Category Archives: Live positively

Effect of Forgiveness on Health

“When you forgive, you in no way change the past – but you sure do change the future.”  Bernard Meltzer

“The first step in forgiveness is the willingness to forgive.” Marianne Williamson

Précis: Recently had a friend go through a difficult break-up from a marriage. The notion of getting past the failed relationship, achieving forgiveness, and moving on without causing illness was of paramount importance. The implications of forgiveness/unforgiveness as it relates to health-illness crossed my mind. It started with assembling the quotes in this post. Next, I did a Google Scholar search for “forgiveness and health” and discovered a whole new area of psychology-science-medicine (well, it was new to me). Most of us would agree that forgiving yourself promotes wellness; whereas remaining unforgiven could disrupt your mental and possibly even your physical health.  This post reviews forgiveness and its positive impact on our health.

“Forgiveness is really a gift to yourself – have the compassion to forgive others, and the courage to forgive yourself.” Mary Anne Radmach

Forgiveness and Health: The Oxford dictionary defines ‘forgive’ as to stop feeling angry and resentful towards (someone) for an offense, flaw, or mistake.  Positive psychology is the scientific study of the strengths that enable individuals and communities to thrive. Forgiveness is a big part of positive psychology regarding both physical and mental well-being.   Over the past 15 years, researchers have focused on 2 primary hypotheses: (1) forgiveness has important connections to physical health; and (2) this relationship is guided by an association between lack of forgiveness and anger.  Evidently, there is consensus in the field that these two primary processes form the basis of forgiveness: (i) letting go of one’s right to resentment and negative judgment; and (ii) fostering undeserved compassion and generosity toward the perpetrator.  The first process implies a person would reduce their negative emotions (i.e., anger and revenge); while  the second process involves increasing positive feelings and might even include reconciliation. Collectively, there is growing scientific evidence that links the positivity of forgiveness and health.

“He who is devoid of the power to forgive is devoid of the power to love.” Martin Luther King, Jr.

“The more you know yourself, the more you forgive yourself.” Confucius

Forgiveness vs. Unforgiveness: It is probably apparent (to you) that forgiveness is generally associated with improved mental and physical health, as opposed to someone unable/unwilling to forgive.  Modeling the relationship between forgiveness and health, based on the hypothesis that forgiveness reduces hostility (and this would be considered healthier), 6 paths linking forgiveness and health have been described: (i) decrease in chronic blaming and anger; (ii) reduction in chronic hyper-arousal [“a state of increased psychological and physiological tension marked by such effects as reduced pain tolerance, anxiety, exaggeration of startle responses, insomnia, fatigue and accentuation of personality traits.”]; (iii) optimistic thinking; (iv) self-efficacy to take health-related actions; (v) social support; and (vi) transcendent consciousness (“state achieved through the practice of transcendental meditation in which the individual’s mind transcends all mental activity to experience the simplest form of awareness“).

What does this mean? The majority of studies on forgiveness indicate a reciprocal relationship to hostility, anger, anxiety and depression.  Forgiveness may directly alter sympathetic reactivity, which is often referred to as the “fight-or-flight” response. These responses include increases in heart rate, blood pressure, cardiac contractility, and cortisol.  This implies that unforgiveness could promote an acute, stress-induced reactivity that could be associated with general health problems.  However, it is much more complicated than this simplistic flow of events: anger is a component of unforgiveness; anger is a health risk; therefore, unforgiveness is a health risk.  This is really interesting reading but way beyond my training as a protein biochemist (If interested, look over the references listed below)

Forgiveness and Mental Health: Let’s take a different angle by looking at mental health. We begin with unforgiveness as being associated with stress from an ‘interpersonal’ offense and stress is associated with diminished mental health. Furthermore, unforgiveness due to an ‘intrapersonal’ wrongdoing may lead to shame, regret and guilt, which could also negatively affect mental health. The positive impact of forgiveness may help correct the downturn in mental health that resulted from either interpersonal or intrapersonal stress.  In many instances, mental health is linked to physical health. This suggests that practicing forgiveness would positively influence mental health and could therein bolster physical health.

To summarize the ability of forgiveness to bolster mental health, I have re-drawn the figure from Toussaint and Webb  (2005) as a 4-piece puzzle. It begins with the ‘direct effect’ of forgiveness as told through unforgiveness with emotions of resentment, bitterness, hatred, residual hostility, and fear. The negative emotions of unforgiveness could contribute significantly to mental health problems.  By contrast, the emotion of forgiveness is positive and strong and love-based that could improve mental health. The ‘indirect effect’ of forgiveness through social support, interpersonal behavior and health behavior are all positively-linked to good mental health. The ‘developmental stage’ describes the recognition of the problem, need for an alternative solution, and ultimately the effect of forgiveness augments mental health.  The final piece to the puzzle is the ‘attributional process’, which suggests that being able to forgive bolsters personal control of one’s life, which is perceived to be positive.  By contrast, unforgiveness blocks this life-controlling process by consumptive negative emotions made worse in the individual through rumination.  Due to my own internal word limit and time-period to read/understand the topic, I have not included the religious or spiritual basis of the forgiveness of God, feeling God’s forgiveness, and seeking God’s forgiveness in the narrative of this post.  For many people, these would be integral components to the discussion here on forgiveness and its overall impact on both mental and physical health.

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“I don’t know if I continue, even today, always liking myself. But what I learned to do many years ago was to forgive myself. It is very important for every human being to forgive herself or himself because if you live, you will make mistakes- it is inevitable. But once you do and you see the mistake, then you forgive yourself and say, ‘Well, if I’d known better I’d have done better,’ that’s all.” Maya Angelou

9 Steps to Forgiveness (Fred Luskin, LearningToForgive.com): Dr. Luskin is a noted-researcher in the field of forgiveness. His belief is that by practicing forgiveness, your anger, hurt, depression and stress will all be reduced and it will increase feelings of hope, compassion and self confidence. Furthermore, he believes that practicing forgiveness contributes to healthy relationships and to improved physical health; here are the 9 steps to forgiveness:

