May 12, 2026 • 43 mins
- Listen Saturday mornings at 8 as Dr. Msonthi Levine discusses medical issues and takes your calls on News Talk 560 KLVI. Dr Levine is board certified in Internal Medicine and Geriatrics. His office is located at 3080 Milam in Beaumont, Texas. He can be reached at 409-347-3621.
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Speaker 1 (00:00):
All right, welcomes South these Texas Internet radio listeners. Welcome
to another edition of the Doctor Levine Medical Hour. I
am your weekly host, Doctor Levine, taking your phone calls
live from the studios of klv I hear both my
Texas Cross Street from Parkdale Mall, where we try and
help you figure out how to stay alive, longer and
(00:22):
healthier without being too ill, too sick. What's the right way,
what's the wrong way? So much information out there that
seems very confusing sometimes and contradictory. One resource says this,
another one says that they seem to contradict each other.
Who's right, who's wrong? What's right for me? That can
(00:47):
be difficult to figure out, just because again all the
information that's available to us with the Internet and social media, man,
it is super confusing. So here, for one hour every Saturday,
we're here to see what your question is and try
to help you figure out what's good for you so
(01:07):
you can stay alive and be healthy. Staut of the
doctor's office, out of the hospital, keep your medication list
to a minimum. If none, that's awesome. Phone lines are
open eight nine to six klv I one in one
hundred three three zero kalv. I would love to hear
from you and talk about what it is is bothering you,
(01:29):
are confusing to you, to help you try and figure
it out. Sometimes it's confusing to me as well. Even
as a healthcare provider, this job is not easy sometimes.
Although we do have our routine, as every person who
works has their routine, we have our routine as well,
meaning that certain questions that we're answering every single day
(01:54):
to again try and help patients feel better. Answer questions
about why you might feel a certain way, you have
a physical complaint that you don't quite understand, and you
just need some guidance on whether or not it needs
to be worked up, whether or not it could be ignored.
What is it? Certainly as a primary care provider PCP
(02:18):
for short, right, that acronym in that term was coined
many years ago and it's still being used today. PCP
primary care physician sort of like the guy on the
front line of the girl on the front line that
you go to first to start the medical investigation of
(02:39):
medical journey and to figuring out why it is you
feel the way you do when you just don't feel
like you think you should feel and most of us
know how that feels, just because as you get older,
it's hard to get to your seventies and eighties with
(02:59):
that feeling something wrong with you at some point. I mean,
I do find patients like that. They're in their eighties
and they're on no medicines, and they've had minimal to
know surgeries and they've never been hospitalized. I mean, what
a remarkable patient. Hey Mike from Port Natis, how can
(03:20):
we help you?
Speaker 2 (03:23):
Oh? Yes, doctor, I've been diagnosed with early onset Alzheimer's disease.
I'm sixty one. I was diagnosed at sixty and every
bood test that they've ran on me, whether it's petl
(03:44):
or plaque or genealogy, just you name it, has come
back Alzheimer's, Alzheimer's, Alzheimer's. My mother had Alzheimer's. She passed
away when she was eighty one. She probably lived for
about fifteen sixteen years after she was diagnosed. Then it
(04:09):
was back. She died in twenty sixteen on my birthday.
And anyhow, my sister also died of Alzheimer's in twenty
twenty three October twenty thirty thirty. And come to find out,
(04:32):
my father, which I was caring for keeping up of
nursing home and hospice. I haven't found the document lately
that basically number the number nine diagnosis was Alzheimer's unspecified.
So I've got a big time history and Alzheimer's And anyway,
(04:57):
I was very good, very good student, going to all
the status at Poor Nations grows. I was Magne Kumbay
graduate and the GPO was really really high, and then
graduated Lamar University with a finance degree with another really
good GPA. And it feels like because of this, my
(05:17):
I feel like my all my education, all my accomplishments
has been taken from me. And I was wondering if
you had any advice or what would be good for
me to uh to do. I've even heard about even walnuts,
something about walnuts to if you eat walnuts or different things,
or is there anything that you can recommend as far
(05:42):
as diet or also I exercise. I'll walk my dog
a lot and even go to the river and walk
my dog. So I'm doing it the best I can
and doing things around my house. And I just started
listening to your show and I just wanted to get
what you would recommend.
Speaker 1 (06:01):
For me, yeah, Mike, and I'm sorry to hear about
the family history and the recent diagnosis, especially at sixty one,
that's still young. And yes, I would agree there should
be some concern on your part that maybe things are
happening in a negative way for you, and normally with
(06:26):
Alzheimer's dementia, if there is what we call it early onset,
I mean someone in their eighties. I think most doctors
healthcare providers sort of expect that or anticipate that. But
at sixty that's still pretty young. There are families that
are predisposed to Alzheimer's, just like you're mentioning, it's just
a genetic trait that you were born with and you
(06:49):
have a high risk of developing that, and sometimes it's inevitable,
you know, no matter what diets you consume, no matter
what you do, the disease are sort of locked in. Certainly,
my advisor is to get in with the neurologist as
soon as possible. There are some new medications that are
(07:11):
available that only neurologists are prescribing, and they have mixed
reviews from the experts in terms of how effective they
are or not. But certainly I would get with your
primary care petition to get you into a neurologist as
soon as possible so you can sort of start treatment
(07:32):
and start the management of the disease again. There is
some a new medication available. I think it's an IV
medication that requires an IV infusion and there's a lot
of aggressive monitoring if you do decide to take this medication.
I'm sorry, I don't remember the name of it, just
because it's it's sort of brand new. It's not a
(07:54):
household name at this point, and it's something I don't prescribe,
so it's just sort of not in my nomenclature yet.
But the neurologists are getting a little bit more aggressive
with the management of Alzheimer's in terms of finding it
as soon as possible than if they do find it,
being more aggressive with the management of it. So that's
(08:16):
Number one, is to get in with a neurologist to
start that journey. Number two. I think experts agree that
the disease process is influenced or can be impacted by
what you eat and drink, no question, And the one
ingredient that they keep coming up with is sugar and
(08:38):
the exposure to sugar. I hear that more frequently as
the years have gone, and they do feel like if
you are exposing yourself or consuming a lot of sugar
ultra processed foods, as I've mentioned a lot on this show,
that it tends to increase the chances of developing them
(09:00):
and certainly can worsen than demni. I hear this about
cancer as well. Just sugar sort of feeds these diseases,
and so that is one bit of advice that I
would do give to you, is to do what you
can to limit your consumption or exposure to sugar. And
we all know those those sources, right. A lot of
(09:21):
times it's the beverage, or a lot of times it's
you know, in the food that you consume, and if
you're consuming processed foods, a lot of times the processing process,
sugar is added to this food so that it does
taste good. So you want to try and eat as
clean as possible and as fresh as possible, meaning you're
(09:45):
probably getting the raw ingredients yourself, and you're cooking at yourself,
and you're staying away from all of the ultra process
sugar substances that are out there. Certainly pastries, soft drinks,
you know the easy ones, right, but again you have
to be careful and get better at reading the labels
(10:06):
on a lot of the food items, especially if it's packaged,
it's frozen, that means it's processed, that means it's preserved,
and just the food manufacturers have gotten really good at
preserving this food and making it taste good so you'll
eat it over and over again. And sugar is one
substance that they love. So that would be two points
(10:31):
of advice for you, Mike, to kind of get started
on your journey. I do agree or feel like your
lifestyle can impact how aggressive this disease is. If it
can be managed, if it can be mitigated, you have
to do your part, just like with any chronic disease.
(10:51):
You have to start doing the things that reduce the
severity of the disease, and it can happen. You can't
do it if it means that much to you. So
those would be my two points of advice.
Speaker 3 (11:05):
All right, Mike, I want to ask you if you've
had an injury, be a automobile accent or something, you've
experienced a frontal lobe funnel of damage. And my short
(11:31):
term memory is like a big time problem, and I
think I remember hearing somewhere somewhere in the past that
that if you've had injury to your frontal lobes.
