Budgeting: ReCODE Reports™, Lab Tests, Doctors

The Bredesen Protocol™ entails a “cognoscopy” of lab tests and assessments to generate a personalized ReCODE Report™ that identifies underlying issues to be addressed with diet, lifestyle, supplements, and medical therapies.   The cognoscopy and treatments require out-of-pocket costs that are not covered by most health insurance.  When living on a more limited budget, this may seem like enough of a financial hurdle to prevent you from taking the next step forward. 

Therefore, I’m going to loosely describe how I envision cost-conscious paths forward—one for prevention and one for reversing cognitive impairment.  I’ll share some of my thinking around navigating in the Bredesen ReCODE Protocol™.  I do NOT receive any kick-backs if you sign up for an Apollo Health program below.  I’m just giving you the lay of the land from my perspective.

Prevention:

I happen to be in Alzheimer’s prevention mode, leveraging the most cost-effective lifestyle choices and therapies for optimizing my own health.

If you can afford it, an exemplar way to begin living the Bredesen Protocol™ is to invest in Apollo Health’s “ReCODE™” program—a combination of Dr. Bredesen’s basic suite of lab tests and a single ReCODE Report™ for $1,399, intended for people at the stage of prevention.  (Contact Apollo Health at info@ahnphealth.com for a list of the included lab tests as I’m not allowed to post that information here.)  The lab tests are direct-to-consumer and can be accomplished in one visit to Quest.  A cognitive assessment, a consultation with a ReCODE Qualified™ doctor, and a couple of sessions with a Bredesen-trained health coach will start identifying root causes of cognitive decline (and other chronic disease).  This will help you quickly jump-start living in a way that increases your chance for a long, healthy life while diminishing your risk of dementia.

cloudyI understand how many people, including retirees on a modest fixed income, may be keen on preventing cognitive decline, yet feel they cannot afford the aforementioned.  In November 2018, I reached out to two different people at AHNP (now Apollo Health) to request a lower-priced option for a single ReCODE Report™ with the just the pivotal lab tests not commonly covered by Medicare or common health insurance.  I was informed that people are working toward Medicare coverage and that this will “take time”.  Unfortunately, I imagine it will take years.  I will continue to advocate for people without ample financial resources.

When you starting without any cognitive symptoms and have an average risk of Alzheimer’s, then chances are good that you have a longer prevention timeline ahead.  When you do not have money to spare and are truly at the stage of primary prevention, you may opt to get started with the general Ketoflex 12/3™ diet and lifestyle recommendations described in “The End of Alzheimer’s” book on your own.  Utilize the free resources I provide on this website, along with Dr. Bredesen’s book, to begin guiding you towards a more brain healthy life.  Your lifestyle choices today dramatically influence your future risk of Alzheimer’s and other chronic diseases.

That said, a holistic transition to brain healthy food and lifestyle is too much for most people to bootstrap on their own.  Furthermore, most people will remain unaware of the aspects of the Bredesen Protocol™ they are missing without professional help.  For affordable expert support to get on the Ketoflex™ eating plan and the full spectrum of ReCODE™ lifestyle modifications for brain healing and optimal overall health, consider joining my group coaching program or getting one-on-one support.  Here’s a two-minute video clip of Dr. Bredesen explaining the critical difference that coaching can make.

 

Budgeting Preventative Health Lab Tests

sunshineIf you cannot afford the ReCODE™ program, another avenue is to ask your doctor to run some of the lab tests listed in Dr. Bredesen’s 2017 book.  The cognoscopy lab tests with the best chance to be covered under typical insurance, especially during your annual physical exam, include a lipid panel, comprehensive metabolic panel with fasting plasma glucose, hemoglobin A1c, hs-CRP, TSH, vitamin D, and vitamin B12.

To make a reasonable request for the ReCODE™ lab tests above, show your doctor Table 2 in “The End of Alzheimer’s” book and offer printouts of Dr. Bredesen’s most relevant research articles [print 1, and 2].  Make your case for additional relevant testing.  If you have a strong family history of Alzheimer’s disease, you may be able to justify the medical necessity for an ApoE genetic test along with genetic counseling.  If you question whether you have cognitive symptoms, request a MoCA or other cognitive test.  If you have reason to suspect heavy metal toxicity, you may be able to get initial blood mercury, lead, arsenic, zinc, and copper tests.  If you have a documented inflammatory issue, use Dr. Bredesen’s book to make your case for additional tests such as homocysteine.

Apollo Health’s ReCODE program could be cost-effective if, due to limited health insurance or a high deductible, you’re paying cash for lab testing.  For comparison, the out-of-pocket cost for a similar, relatively well priced, direct-to-consumer Brain Health Panel is $1,350, yet this panel does NOT include an MMP-9 blood test NOR the valuable ReCODE Report™ as in the $1,399 “ReCODE™” or $940 add-on blood panel when subscribed to “PreCODE™” or “ReVERSE™”.