  1. Know exactly how you feel about what happened and be able to articulate what about the situation is not OK. Then, tell a trusted couple of people about your experience.
  2. Make a commitment to yourself to do what you have to do to feel better. Forgiveness is for you and not for anyone else.
  3. Forgiveness does not necessarily mean reconciliation with the person that hurt you, or condoning of their action. What you are after is to find peace. Forgiveness can be defined as the “peace and understanding that come from blaming that which has hurt you less, taking the life experience less personally, and changing your grievance story.”
  4. Get the right perspective on what is happening. Recognize that your primary distress is coming from the hurt feelings, thoughts and physical upset you are suffering now, not what offended you or hurt you two minutes – or ten years – ago. Forgiveness helps to heal those hurt feelings.
  5. At the moment you feel upset practice a simple stress management technique to soothe your body’s flight or fight response.
  6. Give up expecting things from other people, or your life, that they do not choose to give you. Recognize the “unenforceable rules” you have for your health or how you or other people must behave. Remind yourself that you can hope for health, love, peace and prosperity and work hard to get them.
  7. Put your energy into looking for another way to get your positive goals met than through the experience that has hurt you. Instead of mentally replaying your hurt seek out new ways to get what you want.
  8. Remember that a life well lived is your best revenge. Instead of focusing on your wounded feelings, and thereby giving the person who caused you pain power over you, learn to look for the love, beauty and kindness around you. Forgiveness is about personal power.
  9. Amend your grievance story to remind you of the heroic choice to forgive.

“Forgiving does not erase the bitter past. A healed memory is not a deleted memory. Instead, forgiving what we cannot forget creates a new way to remember. We change the memory of our past into a hope for our future.” Lewis B. Smedes

Forgiveness in the Presence of Parkinson’s:  Receiving a diagnosis of Parkinson’s, a lifelong chronic progressive neurodegenerative disorder is a real shock.  The diagnosis comes with a variety of emotions. After a while, acceptance takes over; no, not your identify, just ok, I’ve got Parkinson’s, live through it, make the most of this experience. Eventually I had to put forgiveness into part of this living-life-equation. There were two self-involved events where I might have contributed to the development of my own disease.  The first was as a young boy in the summertime riding my bicycle behind the DDT trucks spraying for mosquitoes on our Air Force bases [Dichlorodiphenyltrichloroethane (DDT) is a colorless, tasteless, and almost odorless crystalline organochlorine known for its insecticidal properties]. DDT is one of the known chemical inducers of Parkinson’s. Second, in graduate school before OSHA took over regulating lab safety, I routinely used many different noxious compounds for the benefit of science and for the completion of my PhD. Both events caused me to pause and ponder; however, I decided to forgive myself. I truly believe had I remained unforgiving, I would have paved a path of ill health.

This whole process of dealing with the emotion from diagnosis to acceptance (and forgiveness) of Parkinson’s reminds me of the opening verse of “We Are The Champions” by Queen: “I paid my dues/ time after time./ I’ve done my sentence/ but committed no crime./ And bad mistakes-/ I’ve made a few./ I’ve had my share of sand kicked in my face/ but I’ve come through./  (And I need to go on and on, and on, and on)

The vast majority of people with Parkinson’s are 60-years of age or older (although there is a group of early-age-onset). Interestingly, in a recent study with an elderly population, forgiveness showed positive and significant association with mental and physical health.

“You cannot travel back in time to fix your mistakes, but you can learn from them and forgive yourself for not knowing better.” Leon Brown

“Accept the past as past, without denying it or discarding it.” Mitch Albom

Forgive Ourselves: Dr. Elaine in her post “The-healing-power-of-forgiveness” nicely summarized self-forgiveness: “We tend to believe that forgiveness supports the transgression that has been committed against us. But forgiveness is not an endorsement of wrongdoing; rather, it’s an act of releasing the pain and hurt it caused through love, the root of forgiveness—and it is not love of the other but of the self. We must forgive ourselves as well as others in order to be whole and healed.”

Effect of Forgiveness on Health: The sum total of our health is a complex formula that differs slightly for each one of us.  Those of us with a progressive neurodegenerative disorder like Parkinson’s increases the complexity of this life-equation.  Thus, dealing with the axis defined by forgiveness/unforgiveness in the matter of health (both mental and physical) clearly could complicate our health.  Truly we need to add forgiveness as a filter to our life-lens; the benefits from this addition should favor our health in the long-run.

“If we all hold on to the mistake, we can’t see our own glory in the mirror because we have the mistake between our faces and the mirror; we can’t see what we’re capable of being. You can ask forgiveness of others, but in the end the real forgiveness is in one’s own self.” Maya Angelou

Cover photo credit: https://orig05.deviantart.net/0a42/f/2015/095/1/6/painted_wallpaper___fog_on_lake_by_dasflon-d8oiudk

Useful References:

Lawler KA, Younger JW, Piferi RL, Jobe RL, Edmondson KA, Jones WH. The Unique Effects of Forgiveness on Health: An Exploration of Pathways. Journal of Behavioral Medicine. 2005;28(2):157-67. doi: 10.1007/s10865-005-3665-2.

Akhtar, S., Dolan, A., & Barlow, J. (2017). Understanding the Relationship Between State Forgiveness and Psychological Wellbeing: A Qualitative Study. Journal of Religion and Health, 56(2), 450–463. http://doi.org.libproxy.lib.unc.edu/10.1007/s10943-016-0188-9

Lawler-Row KA, Karremans JC, Scott C, Edlis-Matityahou M, Edwards L. Forgiveness, physiological reactivity and health: The role of anger. International Journal of Psychophysiology. 2008;68(1):51-8. doi: https://doi.org/10.1016/j.ijpsycho.2008.01.001.

Rey L, Extremera N. Forgiveness and health-related quality of life in older people: Adaptive cognitive emotion regulation strategies as mediators. Journal of Health Psychology. 2016;21(12):2944-54. doi: 10.1177/1359105315589393. PubMed PMID: 26113528.

Toussaint, L., J.R. Webb.  Theoretical and empirical connections between forgiveness, mental health, and well-being E.L. Worthington Jr (Ed.), Handbook of forgiveness, Brunner–Routledge, New York (2005), pp. 207-226

 

 

 

 

Diet and Dementia (Cognitive Decline) in the Aging

“When diet is wrong medicine is of no use. When diet is correct medicine is of no need.’’ Ancient Ayurvedic Proverb

‘‘What is food to one man may be fierce poison to others.’’ Lucretius (99 B.C.-55 BC).

