welcome to the organic green doctor blog

i am a family physician who was diagnosed with
early mild cognitive impairment(mci) amnestic type on december 21, 2010
this is a precursor to alzheimers disease
because of this diagnosis i have opted to stop practicing medicine
this blog will be about my journey with this disease
please feel free to follow me along this path
i will continue blogging on organic gardening, green living,
solar power, rainwater collection, and healthy living
i will blog on these plus other things noted to be interesting

Wednesday, November 20, 2024

organicgreendoctor: alzheimers news-why i am better

organicgreendoctor: alzheimers news-why i am better: WHY I AM BETTER getting aduhelm infusion at ucla this fall i was interviewed via zoom by deborah kahn from being patient.com she was intervi...

alzheimers news-why i am better

WHY I AM BETTER

getting aduhelm infusion at ucla

this fall i was interviewed via zoom by deborah kahn from being patient.com
she was interviewing me about my finding out my apoe4 apoe4 status
if you are in the alzheimers world i suggest you follow her website

apoe 4 is called the late onset alzheimers gene
if you have the single apoe4 ie heterozygous your risk of getting alzheimers is about 5 times increased
if you get the double version apoe4 apoe4 or homozygous your risk of getting alzheimers is about 12-20 times

you can partially overcome that gene by living a healthy life doing those things mentioned below

after we talked about my homozygous apoe4 status she asked me a lot about my story 
the more we talked the more she was interested
she asked if i would write two articles to submit for possible posting on their site 

one i wrote about here in this blog called why i did it

the second one she wanted me to write was

what finding out my genetic status meant to me

several things happened at the same time
i find out i had mci that has turned out to be due to alzheimers disease while taking a neuropsychological exam as part of the normal control group of an alzheimers research study called adni 2 or alzheimers disease neuroimaging imitative 2 it was found i had memory loss greater than it should be for my age and degree of education
i was advised to see a neurologist who gave me my diagnosis and also put me on aricept or donepezil

at the same time i had a spinal tap for amyloid and tau plus i had my apoe4 gene status checked
my spinal tap was compatible with alzheimers disease and my apoe4 was homozygous

my reaction to all of this was overwhelming at first
i was sad i cried a lot 
i always knew i would get alzheimers and knew when i did have any symptoms i would retire from practicing medicine
i got chills and got sweaty when i took my memory test
i cried and i wanted to be alone for a while
each of these results just piled on top of each other

i didnt really understand what the apoe4 gene meant then but now i do
i felt it getting the results was another nail in my coffin

here i am 14 years later cognitive normal
my moca test and mmse tests are normal and have been so for the last few years.

knowing what i know now i would not have been surprised since i have such a strong family history of alzheimers and have a terribly high cholesterol level well controlled on meds now

now i know i could have overcame this apoe4 gene if i had been even more aggressive with my health when i was younger

specific lifestyle changes i made in response to knowing i had apoe4 homozygous

after my diagnosis of mci and getting my amyloid and tau results and getting my apoe4 results i got more aggressive with my health
i was borderline hypertensive so i started blood pressure meds
i got on a more aggressive statin regimen to keep my ldl cholesterol below 100
i changed my diet to a mind diet 
i say i am a 90% vegetarian
i take aricept which interferes with my sleep at night so i take a daily afternoon nap or 1-2 hours
i stay active mentally socially and physically
i dont smoke and i dont drink alcohol

why i believe i am cognitively healthy 14 years after my mci diagnosis

i started aricept or donepezil early in my diagnosis probably earlier than most people do
aricept slows down symptoms but also folks who take it early on tend to do better with their symptoms over time and also live longer
i follow all those healthy things i listed above

in 2016 i was accepted into the biogen aduhelm study where i received 18 months of placebo then 34 months of aduhelm infusions
aduhelm is a monoclonal antibody against amyloid and given as an infusion it removes amyloid plaques from the brain

at the beginning of the study i had amyloid plaques on my amyloid pet scan
after completion of the treatments the measurable amyloid plaques were not present on my final amyloid pet scan

all these things added up are why i feel like am doing well 14 years after my diagnosis
i am glad i was diagnosed early and am aggressive at taking care of my health and was able to access clinical trials early for treatment

i am waiting now to find out what to do next

the organicgreen doctor

Tuesday, November 19, 2024

organicgreendoctor: its dark out there

organicgreendoctor: its dark out there: ITS DARK OUT THERE the other day it was dark and dreary outside i had just gotten up from a 2 hour late nap after not sleeping well the nigh...

