Friday, October 27, 2023
organicgreendoctor: alzheimers news-wish i could do this one
alzheimers news-wish i could do this one
ALZHEIMERS NEWS-WISH I COULD DO THIS ONE
i have not been able to find the results yet
i do have an appointment next week art ucla where i see the research neurologist who was at the conference and we will get a report on what our study showed from her
my drug aduhelm removes amyloid plaque slower than the leqembi drug does
the question is after 3 years of infusions is the plaques all gone ie does it work as well as leqembi does
i think the results will show it does
leqembi reported out its study where it was given as a shot ie subcutaneous injections every week
its results show taking it as a shot works as well as getting bimonthly infusions
what this means its you can give it to yourself at home each week
they are applying for fda approval in march to do just that
the big hassle of getting infusions is the trip to the infusion center and waiting on the infusion to be readied by the pharmacy then getting the infusion over an hour
our trip from the time we leave our house to the time we return is about 7-9 hours depending on traffic
in the future if i were to receive leqembi i could get it at home
probably a 10 minute event
my guess is my drug aduhelm even though it probably will work will fall by the way side and leqembi and the soon to be released donanemab will dominate the alzheimers treatment market
this week a new study at ucsf university of california at san francisco caught my eye
if i could qualify i would enter this study
my enigma is that ive had my amyloid plaque removed by aduhelm and until it returns over the next 5-10 years i probably wont qualify for any studies
tau tangles in the brain are lowered somewhat by the aduhelm and leqembi and probably donanemab but not significantly enough to probably make a difference
in the ucsf study they will be giving leqembi to remove the amyloid plaques but then also they will be giving two new anti tau drugs that will remove the tau tangles
thus
treating 2 of the 3 things that occurs in alzheimers thats does all the damage
amyloid plaques and tau tangles
the only thing left is the inflammation
new drugs are being studied now to do treat the inflammation
all 3 of these destroy brain cells
so
we are getting closer to treating this disease with drugs that will significantly slow it down
anti amyloid drugs like aduhelm leqembi or donanemab are here now
anti tau drugs are in the final studies and will eventually be available
anti inflammation drugs are in early studies
for me
i will try to get an anti tau drug as soon as its available
i probably will not be able to get in a clinical trial since i took aduhelm
then
when the antiinflammation drugs are available ill take those
for many of you younger than i am
you will need to be diagnosed early
maybe even before you have symptoms
then
you will be able to get these 3 classes of drugs to slow down or stop alzheimers
we are getting closer to someone getting that white alzheimers flower for the first survivor of alzheimers
who knows
that could be me
the organicgreen doctor
Thursday, October 26, 2023
organicgreendoctor: garden news-a busy month in the garden
garden news-a busy month in the garden
GARDEN NEWS-A BUSY MONTH IN THE GARDEN
this is me leading a group of kids through our tunnel of trumpet squash hanging down from a trellis
as i walked through the tunnel i hit the squash making them swing back and forth so its like an obstacle course
i tell the kids not to touch the squash and try not to let the squash touch them as the squash sways back and forth
they never listen but they enjoy the experience
here after a 20 minute session on nature appreciation where they sat under the big ole giant grandfather pepper trees and they learned about the bees and the big ole tree and listened quietly for a few seconds listening for sounds and listening to the song what a beautiful world by l armstrong
i told them first we would take the poppy seeds in their pincher fingers and throw them on the hillside
so that this spring poppies would be growing there
then
i warned them we were headed into the banana grove to see the banana trees and the bananas hanging down with its big ole purple flowers
there also may be a monkey sighting
geoge the stuffed monkey
some believe he is real and some dont
they get quiet though as they travel through the banana grove
before we get to the banana grove we stop along the way
i tell them that in nature the poppies pop out their seeds into the air to plant them
they are allowed to throw their seeds or pop them out over the hillside on the count of 3
yes i count in my donald duck voice which they enjoy
they are told to come back this spring to see our poppies in our garden
some will be theirs
our fall harvest program had over 400 elementary students do our 2 hours program this month
they also picked their own pumpkin
lots of smiles this month
we received a large grant this year to help with our expenses
so we bought a 15 yard load of good organic compost to use in our gardens
we make most of our compost ourselves but we need more especially during fall and spring plantings
remember the best compost is the one you make yourself
