bordetella

BORDETELLA

this is a picture of a bordetella bacteria
pretty huh
but boy can it cause us problems
luckily for us there is a vaccine for it
that is given the first year of life and beyond
like a lot of things in medicine though vaccines are not 100%
and
a lot of people dont vaccinate their kids now like
its recommended

this combo makes outbreaks happen frequently across
the united states

oh ths germ is the pertussis or whooping cough germ

easily prevented usually
easily treated with antibiotics to eradicate it
problem is
even when treated especially babies who have been infected
they will remain symptomatic with that cough
some get the barking whooping cough as they try to catch
their breath when they cough

most fatal cases occur in children under 1 year of age

the pertussis is now added to vaccines for all kids and adults
who get immunized for tetanus
in dtap or the tdap vaccines
the ap stands for acellular pertussis
the t for tetanus
the d for diptheria a third world disease

nowadays a third world person can be living or visiting
next door to you or working with you within 1 day of leaving
their country

although we americans are more riskier to each other than
foreign visitors for most of these diseases

my first exposure with bordetella pertussis or whooping cough
was in my residency program
an impressive exposure that i will probably remember even
when i get demented

i had delivered one of the first pregnant patients that i had followed
through out her pregnancy
the beautiful little baby at about 3-4 weeks of age
before the first pertussis shot was given
became ill with a runny nose and a cough that worsened and
worsened

she was eventually admitted to the childrens hopital where i trained
arkansas childrens hospital
because she would turn blue with the coughing fits her oxygen levels
would drop significantly and she couldnt feed well

once the diagnosis of whooping cough was made
not as easy at that time
now a nose swab or blood test can help make the diagnosis
she was treated with antibiotics
erythromycin at that time
now they use zithromax better known to adults as zpack
the most overused antibiotic in america
the erythromycin was tough to use as it made people nauseated
and vomit a lot

after discharge she coughed impressively for months
even at her 9 month old well child exam
she still coughed a lot
and her face would get these small petechiae on her that made
her face look red and bruised

i followed her for another 2 years and she turned into a cute
3 year old kiddo
but
her case left an impression on me
that lasted throughout my career
and made me such an advocate for vaccination especially the
pertussis one

i never had anyone with pertussis or whooping cough that bad
for the rest of my career
thank goodness
not sure how i would have handled it as a parent

so how can you not get pertussis or whooping cough
remember most people who get this disease do well
except
babies less than 1 year
adults over 60 years old
and
immunocompromised folks eg cancer patients hiv patients
transplant patients patients on immunosuppressive drugs
like those with rheumatoid lupus crohns etc

the number one thing to do is get immunized
get your child immunized with the childhood series that starts
at 2 months of age
get the 4 year old dtap
get the 10 year old tdap
then get the tdap every 10 years
i got my tdap 3 years ago

if you are pregnant yours should be up to date
and
anyone who will be around your baby a lot should get
immunized like grandparents neighbors siblings parents aunts
uncles etc

if those around the baby are immunized the chances are less
that your baby will get the whooping cough

if you are exposed you probably dont need antibiotics
if you become symptomatic and have the infection
a course of antibiotic will stop the infection to make you
less contagious
but more than likely will not stop your symptoms
that cough barking for some has to run its course

the time for us to get paranoid about this disease is before
it happens

another preventable disease that we should be seeing less of
in the united states
but we dont

a relative infant was admitted this weekend
at the same hospital where that impressive whooping cough
patient spent days 25 years ago
from reading the story of his illness and seeing pictures
he should do fine and recover without any long term effects
nothing anywhere close to what my first patient had

what is really going for this child my relative
is that the mom took care of herself during pregnancy
eating correctly and living correctly
breastfed her child and continued the good living while
breastfeeding
this for infants is the same for adult
proper diet and healthy living keeps us from getting ill
but when we do we get a less severe illness and  recover faster

this is a good time to educate people about this disease
bordetella pertussis or whooping cough

the organicgreen doctor

who i am

WHO I AM
kenny chesney wrote this song
this son put it to a video of his father
i watched it and cried
i watched it again and cried again
ok i cried again this morning again