Speaker 2 (11:45):
That uh and uh. Anyway, you're fifty percent more likely
to develop Alzheimer's because of that, and also with the
family history. I'm wondering how that could pat that plays
into it too, because it had some damage to my
phone loves from my automobile accident that was my fault.
Speaker 1 (12:07):
Well, yeah, I mean no question, any previous brain injury
certainly can be another risk factor for the development of Alzheimer's.
Dementia strokes is a very common risk factor or brain
injury that increases your risk. And yeah, I would agree
that if you were in a motifical accent or some
(12:28):
sort of other physical trauma, you had a major injury
to the brain, that yeah, you're affecting the brain tissue.
You're the brain tissue gets inflamed and it has to heal,
and sometimes the healing process doesn't return to normal brain tissue.
With the process of how Alzheimer's developed, I can see
(12:48):
that being a risk factor as well. Again, it's not
one hundred percent connected, meaning there's a lot of patients
out there who've had major brain injuries and they never
developed dementia. So yeah, it's another risk factor for that
to look out for, But it doesn't mean you're going
to have it. I think for you, Mike, it's your
family history. It's really the most important risk factor that
(13:12):
you have. Obviously, Alzheimer's dementia is on the radar of
America and on the radar of the healthcare community, just
because we're sort of winning the battle with cardiovascal disease
as well as cancer, and patients are staying alive longer,
they have higher function. Even though they might have cardiovascal disease,
(13:34):
they might have a darkness of cancer, they're living longer.
Getting older is really the biggest risk factor for the
development of Alzheimer's dementia. Just the body is programmed to
sort of start a shut down process, and your brain
shutting down. Dementia can be a part of that. So age,
getting into your deep seventies eighties is the biggest risk factor.
(13:57):
Can't do anything about that, but I'm trying to lift
This lifestyle where you're doing everything you can to reduce
the possibility of the onset of dementia is what I
would certainly endorse. So certainly, frontal brain lobe injury of
any type can be another risk factor. Absolutely, any other questions, Mike,
(14:23):
all right, Well, appreciate Mike's question. Very very big topic.
Alzheimer's dementia. You don't really talk about it a lot
on the show. Spend a lot more time talking about
prevention cardiovasts disease. But Alzheimer's dementia is certainly a big,
big disease in this country. Again, just because people are
(14:45):
a lot more people are getting into their deep seventies
eighties pretty high functioning, and again, this is the disease
that's sort of lurking in the back if you do
reach that age, these are this is a disease that
is kind of hanging out there. I try to make
(15:06):
listeners understand that infections are also out there as well.
You get into your deep seventies eighties, infections are big
reason to be hospitalized as well as increase morbidity immortality.
So it's sometimes difficult getting into the seventies and eighty
(15:27):
year old range just because something is found to happen,
and Alzheimer's dementia is one of those diseases, and it's unfortunate.
I've been a doctor for over twenty years and sort
of the basic gross management of Alzheimer's. The diagnosing capacity
or ability of modern American doctors healthcare providers to diagnose
(15:51):
Alzheimer's dementia has for the most part been kind of
the same in over twenty years, which is surprising to me.
It's unfortunate just because it is on the radar. There
is a lot of research, there's a lot of people
involved with investigating dimension how it works. There's a lot
of money being pumped into dementia research. It would seem
(16:17):
that we would be bearing some fruit. And again, as
I mentioned to you, there is a medication on the market,
brand new, has been out maybe for a year two.
I'm a little unfamiliar with it just because I don't
prescribe it every single day. I believe it's an IVY infusion,
and when it hit the market a year or two ago,
it is really only to be used by neurologists and
(16:39):
it's not for the general population usage. If you will,
most medications that you're familiar with that are household names,
they're basically general population medications, meaning that anybody. It's indicated
for just about any person in any general situation, but
this particular medication for Alzheimer's dementia that's out is for
(17:03):
specific scenarios or specific situations. So you're probably talking about,
you know, less than twenty percent of dementia patients in
general are candidates for this particular medicine, maybe even less. Again,
I'm not an expert on the medication and it's indications,
but this is my general understanding of when the medication
(17:26):
hit the scene, and then talking with my neurology colleagues
that it requires a lot of pre testing, post testing, surveillance.
So it's kind of cumbersome activity that you are involved
with if you do take this medicine. It's not one
hundred percent effective. It's very controversial when it hit the
(17:46):
market in terms of the experts looking at the medication
to decide if it was a good thing or bad thing,
if it shouldn't hit the market, that sort of thing.
So it's got a lot of work in terms of
being available for GP or population dementia, which is where
a medication really wants to go if it wants to
be a blockbuster medication right such that it can be
(18:09):
used for all deminsia patients. It's not at that point
yet so it's unfortunate, unfortunate that after twenty years my
experience personally, we're still not that good at it in
terms of managing it, mitigating it, and trying and having
(18:30):
the power to really change the disease course. For this disease,
there are a couple of medicines tablets. I've prescribed these
medicines over the years, and they do help, no question,
especially if they're started earlier rather than later. And that's
kind of the tricky point with dementia right now, is
(18:50):
because our testing is, in my opinion, is still kind
of crude, meaning we have a few tasks. You know,
they're okay, but they're not the best because of that,
because we can't really have a specific lab or a
specific X ray that can see it and if it's positive,
you have it, if it's negative, you don't have it.
(19:11):
We just sort of don't have that test yet where
everybody agrees on the specific nature of the test as
the call to mention they have had some testing and
things are pointing in that direction, but sort of like
a bopsy if you will, that proves this is what
(19:32):
you have, or when you get your angiogram of your heart,
and we can see your blood vessels, we can see
exactly whether blockages are everybody agrees on a one hundred percent.
We're kind of not there with Alzheimer's in terms of
its lab testing. Sort of like when you get a
CBC or a blood test. It's a specific lab that
(19:55):
says a specific thing, and everybody kind of agrees on
what that value means. It's just sort of not there
with as it pertains to dimension it's diagnosis, and again,
it sort of leaves a lot open for interpretation, and
that certainly can impact whether or not you're diagnosed or
maybe diagnosed. And then we start medicine hold medicine. We
(20:17):
just need to get better at that as a community,
and we're working very diligently to get there. Just not there,
and hopefully in the next few years we can continue
to pump out better medicines than testing for this particular
disease process because it is again, as experts say, probably
going to eclipse maybe cancer cardiovascu disease as being the
(20:39):
number one problem in our country. As we're controlling and
winning the battle of cancer and cardiovascusease, which are number
one and two at this point in our country. So
it's not going away. If anything, it's going to become
more prevalent. So we need to get better at that,
and I'm sure we will, just because our healthcare industry
(21:00):
is one of the most innovative in the world and
a lot of interest is on that disease, and normally
we come out with some discoveries at some point just
because of the diligence and the persistence of the healthcare
providers out there, the scientists or researchers that are working
hard every day to come out with some good products.
So we're certainly anxiously waiting for that. Anyway, phone lines
(21:23):
are open eight nine to six kalva. I want one
hundred three three zero kofy. I'll be back in two minutes.
All right, Welcome back to the doctor and medical Our
phone lines are open eight nine six kalfy. I want
one hundred three three zero kofy. I'll give us a call.
(21:44):
We'd love to talk to you. Hear from you talking
a little bit about Alzheimer's dementia. But every time we
look at our social media or our resource where we
get our information is periodically some conversation about some medication
and that's on the market that's causing this or causing that.
We see that a lot every single day, just because
(22:07):
a lot of Americans are taking prescription drugs, prescription medications,
and there's just a lot of surveillance that's going on
with all these medications. So every now and then, a
certain drug will sort of have its day in the
spotlight where it's a bad thing and it's hurting people.
And I get those conversations all the time, doctor, should
(22:27):
I stop this medicine? I heard this about this medicine.