Précis: Last month in London, England, at the Alzheimer’s Association International Conference (AAIC) 2017, there were several presentations focused on diet and the link with dementia/cognitive decline in the elderly population.  Two reports described the effect of specific diets [Mediterranean, DASH (Dietary Approaches to Stop Hypertension), MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay), and NPDP (Nordic Prudent Dietary Pattern)] to maintain cognitive function in the aging population. In another study, the MIND diet was shown to reduce dementia in the women from the Women’s Health Initiative Memory Study (WHIMS).  Finally, it was shown that either the absence or excess of certain vitamins, minerals and other key nutrients could promote neuro-inflammation, which would be detrimental to the brain. This post reviews elements of these presentations.

“One should eat to live, not live to eat.” Moliere

A Healthy Body and Brain Combine Diet, Life-style, and Attitude: It is easy to say what it takes to be healthy; however, approaching/achieving/accomplishing it takes a concerted effort. In a minimal sense, achieving a healthy body and brain unites an efficient diet, an effective lifestyle, and a positive attitude.  Thus, a healthy body and brain requires a collective approach to living properly (and it helps to have good genes).

“Take care of your body. It’s the only place you have to live.” Jim Rohn

Inflammation and Parkinson’s: One of the many suggested causes of Parkinson’s is neuro-inflammation (see figure below).  The impact of diet promoting inflammation and cognitive decline in the aging population got my interest.  The combination of eating too much of ‘bad’ foodstuff with too little of some ‘good’ food components somehow promotes neuro-inflammation that contributes to the development of dementia. If the goal of my blog is related to Parkinson’s, what is the goal of this particular post? To present the notion that detrimental effects of neuro-inflammation could diminish brain function. And it’s this ‘possibility’ that makes the story relevant to this blog because neuro-inflammation is linked to the development of both Alzheimer’s and Parkinson’s.  Therefore, the specific pathway to how you develop that inflammation of the brain is relevant and an important topic.

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“Tell me what you eat, and I will tell you who you are.” Jean Anthelme Brillat-Savarin

Diet Linked to Neuro-inflammation: There’s an old phrase “You Are What You Eat”, which simply means it’s critical to eat good food in order to stay healthy and fit. Building on solid evidence that eating well is brain healthy, researchers are beginning to explore mechanisms through which dietary mechanisms may influence cognitive status and dementia risk. Dr. Gu and colleagues (Columbia University, New York) examined whether an inflammation-related nutrient pattern (INP) was associated with changes in cognitive function and structural changes in the brain. Gu, Y., et al. (An Inflammatory Nutrient Pattern Is Associated Both Structural and Cognitive Measures of Brain Aging in the Elderly) presented a follow-up study to earlier work using brain scans (MRI) combined with levels of inflammatory makers [C-reactive protein (CRP) and interleukin-6 (IL-6)] and cognitive function studies of >300 community-dwelling elderly people who were non-demented.

They created what was termed an “InflammatioN-related Pattern (INP) where increased levels of CRP and IL-6 were found in participants with low dietary intake of omega-3 polyunsaturated fatty acids, calcium, folate and several water- and fat-soluble vitamins (including B1, B2, B5, B6, D, and E) and increased consumption of cholesterol, beta-carotene and lutein. The INP was derived from a 61-item food frequency questionnaire that the study participants answered about their food intake during the past year. Study participants with this ‘INP-diet-pattern’ also had poorer executive function scores and smaller total brain gray matter volume compared to study participants with a healthier diet.  The strength of the study was the scientific precision and methodology; however, it was not directly comparing one diet to another.  Further studies are needed to verify the role of diet to induce neuro-inflammation-related changes in dementia (cognitive health).  Furthermore, mechanistic insight is needed to understand how a diet with either an absence or an excess of certain nutritional components promotes neuro-inflammation to alter brain function and structure. Their results imply that a poor diet promotes dementia and smaller brain volume in the aging brain through a neuro-inflammatory process.

“The food you eat can either be the safest and most powerful form of medicine, or the slowest form of poison.” Ann Wigmore

What is Good for Your Heart is Good for Your Brain: The Mediterranean diet, a diet of a type traditional in Mediterranean countries, characterized especially by a high consumption of vegetables and olive oil and moderate consumption of protein, is usually thought to confer healthy-heart benefits. The DASH (Dietary Approaches to Stop Hypertension) diet was developed to help improve cardiovascular health, especially hypertension. The DASH diet is simple: eat more fruits, vegetables, and low-fat dairy foods; cut back on foods that are high in saturated fat, cholesterol, and trans fats; eat more whole-grain foods, fish, poultry, and nuts; and limit sodium, sweets, sugary drinks, and red meats. Neurologists have merged the two diets, creating the Mediterranean-DASH Intervention for Neurodegenerative Delay, or MIND diet; testing the hypothesis that if it’s good for the heart it will be good for the brain.   The MIND diet is gaining attention for its potential positive effects on preserving cognitive function and reducing dementia risk in older individuals. In an earlier study, Morris et al. (Alzheimer’s Dement. 2015; 11:1015-22) found that  individuals on the MIND diet showed less cognitive decline as they aged.

Moving to 2017, Dr. McEvoy and colleagues (University of California, San Francisco) studied ~6000 older adults in the Health and Retirement Study. They showed that the study participants who followed either the MIND or the Mediterranean diets were more likely to maintain strong cognitive function in old age (McEvoy, C., et al. Neuroprotective Dietary Patterns Are Associated with Better Cognitive Performance in Older US Adults: The Health and Retirement Study). Their results also showed that study participants with either of these healthier diets had significant retention of cognitive function.

The doctor of the future will no longer treat the human frame with drugs, but rather will cure and prevent disease with nutrition.” Thomas A. Edison

The Nordic Prudent Dietary Pattern (NPDP) Protects Cognitive Function: The NPDP includes both more frequent and less frequent food consumption categories: More frequent consumption of non-root vegetables, apple/pears/peaches, pasta/rice, poultry, fish, vegetable oils, tea and water, and light to moderate wine intake; Less frequent intake of root vegetables, refined grains/cereals, butter/margarine, sugar/sweets/pastries, and fruit juice. Dr. Xu and colleagues (Karolinska Institute, Stockholm, Sweden) studied the relationship of diet to cognitive function in >2,200 dementia-free community-dwelling adults in Sweden (Xu,W., et al. Which Dietary Index May Predict Preserved Cognitive Function in Nordic Older Adults). During six years of evaluation, they reported that study participants with moderate loyalty to the NPDP had better cognitive function compared to study participants who deviated more frequently from the NPDP.  The scientists noted that, in the Scandinavian population studied, the NPDP was better at maintaining cognitive function compared to other diets (Mediterranean, MIND, DASH, and Baltic Sea).

