organicgreendoctor: alzheimers news-the workup

organicgreendoctor: alzheimers news-the workup: ALZHEIMERS NEWS-THE WORKUP this weekend someone was telling me about a relative who had memory issues and was having a workup or evaluation ...

alzheimers news-the workup

ALZHEIMERS NEWS-THE WORKUP

this weekend someone was telling me about a relative who had memory issues and was having a workup or evaluation done for their memory loss

i told them that i would write a blog today about what to do if you have memory loss

its simple
get an evaluation or a workup done

it the diagnosis is not always alzheimers disease
eg
a recent friends husband was having memory issues
they were convinced he had alzheimers
it turns out it was depression and once the depression was treated his memory improved

i have heard of sleep apnea patients who when treated their memory returned to normal
patients with low thyroid have had their memory improved with treatment

its important to seek an evaluation as early as possible
i always say i am the  poster child for an early evaluation
i really think thats why i am doing so well 14 years later
i was diagnosed early and started all these treatments early on

if you wait too late 
it may be too late to help

so
what to do

see a provider for only memory loss 
bring a list of things you and others have noticed
bring a list of all your medications including any over the counter ones including any herbs or supplements

if the memory loss is advancing the patient should not go alone
many providers will want a person to come along with the patient 

you should have a good medical history and exam 
this might show up something that might explain the memory loss

a memory test like the mmse or moca may be done
these are fairly accurate 
commonly they are followed up with a neuropsychological exam if indicated
this exam takes longer and is more accurate
a clock test or similar quicky test may show problems but if things are early they may not show up
the moca test takes about 20 minutes is probably more accurate 
the neuropsychological exam is the gold standard

then labs are done
usually a cbc a chemistry profile that has electrolytes liver functions kidney functions a thyroid level a vitamin b12 level and some would add a vitamin d3

then based on what all this shows an mri scan of the brain is commonly done to rule out other diseases in the brain like strokes masses brain shrinkage and other abnormalities

for some folks these tests will give the provider the diagnosis
but
for other folks 
further testing is needed either a spinal tap for amyloid and tau or an amyloid pet scan for amyloid plaques
if the person has alzheimers then the amyloid pet scan will be positive

these should give you a diagnosis

then
what do you do

maximize your health

control your blood pressure your cholesterol your blood sugar
dont be afraid to use medications to control these

maintain a normal weight

stay active mentally socially and physically

avoid excessive alcohol
dont smoke

get adequate sleep
correct any abnormalities such as sleep apnea

treat and address any depression or anxiety 

eat a well balanced diet
the mind diet is recommended

if you are diagnosed with alzheimers consider start taking aricept or donepezil 
it slows down symptoms
there are side effects like nausea and diarrhea but i found after about 6 weeks those symptoms mainly went away
patients who take aricept or donepezil especially those who start it early on tend to live longer 

then
if you have mild cognitive impairment due to alzheimers or mild alzheimers you should consider taking leqembi or kisunia which are given as infusions 
these monoclonal antibodies against amyloid plaques will remove the plaques
patients may get about a 30+% slowing of memory decline

there are risks like brain bleeds that can occur
i took 3 years of these infusions and my amyloid plaques are now cleared out for now

we dont really know how well these really work long term
i and others chose to take the chance 
since
what else is there to do

you have to remember that you will not beat his 
it will win eventually 
but hopefully you can slow it down

i was diagnosed 14 years ago and really didnt think that in 2024 i would be able to sit here and write this blog
i thought i would be gone by now or in a memory center

i did all those things listed above
i did aricept
i did aduhelm a cousin to leqembi

add all those things up 
thats why i am doing better than i was in 2010 when i was diagnosed

here is my blog with a video on what happens in the brain with alzheimers
i recommend folks watch it so they know what is going on in their loved ones brain

the website beingpatient.com is a good one to look at and sign up for their newsletter
google my name on their site and read my interview from a few years ago

the other website is www.alz.org the alzheimers association website
it is a good resource for information and you can find local services with the local alzheimers association 

remember
get a good workup
dont accept not getting a good workup
change providers if they wont do one

do all the healthy things
consider taking aricept
consider taking the infusions of leqembi or kisunia
educate yourself and your family

