my story revisited 13

MY STORY REVISITED 13

after i had stopped practicing medicine i heard from a lot of my patients via this blog facebook twitter private email messages sent via the clinic and letters
i had sent out a letter to all my patients explaining why i had discontinued practicing medicine

after my diagnosis and subsequent discontinuing my practice my readership on my blog increased dramatically so i added the blog below to review how i got to that point

i had made the decision years before when my mom was diagnosed and especially when my younger brother was diagnosed
i didnt want to be practicing medicine if i had the potential to cause harm to anyone

when i mention below my close relative it was my younger brother
i at that time didnt have his familys permission to write about him specifically
later they gave me the ok
they felt like i did that anyway you can promote awareness of alzheimers disease then do it
i also got permission from my older brother to write and talk about his issues with his memories
he even sent me the scans and labs that were done on him when he had his workup

i really thought that when i was diagnosed 8+ years ago that i wouldnt be able to sit here today and write this
i thought i would probably be where my younger brother was when he was diagnosed
im not there yet
im grateful im not

i realized after i moved here from texas and had to find a new primary care doctor a new eye doctor a new neurologist how important and close you feel to your doctors
i realized how big a void i left in a lot of folks lives and their families

i apologize for that
i have appreciated the messages i have gotten over the last 8+years from former patients
like the one i included below

as i wrote back then
i dont know where i would be in a few years
i would be worse or better or the same
well it looks like so far im better

at the time i was diagnosed it was made by taking my medical history and strong family history of alzheimers disease along with a normal memory test followed by several months later an abnormal memory test to make my presumed diagnosis

now in 2019 its those things plus new things to make a more definitive diagnosis
my genetic test for apoe 4 apoe4 thats known as the late onset alzheimers gene was positive
my spinal fluid was positive for abnormal levels of amyloid and tau
my amyvid pet scan for amyloid was positive
if you have alzheimers disease that will be positive

so today
i know for as sure as one can know that i have alzheimers disease

we know
we plan
we enjoy life

thanks again to all my former patients who have reached out to me


01-07-2011

MY STORY REVISITED
because of the increased viewers of this blog i will
revisit my story

i am a family physician

one year ago while buying long term care insurance i had
a normal memory evaluation

a year and a half later i underwent an evaluation to be in an
alzheimers research study as a control subject

i wanted to be monitored annually so that if i developed any
symptoms of alzheimers that i would know and would
know to stop practicing medicine

a neuropsychological evaluation done for that
showed changes in short term memory that were abnormal
for my age and occupation

looking back i had noted some changes but no one
else had

my mother had alzheimers disease and a close relative has
azheimers disease

my diagnosis was made as early mild cognitive impairment
amnesic type
it is thought to be a precursor to alzheimers disease

a normal evaluation, then a year later an abnormal test  plus
the changes i had noted plus my strong family history made
this clinical diagnosis

there is not a definite test for alzheimers -it is made as a
clinical diagnosis early into the disease

my decision and along with my neurologists decision was that
i start aricept (donepezil)-my mother was on it and my relative
is on it-to slow down the progression of the symptoms which can
progress slow or fast

however nothing slows down the disease
(see blog on napa 1-6-11)

i elected to stop practicing medicine as i always had
concerns this would happen and
i did not want to cause any harm to my patients if this
process progresses

where is my future
i will continue to be in a study at the alzheimers research
center at the university of texas southwestern medical center
i will now be in the study group and not in the control group

i will continue to blog about my involvement in that study
and with my treatments and evaluations as they are done

i want to give a doctors view of all this while also being
a patient

i have had normal lab work and a normal mri
these were looking  for treatable diseases that can cause
these symptoms

i will have genetic studies, more blood tests, a lumbar
puncture, and a pet scan soon    

these are looking for some of the changes that occur in alzheimers

i will either
1   stay the same forever or
2   completely clear up or
3   slowly progress to alzheimers or
4   rapidly progress to alzheimers

a bad thing can be a good thing
i know now
my wife she and i can plan for the future
i can be involved in educating people about this disease
my involvement in the study is my small part in finding
treatments and cures for this disease

below is a message from one of he families i cared for

I wish I had told you the last time I saw you how much I appreciated having you for a family doctor! I would have hugged you right then. We love you and will miss you. I will miss your wit, your knowledge, and the way you interacted with my children. Reading your blog has helped take the sting away from knowing I won't see you when I come to the office. You and your family will be in our family's thoughts and prayers. Love, xxxxx Family

the organicgreen doctor