you know compost is good when you feel like you could eat it since it smells and looks so good
we will add about a 3-4 inch layer of compost on our beds prior to planting
this will be forked in along with some organic compost then the bed will be raked out smooth
we are hoping for a good harvest this year of our fall and winter crops like
cabbage dino kale curly kale swiss chard celery cabbage broccoli onions leeks some beets and carrots lots of sweet peas and snap peas cauliflower and herbs like cilantro and parsley
all will be donated to those in need
we start most of our plants from seed in our greenhouse
we have a greenhouse volunteer that i convinced to run the greenhouse operation
so most of our veggies that one sees growing in our garden was started in our greenhouse
this winter though we will get our onions and leeks from a supplier in texas called dixondale farms
interesting is some of the local nurseries and seed companies get their plants from there also
we plant the onions after thanksgiving and the leeks after the new years
the beds are already prepped with compost and organic fertilizer awaiting the onions and leeks arrival
we also start our fall plant sale next week selling the same plants we have growing for our garden
it runs the month of november ending with our christmas tree lot sale on december 2nd
last sunday we had a leader of the chumash native anerican tribe come talk to folks
it was well attended
he gave a history of the lands around here before the area was taken over by outside folks
and the history since then
he also did his fire dance
the chumash use to use fires to burn some of the lands
this is natures way of rejuvenating the soil and the foliage
we showed a charlie brown movie last weekend also in our front pumpkin patch area after dark
this weekend i will tour a group of gardeners from a local garden coop
it usually takes about an hour to do
then next week a girl scout troop will do an hour tour and do some harvesting that we will donate
later next month a jewish church group will come in to do a 3 hour work day with us
so
this community garden is doing its thing
educating all ages on gardening
providing food for those in need
providing a location for folks to grow their own food
providing a place for others to enjoy
yes
im tired but happy after all this activity this month
i am also the new volunteer garden manager
this is a picture of our evening in the garden fundraiser where about 60 people attended last month
its also the picture we used for our fundraising crowdfunding that starts next month
seedmoney.org allows community and school gardens to fund raise then allows them to compete for grants of up to $1000
eg we spend about $1000 a year on supplies to grow our veggies for planting and our plant sale
go to this link to see our crowdfunding site
https://donate.seedmoney.org/8831/trinity-gardens
on or after november 15 please consider donating to help keep our good work going
the more we raise the higher a grant we qualify for
even small amounts like $5 or $10 will help
thanks
the organicgreen doctor
Wednesday, October 25, 2023
organicgreendoctor: my story revisited #191-the facts arent better
my story revisited #191-the facts arent better
MY STORY REVISITED #192-THE FACTS ARENT BETTER
thats me talking at the 2023 walk to end alzheimers in santa barbara
in 2015 i did the similar talk at the austin alzheimers walk
in my old blog below i mentioned all the stats on alzheimers from 2015
the numbers havent gotten better
here is a link to the alzheimers facts and figures for 2023
here is a short video on the numbers
we are making progress in the treatment of the disease and probably more important is educating the public on how to slow down the disease with healthy lifestyles
the younger the better
_________
04-02-2015
ALZHEIMERS NEWS-THE NEW FACTS
the 2015 new facts are out from the alzheimers association
here they are
its the only cause of death in america in the top 10 that cannot
be prevented cured or slowed
almost 2/3 of americans with alzheimers are women
1 in 3 seniors die from alzheimers or related dementias
alzheimers is the 6th leading cause of death in the united states
only 45% of the alzheimers patients or their caregivers report
being told of their diagnosis
while 90% of the patients with the 4 most common cancers
have been told of their diagnosis
in 2015 alzheimers and related dementias will cost the us
226 billion dollars
$226,000,000,000
by 2050 those cost could rise to $1.1 trillion
$1,100,000,000,000
every 67 seconds someone develops alzheimers in the us
my thoughts
some researchers think when they look at the data
that alzheimers is really the 3rd leading cause of death
there are 5.1 million in the us with alzheimers over 65
by 2025 the number will be 7.1 million
by 2050 the number will be 13.8 million
from 2000 to 2013 the number of deaths from alzheimers
increased 71%
there is some hope that we may be able to delay its onset
by taking care of our national health
with
the mind diet
control of blood pressure cholesterol diabetes weight
exercise
adequate sleep
etc
its interesting that if we cured alzheimers disease
that the national debt each year is the same as what
we will be spending on alzheimers if we dont get a cure
i as a physician cannot imagine not telling a family or
