organicgreendoctor: my story revisited #148-seizing the moment

organicgreendoctor: my story revisited #148-seizing the moment: MY STORY REVISITED #148-SEIZING THE MOMENT this morning i woke up at 300 am just like i did 8 years ago when i wrote this blog i still wake ...

my story revisited #148-seizing the moment

MY STORY REVISITED #148-SEIZING THE MOMENT

this morning i woke up at 300 am just like i did 8 years ago when i wrote this blog
i still wake up early every morning thanks to the aricept or donepezil im on for alzheimers

that day i enjoyed the birds achirping
it that day was 80 degrees at 3am and muggy like only texas and the south can get in the summer if the humidity rises

today here in santa barbara it will start a warming trend that will get us up to the 90s
most folks here do not have air conditioning so these days when its warm reminds me of those hot summer days in texas

i remember that day i wrote about in my blog
i remember that presentation i and the caregiver gave
it was one that the moderator had to finally shut down questions from the audience since we had ran over our time and the folks had another session to go to
still folks lingered around asking the caregiver and i questions about alzheimers
i always would stay for as long as folks had questions
sometimes that would be an extra hour
i always figured that this is what im meant to do as i get older
spread my knowledge ive gained about this awful disease

then that day 
i got to end it as the rain fell on our metal roof and i sat out on our upstairs porch feeling the coolness and relaxing as only this could make you relax

i seized the moment
__________

08-12-2014
A BREATH OF FRESH AIR

when i wake up in the morning i usually open up our
downstairs doors all four of them
to let in fresh air
to use the outside cool night air
remember its 3am when i get up every morning
thanks to mr aricept (donepezil) i take since i may
have alzheimers disease

letting in that cool night air for several hours allows the
inside of the house to get a good exchange of stale
inside air with this cool night air

then the sun comes up and we have to reverse things
usually about 1200 pm we close things back up
for another 15 hours of that inside air
then good country air to be let in at 3am again

this am when i got up though it was 80+ degrees
stale
humid
almost suffocating
if youve lived in the deep south you know what im talking
almost syrupy is how it feels when you breathe it in
so i left the doors closed and turned on the air conditioner

this am i had a meeting with a group doing a seminar
on caregiving
where a caregiver and i will be doing two 45 minute seminars
on caregiving and how not to get burned out
doing a question and answer is what we plan to do
she a caregiver now with her alzheimers husband
and
me a doctor who has cared for those patients
a family member whose mom dad and brother had the disease
and
now me who may have the disease
three perspectives i offer
and how to be a long distance caregiver
which is easier to do yet harder also

when i was driving to the meeting my air conditioner would
hardly work in the car
i got out and felt the heat and humidity
fogging up my glasses is what happened

i had my meeting then home i went
ate lunch
then lay down for my normal afternoon nap hoping to
gain back my two hours of sleep that the aricept sucked
from me

after about an hour
i heard thunder
then the hail hit the roof
now our roof is an all metal roof
so when hail hits its  loud
i mean real loud
the rain was also hard real hard
then it slowed to that nice pleasant
relaxing rain on that metal roof
that sort of slowly rocked me back to sleep
for another 1 and a half hour more

i felt so refreshed when i awoke
i think it was that mesmerizing lullaby that that metal roof and
that slow rain sung on our roof

then my wife she heard i was awake
she who i think may have hid in our storm shelter shower
opened up the house like i do every morning

in rushed this breath of fresh air
that crispy smell good rainy fresh air
that you can only get after a good hail storm
and after the rain has fallen to cool the outside down

now i sit on our upper deck writing this blog
its after 500pm our wine time
listening to it still raining on our metal roof
it seems it has activated all the animals the birds are
active like they are in the morning

even the deer have come out into our far pasture
a mom and her twin fawns moving across the pasture
the fawns ajumping and playing in the slow rain

so i take a slow deep breath that feels so good going down
a sip of wine
and
say thanks for this change
from what would have been a miserable day here at the country n

it makes me contemplate a lot sitting here
especially after having spent 2 hours talking about alzheimers disease
and what memories and thoughts that brings up

i am just thankful that im alive and able to enjoy this moment
seized the moment it is what i did
_________

sometimes i will look at my wife she and say
lets seize the moment

that day 
thats what i did
i seized the moment

our first live walk to end alzheimers here in santa barbara since the pandemic started will be on saturday november 5th
here is the link to the walk
my team organicgreendoctor will be activated soon
its our 12th year to do the walk
join us

the organicgreen doctor

organicgreendoctor: school loan forgiveness

organicgreendoctor: school loan forgiveness: SCHOOL LOAN FORGIVENESS its a racket i said when asked about school debt when you see all those schools and programs advertise on tv and the...