Please know that a full cognoscopy includes more elaborate testing than most conventional doctors will provide.  Additional medical factors get analyzed and summarized in a ReCODE Report™.  To be fully informed about your potential underlying drivers of cognitive decline, invest in a personalized ReCODE Report™.

After implementing a brain healthy diet and lifestyle for six months to a year, retest any previously out-of-range biomarkers to evaluate progressIf unsatisfied with your health, it may be time for…

For people at the stage of prevention, nutrition and lifestyle provide the most bang for your buck.  I operate a lean, low-overhead practice to help you optimize brain health in a cost-effective way.

Consulting a ReCODE Report Qualified™ Doctor

rainbowA Bredesen-trained doctor can examine your overall clinical picture, begin to assess underlying medical issues, provide expert feedback on how you’re doing thus far, and guide you on the relative urgency of additional therapies.

Access to a directory of names, locations, and pricing of Bredesen-trained practitioners is granted to paying “ReCODE™” and “ReVERSE™” program participants.

If you are cost-constrained, search the internet for a Bredesen ReCODE Protocol™ practitioner either in your region or one who offers telemedicine.  (Perhaps this is how you found my website!)

Apollo Health does not permit me to identify the five ReCODE Qualified™ doctors and three other ReCODE Qualified™ practitioners whose San Diego patients I’m worked with (so please do not ask me to name them).  Instead, you can find half of them on the ApoE4 Wiki listing.  You can also search among practitioners certified by the Institute for Functional Medicine [IFM] at this link, by inputting your area then using the advanced search option to select those who have completed the coursework called “Advanced Clinical Training: Reversing Cognitive Decline”.  Three San Diego Bredesen-trained practitioners appeared in my IFM practitioner search in 2019.   While I have certifiably completed the Advanced Clinical Training: Reversing Cognitive Decline” coursework, my name “Jen Felix” doesn’t appear in the search results because my functional medicine coaching training was through FMCA–which is affiliated with IFM–and I haven’t completed the additional IFM training.)

A portrait in prevention:

A 50-year-old San Diego resident reads Dr. Bredesen’s book and starts as much as the diet and lifestyle recommendations as she can figure out alone.  Doing this alone is slow and internet searches only make it more overwhelming and unclear.  Despite a tight budget, she invests in five sessions of personalized coaching and commits to regularly attending my Brain Health Optimizers meetup for general group support every four weeks.  She has her primary care physician run the aforementioned basic lab tests utilizing her in-network health insurance coverage.   One-on-one coaching gives her the Ketoflex-aligned products, recipes, and dining options she wants.  Through the coaching partnership, she creatively adds in more low-cost physical activities, gets a home sleep study through her PCP and HMO insurance, and address her sleep issues.  At her next annual exam, she retests and sees improvements such that almost all of her basic biomarker test results lie within the optimal ranges.  These improved test results are associated with not only marked reductions in her risk for Alzheimer’s disease, but for diabetes and cardiovascular disease.  She can hardly imagine a better return on investment on less than $550 spent for extra brain health over the twelve months.  She plans to consult a doctor within her health insurance network about the risks/costs vs. benefits of bioidentical hormone replacement therapy as a potential preventative measure discussed at support group meeting.  She’s committed to a brain healthy lifestyle and has the option to invest in a ReCODE Report™ and/or ReCODE™ doctor visit(s) if/when her health or financial situation changes.

 


Reversal:

If you have a high risk for Alzheimer’s or are already experiencing cognitive problems, it’s time to financially invest in what’s important–your health.  We know that Alzheimer’s disease is a terminal condition with (as of early 2020) only one treatment demonstrated to reverse cognitive decline: the Bredesen Protocol™.  Make the most of the one life you have by investing wisely.

I have always felt the pinch of financial scarcity when seeking help for my own health issues.  I genuinely understand how a few thousand dollars can feel like an enormous price tag.  Perhaps we can hope for financial assistance in the future: I’ve spoken to one Apollo Health employee who is advocating for free/sponsored ReCODE Reports™ for very low-income individuals with a family history of Alzheimer’s.

When you or your loved one is already experiencing neurodegeneration, your best chance of stopping further decline or some reversal is comprehensive treatment with the full Bredesen ReCODE Protocol™ as early as possible.  The sooner you begin, the more likely you are to realize a better outcome.  This means not only eating the Ketoflex 12/3™ way and living a brain-healthy lifestyle, but also getting all the basic cognoscopy lab tests, getting a cognitve assessment, being informed by a ReCODE Report™, having a Bredesen-trained coach to assist you, and having a Bredesen-trained doctor treat underlying medical issues.  In other words, commit to a cost-effective, complete version fo the Bredesen Protocol™

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Utilize your available funds wisely in order to live your best life.  This doesn’t mean getting caught up in innumerable brain supplements and speculative therapies out of fear, despite weak evidence behind over-hyped marketing campaigns.  It also doesn’t mean throwing money at expensive medical interventions without putting in the effort to improve diet and lifestyle.  Partnering with a Bredesen-trained health coach will overhaul your diet and lifestyle quickly, effectively, and in a more brain healthy way than you can manage alone.  That’s my thinking, perhaps biased by my occupation, but rooted in sincere compassion for your well-being.