This medicine can do this and this and that. Normally
it's pretty negative. And again, most of the drugs that
we're using every single day has had its moment in
the spotlight where it gets called out for causing harm
or increase in the risk of thisness and that. Even
(22:47):
with dementia. I've heard a couple of medications out there,
and there's one medication that we write a lot of
prescriptions for, even me personally, that I wanted to talk
about just because of some recent attention on that. And
that medication is called Gabba Pentin or New rantin which
(23:08):
it's in my opinion, sort of a household name, and
most people have heard of that medication in some way
or another, just because a lot of patients are taking
this Gabba Pentin or New Rantin as the brand name's
been out for a ton of years and I've used
it in various situations or scenarios. Remember, when most medications
(23:34):
hit the market, they get approval from the Food and
Drug Administration for a specific or certain scenario or disease.
It has to go through an approval process to be
able to be sold as a pharmaceutical product. Remember all
of the dietary supplements that a lot of patients are
consuming that are over the counter, that are considered sort
(23:58):
of nutritional supplements. We hear about these nutritional supplements, these
names all the time. There's just too many to list.
Patients a lot of times will bring in their nutritional
supplement of choice that they've either purchased online or they
went to the supermarket, or they're at HGB and they
saw this and they're concerned. We talk about dementia, that's
(24:21):
a big one too. What can I do to prevent dementia?
So they're looking for some help and some protection, if
you will. And a lot of times with these dietary supplements, again,
the story seems true the packaging looks good and it
convinces you that it's a good product for you. And
a lot of times patients will bring it in just
(24:41):
so I can look at it eyeball it. If you will,
you know, make sure it's relatively safe and if I
have any thoughts on that. And again, most of these
products are pretty benign and they're at dosages and the
products are the ingredients of most these products are neutral,
(25:02):
not harmful. Otherwise, like I say, it would be a
pr nightmare, public relations nightmare if a company did put
something on the market that was really harming, killing, maiming
the general population. That would not be good for that company. Remember,
they're in the business to provide a product safely to
(25:24):
the American people to try and make them feel good.
They're not trying to hurt, they're not trying to maim.
That's not their focus. It's not their goal. And again,
because of the sort of surveillance process that we have
in this country, it's just not to their advantage to
put something on the market that's going to harm. And
I have this conversation patience all the time about just
(25:46):
prescribing in general. When healthcare providers write your prescription. All
that's saying is that they have supreme confidence in this
medication that it's not going to harm you, because generally,
if the most health care providers, unless they just graduated yesterday,
have experience with writing all these prescriptions that they're giving you,
(26:10):
and they're basically saying, hey, I've written this prescription time
and time again, and this particular drug works for me,
and I think it's going to work for you. At
least It's worked for all the other patients that I've
written this prescription for, so I have confidence that a
high percentage of the time this thing's going to work.
So here it is, go get it from your pharmacy.
(26:33):
And yes, I'm aware of this potential harm that might
happen to you, like with any drug that any health
care provider provides you, or any drug that you get
on your own at the pharmacy or supermarket can cause harm.
We just can I escape that most of the time
nothing's going to happen. You're going to get treated and
(26:53):
your physical complaint will be solved, just like with this
gab of penton on your want. And there have been
concerned and swirling around this medication for many years and
I thought I would just kind of hit some of
those points. It's FDA proved to treat neuropathic pain. And
again there's different types of pain out there that you
(27:15):
have to understand. I know you feel a certain way,
but the genesis of the pain, which is why a
lot of times when I have pages in the office
and there on pain medication, I'll ask, what is the genesis?
What cause the pain? Nerve pain is its own type
of pain. And most people know about nerve pain from diabetes,
because diabetes is very prevalent in our country, and it
(27:37):
can injure the nerve or the nervous system because of
the high sugar presence. It just injures the nerve and
the nerve starts to malfunction or dysfunction. And a symptom
of that is these signals, these pain signals that you
might get, especially in your feet, are your hands that
(27:57):
are uncomfortable, that tingling, the numbness that you might feel,
and initially it might not bother you, but as it progresses,
it gets really strong and it's hard to ignore, especially
throughout the day. And that's a lot of times. How
it happens is you at nine time, when you're going
to go to bed. That's when you sort of get
a higher sense that it's there. During the day, you
(28:19):
kind of preoccupied and you don't feel anything, but at
the end of the day you might. As you're trying
to go to better you're watching TV, it becomes more prevalent.
So it's been FDA approved to treat neuropathic pain, in
particular what we call post herpetic neuralgia, which is basically
when you get a shingles flare and it causes that
(28:42):
blistering rash. A lot of times the nerves can be
injured and as a part of that you get that pain.
So GABA pensing on your ront and has an FDA
approval to treat that. Carolyn from Beytown, how can we
help you?
Speaker 4 (28:55):
Yes, I'm calling in reference to the man the call
it in about Alzheimer's. Yes, ma'am, I have a friend
that she was diagnosed about a year and a half ago,
and her doctor put her on an infusion. She goes
in once a month and takes it. It takes about
thirty minutes and it takes the plaque out of the
(29:20):
brain and we can tell no difference in her. She's
the same person In fact, after she was diagnosed and everything,
she went on a cruise or trip over with some
other friends to other countries and everything else. And she's
just living a good life. So maybe he could, like
(29:40):
you said, go to a neurologist and because there's hope
out there now for them.
Speaker 1 (29:45):
They say, Okay, Carolyn, thank you for that comment. So
do you feel you feel like the infusion is helping?
Speaker 4 (29:54):
Oh? Yes, yes, Okay, definitely, she's doing great. She sits
in in front of me every Sunday on a church
and we talk and I mean, there's she's just doing
really great, you know, and it's been a long time
by now, she should have started a whole lot of symptoms,
you know what I mean. Yeah, absolutely, So that would
(30:18):
maybe give that guy hope because she suggested that he
see a you know, a doctor about it and everything.
And I just called in maybe to help him not
worry so much about it because there's hope out there now.
Well that's all I wanted to say.
Speaker 1 (30:33):
Well, thank you, Caln. We appreciate that comment. And you
have a good Saturday and Sunday. Happy Mother's Day to you.
And yeah, there's there's some some new medication out there.
Again this infusion, which I'm unfamiliar with, and I get
that name for you here. Again, it's not a medication
that I write for. Came out a couple of years ago,
(30:54):
and with any medication that is on the market that's
new on the scene, it again can promise to help
patients with certain disease processes. In this particular condition Alzheimer's,
we're talking about that for any drug, it does not
help everyone, but it helps some. And again, as this
(31:16):
called mentioned, there is some hope that this can open
up a new era of treatment for Alzheimer's patients because
again we do have a couple of tablet medications on
the market that we've been using for a long time.
Our recept is one name, Nomnda is another name for
(31:36):
the other oral medication. This is what's been available for
general population Alzheimer's patients, meaning any patient who gets diagnosed
with this disease can get this medication with this new infusion.
As I mentioned, this IV medicine, and I will try
to get that name for you. Again, it's not for
every dementia patient yet, and they're doing a lot of
(32:01):
surveillance with this medication again because there is some toxicity
issues with it. Again, I'll have to sharpen my understanding
of that medication for you and get that back to you.
But as far as I know, to get on it,
you have to do a lot of testing before and
then during the process of getting the infusion. Just again,
(32:25):
I think we're trying to do our due diligence to
make sure that even if the drug is on the market,
we're doing our best to protect the general population. We
don't want to harm anyone. So there's just a lot
of before you take the test to make sure everything
is fine, and then while you're taking it to monitor
you in terms of labs and scans that you have
(32:46):
to do. And again, this is being managed primarily by neurologists,
not your primary care physician. Most drugs, again, for these diseases,
when they hit the market, the consultants are the subspecialist.
