its a guide on what to do

ITS A GUIDE ON WHAT TO DO
i get questions all the time about what to do about memory problems
in a family member
a friend
a neighbor
the person asking the question
what do i do


this week the texas dept of health came out with clinical guidelines
for evaluating and treating dementia and memory loss
click on the far right pdf file

i highly recommend that if you are in one of the categories above
that you take your time and read through the new guidelines

eg
if you have a parent or a spouse who has gone to their doctor
to be evaluated for memory loss
then
work your way through these new guidelines
to be sure that a complete evaluation has been done

these guidelines wont be new to you if you have read this blog
over a period of time
as
i have been preaching these things for the last three years

i am actually on a state committee with the health department that
is working on getting this information to primary care providers
in a easy to use form for their daily practices

the viewpoint i offer is that of a former family doctor who
understands what it likes to be working in the trenches when
in the middle of the busy hectic day as a patient leaves the
room the wife says
you know he cant remember nothing anymore
in medicine we call that      oh by the way
which means thats the real reason they came in
just
stop
take out the flip card
work my way down the new algorithm
and get you the answer to the cause that you deserve


of course treating alzheimers is a bottomless pit
as you know what the end result will be
however
maybe a treatable cause is found like depression low b12
poor controlled blood pressure strokes sleep deprivation etc etc

thats why these guidelines are done
for the provider to follow so the proper workup is done
and
for the patient and family and friends to be sure that
the proper workup is done

nothing is worse than to find a memory problemed patient
who has been treated for years for memory loss
to find that they had a treatable cause

then
of course we are on the brink of finding a treatment for
alzheimers disease

so take the time
click on the new clinical guidelines link here
its the third pdf file on the right

make sure the right thing has been done

as you read the new guidelines you may get lost in some of
the words
dont worry if you are put in a situation where a workup
is needed
youll quickly know what these things are

note ive actually had all of the workup that they recommend
its now all available to you in the private world

dont accept anything less

it now is the standard of care for memory loss in the us
that you should be able to get done anywhere you live

no excuses allowed
from you or your health provider

the organicgreen doctor

best of the best

BEST OF THE BEST

this group of panelists that my rainwater brother and i listened
to last weekend in san antonio at the festival of flowers
are some of the gurus of organic gardening in the state of texas

texas by the way is the leader in organic gardening in the united states
thats better than being the leader in poverty the under insured
poor womens health teenage pregnancy rate etc etc etc

that day in the back of the room
was malcolm beck the true god of organic gardening in texas
he was the inspiration for much that has been done in organic gardening
here in texas over the years

the panel consisted of

bob webster organic nurseryman and radio ktsa550am
organic garden show sat and sunday am

andy chidester the ladybug lady from the lady bug company
an avid organic gardener

mr john dromgoole the god of organic gardening around here
the owner of the natural gardener the nursery to visit in austin
radio host of the longest organic show on radio on lbj590 am on saturday
and sunday am

stuart franke president of the median agriculture products mentioned below

bruce deuley organic rancher and farmer and host of organic matters
on ktsa550am

noel garcia from the texas soil and plant lab
if you want a good accurate soil test send it to him

i always think i know a lot about organic gardening until
i go to this forum each year
then i realize how much i dont know
and
how much these people know
and are till learning

each panelist was asked
and mr webster asks this question each year
usually each panelist gives a different answer

this year they all said that the most important thing happening
in organic gardening was
water conservation

theres a shortage
a drought
we are using too much in our landscape
we are wasting a lot of water

a common solution was improving the soil in the yard
with compost
heavy use of mulch
use of rainwater and rainwater collection

a fear that if we continue to be dry we will start around here at
least to start looking like west texas
dry and almost plantless

an organic garden my use 50% less water as a non organic one

use of xeric and native plants were recommended as much as
possible
these plants are just programmed internally to use less water
and survive here

sometimes i look at my garden
which is of course 100% organic
and
see how well it holds water
and
see all the mulch i use
then
i think about those gardens and farmers
those non organic ones
who just dump stuff on their fields to improve the soil
chemicals that is
how can they replenish so much in the soil that needs replenished
they dont im afraid
and
we suffer
by eating their chemicalized produce
by living near their fields
by their over use of water
by the deplenishing of their soil as evidenced
 by the increase in dust storms in farming areas like west texas
and the mid west
just like in the dust bowl from the 1930s