school loan forgiveness

SCHOOL LOAN FORGIVENESS
its a racket i said when asked about school debt
when you see all those schools and programs advertise on tv and the internet
it should make you cautious
someone somewhere is making money

i looked at the cost per year of going to my undergraduate school
its about $35,000 or about $140,000 for 4 years

i looked at the cost per year of going to my medical school
its about $65,000 or about $260,000 for 4 years

so
without any financial assistance it would cost me $400,000 to get my medical degree today

now i graduated in 1982 from medical school
just the tuition i think that year was about $5,000

could i afford to pay back almost a half a million for student debt if i graduated today
yes
but i would be severely restricted financially through half my career

this is how i did it
i went to junior college and paid my own way for two years
i transferred to a university of california school
there my wife she and i worked about 15-20 hours a week
i received scholarships and grants that paid for much of my tuition and fees and books
i had to make enough money to live on
we also did some loan borrowing

then for medical school
the first year i borrowed money from a relative that i paid back later
my wife she worked all through my medical school and residency
thats 7 years

starting my second year i worked as a morgue attendant on call after hours and weekends checking bodies in and out of the morgue and assisting with autopsies on weekends and holidays
i also got on a national health scholarship that paid all my tuition fees and also paid me a monthly stipend in exchange for a year for a year when i finished training
i had to go to an approved underserved site to work
for me that was three years
so when i finished my residency i spent three years in a small town in southern arkansas

during my medical school and residency and my 3 years as a national health care doctor i was able to delay payments on any loans i had
also the federal government paid my interest that was accumulating

my wife she and i had a total school debt of about $20,000
we paid that off just in time for our oldest to start college
it was about 10+ years

so during my schooling 
i got state and federal funding for scholarships and federal grants
i got federal funded interest payments during deferment status
i got most of my medical school paid for via the federal national health scholarship which closed out the year i graduated

that is a lot of money that the state and federal government paid for me to go to college and medical school
but even after working and borrowing from family i still owed $20,000

so i wonder what my total school debt would be now if i was just finishing
my guess it would be 5 or 6 times what it was in 1982
my guess it would be around $100,000
no it would be even more than that since the program i was on doesnt exist now

so
what about school loan forgiveness 
im not sure how i feel about this
i wouldnt ask for loan forgiveness for my $20,000 since so much of my school cost was already paid for by taxpayers

that said
the real problem behind all this is that it is a racket feel to the financing of school debt
many students have got duped into signing up
you see those ads like i do
thats debt folks who you know wont make it are accumulating
the government has let that happen
we the government has allowed this to happen
all those millennials and generation x folks getting strapped with school loan debt that will probably prevent many from ever being financially stable

there is responsibility on both sides

i will admit that money could sure be used in other places like health care schools etc

the schools and the banks and the other loaners are all making a killing on this
they are not bearing any of the responsibility for letting this happen
neither are the politicians on either side

some responsibility is on the students
is a $30,000-50,000 worth it for a masters degree for a school teacher
dave ramsey the financial guy recommends you attend a local junior college and then attend a state university to finish your degree
eg
here in santa barbara local students attend the junior college for free

so
i would say 
if you quality for loan forgiveness 
go for it
take it

if you dont believe in it and you qualify 
i say either
take it and move on 
or
keep paying on those loans

i cant decide if im for loan forgiveness or not

the organicgreen doctor

organicgreendoctor: zero cases of cervical cancer is how many we shoul...

organicgreendoctor: zero cases of cervical cancer is how many we shoul...: ZERO CASES OF CERVICAL CANCER IS HOW MANY WE SHOULD SEE NOW john hopkins medicine this is an hbo movie or documentary on henrietta lacks who...