a patient that they have alzheimers disease
like a cancer diagnosis they have a right to know
i have a sign in my front yard
that says every 69 seconds someone is diagnosed with the
disease
its two years old
time is ticking away for us
now its 67 seconds
we need to stop time in its tracks
we need help from congress
we need help from you and me
________
in 2015 i was one year away from being accepted in the biogen aduhelm clinical trial and 2 years before i started receiving monthly infusions in the study
my first 18 were placebo and my last 35 were the real drug aduhelm
next week i do my exit visit for the study to include a full neurological evaluation and memory testing for several hours and blood tests
then
i will have a final amyloid pet scan and a tau pet scan next month
then
i am done except for maybe a final exit interview in march of 2024
this morning at the clinical trials on alzheimers disease conference in boston the result of my study will be presented at a presentation
hopefully those results will be available online also
the neurologist who directs the study at ucla will be there and will give us a report next week at our visit
how good the results are will be important in deciding what i do next
my prediction is that it will show most if not all the measurable amyloid plaque is removed and most likely there is some lowering of the tau tangle levels in the brain
this is where our 8 year journey we have been on ends
the organicgreen doctor
Tuesday, October 24, 2023
organicgreendoctor: this is where im from
this is where im from
THIS IS WHERE IM FROM
wikipedia,org
this map from the linked wikipedia article on the southern accent shows where it can be found
there is a little dot though out in california where i live
thats dot is me
twice in the last two weeks ive been asked that question that southerners get sometimes when they travel or move
where you from
when doing an elementary tour through the garden a mom asked me
where you from
her mother in law lives near the country n where we use to live so we talked about the area
her mother in law was thinking of moving here
wonder if she has an accent she cant loose
the other time i was doing the walk to end alzheimers in santa barbara and was at the back of the walk as usual when i found myself walking besides this lady
she looked at me and said
i enjoyed your talk before the walk
but
here it came
where you from
my accent which i dont notice unless i hear a recording of my voice is a an influence of where i have lived
i grew up in southern arkansas where the closer you get to the louisiana border the deeper the drawl
i moved in my my early 20s to southern california where i lived for 7 years
from there i moved back to central arkansas to attend medical school
then i moved to central texas where i lived for 30 years
then 6 years ago i moved back to Sothern california
all those locations have had an influence on my accent
i know when i moved back to arkansas folks said
where you from
like they do now here in southern california
so i read with interest this article on the changing accent in georgia especially around atlanta where folks have moved in from everywhere and also now with social media and the internet and tv the accents like the areas genetics is getting all mixed up
so
the southern accent is fading in that area
i presume it is is fading in the austin area some now since its growing like atlanta has
also the generation x kids are losing their accents
however
if you drive out from austin about 30 miles and go to some feed stores or country stores or local bars there is not a loss of the southern accent
as i was practicing my talk for the alzheimers walk i listened to my accent
yes
its there
its not going away
i hope it doesnt change
such that folks will say
you know that guy that talked at the walk or that volunteers at the garden who talks with that southern drawl
if thats how i get identified
im ok with that
im still gonna say yall come back now ya hear
the organicgreen doctor
Thursday, October 19, 2023
organicgreendoctor: talked at the walk
talked at the walk
TALKED AT THE WALK
thats me trying to talk at the walk to end alzheimers this last weekend in santa barbara in the middle of the eclipse
i say trying because it took me awhile to recover myself before i could do my 5 minute talk
the picture is blurry since its from a video
but
thats the way i felt when i was talking
blurry
now i have talked at a walk to end alzheimers somewhere every year since 2010
i must say this time it was harder for me to get started
much harder than usual
one thing i learned since the first time i did this at the santa barbara walk to end alzheimers in 2017 was to not look at my family because if i did i would not be able to finish
one year ms b was younger and she cried out granddaddy
it did take me awhile to compose myself on that day
the one i cried the most was when we did the walk to end alzheimers in little rock arkansas the year my younger brother died from alzheimers
his family was there
there is no way i could have talked that day
i got a reprieve during the pandemic since we did a virtual walk for two years
no crying that year well i did cry some
this year though i said i wasnt going to cry and choke up before i talked
well
that didnt last long
