organicgreendoctor: rsv vaccines are coming

organicgreendoctor: rsv vaccines are coming: RSV VACCINES ARE COMING when i was in practice i saw a lot of pediatric patients in the fall and winter there would be a lot of wheezing kid...

rsv vaccines are coming

RSV VACCINES ARE COMING

when i was in practice i saw a lot of pediatric patients
in the fall and winter there would be a lot of wheezing kids coming into the office with rsv or respiratory syncytial virus infections
most of the care was supportive using fluids and sometimes bronchodilators like albuterol
sometimes some had to be admitted to the hospital for treatment and some ended up in the icu

some years the rsv season would be mild some years it would be severe

those kiddos lower and upper airways would be infected 
they were like asthmatics for months 

it was scary for the parents

now in 2023 a new rsv vaccine for kids under 2 years old is approved
its called beyfortus 

it should decrease significantly those admissions for rsv each winter
most at risk are premature infants kids with chronic lung disease or congenital heart disease or chronic kidney disease or kids whose immune system is decreased eg cancer patients or transplant patients

just normal infants can be severely affected by rsv

its an exciting vaccine to have available now for our kids

next
a new rsv vaccine is seeking full fda approval for use in pregnant moms
the idea is that the infant will have some rsv immunity received from moms rsv shot

if you have ever had a child with a severe case of rsv you know how scary it can be

next
a new rsv vaccine for older adults over 60 has now received fda approval
those folks with any kind of risk factors are vulnerable
yes
grandparents when you visit your younger grandkids with a runny snotty nose and a cough especially a wheezing cough in the winter it possibly could be rsv

rsv in the elderly is like the flu
you can get really sick with the rsv infection with pneumonia
there are a lot of hospital admissions each year with older folks with rsv
those at high risk are those with heart disease kidney disease lung disease kidney disease or any immunosuppressive illnesses

the adult rsv vaccine is called arexvy or abrysvo

add that one to your fall repertoire of vaccines 
eg
flu
coivid
rsv

as i have said several times
i dont want to die from something i could prevent

the organicgreen doctor

organicgreendoctor: these new medications are just the beginning

organicgreendoctor: these new medications are just the beginning: THESE NEW MEDICATONS ARE JUST THE BEGINNING that is me getting an infusion of aduhelm at ucla as part of the embark clinical trial at ucla a...

these new medications are just the beginning

THESE NEW MEDICATONS ARE JUST THE BEGINNING

that is me getting an infusion of aduhelm at ucla as part of the embark clinical trial at ucla
aduhelm is approved by the fda for use in mci or early alzheimers
medicare will only pay for it if its given in a clinical trial
once it gets full approval by the fda medicare will probably give its full approval to pay for it
my study and other studies will be finished soon and will be reported out
if it shows that it improves or slows down cognitive decline it will probably get full approval

the problem was that biogen didnt finish the studies that needed to be done before they sought approval

more than likely in the future aduhelm will be the third choice behind leqembi and donanemab

all 3 grab amyloid or amyloid plaques and remove them
all 3 will show that they slow down cognitive decline

leqembi just got full approval
its given every two weeks in an infusion like im getting above
it is being studied to be given as a shot like insulin is given so folks can give it at home
much like humira is given at home for rheumatoid arthritis

that will make leqembi attractive for use since it eliminates the hassle of going to an infusion center
the infrastructure for giving these drugs is a major obstacle to receiving it 

at home shots eliminate this major problem 

donanemab will probably get full approval later this year
medicare will probably give its full approval to pay for it also
donanemab seems to work better than the other two
when given to real early folks like me who have mci or mild alzheimers 
the cognitive decline was slowed by about 67%+-

it is given as a monthly infusion

donanemab seems to have more side effects than the other two
it also doesnt have to be given as long as the others have to be given

the side effects are aria or amyloid related imaging abnormalities 
aria e means with edema
aria h means with hemorrhage
bot of these can be seen on mri
all my mris show no aria after 32 infusions of aduhelm

if you have the apoe 4 gene you are at increased risk for these aria
if you have two copies of the apoe 4 genes or homozygous apoe 4 your risk is even higher
i am homozygous apoe 4 but had no aria