“The trouble with always trying to preserve the health of the body is that it is so difficult to do without destroying the health of the mind.” Gilbert K. Chesterton

Women on the MIND Diet are Less Likely to Develop Dementia: Dr. Hayden and colleagues (Wake Forest School of Medicine, Winston-Salem, North Carolina) studied diet and dementia in >7,000 participants from the Women’s Health Initiative Memory Study (WHIMS) (Hayden, K., et al. The Mind Diet and Incident Dementia, Findings from the Women’s Health Initiative Memory Study).   The study showed that older women who followed the MIND diet were less likely to develop dementia. These results were obtained by stratification of the WHIMS  participants from very likely to very unlikely to adhere to the MIND diet; they were  assessed for almost 10 years.  Their results imply that it may not require drastic diet changes to help preserve the aging brain.

“It’s not about eating healthy to lose weight. It’s about eating healthy to feel good.” Demi Lovato

Diet and Dementia in the Aging Brain: Four different studies with similar results; diet can  influence dementia and cognitive function in the aging brain.  The single most important finding in these studies was simply that a good diet helps maintain a healthy brain. Strong evidence was presented in three of the studies that the Mediterranean, the MIND and NPBP are excellent diets to help maintain cognitive function as we age.  Mechanistic studies to further demonstrate the link of dietary components with an increase in neuro-inflammation  would be most interesting. A confounding issue is that overall health and a healthy brain are more than just diet alone.  To reduce the chance of cognitive decline and dementia, it’s important to remember as we get older to protect our brain by eating well, exercise regularly, and exercise our brain by becoming lifelong learners (see Word Cloud below).

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“The older I get, the more vegetables I eat. I can’t stress that more. Eating healthy really affects my work. You not only need to be physically prepared, but mentally and spiritually.” James Badge Dale

 Cover photo credit:  C.J. Reuland

 

 

The Mask of Parkinson’s

“I wear the mask. It does not wear me.” Man in the Iron Mask

“See to it, then, that the light within you is not darkness.” Luke 11:35

Précis: The simplest way to describe Parkinson’s is that it’s a movement disorder due to the reduction of dopamine production.  Sometimes one of the more obvious places this absence of dopamine is noticed is the reduction of facial expressions (also referred to as masked facies or hypomimia).  The “mask of Parkinson’s” is further described below.

Loss of facial expression: There are 43 muscles in the face, which are all mostly controlled by the seventh cranial nerve.  Johann Kaspar Lavater said “…The human face is nature’s tablet, the truth is certainly written thereon.” We view the smile as a sign of friendship, happiness, and acceptance; while we view the frown as a sign of sadness or unacceptable.  The Parkinson’s face is somewhat less expressive than before; somewhat more rigid than before.  Many people-with-Parkinson’s also have chronic stiff necks; however, that doesn’t make us Frankenstein.

Scenario #1: You’ve played 17 holes of golf, and you approach the 18th hole to finish the round. This is a long par three with a lake between you on the tee box and the putting surface.  Your three golf buddies have already safely hit their balls over the lake;  you  launch the ball over the water and safely onto the green (this is a big deal).  Without Parkinson’s, your facial expression and your exuberance are so obvious.  With Parkinson’s, your joy and exuberance are still over-flowing inwardly yet it is displayed in a more muted  manner.

‘Life is a mask through which the universe expresses itself.” Frank Herbert

“You wear a mask for so long, you forget who you were beneath it.” Alan Moore

Changes in your voice: The loss of dopamine in your brain leads to reduced volume in your voice along with your voice becoming flatter/softer in tone.  The same process affecting your face is happening in your voice. If you think of dopamine as a “messenger service”, the brain uses it to send orders/messages to nerves.  When dopamine-producing cells die, all muscles are affected and diminish, including muscles involved in speaking, swallowing, facial motion, legs and  walking, and hand/arm movements.

Scenario #2:  You and your partner are attending a college basketball game;  your home team is 3-points ahead of your biggest rival, and it’s near the end of the second half.  Game over, your team wins, let the fun begin.  Like everyone else in the arena, you are standing, jumping around, high-five’s all near you, and you are shouting (and singing) your lungs out.  Such happens during great college basketball rivalry games.  Without Parkinson’s, all of this is a reality, a dream come true.  There is a feeling of satisfaction and there is a huge positive feeling from the game.  With Parkinson’s, there is the same positive feeling of happiness but with a diminished ability to clap  continuously and you’re less able to shout and sing along loudly with everybody.

Two famous masks:

“Without wearing any mask we are conscious of, we have a special face for each friend.’ Oliver Wendell Holmes

“A mask tells us more than a face.” Oscar Wilde

Consequences of the ‘Parkinson’s Mask’: The change is subtle over time. Mostly,  there is a softness to your voice, your smile is not as big, and you don’t blink your eyes as much.

Subtle differences in the before/after pictures (I’m also younger in the without PD pictures):

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Because I do a lot of teaching, I get a lot of teaching evaluations and critiques. Here are two comments from two medical students regarding my lecturing in Immunology (one of the medical school courses I co-direct and teach in):

“Dr. Church is a wonderful lecturer! Not only is he easy to follow during lectures as far as explaining concepts is concerned, but his dedication to his students, their questions, and their general well-being never ceases to amaze me.

“Dr. Church should take it as a huge compliment that he was able to convey enthusiasm about the topic and inspire passion in students despite his expression often being limited by Parkinson’s.”

LSVT LOUD® can certainly help boost the volume and tone of your voice. If you use it and practice, it will make a difference.  My Speech Pathologists told me that we think we’re speaking at a normal volume but we’re really not.  Your goal is to train your brain to really speak loud (almost shouting). You can also practice making accentuated facial motions, trying to accentuate what’s going on with your face. You can practice smiling large, and other facial exercises (try practicing your vowels).  I have never had a loud voice and I’m not an overly expressive person; having Parkinson’s has softened everything. When you listen to someone speaking, you also listen with your eyes; thus,  the reduction in visual cues makes it harder to understand you.  To continue to get these positive comments shown above, I need to be constantly practicing on speaking louder and working on my facial exercises.