Good luck
its a long journey

the organicgreen doctor

organicgreendoctor: lets not go back in time

organicgreendoctor: lets not go back in time: LETS NOT GO BACK IN TIME science museum this is a kid from years ago in an iron lung without the iron lung he couldnt breathe and would die ...

lets not go back in time

LETS NOT GO BACK IN TIME

science museum
this is a kid from years ago in an iron lung
without the iron lung he couldnt breathe and would die
since he was completely paralyzed from polio
some folks had to live their whole life in these
he is smiling in this photo but my guess is he didnt smile much

the solution to prevent this from happening was
the polio vaccine

yes
the polio vaccine thats being under attack how
its becoming political
it should not be 

now its not eradicated 
its still out there waiting for a large group of people who have no immunity so it can infect them 
paralyzing them
killing them
mainly 
kids

the patients i had with polio related disabilities were older than me and had contracted it before the vaccine became available
many wore braces or used crutches or had neurological symptoms from the infection
these disabilities lasted forever
they were the lucky ones
they lived

in my career the one immunization that stands out is the h influenza vaccine
h flu is not the flu but a potentially aggressive bacteria that hits kids under 5 the hardest
causing things like
meningitis
pneumonia
sepsis
joint infections
ear infections
and a potential fatal infection called epiglottitis where the airway closes down
the only emergency treatment is an emergency tracheotomy
they cant even be intubated
yes i saw kids die from epiglottitis

when i started my residency rotations at the childrens hospital one of my first icu patients was an 18 month old child named jeremy who came home sick from daycare and within 1 day was my icu patient with not only h. flu meningitis but also had developed multiple abscesses in the brain
when i left the service 3 months later he was transferred to a long term care facility for brain damaged infants and children
man that left an impression on me that lasted all my career

within 2 years the h flu infections seemed to disappear
the h flu germ didnt disappear
its just waiting for unimmunized folks ie kids to show up
then it will infect many of them
some may end up like my patient 
sadly

thats what happens when politics enters the scientific medical world

most practitioners today that are still working since they are younger than me have never seen a h flu infected patient 
in fact they might not even think about this infection

for some reason i had several families who did not vaccinate their families
i told them i didnt agree with them
but
unlike some doctors that refuse to take care of them i did

on more than one time i was faced with a unimmunized baby or infant with high fever
was it h flu or pneumococcal or meningococcal infection or was it viral
in an immunized child it wasnt an issue
they were protected

nowadays besides h flu add pertussis or whooping cough diphtheria tetanus measles polio hepatitis a hepatitis b flu covid meningococcal and hpv
we shouldnt be seeing these infections
but we are
but we will if politics prevail

i saw  one case of tetanus in my career
in the morgue

i saw one case of measles in my career
in a 12 year old that ended up in a long term care facility with measles encephalitis

my first case of h flu epiglottitis i saw was a 5 year old also in the morgue

unimmunized kids are at risk for these infections
many can be fatal

these cases i have seen are why i am an advocate for immunizations
none of these patients should have died or been disabled from these diseases
these disease ae still out there
they can be prevented by immunizations

no
lets not go back in time

the organicgreen doctor

organicgreendoctor: alzheimers news-what happens in the brain

organicgreendoctor: alzheimers news-what happens in the brain: ALZHEIMERS NEWS-WHAT HAPPENS IN THE BRAIN i have found its important to know as much as you can about the disease so you know how to attack ...

alzheimers news-what happens in the brain

ALZHEIMERS NEWS-WHAT HAPPENS IN THE BRAIN
i have found its important to know as much as you can about the disease so you know how to attack it

this video from the national institutes of health or nih lasts about 4 minutes but it gives you a good summary of what happens over time with this disease

amyloid plaques
tau tangles
inflammation

the new drugs like my aduhelm and leqembi and kisunia remove the amyloid plaques

new drugs in clinical trials are treating the tau tangles and inflammation

these changes shown in the video starts months to years before symptoms start

treatment or prevention should start months to years before symptoms start

eating correctly all your life
getting adequate sleep
treating mental illness such as depression or anxiety
maintaining a normal body weight
staying active mentally physically and socially
controlling your blood pressure your blood sugar and your cholesterol
dont smoke
dont drink or minimally drink
do some meditation activity like i do by gardening every day
do these early in your life
no
do these all your life