2 folks died in the donanemab study from aria 
both were put on blood thinners for other reasons
several other folks on the study were placed on blood thinners and had no issue

dr daniel gibbs from a tattoo on my brain was in the aduhelm study and had a major bleed
he was not allowed back in the study
he can not receive any of these drugs again

most folks in these studies who developed aria e or aria h on mris had no symptoms
the aria e and aria h resolved

so what to expect if you want to get on these drugs
there are strict criteria
you must have mci or mild cognitive impairment or early alzheimers symptoms
not early onset alzheimers as thats a different genetic version that hits younger folks

you have to see a doctor who has done a good through workup to include a history and physical and labs and good through memory tests
you have to have an apoe 4 genetic test since if you have this you are at a higher risk for the aria h bleeds
you if you are positive have to have counseling regards the risk
i was positive
i was counseled
i without hesitation said go for it i want this drug
i accepted the risk knowing there was not another choice for treatment

i saw a neurologists this week who said you know you are an interesting case
you should not be doing this well 

you have an mri
then
if its looking like alzheimers you either have to have a spinal tap for amyloid and tau or you have to have a amyloid pet scan for amyloid 
medicare will probably approve paying for these tests
if they are a positive you are a good candidate to receive this drug

it does not work in folks who have moderate alzheimers or severe alzheimers or the genetic early onset alzheimers or in early alzheimers if you have a high tau tangle level on a tau pet scan

if you do get approved you have to have the infusions at a infusion center 
the first one you have to stay there for 2-3 hours to make sure you have no reaction
the infusion itself takes about an hour

leqembi is setting up infusion centers across the usa so more folks can get them

some think a tau pet scan also needs to be done since if the tau levels are real high in the brain then these drugs wont work as well
right now these arent required

research is trying to decide how long to treat with these drugs then how often to do maintenance dosing

remember these drugs remove almost if not all amyloid plaques from the brain
the amyloid though is continuously being deposited into plaques so the meds have to be given regularly to keep the amyloid plaques from being reformed

so it probably means a lifetime of getting these infusions

for me 
i will finish my embark study in one year
i will then decide which way to go 
im leaning towards leqembi by injections at home when they become available
other results from all these studies though may alter that decision
also 
a new pill that removes amyloid and keeps the plaques from forming is being studied now
its expected to get  approval in about 2 years
that sounds good to me
then
right after that will be a medication to remove the tau tangles from the brain

so
eventually probably ill take a pill to prevent the amyloid from forming new plaques
then take infusions to remove the tau
then
when a new drug to treat the inflammation in the brain becomes available ill take that one

these new drugs the antiamyloid antibody drugs like aduhelm or leqembi or donanemab have opened the door to even newer drugs to treat this disease

next also
they will probably start treating folks who have the amyloid plaques in the brain with no symptoms
this will be diagnosed initially via a blood test in your primary care office
then
you can then start one of these new drugs plus do all the healthy things one should be doing

the goal
you wont ever develop alzheimers disease

for me
i am so early in my disease earlier than most so i have benefited most form these treatments
i like being an interesting case

these are exciting times in the alzheimers world

the organicgreen doctor

organicgreendoctor: kennel cough

organicgreendoctor: kennel cough: KENNEL COUGH thats my wife she on the shore above the pacific ocean near the elwood preserve where the monarchs come in the winter she is al...

kennel cough

KENNEL COUGH

thats my wife she on the shore above the pacific ocean near the elwood preserve where the monarchs come in the winter
she is all masked up since this was taken at the beginning of the pandemic in 2020
we used the outside parks and beaches and gardens to stay away from folks
we stayed masked anytime we went outside
later we unmasked outside as we knew more about the virus and how it spread

an aside
that little dot above her head is a oil platform that is shut down
its there forever however
one of these platforms in this area caused the massive oil leak that devastated this area  for years
it is the event that lead to earth day and the green movement

what is kennel cough
it is what dogs and cats get when put in a kennel then after you pick them up after your vacation they start coughing and coughing
it lasts for days
its caused usually by a virus

when i was in practice i use to see folks who would go on business trips to china and other countries
they would spend hours on the airplane
commonly beside fatigue and jet lack they would come back with this cough
i would tell them
you got kennel cough
you know
like your dog gets in the kennel when you go on vacation
you were like your dog and were locked up in an airplane for hours
so
you probably picked up a virus from the airplane and trip that caused you to have a bronchitis making you cough for days if not weeks

at that time there was no really good way to treat this or to prevent it
however
since covid and the heavy use of good n95 masks i expect the incidence of kennel cough has gone down