if you have had a family member fade away
watch this video

each time ive watched it
i go deeper inside myself
thinking about the past and the future

or
click here to watch while he still knows who i am

the organicgreen doctor

the pill

THE PILL
when i write the pill
the first thing you think about is the pill
you know the one that the supreme court is trying
to decide if insurance has to cover
why in 2014 are we having this discussion

however thats not the new pill that im writing about


i have a long time love affair with chocolate
with my most favorite source being a snicker bar
i know they added all those peanuts and sugar and fat
but it satisfies my sweet tooth more than anything

if fact my dentist who has gotten wealthy off me over
the years
and
he really encourages me to eat more of them
not really
but i wonder when i write those checks for root canals
and fillings and crowns

my mother in law works for sees candy in california
and
has a ready access to lots of chocolate of different sizes
and shapes
my favorite is what i call the chocolate cream ones
i know thats the ones she sends because the box
is so darn heavy

however my biggest problem with chocolate nowadays
is sleep
yes i said sleep

there is a lot of caffeine in chocolate especially dark chocolate
my favorite
when you add that to my 2 cups of coffee a day
the caffeine level in my blood stream goes up
plus me like many of you cant  just eat one of those sees candies

add the effect of of the aricept (donepezil)
which knocks off about 2 hours of sleep a night
when i chocolicize myself
i dont hardly sleep at all when im on a chocolate binge
not hard to do when you are faced with a box of chocolates
from sees

life is like a box of chocolates
you just have to take it all in

now mars candy the ones who make my favorite snicker bars
ok sees is right up there with them
has decided to finance a study to see if chocolate can improve
heart health
it already seems to help some with alzheimers disease
so
i try to treat myself everyday

in the study they will extract flavanols from chocolate and give
it to volunteers
maybe i want in that study
the problem is its in a pill
how good can that look in a box
and
the taste wont be there
the pleasure of the flavor not flavanols wont be there
and
the slight rush and burst of energy from the caffeine
wont be there

somehow all this just doesnt seem right to me
its like when they extract vitamins etc from vegetables and fruits
and we take it as pills
however
the health benefits arent there in the pills vs the eating the real plants

maybe thats the way it will be with these new chocolate pills

i say
no pleasure
no benefit

the organicgreen doctor

pinned

PINNED
ive been pinned
no
my wife she is not holding me down
although sometimes she would like to
just duct tape me to the floor she would
and
leave me there for awhile
to pay me back for those things i do to her to make her
so mad sometimes
happy birthday today

i recently got on pinterest to post my blogs
thats all i ever do is post my blogs
then today someone pinned me
it didnt hurt a bit

its an interesting pinning actually
as you can see all the different raised beds made in a
keyhole fashion

if you ever thought you wanted to do one look at this sites link
and read about the different ones that are pictured

here is the link to this pinterest site
click on the picture and read the blog about the keyhole
garden i did from the old water trough

heres the picture

http://www.pinterest.com/rcdouglas/garden/

one of the big issues gardening in this area is water conservation
since i use rainwater as my only water source
i try to conserve as much as possible
the above picture is an example of a keyhole garden
that does that

this photo has not been pinned but its of interest
this bed originally was made by
laying down newspapers
plopping down about a foot deep of the lady bug
brand of hill country soil
which has everything in it you need to start gardening right away
so thats what i did
adding compost every year
so that over time the height of the bed rose some
however
i noticed that when thing got hot and a little dry the bed just
didnt seem to hold the moisure like the deeper beds did
so

enter the anthill or hugelkulter garden beds
i dug the 8ft x 4ft bed down to a depth of about 16 inches
running into soil that wasnt very good
i removed it
added cardboard my wife she got from her school
she scrounged from whole foods
i got from habitat for humanity builds
and
cardboard well seasoned that had been in our barn
for 12 years accumulating whatever unidentified stuff
that was in it

at the habitat for humanity builds i am known as a
dumpster diver

then i took my old financial records that i didnt want anymore
and didnt want to pay to shred
dumped them in the bottom of the hole

then i added the trunk from a peach tree i cut down
limbs from that tree
limbs and twigs from a small hackberry i cut down at
a habitat for humanity house i was working on