“Take the emotional temperature of those listening to you. Facial expressions, voice inflection and posture give clues to a person’s mood and attitude.” John C. Maxwell

“People are like stained – glass windows. They sparkle and shine when the sun is out, but when the darkness sets in, their true beauty is revealed only if there is a light from within.” Elisabeth Kubler-Ross

Resist the evolving Parkinson’s mask:  The worst-case scenario to what I’ve been describing is the total outward masking/blocking of your inner self and its expression. We must resist that change, we must really work hard to speak louder and to over-accentuate our facial motion to show the emotion that’s within us. Change may be subtle but change is inevitable for most of us regarding this mask. Stay vigilant. Let’s keep working on talking louder and being more expressive. The inner you is still there, it’s functioning and still wanting to get out. Keep working.

“When we can let go of what other people think and own our story, we gain access to our worthiness—the feeling that we are enough just as we are and that we are worthy of love and belonging. When we spend a lifetime trying to distance ourselves from the parts of our lives that don’t fit with who we think we’re supposed to be, we stand outside of our story and hustle for our worthiness by constantly performing, perfecting, pleasing, and proving. Our sense of worthiness—that critically important piece that gives us access to love and belonging—lives inside of our story.” Brené Brown

Cover photo credit: http://7-themes.com/6793576-free-pacific-ocean-wallpaper.html

Sleep Disturbances in Parkinson’s and the Eagles Best Song Lyrics

“There is a time for many words, and there is also a time for sleep.” Homer, The Odyssey

“Man is a genius when he is dreaming.” Akira Kurosawa

Précis: There are many manifestations associated with Parkinson’s; one of the more frustrating aspects is the alteration of sleep patterns.  Herein is a brief overview of sleep disturbances in Parkinson’s.  And in a recent evening of insomnia, I compiled a list of some of my favorite lyrics by the American rock band “the Eagles”.

Sleep problems associated with Parkinson’s: The vast majority, >90%, of people-with-Parkinson’s have some sleep-related problems. The factors related to disrupted sleep pattern in Parkinson’s can broadly be classified as follows:  (1) Parkinson’s-related; (2) treatment-related; (3) psychiatric-related; and (4) other sleep-related manifestations. For further review, please see the following articles: Garcia-Borreguero et al., “Parkinson’s disease and sleep” (click here for the PubMed citation); Barone et al., “Treatment of nocturnal disturbances and excessive daytime sleepiness in Parkinson’s disease” (click here for the PubMed citation) and Chaudhuri et al. “Non-motor symptoms of Parkinson’s disease: diagnosis and management” (click here for the PubMed citation). An expanded description of some of the sleep disturbances in Parkinson’s is given below:

  • Parkinson’s related motor symptoms that could alter sleep patterns include disruption from tremor, difficulty in turning over in bed, impairment of voluntary movement (akinesia), abnormal muscle tone that results in muscular spasm and abnormal posture (dystonia), and painful cramps.
  • Therapy-related nocturnal disruption of sleep from legitimate Parkinson’s drugs, e.g., dopamine agonists, levodopa/carbidopa, and certain antidepressants. The known side-effects of the ‘gold-standard’ of treatment levodopa/carbidopa include: dizziness, loss of appetite, diarrhea, dry mouth, mouth and throat pain, constipation, change in sense of taste, forgetfulness or confusion, nervousness, nightmares, difficulty falling asleep or staying asleep, and headache.
  • A significant portion of people-with-Parkinson’s exhibit psychiatric symptoms.  The most frequent manifestations, which could alter one’s sleep pattern include vivid dreams, insomnia, hallucinations, psychosis, panic attacks, depression, and dementia.
  • Finally, there are other sleep-related disorders linked to Parkinson’s, which include excessive daytime sleepiness, insomnia, restless legs syndrome, periodic leg movements, and sleep apnea.

“Daytime sleep is like the sin of the flesh; the more you have the more you want, and yet you feel unhappy, sated and unsated at the same time.” Umberto Eco, The Name of the Rose

Sleep-related problems from Parkinson’s: Many people-with-Parkinson’s have a difficult time sleeping throughout the night. With or without Parkinson’s, a good night’s rest is critical to feeling well. Thus, understanding and treating the cause of the sleep-related disorder from Parkinson’s is important.  The list described above is somewhat intimidating; especially in trying to sort out the primary-cause(s) of sleep problems from Parkinson’s. My sleeping problems seem to be related to the timing of when I take levodopa/carbidopa (I need to re-focus my effort to take it at the right time each day; not late in the evening), renew my nightly melatonin therapy (3 mg capsule 1-2 h before sleep); sleep apnea (now being treated by CPAP), and stress related to my work deadlines/professional goals-expectations (now being dealt with by increased time for exercise and better use of mindfulness-meditation).

Dealing with sleep-related issues from Parkinson’s is both complex and frequently multi-factorial. Therefore, given below are some websites that may offer guidance and suggestions to better handle your sleep disorder from Parkinson’s:

  • Nighttime Parkinson’s issues and how they can be treated (click here);
  • Sleep Disorders and Parkinson’s Disease (click here);
  • Sleep Disturbances (click here);
  • Parkinson’s Disease and Sleep (click here);
  • Problems with Sleep at Night (click here);
  • And from this blog: Sleep, Relaxation, and Traveling (click here); 7 Healthy Habits For Your Brain (click here);  and try dealing with the stress from and the reality of Parkinson’s using Contentment, Gratitude, And Mindfulness (click here).

“Am I sleeping? Have I slept at all? This is insomnia.” Chuck Palahniuk, Fight Club

“Frank, what’s your favorite line from an Eagles song?”:  A recent Sunday morning on the golf course, my golf buddy and good friend Kim asked Frank, what’s your favorite line from an Eagles song?”; yes, it came our of nowhere.  My initial response was “You can see the stars and still not see the light”.  He quickly replied “We live our lives in chains and we never even know we have the key.” And I followed up with “I’m standing on a corner in Winslow Arizona and such a fine sight to see.”  We talked briefly about the Eagles from the early 1970’s and their song lyrics; however, the thought stayed with me.  If you need a reminder about the Eagles: “The Eagles were an American rock band formed in Los Angeles in 1971 by Glenn Frey, Don Henley, Bernie Leadon, and Randy Meisner. With five number-one singles, six Grammy Awards, five American Music Awards, and six number one albums, the Eagles were one of the most successful musical acts of the 1970s.” [for more information, see https://en.wikipedia.org/wiki/Eagles_(band)%5D