we my wife she and i recently took our first trip on a plane since the pandemic
we both wore our masks in the airport and the airplane
not so much to prevent us from getting covid
but
so we wouldnt get kennel cough

when asked why we were wearing masks we said
so we wont get kennel cough
say what they said
you know like your dog gets

those two crazy old folks they thought im sure

we popped our masks on as we entered the airport and popped them off as we exited the baggage claim

im sorry but all those germs circulating in that airplane for several hours
i want as many of them blocked by my mask to keep down the viral load
a few of them are bacteria that can be treated with antibiotics like legionella mycoplasma pneumococcal but the rest are viruses that have no treatment
well except for covid where you can take paxlovid

we should know in the next week if this worked
ie
if we dont get kennel cough

the organicgreen doctor

organicgreendoctor: my story revisited #181-why i cried all though sti...

organicgreendoctor: my story revisited #181-why i cried all though sti...: MY STORY REVISTED #181-WHY I CRIED ALL THROUGH STILL ALICE still alice is a movie and book about a women who developed alzheimers disease ju...

my story revisited #181-why i cried all though still alice

MY STORY REVISTED #181-WHY I CRIED ALL THROUGH STILL ALICE

still alice is a movie and book about a women who developed alzheimers disease
juleanne moore won an academy award oscar for best actress
i only saw it once with my experience described below
i dont want to watch it again

in 2015 i had finished the adni 2 study and was looking at treatment clinical trials
i was looking closely at the upcoming clinical trial of aducanumab which i was able to get accepted into the study the following year

now 8 years later i really didnt expect to be doing as well as i am doing now

this movie made me do a lot of thinking that week
as it probably did others

once i was diagnosed in 2010 i decided i would freely talk and write about my experiences
hopefully this will help others to do the same


later this week i will have another infusion of aduhelm at ucla
i have 10 more after that
then
i will wait until its decided by neurologists that i need to do a maintenance dosing of one of the antiamyloid drugs

i will probably chose either leqembi or donanemab since they work probably faster removing the amyloid than aduhelm does
__________
02-23-2022
WHY STILL ALICE BOTHERED ME SO MUCH
this weekend my wife she and i went to a special showing
of the still alice movie at the alamo drafthouse on south lamar
that was sponsored by the alzheimers association

a local neurologist the director of the alzheimers association
and i answered questions from the audience for over 30 minutes
afterwards
well i almost didnt make it through it all

what is the matter with me
i thought
as i started watching the movie
i figured i would tear up some
but
i started when the movie started
and
it never stopped all the way through the  movie

i thought theres no way im going to be able to make it through
that movie
then
get up in front of all those folks
and
answer questions about alzheimers disease
heck
i barely at times could see the screen for all the tears

i made my way to the front of the auditorium afterwards
still a little bleary eyed
started my 2 minute introduction
but
when i started talking about my mother my brother my dad
my older brother who fought and whose fighting the disease
i had to stop
and
discontinue talking

lets move on was said to some questions
i took a deep breath
thought i have to do this for them and myself
and
for those other people who wanted some answers
so
i sucked it up
finished my introduction
fielded the first question from a local newspaper reporter
and
did ok the rest of the way

i thought about all this later on my way home
why did it bother me so much to watch that movie
and
to get up and talk about my family and dealing with alzheimers

ive done it numerous times at multiple locations to groups of
all sizes without problems
granted
the first one i ever did after my diagnosis was to about 50 of
my fellow family practice doctors where i use to practice
the same thing happened
it was the first i had seen most of them after i had left there
a year before
i regained my composure then like i did this weekend
and
finished my presentation and fielded their questions

i realized that i had been thinking about my mother all week
and
about her fight with the disease
and
she would have been 93 on saturday
had she lived
had alzheimers not taken her away
almost exactly 8 years ago

seeing the movie
and
seeing those events still alice was experiencing
seeing her family and its dynamics
some accepting it some not
seeing her downfall
brought back strong memories
none of them good
wonder if flashbacks are like this
then
i thought a lot about my younger brother this week
since he had early onset alzheimers like still alice
now he didnt have the dominant gene kind like still alice did
but that doesnt really matter
since
the course and end result is all the same

then i thought about my older brother
just diagnosed over a  month ago
what he must be thinking
what he would feel if he watched this movie
its like a cancer diagnosis with no cure but maybe
a lot slower before it does its job