Apollo Health’s “ReVERSE™” program is a $75/month subscription for unlimited ReCODE Reports™, monthly live online town halls with Dr. Bredesen, and a directory of Bredesen-trained healthcare practitioners.  ReVERSE™ requires a minimum of 12 months—a $900+ commitment.  To complete the needed blood tests and assessments to generate a ReCODE Report™, you may work with your physician and existing health insurance for some of the lab tests, then pay out-of-pocket for remaining tests.  Or order the basic suite of lab tests for an additional $940 through Apollo Health (around $2,000 total).  ReVERSE™” is recommended for people experiencing cognitive impairment.

How I help make the Bredesen Protocol™ more affordable

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If you need test results inputted to generate a ReCODE Report™ , I can upload at a lower fee than your ReCODE Report Qualified doctor.  I charge my individual coaching clients $30-75 to upload the ~150 data points, gathered from laboratory test results, a MoCA score, and responses to Dr. Bredesen’s evaluation questions, to generate their presonal ReCODE Report™.

When you need a MoCA test to generate your ReCODE Report™ document your cognitive progress, I charge a $20-30 fee to administer this cognitive assessment at the end of a coaching session or support group meeting.  If a near-perfect MoCA score is expected, then I offer the CNS-VS test for evaluating more subtle cognitive issues (click to read about a few cognitive testing options).

For many things, it’s less costly to utilize my time in a health coaching session than time during a doctor’s appointment.  For instance, my primary roles include assisting with dietary changes and reviewing each person’s ReCODE Report™ analysis with them.  The Report provides guidance on the most important personalized diet and lifestyle changes for their condition.  I enjoy utilizing my broad education and training to help you understand the why and how the ReCODE Report™ and their doctor’s suggestions.   I inform the people I coach of their cost-effective options every step of the way through diet, lifestyle, supplements, lab tests, and more.  I respect the unique paths of each person pursuing brain health and help them make the most progress with ReCODE™ within their financial constraints.

I also offer a 30% discount off the retail prices of many of Dr. Bredesen’s recommended supplements. My hope is that the money you save on supplements will be invested in coaching to advance your brain healthy diet and lifestyle that will have a greater positive impact the course of your life.

There are no quick fixes to reverse cognitive impairment.  This is why Dr. Bredesen credits the health coach as the most important ReCODE™ practitioner because they assist with the essential diet and lifestyle changes (watch Dr. Bredesen explain this in the video clip above).  In general, more of a brain healthy diet and lifestyle can reduce the need for supplements and medical interventions.  Although I’ve witnessed diet and lifestyle alone reverse subjective cognitive impairment, cases of moderate or more advanced cognitive impairment require medical treatment.

 

Navigating medical costs

The expenses of doctor visits, medical interventions, and supplements can add up significantly, so do your best to navigate these waters thoughtfully.  Some supplements and therapies have greater efficacy than others.  You will likely be presented with numerous speculative supplements and treatments, beyond the efficacious ones.  A seldom-recognized inconvenient truth is that offering more supplements and more treatments generates more profits. This financial incentive permeates both conventional and integrative/functional/naturopathic medicine (and the internet!).

As you receive a doctor’s recommendations, feel empowered to ask:

  • Which supplements are the highest priority for my specific condition?
  • What are my other treatment options?
  • What are the risks?
  • What happens if I first see if option A is effective and wait to take option B?
  • Is this really necessary?

When in significant doubt, get a second opinion.  The consultation fee for a second opinion can be seen in the light of the value of a better health outcome.

A portrait in reversal: 

A 65-year-old talks to his primary care physician about having senior moments.  A brief cognitive test reveals signs of cognitive impairment and he gets referred to an in-network neurologist.  Since one of his parents had Alzheimer’s, he’s seriously motivated to halt or reverse this decline.  He invests in a ReVERSE™ subscription.  Once subscribed, he can access a map of Bredesen-trained practitioners and their fees.  He shops around to find a local ReCODE Report Qualified™ doctor that accepts Medicare and a health coach.  He commits to twelve months of the Bredesen Protocol™ diet, lifestyle, supplements, and medical interventions recommended to restore brain health.  The program is challenging, so he’s grateful to have the support of his wife, doctor, and a coach.  Over months, his Bredesen-trained doctor uncovers and treats physiological issues, deficiencies, and toxicities driving his cognitive decline.  With the help of his health coach, the daily decisions to eat better, move more, and train his brain get easier overtime.  After six months, he feels renewed physically and a bit sharper mentally, plus he sees objective improvements in his lab results and no longer needs three of his four prescriptions.  He believes the $4800 spent so far has been a life-enriching investment.  The money spent will be demonstrably profoundly rewarding if his future cognitive assessment and quantitative MRI show improvements.