“I grew up with another pretty darn good writer: Glenn Frey of the Eagles. We were very good friends, and we kind of studied it together.” Bob Seger

The lyrics from the Eagles songs take us to the limit(s) of our imagination: For me, great music has a memorable beat and meaningful lyrics; and you can just remember these songs years later. The Eagles were wonderful musicians, harmonized beautifully, and wrote songs with a lot of imaginative/descriptive lyrics. The other night, I started listening to the Eagles and decided to compile a list of some of their best (i.e., my favorite) lyrics. I had iTunes open and would start listening and then search for lyrics to certain songs (those that brought back the most memories).  I also used my Echo Dot by saying things like “Alexa, play Desperado by the Eagles”.   At 5:00 AM the next morning, I had 27 favorite lyrics from 24 songs; the result of a very fun and reflective evening.  There is no accompanying narrative to the included lyrics, just the song title/album title/album cover.  All lyrics for the songs by the Eagles were found here: http://www.azlyrics.com/

 “The records in the house I really remember were, well, Glen Campbell’s ‘Wichita Lineman’ and ‘Galveston.’ Even as a kid, I knew these songs were glorious. My dad also had records by Merle Haggard, Charley Pride, Waylon Jennings, and then there was also the Eagles and Don Henley. Anything Texas, which includes Don Henley, was big.”  Keith Urban

Album: “The Eagles” (1972)

01-eagles-1972

“Take It Easy”
I gotta know if your sweet love is
gonna save me
We may lose and we may win though
we will never be here again

“Peaceful Easy Feeling”
I like the way your sparkling earrings lay,
Against your skin, it’s so brown.
And I wanna sleep with you in the desert tonight
With a billion stars all around.

“Most Of Us Are Sad”
Most of us are sad
No one lets it show
I’ve been shadows of myself
How was I to know?

Most of us are sad it’s true
Still we must go on

Album: “Desperado” (1973)

02-desperado-1973

“Desperado”
It may be rainin’, but there’s a rainbow above you
You better let somebody love you (let somebody love you)
You better let somebody love you before it’s too late

“Saturday Night”
What a tangled web we weave
Go ’round with circumstance
Someone show me how to tell the dancer
From the dance

“Doolin-Dalton / Desperado Reprise”
The queen of diamonds let you down,
She was just an empty fable
The queen of hearts you say you never met

Album: “On The Border” (1974)

03-on-the-border-1974

“Already Gone”
Just remember this, my girl, when you look up in the sky
You can see the stars and still not see the light (that’s right)

“Already Gone”
So often times it happens that we live our lives in chains
And we never even know we have the key

“My Man”
No man’s got it made till he’s far beyond the pain
And we who must remain go on living just the same

“The Best Of My Love”
I’m goin’ back in time
And it’s a sweet dream
It was a quiet night
And I would be all right
If i could go on sleepin’

“The Best Of My Love”
But here in my heart I give you the best of my love

Album: “One Of These Nights” (1975)

04-one-of-these-nights-1975

“One Of These Nights”
The full moon is calling
The fever is high
And the wicked wind whispers
And moans

“Take It To The Limit”
If it all fell to pieces tomorrow
Would you still be mine?

“Lyin’ Eyes”
Ain’t it funny how your new life didn’t change things
You’re still the same old girl you used to be

Album: “Hotel California” (1976)

06-hotel-california-1976

“Victim Of Love”
Some people never come clean
I think you know what I mean
You’re walkin’ the wire, pain and desire
Looking for love in between

“Hotel California”
“Please bring me my wine”
He said, “We haven’t had that spirit here since nineteen sixty nine”
And still those voices are calling from far away,
Wake you up in the middle of the night

“Hotel California”
Some dance to remember, some dance to forget

“New Kid In Town”
You look in her eyes; the music begins to play
Hopeless romantics, here we go again

“Wasted Time”
And maybe someday we will find , that it wasn’t really wasted time

Album: “The Long Run” (1979)07-the-long-run-1979

“I Can’t Tell You Why”
Aren’t we the same two people who live
through years in the dark?
Ahh…
Every time I try to walk away
Something makes me turn around and stay
And I can’t tell you why

“The Sad Cafe”
Some of their dreams came true,
some just passed away
And some of them stayed behind
inside the Sad Cafe.

Album: “Eagles Live” (1980)08-eagles-live-1980

“Seven Bridges Road”
There are stars in the Southern sky
And if ever you decide
You should go
There is a taste of thyme sweetened honey
Down the Seven Bridges Road

Album: “Hell Freezes Over” (1994)

10-hell-freezes-over-1994

“Get Over It”
Complain about the present and blame it on the past
I’d like to find your inner child and kick its little ass

“Love Will Keep Us Alive”
I was standing
All alone against the world outside
You were searching
For a place to hide
Lost and lonely
Now you’ve given me the will to survive
When we’re hungry, love will keep us alive

“Learn To Be Still”
Now the flowers in your garden
They don’t smell so sweet
Maybe you’ve forgotten
The heaven lying at your feet

“Pretty Maids All In A Row”
Why do we give up our hearts to the past?

 Album: “Long Road Out Of Eden” (2007)

12-long-road-out-of-eden-2007

“It’s Your World Now”
A perfect day, the sun is sinkin’ low
As evening falls, the gentle breezes blow
The time we shared went by so fast
Just like a dream, we knew it couldn’t last
But I’d do it all again
If I could, somehow
But I must be leavin’ soon
It’s your world now

“I’ve dreamed a lot. I’m tired now from dreaming but not tired of dreaming. No one tires of dreaming, because to dream is to forget, and forgetting does not weigh on us, it is a dreamless sleep throughout which we remain awake. In dreams I have achieved everything.” Fernando Pessoa

Cover photo credit: https://s-media-cache-ak0.pinimg.com/originals/e5/aa/eb/e5aaeb8a5363fdeacccb567becee86b6.jpg

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7 Healthy Habits For Your Brain

   “Your brain – every brain – is a work in progress. It is ‘plastic.’ From the day we’re born to the day we die, it continuously revises and remodels, improving or slowly declining, as a function of how we use it.” Michael Merzenich

“The root of all health is in the brain. The trunk of it is in emotion. The branches and leaves are the body. The flower of health blooms when all parts work together.” Kurdish Saying

7 Basic Brain Facts [click here for more facts]: (1) The typical brain is ~2% of your total weight but it uses 20% of your total energy and oxygen intake. (2) >100,000 chemicals reactions/sec occur in your brain. (3) The latest estimate is that our brains contain ~86 billion brain cells. (4) In contrast to the popular belief that we use ~10% of our brains; brain scans show we use most of our brain most of the time. (5) There are as many as 10,000 specific types of neurons in the brain.  (6) Cholesterol is an integral part of every brain cell. Twenty-five percent of the body’s cholesterol resides within the brain. (7) Your brain generates between 12-25 watts of electricity, which is enough to power a low wattage LED light.