then
so much in the movie triggered things as i watched it
the memory test
brought back the memory of
sitting in the examiners office at the alzheimers center in dallas
being asked to name what those pictures were
five of the things i sat there staring like she did
knowing i knew what they were
but the words werent there for me to reach out
and grab to answer her questions

thats a you know that bird that flies on the beach and
eats fish
you know that thing you sit in on our deck
my wife she sits in it when she grades papers sometimes
i joke that if she grades in that thing they always get as

there were  more of those that day
and
i remember getting that stare
that sinking feeling she had that she showed on the screen
i remember feeling hot and sweaty
knowing what i knew about things
that
my moment had arrived
it changed my life and my familys life that day over four years ago

so thats why as i started watching the movie
i instantly teared up and didnt really clear up
until after i started answering questions

flashback and flashbacks were the answer i guess

so
i feel like all that was cathartic
even though i wasnt sure at the time
im glad i watched the movie
and
answered your questions

by the way so should you
watch the movie

i persevered to finish what i started that day
and
am feeling somewhat refreshed now
ready to move on
as
we all continue the fight against this terrible disease
alzheimers disease

congratulations to julianne moore for winning the oscar
there was no doubt that she would win

you and your older kids need to see it
just bring tissues
__________
it was hard to get up in front of that full movie theater and talk about my family and myself
but
i did it
i would hope more families and patients would do the same

talking about alzheimers is therapeutic

the organicgreen doctor

organicgreendoctor: happy anniversary mr hudson

organicgreendoctor: happy anniversary mr hudson: HAPPY ANNIVERSARY MR HUDSON this is mr hudson planting a pumpkin in our pumpkin patch about a month ago he planted this pumpkin seed in a po...

happy anniversary mr hudson

HAPPY ANNIVERSARY MR HUDSON

this is mr hudson planting a pumpkin in our pumpkin patch
about a month ago he planted this pumpkin seed in a pot in our greenhouse
yesterday he planted it in our patch
all by himself

today a day later is his 3rd anniversary
he had a kidney transplant from a generous donor 3 years ago

here is a review of his story for those who dont know it

late in the pregnancy it was noted he had kidney cysts
later it was decided he had blockage in the draining system from the kidneys

we wouldnt know how bad it was until he was born
mom was put at bed rest at home and eventually at the hospital
a month before he was due mom was transferred to cedar sinai hospital where they have a well known pediatric kidney specialist

he was delivered via caesarean section 
he was in heart failure and kidney failure when he was born
not long after birth a catheter was inserted which opened up the blockage
his kidneys began to drain ok however the damage was done
his kidney function was at about 30%

he spent about 2-3 months in the nicu 
overtime he lost all the retained fluid and his heart failure cleared up

luckily he lived off breast milk until he got older when a formula made just for kidney failure was used to supplement the breast milk
he was able to use breast milk till he was about 2 years old
thanks to his mom

interesting is that breast milk is the best formula to feed a child with kidney failure

he also received growth hormone shots since he wasnt producing enough to grow

he had to wait until he was about 20 lbs before he could have a kidney transplant which he reached at the age of two

his mom and several relatives and friends started a work up to see if they were compatible to donate a kidney to mr hudson


a distant cousins wife heard about mr hudson and contacted his mom to let her know she wanted to donate her kidney
as it turns out she was the best of all those tested to match with mr hudson

she is our kidney angel

the transplant was scheduled once but had to be canceled due to the pandemic

eventually the system said it was ok to transplant
thank goodness since his kidney function had deteriorated so he was about to go on dialysis

then they said ok we are ready

during the throes of the pandemic we were able to fly the donor via a private jet to keep her from getting infected

mr hudson was visibly not feeling well as it shows in the picture above
he seemed sad all the time and had a lack of energy