here at the country n we are doing and using the right things to
improve our soil and to decrease water use

we add compost we make ourselves
we add mulch and lot of it in the hot summer and cold winters
which decreases water loss and makes the soil warmer or cooler
we add organic fertilizers each year
we use only rainwater to water our plants

some recommendations for things im not doing regularly to what
im doing now
is adding humates and molasses once or twice a year
and occasionally adding minerals to the soil
by


humates using medinas humate humuric acid
these humates make it easier for plants to use minerals
hold more moisture and use fertilizer more efficiently
its the humus thats in the soil naturally
weve just all depleted it over the years


molasses using medinas or any commercially available liquid or dry
the molasses provides the food for the bacteria and fungus
thats important for plant growth


minerals need replacing
the best product is greensand which has a lot of these in it

then there are 2 other very important things to add to your garden
love
your shadow

there was a lengthy discussion of gmo seeds
which i wont address much today

i am concerned for the potential disasters that make come
a monocrop of seeds is not good
seeds owed by one or two companies is not good
the seeds are overtaking the wild or heirloom crops by pollinating them
the movement of genes from crops to weeds like resistance to things
like roundup
a super weed may be developed
plus
whats the effect on humans
has the research been done

so
ill add that stuff to my garden this year-humates greensand and molasses
ill keep catching my rainwater
ill not eat gmo stuff when possible-heck we dont know if its used or not in
our food
ill continue to do organic practices
since
it seems to be the least toxic of the approaches
and
its the way our forefathers did it

the organicgreen doctor

its obscene

ITS OBSCENE
thats the best word to describe the $1,000,000,000
thats 1 trillion dollars
 
it is the amount of student debt in the united states
thats guaranteed money for the folks that loan it

there may be no where else in the united states that this exists
not on your mortgage
not on your car note
not on your credit card
well thats another obscene thing

the banks or whoever loaned the money
could care less if the money is paid back
as
its all guaranteed by yes you got it
us
the us government

not like a mortgage or car loan
there is no negotiations of the interest rate or the terms of the loan
or even if you will ever pay it back
you will
it will never ever go away unless you die i guess
then theyll still get paid


so its the debt that your kids are carrying into their future
some of the debt is more than a mortgage
never it seems when you run the numbers ever to be paid off

when i attended college and medical school i sort of did the dave ramsey
method before he even was a financial guru
i went to junior college for 2 years and paid as i went
it took me 4 years to do 2 years as many of the semesters i went
part time
debt starting my junior year was $0

then i went to a four year university now remember this was
40 years ago
i received scholarships grants a few loans and i worked
when i graduated i owed $10,000
it took me 20 years to pay it off
luckily i guess i was able to defer it while i was in medical school
and training

i paid it off just in time for my youngest to start to college

then medical school i didnt have no money to start with
i survived on a brother loan and school loans
then after my first year i sold my soul to the feds
and left school with only $15,000 in debt

i paid it off 20 years later

remember these are 70s and 80s numbers
that was before the laws were against us
and
before the cost of education became so obscene

a relative will be attending a private school whose estimated
yearly cost is $26,000 a year thats $104,000 for 4 years
unless she is on the 5 year plan
which the schools seem to make it happen to a lot of the kids

no you changed majors so those courses dont count
sounds familiar huh
well make it an elective then

hopefully she wont be a school teacher
the starting salary in this area is about $35,000 year
its expensive to live here the closer you get to austin

luckily for her she has a scholarship for $64,000 of that
but do the math and she has to come up with another $40,000
now shes a smart kid thats why she got the scholarship money
and shes a hard worker also so she will work during the year
and the summers to bring that number down

lets presume she borrows money from our vulture system
thats $40,000 in loans
a ten year note at 10% since thats where it appears it will be
by the time she graduates
thats a monthly note of $533
recommended yearly salary to support that is $71,000
total interest paid is $23,669

sure doesnt look like a school teachers salary

now she is luckier than most since she has already dropped
the amount she owes by $60,000
im sure that will go higher but
using her story
im trying to make a point