zero cases of cervical cancer is how many we should see now

ZERO CASES OF CERVICAL CANCER IS HOW MANY WE SHOULD SEE NOW

john hopkins medicine
this is an hbo movie or documentary on henrietta lacks who died from cervical cancer
a disease we shouldnt be seeing at all today in the us
but
sadly we are

amazon.com book review
i read this book several years ago
its story is one that sticks with you

basically she was a poor black person who had cervical cancer 
a biopsy of the cancer was used to make the diagnosis but they also used the cells now called he la to use in clincial research in the labs
her he la cells were grown in the lab and was used all over the world since for research or cerival cancer and other cancers

she never gave permission to have her cells used in such a manner
she died from cervical cancer

because of law suits from her family for the unauthorized use of her cells
now whenever anything from your body is going to be used for research you have to sign away your rights to those cells

eg
i had to sign away my rights to my stuff when they are obtained from the research studies im in
eg
ekgs blood work dna samples rna samples mris amyloid pet scans tau pet scans glucose metabolism tests memory tests neurological medical records and my full human genome

i see frequently research papers about research on alzheimers that is using some of my personal research tests
eg
one comparing memory testing and pet scans and mris over 5 years showing how changes occur in mci and early alzheimers

i agree to not get paid for this 
i also agree to not get to see any of my results

i must say because of her he la cells that have been used in research that a lot was learned about cervical cancer

we know enough that we know now we shouldnt see any cases
but
we are

we seem to be regressing some 

i read this npr article yesterday about this

a female should have a pap smear starting at 21 then every 3 years
they also should have a hpv test done 

any abnormal pap smear should be evaluated further
biopsy early on when cells are just changing can be treated easily by treating the cervix
the cure rate at this stage is over 90%

if you wait until it gets to stage 4 the 5 year survival rate is close to 17%
so a 30 year old who gets stage 4 cervial cancer will more than likely not make it past 35

hpv is the most common std there is
its a virus that almost all of us get exposed to
in females it can change the cervical cells into cervical cancer

so
this virus causes cervical cancer

a vaccine called the hpv vaccine is given around 12 years old
it prevents infection by the most common types of hpv virus
such prevention can prevent abnormal paps and cervical cancer

its important to get the hpv vaccine before sexual exposure occurs

remember almost all all of us have hpv exposure

around 50+% of teens are fully vaccinated against hpv
around 70+-% of teens have at least one shot of hpv

hpv also cause oropharyngeal cancer anal cancer and penile cancer

these hpv cancers are mostly preventable
pap smears and hpv testing can discover the early changes that can occur on the cervix

 

now there is starting to be an uptick in cervical cancer
especially the stage 4 stage

the top group that seems to be affected the most is middle age white women 40-44 in the south

why
women arent tied to getting that annual exam and pap anymore
access to womens health care is being restricted either by economics or new laws limiting womens health care
when i was in practice most of the females who were uninsured got their female care and exams at the planned parenthood or other clinics that gave free or reduced cost care
those have been harder to access
some women just arent doing their recommended female health care visits
many parents wont let their kids get vaccinated for hpv
thankfully its more accepted now than it was a few years ago

these stage 4 cervical cancer patients are females in their 30s and 40s
they are mothers sisters aunts siblings of yours
hopefully not you

i wonder what effect the pandemic and the lack of female health care will have on these statistics
i expect the cervical cancer cases will tick up 
i expect the hpv vaccine rate probably dropped during that time

these effects from the pandemic and the lack of care may not show up for 10-15 yeats
as increased abnormal paps and increased cervical cancer rates

we know how to prevent and treat early cervical cancer
its one of the few cancers we can say that bout it

the organicgreen doctor

organicgreendoctor: alzheimers news-do something now if you are kin to me

organicgreendoctor: alzheimers news-do something now if you are kin to me: ALZHEIMERS NEWS-DO SOMETHING NOW IF YOU ARE KIN TO ME my mother and younger brother died from alzheimers disease my mother also had multiple...

alzheimers news-do something now if you are kin to me

ALZHEIMERS NEWS-DO SOMETHING NOW IF YOU ARE KIN TO ME

my mother and younger brother died from alzheimers disease
my mother also had multiple small strokes
my father probably had it when he died
he had coronary artery disease
he had a coronary bypass done in his 60s
he died from a heart attack at few years later
another sibling has coronary artery disease 
he had his widowmaker artery bypassed a few years ago
i was diagnosed with mci due to alzheimers disease 12 years ago
another younger relative recently this week had a widowmaker heart attack
luckily medicine has advanced enough that he was able to have this main artery to the heart opened up with a stent to allow blood to flow back to his heart

these three disease are all related
coronary artery disease and strokes and alzheimers disease
one common culprit is the cholesterol level
another culprit is probably the apoe 4 gene which all of the above probably carry
its called the late onset alzheimers gene
its involved with cholesterol transport in the body