Primary merely are managing this, whether it be a cardiologist
or onecologist, whatever the disease process is. When it hits
(33:08):
the market, it normally goes through the consultants first, and
it's on the market for many years and we kind
of get good at it. It gets easy to use,
we figure out how to use it. And then it
sort of can trickle down to the primary care physicians
at some point, normally many years later, so that again
it's available to a broader population and now just most
(33:31):
anybody can get on it. It's easy to use, just
like with our diabetes medicine, these diabetic injectibles. Now they're
coming out with tablets because some people just don't like
injections right, coming out with these tablets of the same medication.
Pharmaceutical company is one of the best industries in the world.
They get better at creating the drug and clean it
(33:53):
up biochemically so that it's easy to use once a day,
minimal side effects. So yes, maybe this infusion is opening
up a new era of the treatment of dementia. We
need it just because again we're winning that battle with cardiovasities,
with cancer patients staying alive longer. So getting into your
(34:14):
eighties nineties, dementia is just kind of waiting around, not
that you did anything wrong other than you got to
your eighties and nineties. It's sitting there waiting. So we
need stronger drugs, and this infusion seems to be and
a drug that can offer hope for some patients. Phone
lines are open eight nine to six Kalva one one
hundred and three three zero, Kyova. I'll be back in
(34:36):
two minutes. All right, welcome back to talk with me, Metaga.
(34:59):
Our phone lines are open eight nine to six Kalva.
I won one hundred three three zero al Kalva talking
about dementia and some of the new meds that have
hit the market. And basically, I just got online and
googled new medications for Alzheimer's dimension WHI la. You know,
it pops up in terms of this new infusion that
(35:19):
the FDA approved, and I might butcher that just because
it's not in my nomenclature yet. You know, a lot
of times the medicineaid the market, it takes a while
to get into settle in your brain, so you can
sort of spit it off and it rolls off your mouth.
So I'm gonna do my best to pronounce these medications appropriately.
One of the drugs is called la kana mab l
(35:40):
e c A n E M A B. And the
second drug is called donanamab d o n A N
E M A B. And yes, this is new stuff
FDA approved to treat Alzheimer's, and they signify that it's
early onset Alzheimer's, meaning if you're Alzheimer's is advanced and
(36:03):
it's later in its disease processed, then again you're not
a candidate for this. But the theory is that it
works by clearing these what they call amyloid plaques, which
if you read anything about Alzheimer's, this is part of
the pathophysiology of dementias that you get these abnormal developments
(36:24):
of plaques in your brain tissue. We hear about plaque
for cardiovascal disease. This is how we describe the build
up the calcium cholesterol, inflammatory cellular build up in the
lining of the wall. We call that plaque plaque. But
inside the brain tissue itself, they have found that a
(36:47):
constant presence of patients who have dementia is these amyloid
plaques A M y l OI d amyloid plaques, and
so this is an area that's been targeted by the
researchers and the scientists who study Alzheimer's is how can
we reduce the formation of the amyloid plaque. It seems
(37:07):
to be a generator of brain death and brain inflammation
brain injury. So if we can control the development of
the development of amyloid plaques. Then we can preserve brain
tissue and we can prevent the acute onset of dementia.
So it seems like they're targeting that protein that seems
(37:28):
to be constant, constantly present in the brain tissue of
Alzheimer's patients. And these two new medications, again a new class,
a new category of medications has been out for again
like I say, a year or two, maybe a little
bit longer. But they are IVY infusions and it does
require some monitoring as according to my understanding, there are
(37:51):
a few side effects that are associated with associated with
it which requires some monitoring. Which bleeding in the brain,
which is never good, can happen with these medications. So
that's why you sort of have to be sure that
it's being monitored if you're on these infusions. And again
(38:14):
the thing is that it has to be early onset. Again,
if your disease has been advanced and you sort of
got to the party late, these medications are not good
for you. And the other adverse reaction that's been recognized
with these medication is brain swelling not good either, right,
just because the brain is in the skull and that's
(38:36):
a fixed space, a confined space. So anytime anything starts
happening in the skull with the brain, pressure builds up
and they can injure other parts of brains, so not good.
Either we have built from fire or how can we
help you?
Speaker 4 (38:50):
Can you tell me if a nuclear stress test gives
a good indication of build up or blockages potential blockages.
Speaker 1 (39:01):
Yeah, nuclear stress tests. This is part of the decision
tree of most cardiologists when they're trying to figure out
if you have cardiovascal disease. I would say significant cardiovascal disease.
There are situations bill that come up where you might
have a little bit of plaque in your blood vessel,
but it's not clinically significant, meaning it's not causing any
blood flow issues at this point, so it would not
(39:23):
be picked up. But that's really all they're cardiology just
trying to figure it out. We need significant plaque development.
So these nuclear stress tests are just checking to see
if there is a flow limiting lesion is what they
call it. I was trying to get to that. As
plaque builds up in the blood vessel wall, the blood
flow starts to change, and these nuclear medicine tests can
(39:47):
detect when there is a flow limiting lesion they're in
your blood vessel anatomy, and then if that test is positive,
then they take it to the cat lab and get
a better view, and if they see something they can
fixed and they intervene at that time. So it is
a test that we use religiously just because it works. Bill,
(40:08):
are there situations that come up where you can have
a negative nuclear medicine test and then eventually get diagnosed
with heart disease. Yes, that those scenarios do happen, but
they're in the minorities certainly. So if you go to
your doctor you have a nuclear stress test, it looks
clean for the most parts. You're good and you can
be reassured that you probably don't have any flow limiting
(40:30):
plaque in your blood vessels.
Speaker 2 (40:34):
Thank you very much.
Speaker 1 (40:35):
All right, Bill, we appreciate that, and we're going to
last break. Phone lines are opened eight nine six kV I.
We're one hundred three three zero klv I be back
in two minutes. All right, welcome back to doctor for
you matter. If our phone lines open eight nine to
six kV I won one hundred three three zero kova I,
(40:57):
remember there If there's a specific topic of woman talk
about either call the radio station throughout the week. You
can come an office four one one, three, four seven,
three six two one and give that topic and we'll
be happy to talk about it. This is the genus
of the show. We want to make sure we get
the right content and this show is working for you.
It's educating you. That's really all I'm trying to do
(41:18):
is get your answers. This stuff can be confusing, complicate,
even from me, and so we just need to talk
about it and figure it out. And I just like
today with Alzheimer's, dementia wasn't on my radar today. But
this is why I love my job, love coming to
the radio station, just to talk about it and generate
new ideas and just remind myself that, yes, the treatment
(41:40):
of Alzheimer's is maybe getting a little bit better with
these new infusions that help control the developed I'm sorry
the progression of amloid plaque because a lot of times
when most patients get diagnosed is already amloid plaque in
the brain tissue. We're trying to get to the point
where we can identify who's at risk for just like
we do with cardiovascal disease, and then provide some sort
(42:02):
of medical therapeutic at that point so that the amyloid
plaque does not develop ever, because it seems like the
understanding of Alzheimer's dimensions that amyloid plaque is a central
player in the development of the symptoms of amyloid plac
because it seems to injure the nerve tissue, the brain tissue.
So anything we can do to prevent that, just like
(42:24):
plaque in the blood vessel, wall right, just cholesterol, blood pressure,
sugar control that you won't get plaque and we get
a heart attack. Same thing with the amyloid plaque. Control
the development of that.
Speaker 2 (42:34):
How do we do it?
Speaker 1 (42:35):
A lot of people are saying very similar risk factors
for the development of amyloid plaque. As we had a
call today, strong family history. Sometimes he's just delta back card,
just like we're cardiovascal disease. Some people just have it
running through their family. They can be totally perfect but
still develop that plaque and the blood vessel. Same thing
with Alzheimer's dementia. So new medications again not for GP dementia. Everybody.
(43:00):
It's really early on set. It's not late on set.
Got to get in with your neurologists. There's a lot
of testing before, during after these infusions, but certainly sounds
like maybe opening up some new treatments and helping patients
with their disease process. I want to thank you for that.