you and i need to do something to fix all this
as
her generation will be debtors the rest of their lives if we dont

there is no absolutely no incentive for the colleges and universities
to bring down the cost
you are paying the tuition and fees and you and your kids are going
into a debt deep hole that you may not be able to dig out of


whos winning in all this
the banks and loaners as these are the best loans they make
the schools and universities just get bigger and more expensive

excuse me but im on a budget a tight one self imposed and you are
on a budget
im afraid their budget is open ended
that means someones paying and someones making money
and
its not you

so yes its obscene
if we dont do something
this generation is the new debtor class
unable to buy a home
unable to buy a new car
and
worse i guess they will continue to live with you
a very common occurrence
and
may not be able to get  a job that will pay things off
and
make enough to live on

now that sad isnt it
and
its our fault for letting this happen

the organicgreen doctor

they come in 3s

THEY COME IN 3S

have you noticed how things come in threes
like
when a well known actor or actress dies its seems
that not soon after 2 more will die

if one of our cars dies
the other two vehicles die

they seem to have their batteries and tires go out
at the same time

in medicine
we use to say appendicitis came in threes
you get that first one with appendicitis
then you better be watching out
because the next two would be coming along soon
and
it always seemed one of those would be the real tricky ones
like a young kid with appendicitis
or
an old person with a masked presentation

it helps sometimes to say you know these things come
in threes
so watch out


each morning the first thing i do
is make my coffee in my pot which i really havent had that long
of course ive thrown away all my receipts and booklets
and think i bought it at the heb store
but im not sure
i think its about a year old

it works then it flickers and doesnt work
i even took it apart to check for the problem
shook and pushed on all the connections inside there
all were in place
i even wacked it up side the head once when it flickered out
on me when i really needed that 2nd cup that morning

turned it back on
it worked
then
it didnt later

i guess i voided the warranty since i opened it up
and
wacked it

then when i heated up my egg
my wife she the good wife makes me a microwaved fresh farm egg
each night before she goes to bed
then i reheat it in the microwaved the next am

well usually she does
last night she didnt
must have made her mad
guess because i was making light of the little snake that got
in the house
and
the little mouse that ran under her chair last night

see i figure the little snake was doing his job
he was looking for the little mouse
then he would leave and go outside
so
why bother with any capturing those guys

well she didnt think all that was funny
and
definitely didnt agree with my approach
so
no egg for you mr ogd this morning

that morning recently i went to microwave her tea water
i heard this real loud noise in the microwave
it was its last surge of energy before it died

thats appliance number two

now that microwave dying wasnt bad since it wasnt
working that well anyway
i wasnt that upset when it sputtered

so you know what that means dont you
the third one was about to go

so i became real wary


then last friday night i was making our margaritas that we
always have on friday night
we can have two those nights if we like since we dont have to
drive home
we just have get up those long stairs to bed

as i was making that batch of margaritas
i noticed the machine the blender was making the whirling noise
but was not whirling
uh oh here it comes number three
i knew it but why the margarita machine

so i pour all the stuff into a pitcher
it was not all quite ready
there plopped out was a bent mauled lid off the limeade can

dang it
number three was self inflicted

we had margaritas on ice that night
then
off i went on my shopping spree replacing all three on the same day
now
i hope we are safe for awhile from those appliances dying
since
they come in 3s

does this happen to you too

the organicgreen doctor

its not me

ITS NOT ME



glucose metabolism scan


amyloid pet scan

these pictures and scans above

show a normal brain on the left
and
an alzheimers brain on the right

the second one is a glucose metabolism pet scan
glucose is used by the brain cells as its energy source
it shows as the red stuff in this scan

a normal brain uses it everywhere
a diseased brain with alzheimers uses little glucose as
the damaged cells just dont work and cant take up
the glucose

the third picture is a amyvid pet scan
it shows areas where amyloid has accumulated
thats the red stuff
amyloid levels increase as alzheimers progresses

a normal brain has very little amyloid
an alzheimers brain has a lot of amyloid

this weekend i went to a caregivers form
one of the speakers gave an excellent presentation on
the symptoms of alzheimers disease
you know what you see when you deal with someone
who has this awful disease

at the end she showed a picture like the first one
it was sobering to me
to see the normal brain
then see the rat holed diseased alzheimers brain

