other stuff we saw there
meeting and getting to stay with a couple whos a friend of my
daugtherinlaws family she and getting to know them and
spending time with them
thanks again to jm and d
i got to meet one of my blogging buddies
she is lk who writes the lks grab bag blog which is one of my
favorite blogs i follow
she wrote an article in february about my blog and my dealing
with my diagnosis
she writes every sunday
interesting blog
her daughter was the maid of honor for my daughterinlaw she
we read each others blog but have not ever met
now we have
the rehearsal dinner set up at my wet suitcase sisterinlaws house
was amazing
she did such a good job of helping us host the dinner
thanks again
then of course the highlight of the week was the
memorable wedding day
again what a beautiful wedding
the organicgreen doctor
todays the fourth of july
i know its all about picnicing and fireworks (not here
this year as all the fireworks are cancelled because of the
severe drought)
but today is the day the declaration of independence was
approved by congress on july 4, 1776
most of us havent read it and know most politicians
either havent read it or they definitely dont remember
its contents
maybe we should all take the time and read it again
be safe today
enjoy the day
remember why we have this holiday
HIGHLIGHTS
the highlights of our recent wedding week were
of course just being in santa barbara think-divide our temps
here in texas by 50% and those are the temps
sure would feel good today
seeing the dreier museum and holding babe ruths bat
priceless
and of course all of the other stuff we saw there
meeting and getting to stay with a couple whos a friend of my
daugtherinlaws family she and getting to know them and
spending time with them
thanks again to jm and d
i got to meet one of my blogging buddies
she is lk who writes the lks grab bag blog which is one of my
favorite blogs i follow
she wrote an article in february about my blog and my dealing
with my diagnosis
she writes every sunday
interesting blog
her daughter was the maid of honor for my daughterinlaw she
we read each others blog but have not ever met
now we have
the rehearsal dinner set up at my wet suitcase sisterinlaws house
was amazing
she did such a good job of helping us host the dinner
thanks again
then of course the highlight of the week was the
memorable wedding day
again what a beautiful wedding
the organicgreen doctor
Friday, July 1, 2011
wedding journey the wedding day
WEDDING JOURNEY THE WEDDING DAY
so todays the day
we slept better last night thanks to jm and d
their house is on the top of a hill overlooking santa barbara
what an amazing view overlooking santa barbara at night and
in the am
(their house was burned in the fires that swept through here and
they lost everything in the house
they have only been back in this new house for a few months
they rebuilt it to be just like the old one
again they probably saved our wedding weekend for us
thanks again jm and d)
so we got dressed and went back to the apartment to drop
me off
my wife she and her mom did the makeupprettyingup thing
and was gone until time to get ready for the wedding
not sure what they did for all of those hours but sure am glad
i wasnt with them
here is another good thing from a bad thing
i sat and talked to one of the groomsman who lives
in austin
if not for that mishap with the rooms i would never have
got to sit and talk with him
well hes an organic green gardener so you know we spoke
the language and spent an hour talking about gardening,
looking at pictures of his landscaping, hardscaping,
and garden
we use the same organic green nursery in austin
yep a bond was formed that afternoon
then
the guys walked downtown to watch the summer soltice parade
which was so good this year
think mardi gras atmosphere in the daytime without everyone
drunk but with everyone having a good time
(it was a green parade as all mechanization to move the floats etc
was done with human power)
was sad i couldnt stay to watch all of it but we had something
better to do that day
so got on my tuxedo and it did not hurt at all
the black suit made my white hair stand out
my wife she looked fantastic
almost didnt recognize her after the makeup and hair fixing
we made to to the wedding ok
dang everyone in the wedding party looked so good
am glad they took all the pictures first as i dont think they
could have got them done after the wedding
ok i know its my oldest son hes and my oldest sons fiance
shes wedding but what a great wedding
the weather was perfect
we survived the wedding week
everything is turning out perfect in the end
the bride and goom look fantastic
the bride was given up by her mom as her dad had
died from a lengthy illness
(she gave her up very reluctantly i might add-
she was stuck to my new daughterinlaw shes shoulder to
shoulder with velcro)
luckily my son had met him and got to know him and got to be
there for emotional support as his disease progressed
my son got to ask her dad for permission to marry his daughter
my son was given the ok
just wished her dad could have been there
this was the time at the wedding when i cried the most
the ceremony was so good
the minister was so good and made every one comfortable
with his wit and humor
the people there were a mixture of religions from around