heart attack
stroke
alzheimers disease

thats destined to happen in this family or should i say my family

you cant alter you apoe 4 gene if you have it
remember about 25% of all americans have this gene
but
you can do things to reduce the risk from the apoe 4 gene and the abnormal cholesterol levels

remember you need to start this at as young an age as you can

our family is destined to have one if not all of these 3 fates

for me 
so far i have the apoe 4 apoe 4 homozygous gene
i have if i dont treat it markedly elevated cholesterol and triglyceride levels

these two destined me to be where i am now

had i not got aggressive in my younger years 
younger than that relative who just had the widowmaker but got a reprieve thanks to modern medicine
i would have probably had a heart attack by now or a stroke

so whats my relatives to do 
sorry but its the same for all three diseases 

control your cholesterol even if it takes medication to control it now no matter what your age is
control your blood pressure especially in your younger years remember normal is 120/70
control your weight so that your bmi is less than 25 or lower
control your diabetes if you have it
dont smoke
limit alcohol
exercise even its just walking or just staying physically active eg i get close to 8000-10000 steps a day working in our garden
control stresses in your life

that relative who had the widowmaker event would probably not have survived it 30 years ago

so in summary
heart attack and stroke and alzheimers disease is in your future if you share dna with me
its up to you if you want to do things to slow down or prevent these diseases

how well you do may be determined by how young you start doing preventative things
i waited until my later 30s and early 40s to do something
it would have been even better if i had done something sooner
eg
when i had my first cholesterol level done at 40 i should have been started on a statin cholesterol drug
i also should have gotten on the mind diet at that time
i should have been placed on blood pressure meds around 50 or younger

its never too late to start preventative things though
its just much better if you started them when you are younger

just look at what happened to those who closely share my dna

alzheimers disease in mid 70s with multiple strokes
death from alzheimers disease in mid 80s
coronary artery bypass in late 60s
heart attack in mid 70s
death from heart attack in mid 70s
coronary artery widowmaker artery bypass in early 70s
alzheimers disease at 53
dying of alzheimers disease at 63
diagnosed with mci due to alzheimers disease at 60
widowmaker heart attack mid 40s

thats just in my immediate family
theres more of these 3 diseases scattered diffusely through our family tree

while you are young is the time to do these preventative measures 


our team organicgreendoctor will be walking in the walk to end alzheimers  in santa barbara on november 5th 

the organicgreen doctor

organicgreendoctor: my story revisited #147-more walking helps

organicgreendoctor: my story revisited #147-more walking helps: MY STORY REVISITED #147-MORE WALKING HELPS walking is one of the best form of exercising to do it doesnt cost anything to do its generally a...

my story revisited #147-more walking helps

MY STORY REVISITED #147-MORE WALKING HELPS

walking is one of the best form of exercising to do
it doesnt cost anything to do
its generally atraumatic to your body
it will make you feel good to get outside and see life at the sidewalk level

in the blog below i mention how walking helps
its good exercise
it raises money for a good cause
the alzheimers association
which provides funding to further the care support and research of alzheimers

eg
the first big five year study i was in the adni 2 study was partially funded by the alzheimers association
it was the most important alzheimers study ever done

it the alzheimers association is the go to source for information at www.alz.org
locally they are a good source for information on whats available for patients and caregivers

this year the walk to end alzhiemers here in santa barbara will be on saturday november 5th 
this will be the first walk we have done with my team organicgreendoctor since the pandemic
my last walk was november 2019

i will post my teams link soon for joining and or donating

this will be the 12th year i have done a team for the alzheimers walk
the last two were done virtually

we are now ready to rejoin the event live

i have raised between $2000-5000 each year
totally over $30,000 over the last 12 years

below is a picture of the front of our walk shirt from 2014
it has 3 names on it

nell my mother who died a few years before in the final stages
joe my younger brother who died the year before in the final stages
charles my dad probably had early alzheimers when he died

i guess i could add my name to the shirt now that my diagnosis is official
__________
08-1-2014
WALKING HELPS
it helps two ways
walking does

walking the least traumatic exercise and the least expensive form
of exercise
improves your health and related to alzheimers disease it increases
the blood flow to the brain cells
which improves memory and may help
slow down or prevent the onset of alzheimers disease