3 years ago today he had his transplant by his superwomen transplant surgeon
his stay was complicated by a blood clot in his rt arm from his pic iv line
he had to take a long course of antibiotics iv and a long course of heparin iv to dissolve the clot

eventually he was discharged
man
you could almost see him blossom day to day

he started to eat more play more talk more and become more like a 2 year old

now fast forward 3 years later
he is a typical almost 5 year old who loves legos and swimming and playing width ms b and his friends and going to school

he has a gtube in place so he can take in an adult amount of water since his kidney is an adult kidney 
he can only drink so much water himself
it will be removed eventually
he takes immunosuppressant drugs every day to keep from rejecting his kidney

last week he wanted to show his class how he waters his kidney so he did

his only major setback was a case of severe dehydration from a stomach virus that put him in icu for 4 days and 10 days in the hospital
otherwise he has been healthy 
he had covid once but did ok with the infection

he spent being isolated until he was 3 because of the pandemic and the fact he was immunosuppressed
he really hadnt been around many folks except for close relatives and close friends

now
he is much more outgoing loves to interact with folks and is quite an active almost 5 year old

a miracle boy is what we call him

happy anniversary mr hudson

the organicgreen doctor

organicgreendoctor: garden news-a week in the garden

organicgreendoctor: garden news-a week in the garden: GARDEN NEWS-A WEEK IN THE GARDEN recently our community garden had its first summer school garden week we limited the numbers since it was o...

garden news-a week in the garden

GARDEN NEWS-A WEEK IN THE GARDEN

recently our community garden had its first summer school garden week
we limited the numbers since it was our inaugural launch of the summer school program
here is the garden educator reading a book to some of the campers under the beautiful large grandfather pepper tree
this site is a favorite spot for folks to sit and relax hear the birds hear the wind blow the wispy leaves of the tree 
sometimes it has lots of bees buzzing around
kids like to lay on the ground and look up at the sky through the tree
sometimes they spy a large spider and its web maybe a squirrel or several birds or a hawk flying above 

we hope to increase this successful program next year to include more days

here is mr h and ms b looking in the telescope at the moon right before sunset
later the moon got brighter and more was seen via the scope
the same week as the summer program the local astronomy club brought several telescopes to our garden for the community to come see the skies at dark
we had a large turnout
most also toured our gardens to see it in the twilight


we have several native milkweeds in the garden that have been covered by monarch caterpillars
one crawled up on this comfrey plant 
hung itself upside down 
folded itself to form this chrysalis 
eventually a beautiful monarch will emerge from it
we have been able to observe several this spring and summer


in our front field we have a meadow that we planted wildflowers for the spring
here is some red poppies that brightened the field


after the wildflowers have dried up the field was cleared and tilled fertilized this week
we then prepped the field so we have 3 ft wide rows that we will plant about 140 pumpkins
we started all these pumpkins in our greenhouse a few weeks ago
ms b and mr h did one flat of them for us

the field is about 100 feet by 50 ft
later in late november it will turn into a christmas tree lot for our fundraiser then the cycle starts over again with the wildflower seeding for the spring

some of these pumpkins will be sold via our pumpkin sale
the pumpkin patch will be enjoyed by the local community for weeks

this fall we will have about 500 elementary kids come through the pumpkin patch and grandfather pepper tree area along with the rest of the garden for a 2 hour educational program
their favorite are the chickens 
each child will get their own small pumpkin to take home

the kids say its their favorite field trip of the year 

today with a large group of volunteers we will plant our pumpkins

also yesterday we hosted a tour group of high school students from the east coast to spend 2 hours in our garden
after the tour they harvested vegetables form our garden to use to make a large salad which they all sat down and ate
the vegetables were three different squash kale yes kale lettuce strawberries mulberries boysenberries malabar spinach mint tomatoes lemon juice orange slices

their favorite part of the tour
just like the little kids
it was the chickens
we let them take a dozen eggs with them to make breakfast with today



recently i decided i wanted to try grow bags 
so
i bought several online
they are 30 gallons and are made of a felt like material

inside the bag i added 
mulch
a mixture of soil and compost about half and half
then
i topped it off with a bag of good quality potting mix
i then added a dripper line to the grow bag

in this one i planted a celebration tomato that i grew from a cutting from one i planted earlier this spring

i now have 12 of these grow bags in our garden plot with these veggies in them
basil shashito pepper jalapeno pepper bell pepper sweet banana pepper curly leaf kale tuscan kale cucumbers black beauty eggplant Japanese long eggplant chard arugula tatume squash and strawberries

i am resting my beds since they were overrun with bermuda and mint
they beds are covered with plastic and mulch
next spring i will remove the plastic and mix all the soils together and start growing in the beds again

unless of course
the grow bags are more successful

there is always something going on in our community garden

the organicgreen doctor

organicgreendoctor: my story revisited #180-top questions you ask me r...

organicgreendoctor: my story revisited #180-top questions you ask me r...: MY STORY REVISTED #180-TOP QUESTIONS YOU ASK ME REVISTED in 2015 i wrote about the top 3 questions i am asked about memory here are my answe...