7 Healthy Habits for Your Brain: With or without Parkinson’s disease, taking care of your brain is all-important to your overall well-being, life-attitude, and health. These are  straightforward suggestions of healthy habits for your brain; hopefully, this list will serve as a reminder about their importance.  Here is a 1-page summary of the “7 Healthy Habits for Your Brain” (Click here to download file).

7-healthy-habits-for-your-brain


[1] Exercise and neuroplasticity:
  Exercise is almost like a soothing salve for your brain.  Some benefits of exercise include helping your memory and increased flow of oxygen to brain, which energizes the brain.  Exercise is good for both your heart and your brain. Exercise can reduce inflammation in the brain and increase hormones circulating to your brain.  For a brief overview on the benefits of exercise to your brain, click here.

Neuroplasticity is the ability to re-draw, re-wire the connections in your brain. What this means is that neuroplasticity is a concerted attempt of neurons to compensate for brain injury/disease. Neuroplasticity ultimately modifies your brain’s activities in response to changes in these neuronal-environments.

There is much positive evidence in animal models of Parkinson’s regarding exercise-induced neuroplasticity.  The same benefits are now being tested in humans with Parkinson’s and the results are most encouraging. One of the numerous backlogged blog drafts that will be completed in the near-future is a “Review of Exercise and Neuroplasticity in Parkinson’s”.

“Exercise is really for the brain, not the body. It affects mood, vitality, alertness, and feelings of well-being.” John Ratey

“Neuroplasticity research showed that the brain changes its very structure with each different activity it performs, perfecting its circuits so it is better suited to the task at hand.” Naveen Jain

[2] Diet and brain food: Your memory is aided by ‘what’ you eat.  Harvard’s Women Health Watch makes the following suggestion to boost your memory through diet (click here to read entire article): “The Mediterranean diet includes several components that might promote brain health: Fruits, vegetables, whole grains, fish, and olive oil help improve the health of blood vessels, reducing the risk for a memory-damaging stroke; Fish are high in omega-3 fatty acids, which have been linked to lower levels of beta-amyloid proteins in the blood and better vascular health; Moderate alcohol consumption raises levels of healthy high-density lipoprotein (HDL) cholesterol. Alcohol also lowers our cells’ resistance to insulin, allowing it to lower blood sugar more effectively. Insulin resistance has been linked to dementia.”  WebMD summarized the role of diet and brain health in “Eat Smart for a Healthier Brain” (click here to read article).

A large group of women (>13,000 participants) over the age of 70 were studied and the results showed that the women who ate the most vegetables had the greater mental agility (click here to read the article). These results suggest for a healthy brain we should eat colorful fruits and vegetables high in antioxidants; and foods rich in natural vitamin E, vitamin C, B (B6, B12) folic acid and omega-3 fatty acids. Furthermore, we should avoid refined carbohydrates and saturated fats. In small amounts, vitamin D3 is almost like candy for your brain.

“Hunger, prolonged, is temporary madness! The brain is at work without its required food, and the most fantastic notions fill the mind.” Jules Verne

“Everything one reads is nourishment of some sort – good food or junk food – and one assumes it all goes in and has its way with your brain cells.” Lorrie Moore

[3] Mindfulness/meditation: Greater Good (The Science of a Meaningful Life) describes mindfulness as “…maintaining a moment-by-moment awareness of our thoughts, feelings, bodily sensations, and surrounding environment. Mindfulness also involves acceptance, meaning that we pay attention to our thoughts and feelings without judging them—without believing, for instance, that there’s a ‘right’ or ‘wrong’ way to think or feel in a given moment.”  I recently described mindfulness as “Mindfulness means you stay within your breath, and focus within yourself, with no remembrance of the past minute and no planning for the future moment.”  Here’s a simple mindfulness experience/moment: simply be aware of the steam leaving your morning cup of coffee/tea, clear your immediate thoughts, then sip, focus and savor this moment.

“The picture we have is that mindfulness practice increases one’s ability to recruit higher order, pre-frontal cortex regions in order to down-regulate lower-order brain activity,” a comment from Dr. Adrienne Taren, a researcher studying mindfulness at the University of Pittsburgh. She also said  “it’s the disconnection of our mind from its ‘stress center’ that seems to give rise to a range of physical as well as mental health benefits.”  (Click here to read this article).  “What Does Mindfulness Meditation Do to Your Brain?” (click here to read more)

“Mindfulness practices enhance the connection between our body, our mind and everything else that is around us.” Nhat Hanh

“Mindfulness is a pause — the space between stimulus and response: that’s where choice lies.” Tara Brach

 [4] Stress reduction: When you are under constant or chronic stress your body makes more of the steroid hormone cortisol (a glucocorticoid), which is produced by the adrenal glands above your kidneys.  Over time, chronic stress can trigger changes in brain structure and function. Excess cortisol production reduces neuronal cells, over-produces myelin protective covering to our nerves, and we make more oligodendrocytes.  How do you reduce chronic stress?  Exercise and mindfulness/meditation are both able to lower cortisol levels.  Easier said then done to making life-style changes to reduce chronic stress; however, doing it will allow the neuroplastic process to begin re-wiring your brain. For an overview of stress and trying to manage/reduce chronic stress, click here.

“Stress is an ignorant state. It believes that everything is an emergency.” Natalie Goldberg

“There is more to life than increasing its speed.” Mahatma Gandhi

[5] Work, keep active mentally:  There are 2 sides to this topic.  First, stay engaged at work and you won’t age as fast as someone disengaged.  What I’m trying to say is simply staying active mentally at work will assist your brain during the ageing process.  Keep your brain stimulated with work, thought, challenges; the effort provides your brain with significant growth.  Your reward will be an active-focused and rejuvenated mind.  Second, by contrast, we’re all working long hours balancing too many tasks, all-the-time; ultimately, we’re trying to multi-task when we really can’t multi-task very well.  In a nice article entitled “The Magic of Doing One Thing at a Time“, Tony Schwartz summarized a key problem: “It’s not just the number of hours we’re working, but also the fact that we spend too many continuous hours juggling too many things at the same time. What we’ve lost, above all, are stopping points, finish lines and boundaries.”  As you balance the 2-sides-of-the-topic, focus your energy on the first-side by performing each individual task/topic; clear your mind, keep your brain engaged, focus hard and then let your brain renew.