I want to thank all the callers and the listeners. Remember,
(43:21):
don't drink and drive. Happy Mother's dat all your mother's
out there, have fun, Drink some water, eat some vegetables.
We'll see you next week. Take care,
All right, welcomes South these Texas Internet radio listeners. Welcome
to another edition of the Doctor Levine Medical Hour. I
am your weekly host, Doctor Levine, taking your phone calls
live from the studios of klv I hear both my
Texas Cross Street from Parkdale Mall, where we try and
help you figure out how to stay alive, longer and
(00:22):
healthier without being too ill, too sick. What's the right way,
what's the wrong way? So much information out there that
seems very confusing sometimes and contradictory. One resource says this,
another one says that they seem to contradict each other.
Who's right, who's wrong? What's right for me? That can
(00:47):
be difficult to figure out, just because again all the
information that's available to us with the Internet and social media, man,
it is super confusing. So here, for one hour every Saturday,
we're here to see what your question is and try
to help you figure out what's good for you so
(01:07):
you can stay alive and be healthy. Staut of the
doctor's office, out of the hospital, keep your medication list
to a minimum. If none, that's awesome. Phone lines are
open eight nine to six klv I one in one
hundred three three zero kalv. I would love to hear
from you and talk about what it is is bothering you,
(01:29):
are confusing to you, to help you try and figure
it out. Sometimes it's confusing to me as well. Even
as a healthcare provider, this job is not easy sometimes.
Although we do have our routine, as every person who
works has their routine, we have our routine as well,
meaning that certain questions that we're answering every single day
(01:54):
to again try and help patients feel better. Answer questions
about why you might feel a certain way, you have
a physical complaint that you don't quite understand, and you
just need some guidance on whether or not it needs
to be worked up, whether or not it could be ignored.
What is it? Certainly as a primary care provider PCP
(02:18):
for short, right, that acronym in that term was coined
many years ago and it's still being used today. PCP
primary care physician sort of like the guy on the
front line of the girl on the front line that
you go to first to start the medical investigation of
(02:39):
medical journey and to figuring out why it is you
feel the way you do when you just don't feel
like you think you should feel and most of us
know how that feels, just because as you get older,
it's hard to get to your seventies and eighties with
(02:59):
that feeling something wrong with you at some point. I mean,
I do find patients like that. They're in their eighties
and they're on no medicines, and they've had minimal to
know surgeries and they've never been hospitalized. I mean, what
a remarkable patient. Hey Mike from Port Natis, how can
(03:20):
we help you?
Speaker 2 (03:23):
Oh? Yes, doctor, I've been diagnosed with early onset Alzheimer's disease.
I'm sixty one. I was diagnosed at sixty and every
bood test that they've ran on me, whether it's petl
(03:44):
or plaque or genealogy, just you name it, has come
back Alzheimer's, Alzheimer's, Alzheimer's. My mother had Alzheimer's. She passed
away when she was eighty one. She probably lived for
about fifteen sixteen years after she was diagnosed. Then it
(04:09):
was back. She died in twenty sixteen on my birthday.
And anyhow, my sister also died of Alzheimer's in twenty
twenty three October twenty thirty thirty. And come to find out,
(04:32):
my father, which I was caring for keeping up of
nursing home and hospice. I haven't found the document lately
that basically number the number nine diagnosis was Alzheimer's unspecified.
So I've got a big time history and Alzheimer's And anyway,
(04:57):
I was very good, very good student, going to all
the status at Poor Nations grows. I was Magne Kumbay
graduate and the GPO was really really high, and then
graduated Lamar University with a finance degree with another really
good GPA. And it feels like because of this, my
(05:17):
I feel like my all my education, all my accomplishments
has been taken from me. And I was wondering if
you had any advice or what would be good for
me to uh to do. I've even heard about even walnuts,
something about walnuts to if you eat walnuts or different things,
or is there anything that you can recommend as far
(05:42):
as diet or also I exercise. I'll walk my dog
a lot and even go to the river and walk
my dog. So I'm doing it the best I can
and doing things around my house. And I just started
listening to your show and I just wanted to get
what you would recommend.
Speaker 1 (06:01):
For me, yeah, Mike, and I'm sorry to hear about
the family history and the recent diagnosis, especially at sixty one,
that's still young. And yes, I would agree there should
be some concern on your part that maybe things are
happening in a negative way for you, and normally with
(06:26):
Alzheimer's dementia, if there is what we call it early onset,
I mean someone in their eighties. I think most doctors
healthcare providers sort of expect that or anticipate that. But
at sixty that's still pretty young. There are families that
are predisposed to Alzheimer's, just like you're mentioning, it's just
a genetic trait that you were born with and you
(06:49):
have a high risk of developing that, and sometimes it's inevitable,
you know, no matter what diets you consume, no matter
what you do, the disease are sort of locked in. Certainly,
my advisor is to get in with the neurologist as
soon as possible. There are some new medications that are
(07:11):
available that only neurologists are prescribing, and they have mixed
reviews from the experts in terms of how effective they
are or not. But certainly I would get with your
primary care petition to get you into a neurologist as
soon as possible so you can sort of start treatment
(07:32):
and start the management of the disease again. There is
some a new medication available. I think it's an IV
medication that requires an IV infusion and there's a lot
of aggressive monitoring if you do decide to take this medication.
I'm sorry, I don't remember the name of it, just
because it's it's sort of brand new. It's not a
(07:54):
household name at this point, and it's something I don't prescribe,
so it's just sort of not in my nomenclature yet.
But the neurologists are getting a little bit more aggressive
with the management of Alzheimer's in terms of finding it
as soon as possible than if they do find it,
being more aggressive with the management of it. So that's
(08:16):
Number one, is to get in with a neurologist to
start that journey. Number two. I think experts agree that
the disease process is influenced or can be impacted by
what you eat and drink, no question, And the one
ingredient that they keep coming up with is sugar and
(08:38):
the exposure to sugar. I hear that more frequently as
the years have gone, and they do feel like if
you are exposing yourself or consuming a lot of sugar
ultra processed foods, as I've mentioned a lot on this show,
that it tends to increase the chances of developing them
(09:00):
and certainly can worsen than demni. I hear this about
cancer as well. Just sugar sort of feeds these diseases,
and so that is one bit of advice that I
would do give to you, is to do what you
can to limit your consumption or exposure to sugar. And
we all know those those sources, right. A lot of
(09:21):
times it's the beverage, or a lot of times it's
you know, in the food that you consume, and if
you're consuming processed foods, a lot of times the processing process,
sugar is added to this food so that it does
taste good. So you want to try and eat as
clean as possible and as fresh as possible, meaning you're
(09:45):
probably getting the raw ingredients yourself, and you're cooking at yourself,
and you're staying away from all of the ultra process
sugar substances that are out there. Certainly pastries, soft drinks,
you know the easy ones, right, but again you have
to be careful and get better at reading the labels
(10:06):
on a lot of the food items, especially if it's packaged,
it's frozen, that means it's processed, that means it's preserved,
and just the food manufacturers have gotten really good at
preserving this food and making it taste good so you'll
eat it over and over again. And sugar is one
substance that they love. So that would be two points
(10:31):
of advice for you, Mike, to kind of get started
on your journey. I do agree or feel like your
lifestyle can impact how aggressive this disease is. If it
can be managed, if it can be mitigated, you have
to do your part, just like with any chronic disease.
(10:51):
You have to start doing the things that reduce the
severity of the disease, and it can happen. You can't
do it if it means that much to you. So
those would be my two points of advice.
Speaker 3 (11:05):
All right, Mike, I want to ask you if you've
had an injury, be a automobile accent or something, you've
experienced a frontal lobe funnel of damage. And my short
(11:31):
term memory is like a big time problem, and I
think I remember hearing somewhere somewhere in the past that
that if you've had injury to your frontal lobes.