this last week while in san francisco one observation i made was
that you dont see hardly any morbidly obese people
maybe because more people walk there than most places
and
maybe because of all those dang hills

but

they also walk to end alzheimers there
as evidenced by this sign advertising their walk to end alzheimers
in san francisco

this second way walking helps alzheimers is that it raises money for
alzheimers research and for alzheimers education
its the major way that the alzheimers association raises money to
do all they do

go to www.alz.org to find a walk near you
all states have them

the walk that i am most involved in is the
williamson county walk to end alzheimers 
which will be on saturday september 27, 2014 at 900 am
at the beautiful san gabriel park in georgetown texas

my team called
organicgreendoctor 
is now asking for donations and asking for folks to join us
in that walk

our goal is $3000
we will have an online silent auction that starts next thursday
to raise $1000
click here or go to www.32auctions.com/ogd to preview our
first items

so you can walk to end alzheimers in two ways
for yourself
by getting walking exercise increasing your brains
blood supply
and
for others
by raising funds for research and education

we are so close to being able to treat this disease
we cant do it without your help

to join and or donate to my team organicgreendoctor
click here
or
form your own team where you live

im doing my part as much as i can
for myself
for my family
and
for you and your family
__________
a biogen aduhelm or aducanumab study update
i received my 20th aduhelm infusion last week
my next is due in 3 weeks followed by another mri later that month

by the time we walk to end alzheimers here in santa barbara in november i will have had about 2 years of aduhelm infusions
thats enough to wipe out most of the amyloid plaques in my brain

remember walking is good for your heart and your brain and is good for your soul

the organicgreen doctor

organicgreendoctor: new lymes vaccine

organicgreendoctor: new lymes vaccine: A NEW LYMES VACCINE npr article on lymes vaccine we lived at the country n near austin for 17 years i dont remember ever getting a tick on m...

new lymes vaccine

A NEW LYMES VACCINE

npr article on lymes vaccine

we lived at the country n near austin for 17 years
i dont remember ever getting a tick on my body
there were lots of deer who bedded in our pastures
there were lots of mice running around
some say the fire ants kept the tick population down
i guess thats one good thing the fire ants did

growing up we were always getting covered with ticks
especially those little tiny ones we called seed ticks
they were notorious for getting in the wrong places

i would say that redbugs were more of a nuisance than ticks
since they would make you itch like crazy
we had those at the country n just ask my wife she
they loved her

it use to be that you never heard of rocky mountain spotted fever or lymes disease in the south
it seemed to be in the rocky mountain areas and in the northeast area
i dont remember hearing about it growing up
but
later when i began practicing medicine you had to keep those two diseases on your radar
since people traveled to those areas frequently 
and
eventually those ticks that carried those diseases also wandered down into the upper south

the cases i saw were usually later in the disease process when its harder to recognize and to diagnose 

the good part is that if you catch it early both are easily treated
if you miss the diagnosis rocky mountain spotted fever it can be fatal
lymes can be debilitating

now there are blood tests to make the diagnosis
treatment is easy
if you catch it early

a few times i just empirically  treated folks with antibiotics and later since it took a while at that time to get the labs back i would find out they were positive

the first case of rmsf or rocky mountain spotted fever i saw was in training at the childrens hospital
the patent later died 
it left an impression on me

i read once that a well known singer was diagnosed with alzheimers disease
later he was discovered to have lymes disease
when he was treated with antibiotics his memory improved
he stopped his alzheimers meds

the symptoms look so similar to what you see with long covid
you have fever chills headache body aches and a bulls eye rash
later the symptoms become more long covid like
fatigue myalgia joint pain facial paralysis irregular heart rate peripheral neuropathy inflammation in different parts of the body like the eye and mental fogginess

sometimes it takes a suspicion by the doctor to diagnose it
you have to keep it in the back of your head

what i did in the summer was to be on the look out for potential tick borne illnesses like lymes and rocky mountain spotted fever and tularemia

sometimes if the history was real suspicious i would treat until my labs came back
it also helped to repeat the labs more than once

lymes is carried by the deer tick

i dont remember diagnosing lymes in anyone but i did diagnose the other two 
a few dollars prescription of antibiotics if treated early treats these tick borne illnesses

now there is a new vaccine against lymes that is in clinical trials
if it gets approved we may be able to prevent this debilitating disease lymes disease

there is also a monoclonal antibody being developed that can be used for treatment

the hard part is recognizing the symptoms could be lymes and diagnosing it
the treatment is easy

be careful this summer in tick prone areas  especially if you travel
maybe when the vaccine becomes available if you are in lymes risk situations a lot then you might consider getting the vaccine

maybe the fire ants would work in your area
i wonder if those crazy ants eat ticks

the organicgreen doctor

organicgreendoctor: covid 19-the fall vaxxine

organicgreendoctor: covid 19-the fall vaxxine: COVID 19-THE FALL VAXXINE we are about to enter our 3rd year with the covid 19 virus we lost over a million americans to this virus most wer...