then i added compost from my chicken run that was two
years old and had a lot of twigs and debri in it

then i added a thick layer of the leaves that many of you
have given me over the last year
darlene dee kirsten and dee mark and debra and many
of their neighbors

then i added some of the dirt back that i had dug out
of the bed

then i added more of the compost from the chicken run

then i added some newspapers

i stomped this all down real good as i did the layers

then i added compost again
then i added the rest of the dirt
then i added 4 inches of the rich compost from inside
of the chicken coop real rich stuff
then i added several handfuls of lady bug brand organic
fertilizer
then i added a dusting of cottonseed meal

then around this bed
i had saved the logs from a large tree we had cut down
at a habitat house to use as a border to help hold up the
soil and give the garden bed more depth
which is now at close to 3 feet deep

i have planted 4 tomatoes in this bed
those lucky guys those 4 tomatoes
so much nutrition in there
and so much moisture holding capacity

i also added earthworm castings to the planting hole

i also made the bed concave ) so that it would be like
a bowl to catch as much water as possible
this is an idea i picked up from doing the funky chicken tour
in austin last year
when a local chickener who had a neighborhood garden
explained to me in detail how she did her garden

the old tree trunks make a good sitting down spot
to rest and work in the garden and
to just enjoy sitting and looking around the garden

the white material is row cover which i use to cover
over 5 gallon buckets to protect the tomatoes when
it gets cold
yes there will be another freeze where i live this spring

so thats a hugelkulter garden bed organicgreen doctor method
that has used recycled materials
most of which would have ended up in the landfill
that will be a water conserving monster
producing i hope big juicy tomatoes in a few weeks

now all my beds in my garden
all 400 sq ft are made this way
hopefully in our drought ridden area this will help a lot

fyi here is my first crop of asparagus
most of which never make it inside the house

the oganicgreen gardener

dreamified

DREAMIFIED
i am on a run of dreams
that occur now when i nap and when i sleep at night

they are all triggered from the side effect of aricept (donpezil)
that i take for possible alzheimers

i don t know why they have increased in degree lately
and why they are so vivid
ok i dont really care
as generally i enjoy them as usually they are pleasant
and nondisturbing
usuallly

a google search found one researcher who
said it activates the visual association cortex during rem sleep
boy does it ever make stuff real vivid

like last week when that lady dressed like an antebellum southern
belle who was like a witch
was drifting along the walls of our bedroom
i tried to warn my wife she but i couldnt wake up enough
to yell and scare that wench away the bellle not my wife she

i was paralyzed it felt like but i woke with a start
swinging my arms and yelling hey hey get the hell out of here

i turned over and there my wife she was
sound asleep
i didnt need to make such a scene after all
so
i went back to sleep

so the donepezil enhances the rem sleep to make things
more vivid
think legal lsd
tripping out every night
heck
last night i was stuck on this pedestal over the ocean
it was real high
too high to jump
but i had to get down because the time was out and we
all had to leave
why i was there and why we had to leave i dont know
just tripping was all i was doing

taking it in the morning makes it less likely to occur
wait i already take it in the morning
wow what dreams i have at night though
so vivid
and
lately my noon naps are good ones also
makes me looking forward to the next episode
you know like true detective or something

heck
last week we were staying at this house
the house was my parents house
but not really it was a house we lived in just north of here
for a few years
but not really that one but another larger one
then
this marauding motorcycle gang came by with their
machines aroaring
but they were all in suvs instead of cycles
they chased us into the woods
luckily for us
i woke up and no one got hurt

then the other night i was working at the last clinic i worked
at when i retired
and some of the doctors were conniving to get rid of me
because they heard that i might have alzheimers disease
and was on aricept
they didnt want the stigma of having me around
so
they were trying to force me out
but
i beat them
i woke up and they all went away

why am i writing about this
if you have a love one on this drug
be aware how confusing it may be for them if they are
more advanced than i am
they im sure will get these dreams interwoven in with reality
and may not be able to tell the difference

plus
one of my goals of this blog since i am so early in the disease
is to let you know what happens in the brain
what your loved one may be thinking
what effect does this have on you the patient
no one really has written about all this before