the best prescriptions to prevent alzheimers are these things above

when symptoms start get an evaluation early on
consider taking meds such as aricept or donepezil and or consider taking the new monoclonal antibodies like leqembi or kisunia which may slow down memory loss

stay on the look out for new drugs coming soon to treat tau and inflammation

while you are doing all these healthy things you also are preventing heart disease kidney disease stroke cancer diabetes and other diseases

its all in your hands to prevent this disease

knowledge is power
now act on that power

the organicgreen doctor

organicgreendoctor: duct tape art work

organicgreendoctor: duct tape art work: DUCT TAPE ART WORK several years ago someone bought this piece of art work and sent it to me why you say i was known as the dr duck doctor a...

duct tape art work

DUCT TAPE ART WORK

several years ago someone bought this piece of art work and sent it to me
why you say

i was known as the dr duck doctor and the duct tape doctor

i would talk to my younger patients like donald duck which entertained them
some didnt even know my name 
they called me dr duck

even today when i interact with elementary kids in the garden or in the garden at the elementary school they love for me to talk like donald duck
it makes their day
and mine

the duct tape label started when i began to use duct tape the real strong sticky stuff to wrap over warts 
the duct tape was left on for a week then removed
many times the wart would peel off with the tape

it was a much less painful way to treat the warts
my first use was on a high school track star who developed a large wart on his big toe during this track season
i was afraid freezing it aggressively would hinder his track season
so
i had read about duct tape use for warts so we tried it
a week later the big ole wart came off when he removed the duct tape
all without pain or scarring

from there i became interested in duct tape uses 
folks started sending me duct tape suggestions and it only grew from there

folks also called me the duct tape doctor

this picture uses both of these to illustrate my interest or my nicknames 
the person who  bought this for me was quite pleased with the find

so i am always looking for new duct tape uses

now that picture above is an actually true art work

below is another duct tape art work story
i guess thats what you call it
this one is a little quirky
the full story from npr is linked here

this contemporary or should i say temporary piece of art work sold for 6000000+ at auction
it was bought by a crypto person
its called 
comedian
i guess cause the jokes on him or on us

i guess since its a  joke right
maybe its good for a chuckle or a smirk

what did the new owner plan to do with it
eat the banana

sorry
none of my previous duct tape story could match this one

so
today as i go to the garden i plan to pick a loofah and take my roll of grey duct tape and duct tape the loofah to our front gate

i plan to sell this piece of art work as a fundraiser for our garden
wonder if i have any buyers or donors

or
you could just donate to our end of the year crowd fundraiser for our garden at this link below
seedmoney.org

i like this picture better
all this food was donated to those in need

the organicgreen doctor

organicgreendoctor: my story revisited #213-its here now

organicgreendoctor: my story revisited #213-its here now: MY STORY REVISITED #213-ITS HERE NOW in the clinical trials i have been in over the last 14 years i have had several different alzheimers bl...

my story revisited #213-its here now

MY STORY REVISITED #213-ITS HERE NOW

in the clinical trials i have been in over the last 14 years i have had several different alzheimers blood tests that would show whether i have alzheimers disease or not
like my amyloid pet scans and tau pet scans i had done i never got the results

well i did on my initial amyloid pet scan
they had to tell me the results since i got accepted into the biogen aduhelm clinical trial
you didnt get into that study unless you had a positive amyloid pet scan

then
after my 32 treatments i had a follow up or final amyloid pet scan that showed all the amyloid had cleared from my brain

you can measure amyloid and tau 3 ways

a spinal tap for amyloid and tau levels
ouch 
i had two of these in my clinical trials
mine was positive

an amyloid pet scan
i lost count of how many of these i had 
i had probably about 6 of them over the last 14 years

a tau pet scan
i probably had about 3 or 4 of these
i never got any of these results

i got the result of the spinal tap since i had it done at a private lab
so i know it was abnormal

i had several different alzheimers blood tests over the last 14 years as they progressed in accuracy over that time

today
the alzheimers blood test the good ones are over 90% accurate
there are some on the market available outside of research but the most accurate ones arent quite available yet in the private world
but
they will be real soon