covid 19-the fall vaxxine

COVID 19-THE FALL VAXXINE

we are about to enter our 3rd year with the covid 19 virus
we lost over a million americans to this virus
most were unvaxxed
since this all started we now have a vaxxine that will keep most americans from getting sick enough to be hospitalized or to die from covid

its sad so many died
most didnt have to die
its a blight on our history that history will look back on and say
i cant believe that happened

we lost about  770  from covid yesterday
again
most arent vaxxinated
thats still too many people

all of us havent learned our lesson

now
some cant take the vaxxine but now we at least have meds they can take to keep them from getting sicker

also history will look back and say 
its amazing what science did in those 2 years
a miracle it was

so now most of us are eligible to have gotten 2 shots plus 2 boosters
soon this fall we can get the new fall booster

it will work better against the omicron variants like ba.4 and ba.5
the ba.5 makes up most of the infections now
we are having about 100,000 covid infections a day in the us now

i read where half those folks may not even know they had it
thanks to previous infections and vaxxinations

these variants are more contagious but not as nasty a infection as the original wild type that killed so many folks in the us

so
some recommend if you arent boosted yet then consider getting boosted now with the booster and not wait till the omicron covid booster becomes available
thats based on how bad the infections are in your area and your vulnerability to the covid infection

for me since im quadrovaxxed i plan on getting the fall omicron covid booster when i go in for my flu shot
remember the flu will probably hit us all hard this fall and winter since we all were staying at home and masking so the flu immunity has waned
this is the year to get your flu shot for sure

the supplies may be limited at first so they will only be given to the most vulnerable at first
like old folks and immunosuppressed folks

talking with folks who have got covid recently say it wasnt fun for a 1-2 weeks
it disrupted their lives and they felt awful during that time
a reminder getting the flu does the same thing

as i tell folks
i dont want to get sick when i dont have to

consider the new omicorn covid booster
and
the flu shot

it may make for a better fall and winter 

the organicgreen doctor

organicgreendoctor: alzheimers news-what to do

organicgreendoctor: alzheimers news-what to do: ALZHEIMERS NEWS-WHAT TO DO frequently folks will reach out to me from social media or email or via family or friends wanting to know what to...

alzheimers news-what to do

ALZHEIMERS NEWS-WHAT TO DO

frequently folks will reach out to me from social media or email or via family or friends wanting to know what to do about a loved one or friend or even themselves who are having memory loss

i always tell them
seek an evaluation now dont wait
the earlier you find the cause of the memory loss the sooner it can be evaluated and treated

what evaluation needs to be done

you need to see a medical provider for a good history and examination looking for causes of the memory loss
things like medications alcohol or drug abuse uncontrolled blood pressure or blood sugar or cholesterol or obesity or sleep disturbances or mental health things like depression or anxiety or increased stress
sometimes aggressively addressing these can improve ones memory

then
labs need to be done
a complete blood count or cbc and a chemistry profile looking at electrolytes and kidney functions and liver enzymes and a tsh for thyroid function and a vitamin b12 level
some providers will check a vitamin d3 level and a homocysteine level
eg an abnormal thyroid level can be treated and a low vitamin b12 can be also with oral meds

they are looking for treatable causes and explanations for memory loss

then
a good in office memory test like the moca or the mmse or equivalent needs to be done
the clock test isnt good enough
i like the moca since it will usually identify someone early with mci or mild cognitive impairment whereas the mmse may not

if necessary a full neuropsychological exam needs to be done
its performed by a neuropsychologist and may last 1-3 hours
its the gold standard memory test

then
if no cause is identified an mri is commonly done
it will identify masses tumors increased brain fluid old strokes and other changes called wmhs or white mater hyperintensities and shrinkage of the brain and hypothalamus commonly seen with alzheimers disease
wmh are seen with  high blood pressure and high cholesterol