its dark out there

ITS DARK OUT THERE

the other day it was dark and dreary outside
i had just gotten up from a 2 hour late nap after not sleeping well the night before
i felt groggy headed and tired feeling

someone said to be this time change makes me almost feel depressed and tired all the time
i agreed i said
especially on that day

the time change for daylight not savings time i dont like

now i like the extra sunlight in the morning
every morning around 6ish the sun peeps over the condo roofs and floods into our living room and dining room
its like a jolt of expresso when the sun hits me in the face
i like to stand up and open my arms and close my eyes so i can feel the warmth

I can feel my pineal gland kicking in up in my brain

sadly 
after my nap
thats all gone since it gets so dark so early 

my body just cant seem to get adjusted to the time change
i still wake up at the right time its just the clocks says its an hour earlier

i was feeling sad and bummed for myself suffering so
until 
i read this article about what its like to live in this alaskan town
utqiagvik
no thats not me mistyping thats the way its spelled

it is 330 miles north of the artic circle
it gets 2 month of total darkness in the winter
the sun sets on november 18th and rises again on january 22nd
for only 48 minutes
but
then they have nothing but sun from may 11 to august 19th

im sorry i dont think i could survive living there
my pineal gland wouldnt be activated for several weeks at a time
how bad must they all feel during that dark 2 months

I wonder if those 5000 folks who live in that town all are on antidepressants most of the year
they probably add it to the drinking water along with the fluoride

we thought we had it bad during daylight not savings time
i guess when we think things are bad
they could be worse
i dont plan on going to alaska either in the winter

i still dont like daylight not saving time

the organicgreen doctor

Friday, November 15, 2024

organicgreendoctor: alzheimers news-why so high

organicgreendoctor: alzheimers news-why so high: ALZHEIMERS NEWS-WHY SO HIGH this graph above is from the cdc and a newsweek article linked here if you click on the cdc site or the newswee...

alzheimers news-why so high

ALZHEIMERS NEWS-WHY SO HIGH

this graph above is from the cdc and a newsweek article linked here
if you click on the cdc site or the newsweek article there is an interactive you can click on to see the numbers from each state

the alzheimers association color is purple
on the map the darker the purple the higher the death rate from alzheimers

why is it high in washington
if you look across the deep south almost all of the southern states have a higher rate
why
poor health outcomes like obesity hypertension diabetes poor diet poverty and lack of health care
mississipi ranks number one 
maybe they should be spending more money on their health than on their highly ranked football team
priorities i guess

when it comes to your health you get what you pay for

interesting is that these southern states have the highest rate of alzheimers ie for older folks and they also have the highest rate of maternal and infant mortality 

both due to poor health systems

texas eg has the highest rate of maternal and infant mortality
worse even more than some third world coundtries

they are killiing off folks at both ends of the life cycle
doesnt have to be that way
texas is not a poor state
there is no excuse

washington is higher i think because like utah and idaho they have an older population 
the older you get the increased chance you have to get in alzheimers

the last several years there has been lots of research that shows that addressing ones health and ones communitys health can address or lower the incidence of alzheimers

eating a healthy diet as early in life as possible is important
the mind diet is a good place to start

avoiding obesity 

exercising and staying active mentally and socially

controlling your blood pressure starting early in your middle age
controlling your cholesterol taking medication to do so if needed

controlling anxiety stress and depression

learning to meditate in some way 
i do gardening

getting adequate sleep 
sleep is when your body cleans out debris in your brain that left there accumulates over time

dont smoke
dont drink or drink limited amounts

doing these over your lifetime can decrease the incidence of alzheimers by almost 50%
that works better than aricept or donepezil or leqembi infusions work

additionally it also helps prevent strokes and heart attacks

today as i sit here thinking about this as we approach our 14th year of doing walk to end alzheimers i see a lot of progress being made in alzheimers treatment
but
like it was in 2010 when i was diagnosed
the best treatment plan is still even with the new moncolonal antibody infusions like my aduhelm or leqembi or kisunia and even the newer treatments in clinical trials
it is doing all those healthy things as early in like as possible
it will always be that way probably

take heed will you

tomorrow as i do my 14th year of these walks i look forward to just being a walking participant and walk with others who are affected by this awful terrible disease

wherever you live
look at that map above
click on your state
do what you can to help slow down this disease

look for a walk where you live and participate in it
the alzheimers association is the main reason we are making progress with this disease
support them
www.alz.org
all you need to know about alzheimers is at that link

we will be thinking of my mom my younger brother and my dad
all who suffered with this disease
and
of course me who so far has it slowed down 



if you are in the santa barbara area join us for our walk to end alzheimers at the link below
or
join a walk where you live
here is the link to our team organicgreendoctor to join or donate 
see you on saturday november 16th at chase palm park

the organicgreen doctor

Thursday, November 14, 2024

organicgreendoctor: its time to change it

organicgreendoctor: its time to change it: ITS TIME TO CHANGE IT i voted back in october via mail as soon as my ballot came in the mail i filled it out and mailed it within a few days...