my story revisited #180-top questions you ask me revisited

MY STORY REVISTED #180-TOP QUESTIONS YOU ASK ME REVISTED

in 2015 i wrote about the top 3 questions i am asked about memory

here are my answers today 8 years later

should i be tested
yes if you are having memory issues
my answer is about the same
there are treatable causes of memory loss that can be treated
eg a low vitamin b12 or depression or mediation side effects
now add perimenopausal symptoms
you can definitely tell if you have alzheimers today with the amyloid pet scans and spinal tap for amyloid and tau and soon to be available the alzheimers blood tests

dont put off getting memory tested
if it is dementia its important to know and began treatment asap
i am the poster child for that approach

should i have genetic tests done
if you have memory loss that could be dementia my answer is yes
the early onset dementia that is genetic can be diagnosed with a blood genetic test
it runs in families
if its positive you will get alzheimers at a younger age
you may pass it on to your children

there is no treatment 
one couple who had a parent with early onset alzheimers had genetic testing done on their eggs to pick one that didnt have the early onset alzheimers gene so they could have a child that wouldnt grow up and get early onset alzheimers disease

should i have genetic tests done
thats a personal individual question for each person to ask
do you want to know

my thoughts for myself would be if there is a strong family history of alzheimers then i would definitely get tested

the early onset gene 
if you have this one you will get early onset alzheimers

the late onset gene
this is called the apoe 4 gene

if you have it your chances are increased you will get late onset alzheimers
if you have the gene you can beat the odds of it leading to causing late onset alzheimers by aggressively controlling your cholesterol controlling your blood pressure controlling your diabetes eating a mind diet staying active mentally physically socially maintaining a normal weight controlling depression or anxiety and getting adequate sleep

then
consider getting a blood test for amyloid when it becomes available soon
this is a screening test for amyloid buildup in the brain
its now used to screen patients for clinical trials for alzheimers treatment drugs
if yours is positive and you have the apoe 4 gene you definitely need to be aggressive in doing all those healthy things one is suppose to be doing anyway just more aggressively

if you get a positive test for apoe 4 especially the apoe 4 apoe 4 gene it wakes you up real fast that  you need to be aggressive in taking care of your health
you future longevity is in your hands

also consider getting in a clinical trial treating prealzheimers patients if you are apoe 4 positive
prealzheimers means you have positive amyloid in the brain but have no symptoms yet

soon
my guess is that aduhelm and leqembi and donanemab will get approval to treat folks who are prealzheimers
eg 
for me i have apoe 4 and my amyloid blood test and amyloid pet scan would have been positive when i was in my 50s
had these anti amyloid drugs been available then i would have taken them then

my guess is that you would get a treatments of say a year then get intermittent treatments annually or every 3-6 months to keep down the amyloid from accumulating

clinical trials like the ahead study using leqembi are ongoing at multiple sites across the us

i think this is where alzheimers treatment is heading 
treating long before symptoms start

i compare this to testing for high cholesterol and treating it with medication years before so you wont have a heart attack or a stroke and now we know to add alzheimers to that list

how am i doing
my memory testing is in the normal range and has been that way for the last several years
i do notice some subtle things like name recall and word recall that can easily be explained by my age
i keep my cholesterol normal and my blood pressure normal
i am doing all those healthy things listed in todays blog

my next infusion of aduhelm is next week
i will have 11 more after that
then science will determine when i get my next maintenance treatments after that
maybe once a year or twice a year 
ill let science tell me what to do

_________
02-20-2015
TOP QUESTIONS YOU ASKED ME
i am always asked a lot of questions about alzheimers
dementia memory loss
and
of course lots of gardening questions and rainwater collection ones
but
mostly today ill address the top three im asked about memory

should i be tested is asked at every presentation i do
i answer it this way

if you are having memory issues
you should seek an evaluation
there are a lot of things that causes memory issues that are treatable
like low thyroid low b12 abnormal electrolytes liver disease
kidney disease depression anxiety stress sleep disturbances
medication abuse of drugs and alcohol poor control of diabetes
blood pressure cholesterol
just to name a few

fix these and your memory might improve

before you go to the visit
if the memory is significant have a family member do
an online questionnaire on you like this one
fill it out and print it to take with you

also write out what memory issues you are having
take them in with you
take someone with you since many providers like to
interview family members also