i almost wasnt able to get started this year
why
well it started with this talented singer singing the nat king cole song unforgetable
this song by the talented singer in this setting was more than most of us could handle
there were tears flowing throughout the crowd of about 600 folks
for me it brought back a flood of memories while i was standing near the stage waiting to talk about my story with alzheimers
i thought of my mothers battle with alzheimers and my younger brothers battle that started at such a young age
both battles ended like alzheimers usually does in the final stage
it wins ugly
i thought of them a lot while he was singing
crying the whole time me not him
thinking of my journey and where would it go after finishing the study
when will my disease take off
seeing my two grandkids in the audience and thinking of the other two grandkids
how long will i get to enjoy them and remember it
how long will my wife she and i be meaningfully together
all that was going through my head when i was standing up there waiting
next the person with the yellow flower for a caregiver stared talking about her granddad barely able to talk
then the person with the purple flower for someone who lost a loved one had trouble talking
then i got the blue flower for the someone with the disease
by the time all those folks choked up cried sobbed and talked combined with that rendition of unforgettable
well
i really had a hard time starting to talk
i almost walked off the stage
but
i took a deep deep breath looked up into the skies where the eclipse was fading away
thought of mom
thought of my younger brother
thought of my family
i said
you have to do this
so
i did
yes i made folks cry even more
i think as we walked looking back at the turf on the field where everyone was standing
it was soaking wet from tears
i must say it was one of our better walks
the walk will raise close to a quarter of a million dollars
most of the funds will go to research and to the important alzheimers education
these walks and talks are hard to do but i do them since i know they are important to us in the alzheimers world
you also can still donate to my team organicgreendoctor linked below
our santa barbara walk to end alzheimers was on saturday october 14th
donate here to our organicgreendoctor team or donate to your own local walk team
the organicgreen doctor
Tuesday, October 17, 2023
organicgreendoctor: swiftonomics
swiftonomics
SWIFTONOMICS
wikipedia.org
this is a picture of ts from 2007 from the wikipedia article
her story is well documented in this article
i enjoyed reading her story
i had a chance to go to the ts era tour in los angeles but i chose not to
i also could have gone to the era tour movie here in santa barbara
i have chosen to wait so i can see it online in the privacy of our condo
without so much noise around me with my headphones on turned up loud
my wife she will be the only one i swap a friendship bracelet with
yes ms b is a swiftie also
yes my family loved the concert as did they love the movie
but
me ill just wait
ts turns everything she touches to gold it seems
except for her boyfriends
it seems she is nearing billionaire status thanks to her era tour
add to that the movie and the world tour
she is having a huge effect on local and regional economies
she along with barbie is saving the movie theaters this year
she even is increasing the attendance and prices of tickets to football games
along with increasing viewership of televised nfl games
could she help save our economy
maybe somewhat
the presale of her era tour movie tickets hit a $100 million dollars
i read this bbc article on her economic impact
in denver colorado her concert there added $140 million to the states gdp
in glendale arizona the site of a recent super bowl her era tour brought in more money than the super bowl did
each swiftie spends about $1300 a piece on things like food lodging clothing uber lift travel and merchandising
she even gave her truckdrivers all of them a $100000 bonus
overall the era tours are boosting our economy by $5 billion dollars
add to that is the era movie tour that just started
she has 50 more world tours to go also
yes my wife she contributed to her financial success and helped the southern california economy
this is the way to do a stimulus to our economy
take notice politicians
the organicgreen doctor
Friday, October 13, 2023
organicgreendoctor: garden news-fall harvest program
garden news-fall harvest program
GARDEN NEWS-FALL HARVEST PROGRAM
these are the colors of the rainbow
this is a tarp with the rainbow colors on it
in our community garden we grow these colors of vegetables or fruits
each fall we do a fall harvest program that brings about 500 elementary students through our garden
we do four 25 minute sessions with each group of students
we have 13 schools that send their students here over 13 days
the sessions last from about 9-11am
each child gets to harvest a baby pumpkin from our pumpkin patch
here are the foods we grow or as we call them rainbow foods
purple eggplant passionfruit jujube mulberries
blue blueberries
green kale collards spinach green beans peas peppers onions celery leeks
white white pumpkin white eggplant
yellow squash lemons grapefruit bananas bell peppers
orange oranges pumpkins carrots