its time to change it

ITS TIME TO CHANGE IT

i voted back in october via mail
as soon as my ballot came in the mail i filled it out and mailed it
within a few days i got a notice via text that it was received and counted

or 
was it
what i mean did it really count
since the vote really it seems by the millions spent in those important got to win states counts only there

all that money and political visits and famous folks campaigning like crazy in those few states while ignoring almost all of the other states

heck texas only got the presidential candidates once
pennsylvania got them several times a day for what seems like weeks

that all doesnt seem right

i talk to folks who came here from other countries and they sort of smile and shake their heads when we talk about our electoral system

i understand how it works 
i understand its history and why it was set up that way
a compromise was made
we all suffer from that compromise 

i recommend that we use the popular vote so that whoever wins the most votes in the election wins the election
you know the one person one vote rule

finally this year the republican candidate won the popular vote
george w was the last to do that

to the one that gets the top votes they get the job

man that would make the candidates go everywhere wouldnt it

there seems under the electoral system to be too many places where things can get all jammed up
lets remove that log jam and switch to the rule
whoever gets the most votes win

i think it was set up so the common man really didnt get to decide in the beginning
remember back then women couldnt vote
only property owners voted
blacks were not citizens
only an elite group got to pick the winner

the presidential election needs to be like we do for mayor governor senator house of representative school board tax collector etc

well you name it every other office

yes tis time to change now that the republicans showed they could win the popular vote as well as the electoral vote

here is a good explanation of the us presidential electoral system 

lets change it

the organicgreen doctor

Friday, November 8, 2024

organicgreendoctor: alzheimers news-i will do it

organicgreendoctor: alzheimers news-i will do it: ALZHEIMERS NEWS-I WILL DO IT that is me speaking last year at the walk to end alzheimers  in four years i want to be able to vote again and ...

alzheimers news-i will do it

ALZHEIMERS NEWS-I WILL DO IT

that is me speaking last year at the walk to end alzheimers 
in four years i want to be able to vote again and be able to know that i voted again
i want to be able if asked to speak at the 2028 walk to end alzheimers

to do this
i have to
maintain my healthy living like i have been doing
continue taking my aricept or donepezil to slow down symptoms
then
look for other things that may come available to slow down this disease

i may have found one
maybe

in 2016 i had an amyloid pet scan that was positive for amyloid plaques in my brain
this is the hallmark of alzheimers disease
if you have alzheimers you will have a positive amyloid pet scan

i was accepted in the biogen aduhelm or aducanumab treatment study in 2016

i started infusions for 18 months that turned out to be placebo
the study was delayed twice once by the pandemic and once by problems with the study 
it was eventually restarted and i received 34 months of aduhelm infusions

in the fall of 2023 my last amyloid pet scan was negative for amyloid plaque

in February of 2024 i had a final interview and studies for the biogen aduhelm study 

so the goal was to remove the amyloid plaque
it aduhelm did its job

these drugs called moncolonal amyloid antibodies slow down memory decline by about 25-30%

my drug aduhelm was removed from the market in favor of its sister drug leqembi which showed slightly better results and had all its initial clinical trials completed 

so leqembi is approved for use in mild cognitive impairment due to alzheimers and for early alzheimers
the sooner you take it the better it works
another similar drug kisunia also was approved

now here i am 1 year after having all the amyloid plaque removed from my brain
what do i do now
wait

well no i dont l like to wait

so enter this thing below

this is the leqembi auto injector
it probably will be approved by the fda for administering leqembi

when i got my infusions it was a 3 hr drive to ucla and a 3 hr drive home
a visit to see the neurologist to approve the infusion
a wait for the meds to be mixed up by the pharmacist 
an hour infusion time to get the meds
total time 9 hours

enter auto injector
time involved 
15 secs to inject
done

if the autoinjector is approved by the fda then folks ie me can give it myself at home eventually

they are seeking approval by the fda for leqembi to be given as a maintenance injection once a week to keep the amyloid plaque from reaccumulating

i am anxiously waiting its approval

here is a review article about this from alzheimers weekly

my thoughts
ill definitely do it

if you are in the santa barbara area join us for our walk to end alzheimers at the link below
or
join a walk where you live
here is the link to our team organicgreendoctor to join or donate 
see you on saturday november 16th at chase palm park

the organicgreen doctor

Wednesday, November 6, 2024

organicgreendoctor: my story revisited #212 -why we walk

organicgreendoctor: my story revisited #212 -why we walk: MY STORY REVISTED #212-WHY WE WALK this is a picture of my first walk team for the walk to end alzheimers in austin in 2011 it was the first...