make the appointment just for memory and nothing else

during the evaluation you should be asked lots of questions
labs should be done
a memory test should be done

if you have an in office one that doesnt take 20 minutes or so
to do then you did not have a good one
they are called mmse or moca tests
they may do one called a clock test or minicog as a quick screen
but on that one you have to be more advanced to flunk it

you may need a neuropsych test and an mri

here is the link to a pamphlet that is a gold standard
for evaluation of memory loss for providers to follow
the link is at the bottom of that page to the pdf file

it soon will be available in a quicker reduced form
you can look at this online pdf file to follow your workup
to make sure a complete evaluation is done

dont get ignored if you do go somewhere else for the evaluation

should i have genetic tests done
i would say no if you are not ready to accept what you find
if you are not ready physically mentally emotionally and
financially to get bad news

if a positive genetic test gets in your medical record
you will not get life insurance disability insurance
long term insurance possibly professional insurance like
malpractice insurance and in some cases health insurance
which thank goodness for obamacare most people could get
it even with a diagnosis

i have had relatives and friends get genetic tests done
that show the apoe4 double gene
if its positive and its in your record you will have problems
as above

the genes for alzheimers are rare
less than 1%
if its heavily in your family you could have it
if you have the gene you will get the disease

the apoe4 gene double version is the next bad one to have
your odds are increased 10-20 times you will get alzheimers
but it doesnt mean you will
even then it can be hard to digest and accept your risk

that said
i would want to know and i did want to know
so i got tested
granted this was after already being identified as having
memory loss
and
labeled as amnestic mild cognitive impairment
and
having been shown to have abnormal levels of beta amyloid
and tau in my spinal fluid

so as part of a total workup i had it done
probably without symptoms i would not
but
lucky for me i had all of my ducks in a row re insurances
when my diagnosis was made

that said
knowing you have this increased risk sure makes you more
aggressive in taking care of you health
which i think determines how this apoe4 gene will affect
your memory loss

how are you doing
i must say that compared to 4 years ago when i was diagnosed
and
took all my tests and did all those memory tests and
neuropsych tests
i am much better as evidenced by my scores now on those tests
and
based on what i feel and notice myself

i feel like that fog that was hoovering over me for a couple
of years seems lifted some

why
once all this happened i got very aggressive with my health
my blood pressure was always borderline high
it would come and go
so i gave in and got on a blood pressure medicine that keeps
it normal all the time now

my cholesterol was under pretty good control
but i have aggressively got my levels to those that someone
with heart disease or increased risk for heart disease should
have theirs at
specifically my ldl is less than 100 and my triglycerides are less than 100

i stay very active physically mentally socially as much probably
as when i was in practice if not more

i take aricept which could be part of the reason why im better

stop it and i will find out but im not willing to do that though
the problem with aricept is that it interferes with my sleep
i only get 5 hours a night
but
i compensate that with an afternoon nap
and
i now take a nightly herbal medicine that seems to get me back
my 1-2 hours i am loosing to the aricept
usually
but i do most of the time feel rested

that said the aricept causes a lack of energy and tiredness that
usually hits me in the afternoon
hopefully i dont demonstrate that tomorrow afternoon at the movie

luckily usually i am napping and have done most of what i
like to do in the morning

i take b12 supplements and vitamin d3 supplements since both of
these were low when i had blood tests for them

i eat a mostly vegetarian diet about 90%
i eat a morning egg and toast dried nuts and fruits
i do eat meat but its lean meat like turkey and range fed beef
some occasional chicken
i follow mostly a mediterranean diet
but if i go out to eat i eat what i want too

i am not depressed i dont feel stressed i feel happy and contented
i dont get angry it seems

then
i have been following the protocol from the
reversal of cognitive decline study from dr bredesen from ucla
most of which i was doing already

putting all that together
the answer is
i think i am doing better


still alice
the special showing of still alice  with the alzheimers association at 155pm which
will have a panel that includes me and two others to answer your questions
afterwards
is sold out

it is showing several other times that day and at other locations in austin
for you to see it
it is a must see movie for i think everyone
even young folks since i think they need to be thinking about this

for those who got tickets to the q&a session ill see you there
_________

so my answers are about the same
maybe i would be more aggressive with genetic testing and early treatment of alzheimers

watch still alice to see what happens to the patient and their family as the disease progresses

the organicgreen doctor