Why I’m Exploring Therapeutic Plasma Exchange at 59
I just turned 59. My mother died at 69. It makes me acutely aware of how short life can be. She had no idea she was entering her last decade. I have no idea whether I have days, weeks, years, or decades left. What I do know is that I want to live well for as long as I am here.
I want a quality life. I want independence. I want to adventure. I want to travel. I want to work because I still have things I want to create, teach, formulate, write, and say. I want to know the people I love until my final moments on earth. And more than anything, I want to protect the things that make me me.
These desires come from very personal history. Caring for my dad after his Alzheimer’s diagnosis gave me a front-row seat to his experience of loss. He mourned the loss of his freedom, his ability to drive, his independence, his travel plans, leaving the place he loved so much, and his ability to bike and hike. And most painfully for him, Alzheimer’s took away his ability to spend his life in the woods and mountains that was so woven deeply into who he was.
It is impossible to watch someone you love as they lose those pieces of themselves and not think about your own future. The Alzheimer’s Association estimates that a woman’s estimated lifetime risk of developing Alzheimer’s dementia is about 1 in 5. After watching Alzheimer’s ravage my Uncle Tom and take so much from my dad, it is a risk I take seriously.
What I learned while caring for my dad is that Alzheimer’s doesn’t suddenly begin on the day someone receives a diagnosis. The biological changes associated with the disease can begin years before symptoms become apparent. This made me decide to start working on my future self now.
I had my cognition tested, and for the past two years I have been intentionally working on my cognitive health. In August 2026, I was retested. My score on the dementia scale had improved from 2.6 to 1.4. Dr. Hutchings told me that, based on the progression he would normally expect, a score of 2.6 might have risen to approximately 3.6 over those two years. Instead, my score moved in the opposite direction.
That result was incredibly encouraging to me. It didn’t give me a crystal ball or a guarantee about my future. But it reinforced something I deeply believe: I don’t have to wait for a crisis to start caring for my future self. You can read more about the steps I have been taking here: Your Future Self Starts Now — Kayla Fioravanti.
In that blog post, I mentioned that therapeutic plasma exchange was part of my future plans. And the future was this week. I had my Therapeutic Plasma Exchange done at Next Health here in Nashville and there are locations across the country if it interests you.
I am not letting moss grow over any of my plans for cognitive wellness and strength because I want to give my future self the best chance I can to remain independent, curious, creative, and fully present for the life. I’ve spent much of my adult life thinking about prevention. Not because I’m afraid of getting older. Because I actually am getting older, and I recognize what a privilege it is to grow old.
I like who I am becoming. I don’t want to turn back the clock. I want to move forward with as much of myself intact as possible. My goal isn’t anti-aging. It’s healthy aging. And healthy aging, to me, means paying attention before there is a crisis.
I’ve actually gotten healthier as I’ve aged. I am in less pain than I have ever been. I take zero prescriptions, and I don’t even take over-the-counter drugs. I sleep better than I ever have in my life. I eat with intention. And for the next year, I am deeply focused on Operation 60 Strong, my personal goal to build more muscle and physical strength by my 60th birthday because “thick thighs save lives!”
It also means being willing to explore emerging medical technologies. One of the things I’ve chosen to explore as part of my health journey is therapeutic plasma exchange (TPE) at Next Health, which is a medical procedure in which plasma—the liquid portion of blood—is separated from the cellular components of blood and removed, with a replacement fluid returned along with the blood cells. Therapeutic plasma exchange has long been used for certain medical conditions, and researchers have also investigated its potential role in Alzheimer’s disease. The Alzheimer’s connection is particularly interesting to me.
To give a little context, our plasma, which is the liquid component of your blood, serves as a transportation system throughout the body. Our plasma carries oxygen, nutrients, hormones, signaling molecules, and substances involved in tissue repair. Over time, our plasma also contains a complex mixture of proteins, antibodies, inflammatory molecules, microplastics, environmental toxins, and other substances associated with environmental exposures, chronic stress, infection, and aging. Research continues to investigate how the accumulation of these toxins, stress molecules, and garbage proteins contribute to inflammation, immune dysfunction, and neurodegenerative processes.
The idea behind plasma exchange in Alzheimer’s research is not simply cleaning the blood. Researchers have investigated whether changing components of the plasma, including through albumin replacement, could influence the movement or concentration of proteins and other factors associated with Alzheimer’s disease.
An AMBAR randomized controlled trial studied plasma exchange with albumin replacement in people who already had mild-to-moderate Alzheimer’s disease. The researchers reported less decline on some measures of cognition and daily functioning in certain treatment groups, while also concluding that additional studies were warranted. That’s interesting to me. It’s interesting enough that I chose to make TPE part of my personal health journey.
But I want to be very clear: TPE has not been established as a treatment for preventing Alzheimer’s in healthy people. The AMBAR trial studied people who already had mild-to-moderate Alzheimer’s disease, not people like me who are trying to protect their future cognitive health. I’m not writing this as medical advice. I’m sharing a decision I am making for myself as I think seriously about the next chapter of my life.
In thirty years of practice I’ve watched longevity medicine evolve from supplements and hormone replacement to peptides and stem cells. TPE is the next frontier. It’s the only intervention I know of that directly addresses the accumulated molecules in your blood that drives age-related decline.” Dr. Darshan Shah, MD · Chairman and physician founder of Next Health
I am my own test subject, and I’m sharing the journey along the way. The entire procedure went very smoothly and I feel amazing. Onwards and upwards in pursuit of a life well lived.
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