red tomatoes apples peppers
red foods eg are good for the heart
this is the nature appreciaton session under the grandfather pepper tree
the kids love this one
its their relaxing session to learn about the bees and how to appreciate nature
this is the group walking from the nature appreciation session along a walkway with various fruit and nut trees like passionfruit thai limes mango bay fig macadamia nuts cherimoya pomegranate jujube some i cant pronounce or spell
along the way each student has a pinch of poppy seeds
we pause
count to three with me counting in my donald duck voice
then we pop or throw them onto a small field where they will hopefully germinate next spring
and
produce a blanket of beautiful orange or red poppies
that kid in the orange shirt is mr hudson
yes he enjoyed the visit even though he comes to the garden all the time
from throwing out the poppy seeds or should i say popping them out
the kids go into the banana grove and try to find the racks of bananas hanging from the trees
all knowing there is a monkey named george sitting in one of the trees
they know he is not real
but
they still get quiet when i shake a banana tree and tell them thats how it sounds in the jungle when a monkey jumps from tree to tree
they all get excited when they see george
if you ask them whats the highlight of the field trip
they will mostly say george the monkey and the banana grove and their own pumpkin and of course the chickens
the other two sessions is one on seeds where they go through our greenhouse and see all our baby seedlings growing and see our loofas growing and get to plant their own sweet pea in our garden bed
the other one is the pumpkin or squash session where they see all kinds of different pumpkins and learn about how the pumpkin grows from seed
they also see if a pumpkin floats in water
the answer
it does float
the other highlight beside george the monkey is getting to pick their own pumpkin from our pumpkin patch
after the pumpkin session they get to go see the chickens and feed them some chicken scratch and vegetables
this is another highlight of the trip
a two hour field trip they will be talking about for awhile
george and the banana grove
the chickens
their own pumpkins
the organicgreen doctor
Wednesday, October 11, 2023
organicgreendoctor: my story revisited #190-my first infusion and now ...
my story revisited #190-my first infusion and now my last one
MY FIRST INFUSION AND NOW MY LAST ONE
in my old blog the title is 1 down and 47 to go
it turned out to be 1 down and 52 to go
there was a pause of about 2 years partially due to the pandemic
when it was reactivated after the pandemic i found out i got the placebo
it felt unsettling that i got the placebo since i had a 67% chance of getting the real drug
all said
we my wife she and i were excited when the study was restarted after the pandemic
during the time i was in the study i was interviewed numerous times by local and national news organizations about being in the study
yesterday was my last infusion of aduhelm or aducanumab
if i could see my last amyloid pet scan all or most of the amyloid plaque should be now removed from my brain
the question is does removing that from my brain translate to slowing of the disease
this study should be reported out soon so i will know how well it works
my guess it will be close to leqembi results maybe around 25% reduction in memory decline
my journey started at the university of texas southwestern in dallas in 2016 and ended at ucla yesterday
we have been in this study for 7 years
we said our goodbyes to the staff yesterday
we will do a final exit interview in february of 2024 to include a neurological exam and several hours of memory testing
i may or may not have to have another amyloid or pet scan
i have probably had close to 15 mris and about 4 amyloid pet scans and about 2 tau pet scans and about 40 hours of memory testing and several ekgs and several lab draws
we had about 300 hours of driving time and around 150 hours in infusion centers
all of it was worth it
it was surreal knowing this was my last one
i do remember though the excitement of getting that first infusion in 2017
__________
03-24-2017
ALZHEIMERS NEWS-1 DOWN 47 TO GO
i did it yesterday
got my birthday present
as i wrote the best ever
as i drove the 3 hours trip i did a lot of contemplating
thinking about this 6 year long journey that i have been on
hoping it will last a long long time before its all over
i thought how lucky i am to be this far along
and not have worsening memory loss
during that time this last 6 years
i lost my brother from the final stages of this disease
had my older brother get diagnosed with it
i thought maybe just maybe i am the lucky one
getting an opportunity that they didnt get
to really really slow this down
i am honored to be in this trial
knowing that if its successful as it might be
that it could be a game changer for me
and all my relatives behind me
to have a chance to avoid this awful disease
thats how close we are to finding a treatment
its right now today not off tens of years from now
for me and my family it started yesterday
yesterday the day for the rest of our lives
lets getter on is what i muttered under my breath
i arrived yesterday early of course to the infusion center