i have time
as i expect things will progress slowly
to let you know
whats happening upstairs in this brain
and try to put in on paper or on this page

whoa what was that over in the corner of the room
that just flashed and went away
am i in rem sleep or what

oh whew it was just my verizon card flashing letting
me know the signal had dropped off

sometimes this all seems strange at times

but i plan on dreaming on
let you know when they are good ones

the organicgreen doctor

busted again

BUSTED AGAIN

my younger son was here visiting this weekend
since we both love basketball
we spent most of the weekend watching games
and
well like i usually do
napping

i told him you came all the way home to watch me sleep
he said
whats so different about that

we did watch a lot of the games

my brackets were done
no i didnt make that billion dollar bracket
some  poor guy has picked all the games so far
but
he forgot to enter the billion dollar bracket
but
the odds apparently are infinitesimal to win it
so
i dont enter that one

my bracket has gotten busted down
to four teams on the left side
and
four teams on the right side
with
3 of 4 of my final four teams are still intact
thats virginia florida louisville
that michigan team that beat texas sure looked good
maybe next year horns

what the heck is a shocker anyway
i knew wichita state wasnt going to make it through
you just cant win all your games in a year
just like that billion dollar bracket
its not going to be done

so on to next weeks games
the games just get better and better as they get closer
to the final game
however the wichita state north carolina game was a good one
those tar heels that are one and doners seemed to have
gotten good at the right time
guess its called nba draft prep

enjoyable weekend
thanks for all the birthday wishes

then theres the womens tournament
in case you didnt notice started this weekend
they are trying to fit in to a good time slot arent they

they would do well to wait after the mens and then have theirs
since that will be a dry hole time for sports

texas longhorns women won i noticed this am
guess ill try to follow them as far as they go

busted bracket
thats what i have
just like last year

the organicgreen doctor

whats the price

WHATS THE PRICE
in the next 2 years several alzheimers disease studies will be started with
different criteria for who gets in them
most of not all will be given a new biological infusion called
solanezumab

this will be given monthly for 3 years
it works by binding with antibodies to beta amyloid the sticky stuff
that accumulates in the brain
that  is thought to be the cause of alzheimers disease

the beta amyloid  is then removed from the brain
if it works it will slow down the disease
or
if we are all lucky cure the disease

there are several diseases now that use the same approach for
treating them
one eg is rheumatoid arthritis
patients may get an infusion of biologicals every 1-2 months
with names like infliximab or adalimubab
thats remacaide and humira

cost of getting infusions for a year are $10,000-$30,000+

note the similar sound to their generic names to the new drug
for alzhiemers disease that will be used in these studies

the drugs for alzheimers disease used now
remember they only treat the symptoms
not the disease

these prices below are for 30 days treatment
cash prices from costco pharmacy

donepezil generic aricept $11.41
aricept brand                  $417.67
aricept 23                       $388.90 this was designed after the aricept
went generic and the price plummeted for the generic
folks dont let doctors put your family on aricept 23
its the things big pharma does when their drugs go generic
it doesnt work any better
and it cost you hundreds more a year

rivistagmine generic exelon $52.64
exelon brand                       $226
exelon patch                       $352.25
its no better than donepezil
its used instead of donepezil when donepezil causes stomach issues

for me
my stomach issues improved after 30 days and i was able to tolerate
the donepezil

namenda for now its brand is only $328.08
later this year a new product will be introduced called
you got it namenda xr
sounds familiar
the patent on namenda is going out next year
then other companies can make it

it will not work any better than namenda or the new generic
namenda
you know the cost will probably be in the $300-$400 a  month price range

namenda is usually added to the donepezil when the donepezil
loses its effectiveness later on in the disease
or
some are taking it with donepezil as soon as the diagnosis of
alzheimers is made
i have opted not to do this combo yet
when it is needed i probably will not be capable of making that
decision

if you presume all patients with alzheimers disease in the united states
are on donepezil
5,000,000 people have this disease now
thats $57,000,000 a year for the generic drug
add namenda to them
thats $1,640,000,000 a year more