you realize when you see that swiss cheese brain
why your love one cant remember your name
why they ask the same questions over and over
why you cant reason with them sometimes
why they cant bath feed and care for themselves
why they get angry get aggressive
why they may cry
why they seem to lack empathy they dont understand anymore
     what they say and do can affect someone
why they cant watch movies or finish activities
why they wont or cant eat
why they dont know who you are
why they crap in their pants or pee on things
why they cant remember to change clothes
why they wonder off
why they hoard things
why they take off their clothes or do other inappropriate behaviors

look at those pictures
the brain and its interconnections are just gone

its like the phone service communications electricity during storms
like hurricanes tornadoes floods
all the things that make those things work are just gone

so it is with alzheimers disease
its all gone
but unlike those storm things
the brain cant be fixed
and
it will only get worse

so when you deal with someone with alzheimers disease
or
please oh please
if i end up with this disease
and
you see me like this doing all those things
remember oh please remember

its not me

the organicgreen doctor

victory sign, produce, prune paint

VICTORY SIGN

those of you who have ever been photographed with me
will appreciate this picture

i received in the mail this card
which said inside

i passed by and saw this card and instantly thought of you

i have enhanced or based on your perspective ruined many
a picture with this v sign or rabbit ears over the years

in fact my daughter in law let me know in no uncertain terms
no rabbit ears in the wedding pictures

man that was a real hard one to do
it was tough
sitting through all those photos
but
she did reward me at the end by allowing me
one picture with my using rabbit ears

i googled
 why do people use rabbit ears in photographs

the urban dictionary said it is what third graders do
hum
what do they know

this person a former patient considers it an honor to be
rabbit eared by the ogd

i think it enhances the photo
however
thats not an opinion shared by wife she
or
my daughter in law

what do you think

PRODUCE

i wear a size 13 shoe
this is my largest onion i have ever grown
i call it my 5 lb onion

this since ive done the anthill garden raised bed
using my own chicken generated compost
and
using the planting instructions from the natural gardener
all using strictly organic methods
this will be the best onion crop i have ever produced
200+ of these suckers will soon be harvested

PRUNE PAINT

here is the official word from many arborists and organic folks

here in central texas only paint the limb cuts on red oaks
and live oaks
to prevent the spread of oak wilt disease

all other tree cuts dont need to be painted

also
november december january is the best time to trim
red oaks and live oaks here in central texas

the organicgreen doctor

is the option working

IS THE OPTION WORKING

its the land of opportunity
arkansas
i grew up there and went to medical school and residency there
most of my family lives there
so i think im familiar with the state

its a red state with a touch of blue
a republican legislature with a democratic governor
a republican senator and a democratic senator


thats the right combo i think for a political system
where one party doesnt totally dominant the state
a one party system is not a good thing
whether its democratic or republican
we need that balance that the two parties provide so
we dont get too extreme either way
as
most people are in the middle any way

so when the obamacare law went into effect
most republican states said no to the medicaid option
those billions of dollars that would go to those who
really are caught in no mans land
too "rich" for regular medicaid
too poor for subsidies on the exchanges
they just got left out in those states
those folks who needed it the most


although arkansas is part of the deep south
it has always it seems been a little different at times
from the other southern states
sometimes it will turn blue on issues that wont happen
elsewhere

so
arkansas applied to the feds to be allowed to take the money
for the medicaid extension and put into a private option
for those folks screwed by the failure to accept money like
eg texas and florida and lousiaina etal did

people there were able to buy private insurance with the money


now in the state since this option has taken effect
the number of emergency room visits in the states have
dropped by 2%
and
the number of visits by the uninsured have dropped by 24%
and
one hospital has noticed a 50% drop in the uninsured visits

why
its the private option that the state allowed to occur with the
new obamacare law

according to many hospital administrators in the state the
new private option in arkansas is the deal maker
that will keep their hospital afloat

when i was a resident i use to moonlight in the emergency room
in the area where the emergency room saw a drop of 50%
in the uninsured emergency room visits


its a poor part of the state
on the edge of the delta
real poor
so im not surprised that more folks in that area were benefited
by the private option
as well as a result the local hospitals
which now may survive financial
thanks to the two parties working together to make the system work