Speaker 2 (11:45):
That uh and uh. Anyway, you're fifty percent more likely
to develop Alzheimer's because of that, and also with the
family history. I'm wondering how that could pat that plays
into it too, because it had some damage to my
phone loves from my automobile accident that was my fault.
Speaker 1 (12:07):
Well, yeah, I mean no question, any previous brain injury
certainly can be another risk factor for the development of Alzheimer's.
Dementia strokes is a very common risk factor or brain
injury that increases your risk. And yeah, I would agree
that if you were in a motifical accent or some
(12:28):
sort of other physical trauma, you had a major injury
to the brain, that yeah, you're affecting the brain tissue.
You're the brain tissue gets inflamed and it has to heal,
and sometimes the healing process doesn't return to normal brain tissue.
With the process of how Alzheimer's developed, I can see
(12:48):
that being a risk factor as well. Again, it's not
one hundred percent connected, meaning there's a lot of patients
out there who've had major brain injuries and they never
developed dementia. So yeah, it's another risk factor for that
to look out for, But it doesn't mean you're going
to have it. I think for you, Mike, it's your
family history. It's really the most important risk factor that
(13:12):
you have. Obviously, Alzheimer's dementia is on the radar of
America and on the radar of the healthcare community, just
because we're sort of winning the battle with cardiovascal disease
as well as cancer, and patients are staying alive longer,
they have higher function. Even though they might have cardiovascal disease,
(13:34):
they might have a darkness of cancer, they're living longer.
Getting older is really the biggest risk factor for the
development of Alzheimer's dementia. Just the body is programmed to
sort of start a shut down process, and your brain
shutting down. Dementia can be a part of that. So age,
getting into your deep seventies eighties is the biggest risk factor.
(13:57):
Can't do anything about that, but I'm trying to lift
This lifestyle where you're doing everything you can to reduce
the possibility of the onset of dementia is what I
would certainly endorse. So certainly, frontal brain lobe injury of
any type can be another risk factor. Absolutely, any other questions, Mike,
(14:23):
all right, Well, appreciate Mike's question. Very very big topic.
Alzheimer's dementia. You don't really talk about it a lot
on the show. Spend a lot more time talking about
prevention cardiovasts disease. But Alzheimer's dementia is certainly a big,
big disease in this country. Again, just because people are
(14:45):
a lot more people are getting into their deep seventies
eighties pretty high functioning, and again, this is the disease
that's sort of lurking in the back if you do
reach that age, these are this is a disease that
is kind of hanging out there. I try to make
(15:06):
listeners understand that infections are also out there as well.
You get into your deep seventies eighties, infections are big
reason to be hospitalized as well as increase morbidity immortality.
So it's sometimes difficult getting into the seventies and eighty
(15:27):
year old range just because something is found to happen,
and Alzheimer's dementia is one of those diseases, and it's unfortunate.
I've been a doctor for over twenty years and sort
of the basic gross management of Alzheimer's. The diagnosing capacity
or ability of modern American doctors healthcare providers to diagnose
(15:51):
Alzheimer's dementia has for the most part been kind of
the same in over twenty years, which is surprising to me.
It's unfortunate just because it is on the radar. There
is a lot of research, there's a lot of people
involved with investigating dimension how it works. There's a lot
of money being pumped into dementia research. It would seem
(16:17):
that we would be bearing some fruit. And again, as
I mentioned to you, there is a medication on the market,
brand new, has been out maybe for a year two.
I'm a little unfamiliar with it just because I don't
prescribe it every single day. I believe it's an IVY infusion,
and when it hit the market a year or two ago,
it is really only to be used by neurologists and
(16:39):
it's not for the general population usage. If you will,
most medications that you're familiar with that are household names,
they're basically general population medications, meaning that anybody. It's indicated
for just about any person in any general situation, but
this particular medication for Alzheimer's dementia that's out is for
(17:03):
specific scenarios or specific situations. So you're probably talking about,
you know, less than twenty percent of dementia patients in
general are candidates for this particular medicine, maybe even less. Again,
I'm not an expert on the medication and it's indications,
but this is my general understanding of when the medication
(17:26):
hit the scene, and then talking with my neurology colleagues
that it requires a lot of pre testing, post testing, surveillance.
So it's kind of cumbersome activity that you are involved
with if you do take this medicine. It's not one
hundred percent effective. It's very controversial when it hit the
(17:46):
market in terms of the experts looking at the medication
to decide if it was a good thing or bad thing,
if it shouldn't hit the market, that sort of thing.
So it's got a lot of work in terms of
being available for GP or population dementia, which is where
a medication really wants to go if it wants to
be a blockbuster medication right such that it can be
(18:09):
used for all deminsia patients. It's not at that point
yet so it's unfortunate, unfortunate that after twenty years my
experience personally, we're still not that good at it in
terms of managing it, mitigating it, and trying and having
(18:30):
the power to really change the disease course. For this disease,
there are a couple of medicines tablets. I've prescribed these
medicines over the years, and they do help, no question,
especially if they're started earlier rather than later. And that's
kind of the tricky point with dementia right now, is
(18:50):
because our testing is, in my opinion, is still kind
of crude, meaning we have a few tasks. You know,
they're okay, but they're not the best because of that,
because we can't really have a specific lab or a
specific X ray that can see it and if it's positive,
you have it, if it's negative, you don't have it.
(19:11):
We just sort of don't have that test yet where
everybody agrees on the specific nature of the test as
the call to mention they have had some testing and
things are pointing in that direction, but sort of like
a bopsy if you will, that proves this is what
(19:32):
you have, or when you get your angiogram of your heart,
and we can see your blood vessels, we can see
exactly whether blockages are everybody agrees on a one hundred percent.
We're kind of not there with Alzheimer's in terms of
its lab testing. Sort of like when you get a
CBC or a blood test. It's a specific lab that
(19:55):
says a specific thing, and everybody kind of agrees on
what that value means. It's just sort of not there
with as it pertains to dimension it's diagnosis, and again,
it sort of leaves a lot open for interpretation, and
that certainly can impact whether or not you're diagnosed or
maybe diagnosed. And then we start medicine hold medicine. We
(20:17):
just need to get better at that as a community,
and we're working very diligently to get there. Just not there,
and hopefully in the next few years we can continue
to pump out better medicines than testing for this particular
disease process because it is again, as experts say, probably
going to eclipse maybe cancer cardiovascu disease as being the
(20:39):
number one problem in our country. As we're controlling and
winning the battle of cancer and cardiovascusease, which are number
one and two at this point in our country. So
it's not going away. If anything, it's going to become
more prevalent. So we need to get better at that,
and I'm sure we will, just because our healthcare industry
(21:00):
is one of the most innovative in the world and
a lot of interest is on that disease, and normally
we come out with some discoveries at some point just
because of the diligence and the persistence of the healthcare
providers out there, the scientists or researchers that are working
hard every day to come out with some good products.
So we're certainly anxiously waiting for that. Anyway, phone lines
(21:23):
are open eight nine to six kalva. I want one
hundred three three zero kofy. I'll be back in two minutes.
All right, Welcome back to the doctor and medical Our
phone lines are open eight nine six kalfy. I want
one hundred three three zero kofy. I'll give us a call.
(21:44):
We'd love to talk to you. Hear from you talking
a little bit about Alzheimer's dementia. But every time we
look at our social media or our resource where we
get our information is periodically some conversation about some medication
and that's on the market that's causing this or causing that.
We see that a lot every single day, just because
(22:07):
a lot of Americans are taking prescription drugs, prescription medications,
and there's just a lot of surveillance that's going on
with all these medications. So every now and then, a
certain drug will sort of have its day in the
spotlight where it's a bad thing and it's hurting people.
And I get those conversations all the time, doctor, should
(22:27):
I stop this medicine? I heard this about this medicine.