now
we know this new solanezumab that will be used in these new
alzheimers disease trials will be expensive
if it works all those newly early diagnosed patients will be getting it
and
those of you who are young and who are tested for alzheimers disease
will probably start this drug early in life
maybe in the 40s
and will take it for the rest of your life
if you want to slow the disease down

cost im presuming for a years treatment will be $20,000-$30,000+
a year
we are talking about 20 years of people who will be told you will get
alzhiemers disease
there will be millions of people wanting this drug

if you multiple the cost times 5,000,000 people an underestimate
thats $150,000,000,000 a year for this new drug

but can we afford as a society to spend that amount of money
each year to prevent or treat this disease

that 150 billion dollars just so happens to me the amount
that medicare and medicaid spends now each year on
alzheimers disease patients

interesting huh
and
that does not include what private health insurance pays what long term
care insurance pay and what we all pay out of our pocket

its a financially devastating as well as socially devastating disease
but
can we afford these new treatments

well
maybe we can

lets just hope that in the next 3-5 years that this new drug
works to slow down or stop this disease
so that we can answer this question

the organicgreen doctor

amplify

AMPLIFY

amplify means make larger or greater

over the next 24 hours amplify austin will do that
for nonprofits

we all whine about taxes that are used for things we arent
interested in and dont want our money used for
i do it and im sure you do it

donating to a nonprofit is a way to direct your money to
an organization that promotes what you believe in

for my wife she and i  we direct our charity donations to
the alzheimers association
and
meals on wheels williamson county
in fact if you click on these two items you can donate
via amplify austin 

the way this works
its a 24 hour fund raiser done on the internet for nonprofit organizations
there are over 400+ listed
you can find one im sure that you believe in like i do for the two
i donate to
then
you can donate online

last years goal was $1,000,000 but they raised $2,700,000+
this years goal is $4.000,000

go to this link i live here i give here
read about amplify austin
click on nonprofit
find the one you like and support
make a donation
minimal donation is $10
as you can see the clock is ticking when you go to the website
dont let the time run out on your donation

amplify what you believe needs support
with your donation today

the organicgreen doctor

me bad

ME BAD
yesterday it was longevity
today it is me bad
thanks to kja from facebook



the most you can get is $81.50
now if you are a pk like i am
thats preachers kid
your score should be high also

now if your score is real low
well then i guess you havent lived life enough
or
one of your parents wasnt a preacher

my score was respectable for a preachers kid
$63.50

the organicgreen doctor

longevity

LONGEVITY
i  have written several times about what you can do to live
longer
eat right stop smoking drink moderately exercise sleep well
keep weight down control blood pressure control cholesterol
control diabetes be happy

now an insurance company has created a calculator
where you put in your age
answer questions about your health
then it makes adjustments on your longevity
ie that activity could make you live longer

here is the link to the longevity calculator. click on it
and
answer the questions and see how life style changes
can affect your life

so i went to the website
typed in my age and sex
78
doesnt leave me much time does it

typed in my ht and wt
bmi 26
ok so my pants have got a little tighter since i retired
oops lost 1 year
77

no history of heart disease before 55 in a family member
gained 2 years back
79

blood pressure under control with medicine
79
if i didnt have high blood pressure it would be 82

stress not a issue
gained a year
80

exercise every day
gained 2 years
82

eat 5 fruit and vegetables a day
gained 3 years
85

wear my seat belt
gained a year
86

driving record for accidents is clean
well in the last three years
gained a year
87

drink less than two drinks a day
gained another year
drink too much and you lose 4-7 years
88

dont smoke
gained two years
90

dont use recreational drugs
seems willie lost some on this one
gained a year
91

so if i do those healthy things that i recommend that you do
i can increase my longevity by 13 years
if i lose those love handles i could gain a year

so i recommend that you click on the longevity calculator game
and
calculate how you are doing
see what a life style change could do for your health

when i looked at this though
i thought
what if it asked are you at high risk for alzheimers disease
i would lose all those years and more
no way would i make it to 91
however
it would slow down the progress of the disease
and delay its onset

try the calculator
put your partners information in there
so
you have something to use to encourage them

the organicgreen doctor