commonly these above evaluations can be enough to give you your diagnosis

then
if needed consideration should be done to do a amyloid pet scan
if you have alzheimers disease it will be positive
keeping in mind that other things can make it show amyloid accumulation in the brain
but
it will be positive if you have alzheimers

medicare and insurance does not pay for this scan
it needs an experienced neuroradiology person to properly interpret it
it costs $5000+-

if you go through all this you should be able to identify whether or not you have alzheimers disease or have some other cause
like
lewy body dementia or fontal temporal dementia or vascular dementia or some other treatable cause

looking at my case
i have had all of these tests and more
here are my results

the history showed i had a strong family history of alzheimers disease
my physical exam was normal
my blood pressure was elevated so i took blood pressure pills to control it 
lately since ive lost weight and quit drinking caffeinated coffee and alcohol my blood pressure is normal
my blood cholesterol was elevated so i was started on a statin called lipitor or atorvastatin
my weight was slightly elevated now its normal
my labs showed a below normal vitamin b12 and an abnormal level of homocysteine and a low vitamin d3 all easily corrected with oral vitamin b12  and folate and vitamin d3

my moca was in the mci range at 24-25 which matched with the findings in my neuropsychological exam
my moca now is normal at 30

my mris all 10+ are normal except for a few wmhs or white matter hyperintensities due to my blood pressure and cholesterol

i had genetic screening and have the homozygous or apoe 4 apoe4 gene
this puts me at risk for late onset alzheimers

i have abnormal levels of amyloid and tau in my spinal fluid

i have had multiple amyloid pet scans all done in research studies
i have only got the results from the one done prior to the start of the biogen aduhelm study
you have to be positive for amyloid to be in the study

i also have had the blood amyloid and tau tests done in research studies but dont have the results
these are now used to screen folks for the research studies
soon they will be available in the private medical world

so 
now youve had a good workup
many folks can end the workup with an mri if it shows changes that help with the diagnosis

some folks may want to get an amyloid pet scan to be more sure of the diagnosis
remember to understand the limitations of the test
also
remember the diagnosis is made by putting all the testings together to make the diagnosis
no one test is 100% accurate
so
now you have been told you have mci due ot alzheimers or early alzheimers

what do you do

realize there is nothing you can do that will cure this disease
there are only things you can do to slow down the symptoms

this disease may take up to 20 years to reach its last stage
or 
it can take only 5-7 years to reach that stage

my mother and brother was in that last group
it appears im in that first group

consider getting on aricept or donepezil
it makes 1/3 get better but 1/3 stay the same and 1/3 get worse
read my blog last week on how it can prolong the symptoms and prolong death
its worth trying and staying on it even though you dont think its working
im glad ive been on it for 12 years and it may be one of the reasons im doing good

maximize your health
control blood pressure cholesterol diabetes weight and sleep issues
limit alcohol
treat any mental health issues
stay active physically mentally socially 
dont smoke

eat a mind diet

remember none of this stops the disease it only slows down the symptoms

i realize that even though im doing good now i will one day hit that drop off point that happens as the disease progresses
the fall will be sudden and rapid
i just hope its a few years away

aduhelm or aducanumab is available to get as monthly infusions
medicare or insurance don not pay for it
many neurologist dont give the infusions
they are usually received in a research study

do they help
we dont really know yet
we should know for sure in 2-5 years

most of the major alzheimers centers are doing the studies

it takes a commitment to do the studies

for me
if they help some its worth all the effort
but
i may go through 7 years in the study im in and find out later it doesnt really work

also
get all your legal paperwork done while the  patient is mentally competent
it may be hard to do if you wait too late

if you are the caregiver
you have to take care of yourself
seek help 
reach out to the local  alzheimers organizations like the local alzheimers association
they know what services are available for you
you are no good to the patient if you dont take care of yourself

so
thats what i would do

the organicgreen doctor 

organicgreendoctor: these are george carlinish

organicgreendoctor: these are george carlinish: THESE ARE GEORGE CARLINISH recently on facebook someone vj posted these sayings to ponder i read them and thought  those are george carlinis...

