Ljflynn47 wrote:...I spoke with my doctor who seemed, initially, onboard with helping me navigate through some of this. I sent her Dale Bredesen’s book so she could see the cognoscopy list and suspect she has gotten daunted. She mentioned another of her patients is working with a functional medicine doctor and suggested I reach out, so I did. The responding email was a list of charges, including $2250 for an initial consult and up to $5000 for labs and supplements plus plus. It was jarring. So - two things for comments or advice, please (from you or others):
1. Is this typical and should I expect that any engagement with a physician in this space is “no insurance” and lots of out-of-pocket including the implication that I buy their supplements (which I’m assuming, rightly or wrongly, are on the pricier side)? If this is the norm I’ll figure it out but I don’t want to be taken advantage of either.
2. This seems to suggest that only those that can afford hefty bills have a chance at beating this monster back, which feels fundamentally wrong. Are you aware of any actions being taken to address this? Lobbying insurance companies, etc.?
Thanks again - and I hope my questions don’t aggravate. I was just seriously caught off guard.L
Don't ever worry about "aggravating" us with questions! Posing questions, including ones that make people uncomfortable at times, is how lots of new ideas become considered, tested and developed. I'll try to answer your questions, with the provision that "it depends" is always on the list of correct answers.
1. Many large metropolitan areas have multiple doctors who have received training in "functional medicine" or "integrative medicine". Here's some tips on how to find one from our Wiki Searching for a Healthcare Practitioner
. This is a list of practitioners who have been recommended by forum members, or who have requested to have their information included on our forum: ApoE4-Aware Healthcare Practitioners
Dr. Lisa Mosconi, who directs the Women's Health Initiative at Cornell-Weill Medical Center in NYC recently published a book on "The XX Brain" focused on cognitive health and the effects of menopause on women's brains. (I have only started it, so this isn't an endorsement to buy it.)
Generally, FM doctors see fewer patients each day and devote much more time to each patient, and often a team approach of other professionals in their practice. Insurance generally does not cover that time, hence the cost to the patient. Some FM doctors will work with your insurance company to bill for what will be covered. Not all FM doctors sell their own supplements and you would be under no obligation to buy their supplements. (We have some forum topics on how to determine good quality supplements.)
Some people choose to use FM doctors at the beginning of their journey to guide the route; others feel that their needs require consistent and in-depth monitoring. (I know someone who traveled around the world on her own and never had a problem. But if I ever travel to a country without knowing its customs, language or culture, I will hire a skilled guide! )
A "guide" for some others is a certified health coach who is trained in functional medicine and aware of ApoE4. (You can find a list of some of those people here: ApoE4-Aware Health Coaches
2. I would never endorse the idea that only those who can afford hefty bills can avoid Alzheimer's--if that's true, then I'm in big trouble at 68, since I don't use an FM doctor! Instead, I use direct-to-consumer lab tests Direct to Consumer Lab Testing Options
,the forum, and my own deep dives to decide what I need to focus on and how to maintain a sense of control.
Just today, I saw a talk at the Alzheimer's Association International Conference noting that there are people in their 90's with both amyloid plaques and tau tangles who have normal synapses (connections) in their neurons and normal cognition when they die.
Researchers are working hard to find out exactly what is most important to reaching that goal, but one strong suspicion is good vascular health (normal blood pressure, good coronary health) and low inflammation in the brain. One study suggests that getting a flu and pneumonia vaccine may protect against AD, because it boosts the brains immune system! A major study called the POINTER study (based on earlier studies in Finland and Europe) is examining whether exercise, a Mediterranean style diet (the MIND diet), cognitive stimulation, and social engagement can reduce dementia. The earlier study in Finland and one called SPRINT-MIND here showed up to 1/3 of dementia cases might be prevented with those measures (and avoiding serious or repetitive head injuries.)
I hope this is a start in answering your questions!