so
arkansas arkansas i salute thee

now
if only texas could do the same
maybe they wouldnt be first in  all the bad healthcare stats

heck texas isnt even close to being number one in football anymore

the organicgreen doctor

aichtooh

AICHTOOH
thats the phonetic spelling of h2o
or for those nonchemistry folks thats
water

cactus bloom

in the last two weeks we got about 3 inches of rain
and
for those who collect and especially those of us
who rely on rainwater for our water system
that rain came at an important time
as
we head into our driest time of the year
without that rain the country n owners were looking
at possibly buying water which i hate to do

another type of cactus with flower

now i know most of you buy your own water
but
when you have it delivered in a water truck
you pay $300+ for 3000 gallons

the average homeowner in austin texas uses 7,727
gallons a month

we at the country n use about 1500 gallons a month

if it was delivered that would cost them $0.1 a gallon
so their bill would be $772.70

um maybe that would be a way to curb some of the water
use by raising the cost

plant salvaged from destruction from westwood high school

so i got about 1800 gallons per inch x 3 inches =5400 gallons
of water from that rain
thats $540 if i had bought it

the average homeowner in austin would have sucked that up
and out the drain in about 20+- days

native wildflower firewheel

what made me think about all this
is
austin is about to hit a water crisis soon
they are conserving water fairly well but could do better
this conservation has made the price of water climb
since less water is bought
less money in coming into the city
they have fixed water costs that arent being met well

i say raise the prices
let the market control the water use
not sure if that works well though

salvia greggi or autumn sage

i was at a friends house last night looking at his landscape
he is on the austin water system
he can only water the yard and landscape once a week
it still looks pretty lush
thanks i guess to the weekly watering and the recent rains

he has landscaped away a lot of his grass
and more is planned

he rocked that no mans land between the sidewalk and the
curb which covers half the length and width of his lot
he is on a corner lot

the other no mans land at one side of his house where
no one ever goes
you know most home owners have this spot
he is covering it with black plastic and rocks so he can stop
watering it and mowing it and fertilizing it and deweeding it etc

zexmenia

then i looked at all his landscape
he and the person that helped him choose his plants
did a good job
they are mostly xeric natives
and are in the grow green pamplet from the city of austin 

i reminded him which he didnt know that he could get some
reimbursements and credits on his water bill from all the
landscaping he had done
several hundreds of dollars

now i have the same plants he has minus a few that tend to
not do as well here
like indian hawthorne magnolia tree etc

crossvine

he waters his plants
yes they look good
but so do mine
in fact they look the same

my water use on my landscape is zero
his well he is an average austin homeowner

he could cut off the drippers to all of his landscape
and only water them during all the real dry times
or
not at all
he would have to accept some browning of some
of the plants when it gets real dry
but
these xeric native plants dont die

thistle

i have a solution
only xeric natives can be planted
no supplemental irrigation is allowed
unless
its provided from rainwater collected off the roof
a requirement that should be made when homes are
built in this area

heck what if all those big mansion high schools that they
build around here were equipped with rainwater collection
systems to collect water for irrigation and flushing toilets

you know we are paying for them and we are paying their
water bills

eventually the added expense will pay for itself over time
either at home or at school

but
i guess nothing like this will happen until its too late
thats what we always seem to do here in america
crisis management

(note these pictures are a few of the flowering plants i have
planted in our yard at the country n
zero nadda no water has been used on these plants)

well here at the country n
we are well ahead of the curve

the only problem is
i may have to buy new fencing to keep people out
i may have to buy guns to protect my water supply
i may have to get another mean guard dog

sure hope it doesnt come to that
we all could just practice conservation
and
collect rainwater

the organicgreen doctor

more questions no answer

MORE QUESTIONS NO ANSWER
this weekend i was on a panel of folks that answered questions
from caregivers and family members about alzheimers
sponsored by the capital area agency on aging

is there treatment for alzheimers disease
sorry
but there is no treatment or cure for this disease

yet
is what i add at the end
to give us hope
and
because i feel like we are getting closer to being able
to answer that question in another way

i look forward to the day when someone can answer that
question by saying

yes there is a treatment or cure for this terrible disease

i would love to be taking a cure pill every day

right now we are just not there yet

as ive written before there are several new treatment studies
using the alzheimers vaccine and the nasal insulin that are
or will be starting up this year