the world
the scripture read was one that one would not realize was out
of the bible and was so appropriate to marriage
for the wedding vows my now daugherinlaw she read her vows
wow she may turn out to be a good one after all
can tell they both love each other
my son the groom when he got to read his vows
reached in his pocket and pulled out his iphone
and clicked on his posting and read his vows from the phone
well we are in a new technological age arent we
what a great ceremony
what a great toast from my youngest son as the best man
ok so my wife she and i cried again when he did that toast
the bride and grooms speech was equally as good
the food was great
the band was great
the family and friends seemed to have a good time
what a great wedding and reception
the journey is not over though as their journey
has just begun
a toast to my oldest son he and my new daughterinlaw she
we wish you the best
may you have a happy life together
(a special thanks to
my motherinlaw she for allowing us to take over her apartment
jm and d for allowing us to use their home to rest our tired heads
my wet suitcase sisterinlaw for setting up and having such a
great rehearsal dinner)
the organicgreen doctor
so todays the day
we slept better last night thanks to jm and d
their house is on the top of a hill overlooking santa barbara
what an amazing view overlooking santa barbara at night and
in the am
(their house was burned in the fires that swept through here and
they lost everything in the house
they have only been back in this new house for a few months
they rebuilt it to be just like the old one
again they probably saved our wedding weekend for us
thanks again jm and d)
so we got dressed and went back to the apartment to drop
me off
my wife she and her mom did the makeupprettyingup thing
and was gone until time to get ready for the wedding
not sure what they did for all of those hours but sure am glad
i wasnt with them
here is another good thing from a bad thing
i sat and talked to one of the groomsman who lives
in austin
if not for that mishap with the rooms i would never have
got to sit and talk with him
well hes an organic green gardener so you know we spoke
the language and spent an hour talking about gardening,
looking at pictures of his landscaping, hardscaping,
and garden
we use the same organic green nursery in austin
yep a bond was formed that afternoon
then
the guys walked downtown to watch the summer soltice parade
which was so good this year
think mardi gras atmosphere in the daytime without everyone
drunk but with everyone having a good time
(it was a green parade as all mechanization to move the floats etc
was done with human power)
was sad i couldnt stay to watch all of it but we had something
better to do that day
so got on my tuxedo and it did not hurt at all
the black suit made my white hair stand out
my wife she looked fantastic
almost didnt recognize her after the makeup and hair fixing
we made to to the wedding ok
dang everyone in the wedding party looked so good
am glad they took all the pictures first as i dont think they
could have got them done after the wedding
ok i know its my oldest son hes and my oldest sons fiance
shes wedding but what a great wedding
the weather was perfect
we survived the wedding week
everything is turning out perfect in the end
the bride and goom look fantastic
the bride was given up by her mom as her dad had
died from a lengthy illness
(she gave her up very reluctantly i might add-
she was stuck to my new daughterinlaw shes shoulder to
shoulder with velcro)
luckily my son had met him and got to know him and got to be
there for emotional support as his disease progressed
my son got to ask her dad for permission to marry his daughter
my son was given the ok
just wished her dad could have been there
this was the time at the wedding when i cried the most
the ceremony was so good
the minister was so good and made every one comfortable
with his wit and humor
the people there were a mixture of religions from around
the world
the scripture read was one that one would not realize was out
of the bible and was so appropriate to marriage
for the wedding vows my now daugherinlaw she read her vows
wow she may turn out to be a good one after all
can tell they both love each other
my son the groom when he got to read his vows
reached in his pocket and pulled out his iphone
and clicked on his posting and read his vows from the phone
well we are in a new technological age arent we
what a great ceremony
what a great toast from my youngest son as the best man
ok so my wife she and i cried again when he did that toast
the bride and grooms speech was equally as good
the food was great
the band was great
the family and friends seemed to have a good time
what a great wedding and reception
the journey is not over though as their journey
has just begun
a toast to my oldest son he and my new daughterinlaw she
we wish you the best
may you have a happy life together
(a special thanks to
my motherinlaw she for allowing us to take over her apartment
jm and d for allowing us to use their home to rest our tired heads
my wet suitcase sisterinlaw for setting up and having such a
great rehearsal dinner)
the organicgreen doctor
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