its located in this building at the university of texas southwestern
medical center
i walked up to this desk where the busy infusion center is
there sits this guy called santa claus
he is the receptionist
everyone calls him that
since he looks like santa claus
and
plays one at christmas
nice as you would expect santa claus to be
nice first person to interact with
then there was some snafu
we may have to reschedule
some protocol has to followed exactly right
i was the first one starting this study there
some special approval had to done by some god in massachusetts
or somewhere back east at biogen
we may need to reschedule if you dont want to wait
nope i said
im staying until this gets settled
ive waited too long and this may mean to much to me and my family
i just want to get this thing done
getter done i mumbled under my breath
finally after awhile it all got cleared up
back i went
nice nurse
nice receptionist
nice neurologist
it helps to have nice medical personal taking care of you
when you are dealing with the unknown
dealing with a terminal illness
i remembered as i watched them start my infusion and draw my blood
their patients are the ones that dont usually fair well
its their diagnoses
below thats the brown bag stuff hanging on the pole
the stuff thats either fake stuff or the real deal
the real deal for me please
me
i thought as i watched them hook all this up
i want to be the exception for them
i want to be a success result
the only thing i noticed as i got my infusion was
that i tasted salt on my tongue and i got real thirsty
dont know if thats a good sign or not
when it comes to whether or not i am in the placebo group
or not
if i get headaches get confused have some dizziness
then theres a good chance i got the real deal stuff
however not everyone has side effects
i am at higher risk for side effects since i have the apoe 4/apoe 4 gene
this gene put me at an increased risk for getting alzheimers disease
prior to getting the infusion i had a memory test done
for some reason i noticed that i did better on it than usual
it may be because i have had it done so much
i can anticipate the answers before they ask the questions
however
they for this study do a variety of memory tests
most of which i havent done before
which make them more accurate
so
i finished my infusion without any effects
now
i return each month to do the same thing all over again
except
i dont have to wait around the extra hour or so like i did
this time
in and out in an hour or so each time
i decided i can deal with whatever problems pop up
for
in the end it may be all worth it
i scheduled my next infusion date on 4/20
i did that date on purpose
its in case you dont know is marijuana day
why pick that day
well
there is a lot of research that needs to be done on the ingredients
in marijuana
they appear to be useful in the treatment of neurological diseases
like alzheimers
however
the federal government severely limits the research that needs to
be done on these marijuana ingredients
in my contact with folks affected by these diseases
they are using marijuana
obtaining it from states where its legal
using strands that have the potential to help
its sad that good scientific research cant be done
to find things like this that may help
its my small way of protesting our governments restrictions
on this research
but
hopefully if this aducanumab stuff works for me
i wont have to get involved with using any 420 stuff
next
a month of waiting
then
round two
keep following me on this journey
i am hoping the end result will be a good one
if it is
there may be hope for a lot of people
__________
so far the marihuana or cannabis treatment hasnt been proven yet
the feds are starting to allow more research on it
i tried cbd but i think it interacted with my aricept to effect my dreams making them worse
cbd has anti inflammatory effects
maybe science will settle whether it helps or not
as i look forward i know that probably all my measurable amyloid plaques are gone from my brain
the question is will that make any difference in how the disease progresses
time will tell
the journey is well worth it
now i will continue doing all the healthy things ones should be doing for their health
i will control my blood pressure my cholesterol my weight
i will stay busy mentally physically and socially
i will continue on the mind diet
i will do all the healthy things one should be doing also
then
ill search looking for something to remove the tau tangles from my brain and something to treat the inflammation thats occurring up there
those drugs are on the horizon
i will keep an eye on them
i do feel like my aduhelm the new drug leqembi the soon to be released donanemab and others will slow down the disease
but
they wont stop the disease
they will only slow it down some
they wont cure the disease
for
there is no cure for alzheimers disease
but
they do give us some hope
and
SOME HOPE IS BETTER THAN NO HOPE AT ALL
do your part be looking for your local walk to end alzheimers in your area
join a team and or walk with them
donate to the cause
you also can donate to my team organicgreendoctor linked below
join me for our santa barbara walk to end alzheimers on saturday october 14th
join us and or donate to our organicgreendoctor team
or do your own local walk