whenever i do these panels or give a talk on alzheimers disease
the audience seems so thirsty for answers to their questions
usually the moderator has to cut off the questions as the
time runs out

ive tried to hang around and answer questions until they
run me off
we were the last to leave there this weekend again

so
i dont have the answer
but i do have a lot of information i can give them
i think that helps them deal with whats happening
in their lives

here is
the link to the 21 question alzheimers questionnaire
the link to the online 5 best alzheimers self memory tests

the link to the alzheimers research center at ut southwestern dallas
the link to the central texas alzheimers association


dont go it alone
dont put off getting an evaluation done

the organicgreen doctor

im not really but

IM NOT REALLY BUT
the next time i go see my primary care doctor
im going to say
i feel sad all the time
i cant sleep at night   now that one is true
i feel an impending doom   now that one is partially true
its called alzheimers disease
im having trouble with my appetite   now that one is true also
but thats due to the aricept (donepezil) im taking
i feel tired a lot   now thats true but thats usually in the afternoon
and evening and again thats from the aricept (donepezil) im taking

now when you look at those symptoms they are when put
together some of the symptoms of depression

now i know that most of my symptoms are due to my aricept (donepezil)
and its side effects
side effects who cares about side effects when it comes to aricept
those side effects are nothing compared to whats looming in the
future
so please dont talk to me about side effects i dont care about them

now i get screened on an annual basis for depression when i have
my 2 hour neuropych exam as part of the adni-2 study that im in
thats alzehiemers disease neuroimaging initiative

so i know that im not depressed
i dont really feel depressed
but
if he asked me questions i would answer them truthfully
mostly
because i might just want to take an antidepressant
maybe a ssri selective serotonin reuptake inhibitor

basically it makes the serotonin levels stay high in the brain

now of course i would want a generic one since its cheap
i dont want to increase the profits of big pharma too much
maybe
one like what i use to order first for depression

citalopram
a 10 mg tablet would cost $6.40 for 30 pills at costco
the brand celexa would cost $157 for those same pills
nice profit huh

why in the heck would i fake depression to just get a depression
pill a ssri one called citalopram

it seems that citalopram and the other ssris by keeping the serotonin
levels up in the brain appear to decrease the levels of beta amyloid
that accumulates there

now its the beta amyloid that bad stuff that accumulates forms those
sticky gooey plaques that leads to the cascade of events that
causes tau protein destruction tangles that leads to or causes
the symptoms of alzheimers disease

wait now i thought that new alzheimers vaccine was going to do
that also

why is this 20 cent pill not been looked at before

they just now did it on rats
yep it worked dropped the bad boy beta amyloid down 40%
wow if it only worked in humans

so why not give it to humans and see if it works
they did
gave it to normal folks and the levels in the brain fluid dropped
by over 25%

wow
now the plan is to give it to folks who hopefully are early in the
disease to see if it drops the levels and substands that low level
over time

wow if that works
lets pour the money into more research to find out if it could
be this simple

first the warning from researches well we worry about the side effects
do more study needs to be done

excuse me one minute here

side effects dont talk to me about side effects
have you mr researcher ever taken aricept for a month
then do it and talk to me about side effects

side effects dont talk to me about side effects
im looking down into my future
if i have alzheimers which i personally feel i do
then whats in store for me and my family over the next few years
is nothing compared to any damn side effects
side effects give me a break

then this is the thing that makes me want to vomit this morning

this drug is a generic drug easily manufactured by many companies
its almost as cheap as aspirin
so
there is no big pharma who will finance the research that needs
to be done to see if this works
folks its expensive to do the research

then thanks to the no good congress who struck out all the
big research monies from the budget a few years ago
there is not enough money available for all the research that needs
to be done

this research on this cheap medicine citalpram was sponsored by
the national institue of health nih and the alzheimers association
yes
that money that you and i paid in taxes
and
you and i donated to the alzheimers asscoiation

now ive stepped down off my high horse
calmed down some

i think i call dr b today
i think i need a medicine for depression
could i maybe try citalpram

hopefully he doesnt read this blog

the organicgreen doctor