my story revisited #212 -why we walk

MY STORY REVISTED #212-WHY WE WALK

this is a picture of my first walk team for the walk to end alzheimers in austin in 2011
it was the first walk after i was diagnosed
i will have done 13 years of these walks this month

the flowers we carry at these walks have the same names on them 
there thank goodness have not been any additions 
well maybe my name could be added

i wrote this to ms b to tell her about my younger brother who died with alzheimers
plus my mother who died with it and my father who probably had it when he died

this year we will do the local walk here in santa barbara
this year i will not be talking at the open ceremonies like i have done for years
i look forward to it 
just savoring the moment with my family
i promise to cry
__________
10-12-2015

DEAR MS B-YOUDVE LIKED HIM


ok ms b this will be the last sad blog i write to you
well i hope it is

you have two ancestors named joe
both are not with us now
both taken down by two different diseases
one taken by an als like disease
the other taken by alzheimers disease
one your other grandpa
the other your great uncle

now your grandpa joe i only met once
even though he was ill you could tell he
was a powerful man
powerful in the way he carried himself
but
compassionate

i wish i could have got to know him better

Image result for organicgreendoctor.com joe nash
the other joe
your uncle joe
was also compassionate
had a great smile
worked for years as a fireman then later a deputy sheriff
loved his family like the other joe did
loved life like the other joe did
loved hunting and outdoor stuff the other joe loved the outdoors

ms b he had two daughters and two granddaughters
so he knew about raising girls

now this weekend ms b
we will be honoring uncle joe
at a walk to end alzheimers in little rock
walking with his familys team
#joe nash

we will be walking to raise money for the
alzheimers association to use for research and education
on alzheimers disease

you see ms b
we are getting close real close to finding a true treatment
and a cure
real close

when we walk this weekend these are the four folks we
will be walking for

nell-your great grandmother a nurse
charles-your great grandfather a minister
joe-your great uncle joe taken like your grandpa joe much too
soon before their lives were complete

ms b uncle joes wife 2 daughters 1 grandson 2 granddaughters
will all shed tears this weekend as they walk
as will his friends and siblings that are walking
and
those who cant be there will be thinking of him and his
family saturday morning

yes ms b
your gma and i still cry every time we do this
walk for uncle joe and our other family members
affected by this terrible disease

ms b
if you met your uncle joe
you would have liked him
his smile
his laugh
yes he would probably pinch your cheeks
maybe give you a kiss

yes ms b

youdve liked him
_________
ms b you would have liked him
all kids did
yes
like me 
he would tease you a lot
and
make your smile

this is why we do the walks
to honor these relatives affected by this horrible disease

yes
we are getting closer to a treatment for this disease
lucky for me i was able to receive treatments that may slow things down
which means i may be around a little longer to tease you

if you are in the santa barbara area join us for our walk to end alzheimers at the link below
or
join a walk where you live
here is the link to our team organicgreendoctor to join or donate 
see you on saturday november 16th at chase palm park 

the organicgreen doctor

Tuesday, November 5, 2024

organicgreendoctor: its a disadvantage

organicgreendoctor: its a disadvantage: ITS A DISADVANTAGE today is election day thank goodness all those political ads will go away sadly those medicare disadvantage ads will take...

its a disadvantage

ITS A DISADVANTAGE

today is election day
thank goodness all those political ads will go away
sadly
those medicare disadvantage ads will take over now until the end of the year
you know the one with folks like joe namath hawking these 
just call this number
we will help you decide
no
they will trick you to decide

ill be upfront here
i have regular medicare that comes right out of my social security check
it gets adjusted based on your income
i have a medicare supplement f i pay $294 a month for 
i have a prescription drug plan i pay 84 cents a month for

I have been on these since 2010 and except for some small copays for meds i have not paid anything extra for my health care

my wife she is on the same plans

she was offered a medicare disadvantage plan with her retirement but she opted not to take it

why
when someone advertises like crazy all day like a political ad someone is making money
here is who
the folks selling it to you
the insurace company like humana etc
the doctors
the hospitals
but
who is paying more if they get real sick
its the patient
thats you

some disadvantage plans are better than others

having worked with these plans in the beginning when they first came out
the ones that lost out were the patients
think medicare hmo with all its rules of denying or delaying care

with my non medicare advantage plans ie regular medicare i chose where to go and dont need referrals and have no extra monies i have to pay for care

also 
when they offer you free stuff someone is getting wealthy off of it
its usually at the cost of the patient or the taxpayer

that is why we chose to go with regular medicare and a medicare supplement and a prescription plan that is the best health insurance we have ever been on

know what you are getting when you look at a medicare disadvantage plan

here is a good review article from investopedia on these disadvantage plans
i suggest you read it before you decide what to do

the organicgreen doctor