This medicine can do this and this and that. Normally
it's pretty negative. And again, most of the drugs that
we're using every single day has had its moment in
the spotlight where it gets called out for causing harm
or increase in the risk of thisness and that. Even
(22:47):
with dementia. I've heard a couple of medications out there,
and there's one medication that we write a lot of
prescriptions for, even me personally, that I wanted to talk
about just because of some recent attention on that. And
that medication is called Gabba Pentin or New rantin which
(23:08):
it's in my opinion, sort of a household name, and
most people have heard of that medication in some way
or another, just because a lot of patients are taking
this Gabba Pentin or New Rantin as the brand name's
been out for a ton of years and I've used
it in various situations or scenarios. Remember, when most medications
(23:34):
hit the market, they get approval from the Food and
Drug Administration for a specific or certain scenario or disease.
It has to go through an approval process to be
able to be sold as a pharmaceutical product. Remember all
of the dietary supplements that a lot of patients are
consuming that are over the counter, that are considered sort
(23:58):
of nutritional supplements. We hear about these nutritional supplements, these
names all the time. There's just too many to list.
Patients a lot of times will bring in their nutritional
supplement of choice that they've either purchased online or they
went to the supermarket, or they're at HGB and they
saw this and they're concerned. We talk about dementia, that's
(24:21):
a big one too. What can I do to prevent dementia?
So they're looking for some help and some protection, if
you will. And a lot of times with these dietary supplements, again,
the story seems true the packaging looks good and it
convinces you that it's a good product for you. And
a lot of times patients will bring it in just
(24:41):
so I can look at it eyeball it. If you will,
you know, make sure it's relatively safe and if I
have any thoughts on that. And again, most of these
products are pretty benign and they're at dosages and the
products are the ingredients of most these products are neutral,
(25:02):
not harmful. Otherwise, like I say, it would be a
pr nightmare, public relations nightmare if a company did put
something on the market that was really harming, killing, maiming
the general population. That would not be good for that company. Remember,
they're in the business to provide a product safely to
(25:24):
the American people to try and make them feel good.
They're not trying to hurt, they're not trying to maim.
That's not their focus. It's not their goal. And again,
because of the sort of surveillance process that we have
in this country, it's just not to their advantage to
put something on the market that's going to harm. And
I have this conversation patience all the time about just
(25:46):
prescribing in general. When healthcare providers write your prescription. All
that's saying is that they have supreme confidence in this
medication that it's not going to harm you, because generally,
if the most health care providers, unless they just graduated yesterday,
have experience with writing all these prescriptions that they're giving you,
(26:10):
and they're basically saying, hey, I've written this prescription time
and time again, and this particular drug works for me,
and I think it's going to work for you. At
least It's worked for all the other patients that I've
written this prescription for, so I have confidence that a
high percentage of the time this thing's going to work.
So here it is, go get it from your pharmacy.
(26:33):
And yes, I'm aware of this potential harm that might
happen to you, like with any drug that any health
care provider provides you, or any drug that you get
on your own at the pharmacy or supermarket can cause harm.
We just can I escape that most of the time
nothing's going to happen. You're going to get treated and
(26:53):
your physical complaint will be solved, just like with this
gab of penton on your want. And there have been
concerned and swirling around this medication for many years and
I thought I would just kind of hit some of
those points. It's FDA proved to treat neuropathic pain. And
again there's different types of pain out there that you
(27:15):
have to understand. I know you feel a certain way,
but the genesis of the pain, which is why a
lot of times when I have pages in the office
and there on pain medication, I'll ask, what is the genesis?
What cause the pain? Nerve pain is its own type
of pain. And most people know about nerve pain from diabetes,
because diabetes is very prevalent in our country, and it
(27:37):
can injure the nerve or the nervous system because of
the high sugar presence. It just injures the nerve and
the nerve starts to malfunction or dysfunction. And a symptom
of that is these signals, these pain signals that you
might get, especially in your feet, are your hands that
(27:57):
are uncomfortable, that tingling, the numbness that you might feel,
and initially it might not bother you, but as it progresses,
it gets really strong and it's hard to ignore, especially
throughout the day. And that's a lot of times. How
it happens is you at nine time, when you're going
to go to bed. That's when you sort of get
a higher sense that it's there. During the day, you
(28:19):
kind of preoccupied and you don't feel anything, but at
the end of the day you might. As you're trying
to go to better you're watching TV, it becomes more prevalent.
So it's been FDA approved to treat neuropathic pain, in
particular what we call post herpetic neuralgia, which is basically
when you get a shingles flare and it causes that
(28:42):
blistering rash. A lot of times the nerves can be
injured and as a part of that you get that pain.
So GABA pensing on your ront and has an FDA
approval to treat that. Carolyn from Beytown, how can we
help you?
Speaker 4 (28:55):
Yes, I'm calling in reference to the man the call
it in about Alzheimer's. Yes, ma'am, I have a friend
that she was diagnosed about a year and a half ago,
and her doctor put her on an infusion. She goes
in once a month and takes it. It takes about
thirty minutes and it takes the plaque out of the
(29:20):
brain and we can tell no difference in her. She's
the same person In fact, after she was diagnosed and everything,
she went on a cruise or trip over with some
other friends to other countries and everything else. And she's
just living a good life. So maybe he could, like
(29:40):
you said, go to a neurologist and because there's hope
out there now for them.
Speaker 1 (29:45):
They say, Okay, Carolyn, thank you for that comment. So
do you feel you feel like the infusion is helping?
Speaker 4 (29:54):
Oh? Yes, yes, Okay, definitely, she's doing great. She sits
in in front of me every Sunday on a church
and we talk and I mean, there's she's just doing
really great, you know, and it's been a long time
by now, she should have started a whole lot of symptoms,
you know what I mean. Yeah, absolutely, So that would
(30:18):
maybe give that guy hope because she suggested that he
see a you know, a doctor about it and everything.
And I just called in maybe to help him not
worry so much about it because there's hope out there now.
Well that's all I wanted to say.
Speaker 1 (30:33):
Well, thank you, Caln. We appreciate that comment. And you
have a good Saturday and Sunday. Happy Mother's Day to you.
And yeah, there's there's some some new medication out there.
Again this infusion, which I'm unfamiliar with, and I get
that name for you here. Again, it's not a medication
that I write for. Came out a couple of years ago,
(30:54):
and with any medication that is on the market that's
new on the scene, it again can promise to help
patients with certain disease processes. In this particular condition Alzheimer's,
we're talking about that for any drug, it does not
help everyone, but it helps some. And again, as this
(31:16):
called mentioned, there is some hope that this can open
up a new era of treatment for Alzheimer's patients because
again we do have a couple of tablet medications on
the market that we've been using for a long time.
Our recept is one name, Nomnda is another name for
(31:36):
the other oral medication. This is what's been available for
general population Alzheimer's patients, meaning any patient who gets diagnosed
with this disease can get this medication with this new infusion.
As I mentioned, this IV medicine, and I will try
to get that name for you. Again, it's not for
every dementia patient yet, and they're doing a lot of
(32:01):
surveillance with this medication again because there is some toxicity
issues with it. Again, I'll have to sharpen my understanding
of that medication for you and get that back to you.
But as far as I know, to get on it,
you have to do a lot of testing before and
then during the process of getting the infusion. Just again,
(32:25):
I think we're trying to do our due diligence to
make sure that even if the drug is on the market,
we're doing our best to protect the general population. We
don't want to harm anyone. So there's just a lot
of before you take the test to make sure everything
is fine, and then while you're taking it to monitor
you in terms of labs and scans that you have
(32:46):
to do. And again, this is being managed primarily by neurologists,
not your primary care physician. Most drugs, again, for these diseases,
when they hit the market, the consultants are the subspecialist.
Primary merely are managing this, whether it be a cardiologist
or onecologist, whatever the disease process is. When it hits
(33:08):
the market, it normally goes through the consultants first, and
it's on the market for many years and we kind
of get good at it. It gets easy to use,
we figure out how to use it. And then it
sort of can trickle down to the primary care physicians
at some point, normally many years later, so that again
it's available to a broader population and now just most
(33:31):
anybody can get on it. It's easy to use, just
like with our diabetes medicine, these diabetic injectibles. Now they're
coming out with tablets because some people just don't like
injections right, coming out with these tablets of the same medication.