these are george carlinish

THESE ARE GEORGE CARLINISH

recently on facebook someone vj posted these sayings to ponder
i read them and thought 
those are george carlinish

you might remember george carlin the comedian that came up with those 7 words you cant say on television
well
now it seems 4 of them are used frequently it seems in news shows that are reporting on what someone says
he got in a lot of trouble for those 7 words

george was funny
he was irreverent 
he dropped out of school in the ninth grade
its said is iq was around 165

here are those things to ponder
ponder them
im sure there are more things we could ponder like this

what if my dog brings the ball back only because he thinks i like to throw it

jf the poison expiration date is past does that mean its more or less poisonous

which letter in scent is silent the s or the c

do twins realize that one of them was unplanned

why is w pronounced double u instead of double v
in the south we say dubya

what if oxygen is slowly killing you and it takes 75-100 years to kill you

every time you clean you make something else dirty

100 years ago everyone owned a horse and only the rich owned a car
now everyone owns a car and only the rich own a horse

if you replaced the w with a t in what when where you would have the answer to each one

if you rip a hole in a net you have less holes than what you started with

im sure george said some of these above

these below are for sure george carlins quotes 

is a vegetarian permitted to eat animal crackers

weve added years to life but not life to years
i guess he saying it sucks to get old

death is caused by swallowing large amounts of saliva over a long period of time

if all the world is a stage then where is the audience sitting

think about how stupid the average person is then realize that half of them are stupider than that

never underestimate the power of stupid people in large groups

finally 
in america anybody can become president
thats the problem

his quotes and those other quotes make you think 
and
smile some

they did for me

the organicgreen doctor

organicgreendoctor: an ode to teachers

organicgreendoctor: an ode to teachers: AN ODE TO TEACHERS i wrote this blog about 6 years ago it was to my granddaughter ms b i would write blogs titled dear ms b hoping one day w...

an ode to teachers

AN ODE TO TEACHERS
i wrote this blog about 6 years ago
it was to my granddaughter ms b
i would write blogs titled dear ms b
hoping one day when she got older she could read them to get a feel of how my wife she and i felt about her

my wife she was a school teacher
the year i wrote this was the start of her last year teaching
at that time we didnt know for sure that we would be moving to california 
but
a year later we were there getting to see ms b frequently during the week
a bond between us formed that will last forever
a move we never regret doing
even though we had to leave our beloved country n

that teacher ms b rode in the wagon with my wife she to sit in her classroom turned out a few years later to be her kindergarten teacher
an experienced teacher who had to teach zoom classes for a year to 20+ kindergarteners

how about yall try that for a whole school year
it would make you appreciate your kids teachers more

as the school year starts
think about your favorite teachers and your kids teachers
especially after you read this blog below
__________
08-16-2016
DEAR MS B-SHESA TEACHA

now ms b your gma had to start back to work this week
im not sure you know this but
shes a teacher
a teacha you might say when you start talking better

now you dont know what a teacha is yet
but
remember when gma and great gma took you in that wagon
down that long trail
over to that school where all those kids were playing
running around laughing and shouting having fun

you sat there in that wagon
all wide eyed you were

the lady ms sb that was leading that classroom
well she is a teacha
which
is what you gma is

so gma started back this week
getting things ready for the kiddos to come back next week
if the admin folks dont put them in too many meetings

now ms b
its so funny to see a room full of teachas
at these meetings
youll find out when you start to school
but
those teachas wont let you do nothing
no talking no texting no chewing gum
but
when those teachas all get together in those meetings
even when the head principal is talking
well
if they were students they would all get sent to the office
they talk
they text
they sleep
they chew gum
they get up and walk out

yes
ms b
they dont practice what they teach
but
they are good folks though
they love kids well most of them do

ms b
they even dont hardly get no social security when they get old
some dont get none
not right is it
why your gma paid in for years
but will get very little if any when she retires

so it is with the life of a teacha
but
they love their profession and probably wouldnt do anything else

you know the ones that do
youll remember them forever

ms black ms olive ms dugal are three to come to my mind
that i had
the last one was special
yes youll have at least one of those

now ms b
your gma works part time
every other day
so shes off every other day
well ms b
she really works on that other day
doing her teacha stuff
that she use to do late into the night and all weekend
when she worked full time
no she didnt get overtime

so
now at least i get to see her some at night
and weekends
thanks to her being part time

so ms b
when you sit in front of your new teacha
i want you to think of your gma and her friends
remember
they want the best for you
they are dedicated
they love their job
so
give em a hug
tell them thanks
___________
dear ms b
hug your gma today thats my wife she
tell your new teacher
thanks
or
give them a hug
that means a lot to them
its better than a gift or an apple

the organicgreen doctor