__________
10-30-2015

ALZHEIMERS NEWS-A TEST SOON?

strewn across our family tree are lots of folks who died
from heart attacks and strokes
and
dementia probably alzheimers disease

when i reached 40 i had my first cholesterol level done
since it had been shown that an elevated cholesterol
especially the ldl cholesterol
the bad i always called it
was associated with an increased risk for heart attack and
later stroke was added to this warning

so because of my family history
my dad died of a heart attack my older brother had his
first one at 60 my mother had multiple strokes
interesting all three also had or probably have alzheimers disease
i decided to have my cholesterol labs or lipid profile done

whoa omg
is what i said when i got mine back
my total cholesterol was over 325 with normal less than 200
my ldl bad one cholesterol was over 240 with normal less than 100
my triglycerides were well over 500

so knowing what lay ahead for me
i did a lot of life style changes
diet
exercise
later a few years later i added the statins to my regimen
so
my lipids now are
total cholesterol less than 200
ldl cholesterol less than 90
my triglycerides less than 100

so having that blood test at 40
probably kept me from having a heart attack or stroke by now
both my dad and older brother had heart disease at my age

as it turns out
knowing now what we now know
it also probably slowed down the progression of alzheimers in
my brain
but at the time i didnt know that

remember whats good for the heart is good for the brain


now researchers have found a way to predict if you will get
alzheimers disease years before you develop it

now i am in a study at ut southwestern using an alzheimers blood test
that according to recent tests seems to be about 90% accurate
in predicting if you have alzheimers disease
years before symptoms start

yes folks that test or one like it will be in your doctors
before this decade is over

yes you can go to your doctor soon
get a blood test
yes you have alzheimers disease you will be told

so if i have alzheimers disease now
when i was 40 the disease process was starting to pick up
so that the bad beta amyloid and tau levels up there would
have been abnormal
my alzheimers blood test would have been positive

do you want to know
is society ready for this test
can you handle this back to the future test

i say yes i can
i sort of did 5 years ago when i got diagnosed
i made even more life style changes
like stricter diet exercise increased mental activity and
social activity more aggressive blood pressure and
cholesterol and weight control use of some
recommended vitamins and supplements that might help
etc etc

now also coming soon this decade
if the phase 3 tests show they work
new treatment and prevention medication can be used
to slow down or prevent this disease

so like the cholesterol test
the alzheimers blood test
can potentially add years and years of good health
alzheimers free

would you have it done
i know i would have
_________

so maybe this next year you will be able to get an accurate alzheimers blood test in your primary care office
if you do one make sure its the good one 

the amyloid pet scan is the gold standard for identifying amyloid and diagnosing alzheimers
the alzheimers blood test will probably be the silver standard 

if the blood test is negative you probably dont have alzheimers
if the blood test is positive you might have it but will need an amyloid pet scan to verify the results
the amyloid pet scan costs around $5000-$8000
the blood test will probably cost around $1000

so when do you get this blood test when its available
remember just because the blood test is positive doesnt mean you have alzheimers
it means you are at risk for it and if you have symptoms it helps make the diagnosis

eg
a high cholesterol like i had doesnt mean i have heart disease
it just means i am at real high risk for having one or a stroke or alzheimers disease

an abnormal alzheimers blood test doesnt mean you have it
just that you are at a high risk for getting it

plan your life accordingly 

like with a high cholesterol you can make life style changes earlier in your life that may slow down the disease

you might start on aricept real early or start on the monoclonal antibody treatments real early if you develop symptoms

the secret to success is going to be early preventative measures and early treatment

they are doing this now in clinical trials 

now if you go in to your primary care doctor or specialist for memory loss and your alzheimers blood test is positive
they will tell you that you may have alzheimers disease

here is a good discussion of this from being patient.com

then
you have to answer the question 
do i want to know 

will it affect my life insurance disability insurance long term care insurance health insurance or maybe a job

will you emotionally be able to handle the results

i can tell you from personal experience its like getting a cancer diagnosis thats not curable
its a fatal disease

if you are thinking about getting this test read this interview from being patent before you do it

this test is here now
think long and hard before you get the test

the organicgreen doctor