Pharmaceutical company is one of the best industries in the world.
They get better at creating the drug and clean it
(33:53):
up biochemically so that it's easy to use once a day,
minimal side effects. So yes, maybe this infusion is opening
up a new era of the treatment of dementia. We
need it just because again we're winning that battle with cardiovasities,
with cancer patients staying alive longer. So getting into your
(34:14):
eighties nineties, dementia is just kind of waiting around, not
that you did anything wrong other than you got to
your eighties and nineties. It's sitting there waiting. So we
need stronger drugs, and this infusion seems to be and
a drug that can offer hope for some patients. Phone
lines are open eight nine to six Kalva one one
hundred and three three zero, Kyova. I'll be back in
(34:36):
two minutes. All right, welcome back to talk with me, Metaga.
(34:59):
Our phone lines are open eight nine to six Kalva.
I won one hundred three three zero al Kalva talking
about dementia and some of the new meds that have
hit the market. And basically, I just got online and
googled new medications for Alzheimer's dimension WHI la. You know,
it pops up in terms of this new infusion that
(35:19):
the FDA approved, and I might butcher that just because
it's not in my nomenclature yet. You know, a lot
of times the medicineaid the market, it takes a while
to get into settle in your brain, so you can
sort of spit it off and it rolls off your mouth.
So I'm gonna do my best to pronounce these medications appropriately.
One of the drugs is called la kana mab l
(35:40):
e c A n E M A B. And the
second drug is called donanamab d o n A N
E M A B. And yes, this is new stuff
FDA approved to treat Alzheimer's, and they signify that it's
early onset Alzheimer's, meaning if you're Alzheimer's is advanced and
(36:03):
it's later in its disease processed, then again you're not
a candidate for this. But the theory is that it
works by clearing these what they call amyloid plaques, which
if you read anything about Alzheimer's, this is part of
the pathophysiology of dementias that you get these abnormal developments
(36:24):
of plaques in your brain tissue. We hear about plaque
for cardiovascal disease. This is how we describe the build
up the calcium cholesterol, inflammatory cellular build up in the
lining of the wall. We call that plaque plaque. But
inside the brain tissue itself, they have found that a
(36:47):
constant presence of patients who have dementia is these amyloid
plaques A M y l OI d amyloid plaques, and
so this is an area that's been targeted by the
researchers and the scientists who study Alzheimer's is how can
we reduce the formation of the amyloid plaque. It seems
(37:07):
to be a generator of brain death and brain inflammation
brain injury. So if we can control the development of
the development of amyloid plaques. Then we can preserve brain
tissue and we can prevent the acute onset of dementia.
So it seems like they're targeting that protein that seems
(37:28):
to be constant, constantly present in the brain tissue of
Alzheimer's patients. And these two new medications, again a new class,
a new category of medications has been out for again
like I say, a year or two, maybe a little
bit longer. But they are IVY infusions and it does
require some monitoring as according to my understanding, there are
(37:51):
a few side effects that are associated with associated with
it which requires some monitoring. Which bleeding in the brain,
which is never good, can happen with these medications. So
that's why you sort of have to be sure that
it's being monitored if you're on these infusions. And again
(38:14):
the thing is that it has to be early onset. Again,
if your disease has been advanced and you sort of
got to the party late, these medications are not good
for you. And the other adverse reaction that's been recognized
with these medication is brain swelling not good either, right,
just because the brain is in the skull and that's
(38:36):
a fixed space, a confined space. So anytime anything starts
happening in the skull with the brain, pressure builds up
and they can injure other parts of brains, so not good.
Either we have built from fire or how can we
help you?
Speaker 4 (38:50):
Can you tell me if a nuclear stress test gives
a good indication of build up or blockages potential blockages.
Speaker 1 (39:01):
Yeah, nuclear stress tests. This is part of the decision
tree of most cardiologists when they're trying to figure out
if you have cardiovascal disease. I would say significant cardiovascal disease.
There are situations bill that come up where you might
have a little bit of plaque in your blood vessel,
but it's not clinically significant, meaning it's not causing any
blood flow issues at this point, so it would not
(39:23):
be picked up. But that's really all they're cardiology just
trying to figure it out. We need significant plaque development.
So these nuclear stress tests are just checking to see
if there is a flow limiting lesion is what they
call it. I was trying to get to that. As
plaque builds up in the blood vessel wall, the blood
flow starts to change, and these nuclear medicine tests can
(39:47):
detect when there is a flow limiting lesion they're in
your blood vessel anatomy, and then if that test is positive,
then they take it to the cat lab and get
a better view, and if they see something they can
fixed and they intervene at that time. So it is
a test that we use religiously just because it works. Bill,
(40:08):
are there situations that come up where you can have
a negative nuclear medicine test and then eventually get diagnosed
with heart disease. Yes, that those scenarios do happen, but
they're in the minorities certainly. So if you go to
your doctor you have a nuclear stress test, it looks
clean for the most parts. You're good and you can
be reassured that you probably don't have any flow limiting
(40:30):
plaque in your blood vessels.
Speaker 2 (40:34):
Thank you very much.
Speaker 1 (40:35):
All right, Bill, we appreciate that, and we're going to
last break. Phone lines are opened eight nine six kV I.
We're one hundred three three zero klv I be back
in two minutes. All right, welcome back to doctor for
you matter. If our phone lines open eight nine to
six kV I won one hundred three three zero kova I,
(40:57):
remember there If there's a specific topic of woman talk
about either call the radio station throughout the week. You
can come an office four one one, three, four seven,
three six two one and give that topic and we'll
be happy to talk about it. This is the genus
of the show. We want to make sure we get
the right content and this show is working for you.
It's educating you. That's really all I'm trying to do
(41:18):
is get your answers. This stuff can be confusing, complicate,
even from me, and so we just need to talk
about it and figure it out. And I just like
today with Alzheimer's, dementia wasn't on my radar today. But
this is why I love my job, love coming to
the radio station, just to talk about it and generate
new ideas and just remind myself that, yes, the treatment
(41:40):
of Alzheimer's is maybe getting a little bit better with
these new infusions that help control the developed I'm sorry
the progression of amloid plaque because a lot of times
when most patients get diagnosed is already amloid plaque in
the brain tissue. We're trying to get to the point
where we can identify who's at risk for just like
we do with cardiovascal disease, and then provide some sort
(42:02):
of medical therapeutic at that point so that the amyloid
plaque does not develop ever, because it seems like the
understanding of Alzheimer's dimensions that amyloid plaque is a central
player in the development of the symptoms of amyloid plac
because it seems to injure the nerve tissue, the brain tissue.
So anything we can do to prevent that, just like
(42:24):
plaque in the blood vessel, wall right, just cholesterol, blood pressure,
sugar control that you won't get plaque and we get
a heart attack. Same thing with the amyloid plaque. Control
the development of that.
Speaker 2 (42:34):
How do we do it?
Speaker 1 (42:35):
A lot of people are saying very similar risk factors
for the development of amyloid plaque. As we had a
call today, strong family history. Sometimes he's just delta back card,
just like we're cardiovascal disease. Some people just have it
running through their family. They can be totally perfect but
still develop that plaque and the blood vessel. Same thing
with Alzheimer's dementia. So new medications again not for GP dementia. Everybody.
(43:00):
It's really early on set. It's not late on set.
Got to get in with your neurologists. There's a lot
of testing before, during after these infusions, but certainly sounds
like maybe opening up some new treatments and helping patients
with their disease process. I want to thank you for that.
I want to thank all the callers and the listeners. Remember,
(43:21):
don't drink and drive. Happy Mother's dat all your mother's
out there, have fun, Drink some water, eat some vegetables.
We'll see you next week. Take care,
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