“To let the brain work without sufficient material is like racing an engine. It racks itself to pieces.” Arthur Conan Doyle

“A fresh mind keeps the body fresh. Take in the ideas of the day, drain off those of yesterday.” Edward Bulwer-Lytton

 [6] Positive and happy is better for your brain:  I truly believe you need to be positive in dealing with Parkinson’s; trying to focus on staying happy will benefit all-around you and bolster your brain’s health. Using positivity will allow you to creatively handle many obstacles ahead, whether in the absence or presence of Parkinson’s.  Susan Reynolds summarized in “Happy Brain, Happy Life” that being happy: “stimulates the growth of nerve connections; improves cognition by increasing mental productivity; improves your ability to analyze and think; affects your view of surroundings; increases attentiveness; and leads to more happy thoughts.”  On the notion of staying positive, she said: “…thinking positive, happy, hopeful, optimistic, joyful thoughts decreases cortisol and produces serotonin, which creates a sense of well-being. This helps your brain function at peak capacity.”


Positive

“Do the best you can until you know better. Then when you know better, do better.” Maya Angelou

“You have to train your brain to be positive just like you work out your body.” Shawn Achor

[7] Sleep: It’s simple; our brains, our bodies need sleep.  Many of us battle with less than adequate daily sleep habits.  However, it’s really simple; our brains, our bodies need sleep.  Much of our day’s success resides in the quality of sleep the night before.  The science of sleep is complex but much of it revolves around our brain.  We use sleep to renew and de-fragment our brain; and sleep helps strengthen our memory.  For more details on sleep science, please look over “What Happens in the Brain During Sleep?” (click here).  Alice G. Walton very nicely summarized several aspects of the sleep-brain interactions focusing on the following 7 headings: “Sleep helps solidify memory; Toxins, including those associated with Alzheimer’s disease, are cleared during sleep; Sleep is necessary for cognition; Creativity needs sleep; Sleep loss and depression are  intertwined; Physical health and longevity; and Kids need their sleep” [click here for “7 Ways Sleep Affects The Brain (And What Happens If It Doesn’t Get Enough)”].  Finally, the Rand Corp. just released a comprehensive study on sleep and the economic burden being caused by the lack of sleep (click here to read the 100-page report).

Sleep is the golden chain that ties health and our bodies together.Thomas Dekker

A good laugh and a long sleep are the best cures in the doctor’s book.   Irish Proverb

A Personal Reflection on the “7 Healthy Habits for Your Brain”:  My fall semester is physically, mentally, and emotionally draining; and I cherish doing all of these tasks, I really do.  The writing of this blog is a deliberate attempt to remind me what I need to be doing, to re-initiate tomorrow in my daily life.  I could explain each point in detail in what poor-brain-health-habits I’ve developed this semester (but I won’t).  However, I am printing out the 1-page handout of 7-healthy-brain-habits to keep it with me as I spend the rest of December re-establishing effective habits for my brain; and doing a better job of balancing work with life-love-fun.

“Your body, which is bonding millions of molecules every second, depends on transformation. Breathing and digestion harness transformation. Food and air aren’t just shuffled about but, rather, undergo the exact chemical bonding needed to keep you alive. The sugar extracted from an orange travels to the brain and fuels a thought. The emergent property in this case is the newness of the thought; no molecules in the history of the universe ever combined to produce that exact thought.” Deepak Chopra

Cover image: https://img1.etsystatic.com/000/0/6392236/il_fullxfull.267319437.jpg

Mindfulness list: http://www.mindful.org/7-things-mindful-people-do-differently-and-how-to-get-started/

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Believe in Life in the Presence of Parkinson’s

“Life is not only merriment, it is desire and determination.” Kahlil Gibran

“Nothing will work unless you do.” Maya Angelou

Dedication: I recently participated in a Parkinson Wellness Recovery (PWR!) Instructor Workshop in Greenville, SC (July 30-31, 2016); now I am certified in PWR!Moves.  This post is dedicated to the workshop instructor Jennifer Bazan-Wigle; and to my classmates, all of the personal trainers interested in working with Parkinson’s disease patients.  Jennifer was simply a great instructor, with a real understanding of Parkinson’s and a true ability to ‘teach’.  The personal trainers who participated were very dedicated in their effort to master PWR!Moves and their willingness to instruct me during the weekend workshop made for a memorable experience.  And not to forget Steve Miller, a PWR!Moves instructor, who also helped teach; you were the inspiration that led me to apply for this workshop. To everyone certified in PWR!Moves and to those involved in my PWR!Moves workshop, thank you, thank you so very much.

PWR! Logo

“There are no shortcuts to any place worth going.” Beverly Sills

Introduction: Coach Lou Holtz said “Ability is what you’re capable of doing. Motivation determines what you do. Attitude determines how well you do it.”  This got me thinking about ability, motivation and attitude but especially how vital both motivation and attitude are for living successfully with Parkinson’s.

Believe in Life in the Presence of Parkinson’s:
I’m a healthy person that happens to have Parkinson’s; this is what I believe:
I believe daily exercise enhances my life in the presence of Parkinson’s.
I believe people-with-Parkinson’s can become healthier with exercise.
I believe sustained exercise can promote neuroplasticity to re-wire my neural network.
I believe I have the ability to do the repetitions to re-train my brain.
I believe staying positive will help control the course of my Parkinson’s.
I believe having courage will provide mettle in the battle against my disorder.
I believe being persistent allows me to restrain my Parkinson’s.
I believe motivation begins from within, and there can be no backing down to this disease.
I believe if I don’t give up I can slow the progression of my disorder.
I believe if you pity me it feeds the hunger of my Parkinson’s.
I believe if you join my team, you can help me stall this slowly evolving disorder.
I believe attitude is the fuel to sustain the effort to combat Parkinson’s.
I believe in science that new therapies/strategies against Parkinson’s are on the horizon.
I believe exercise with ability, motivation and attitude will work to my advantage each day.
I believe that each new day renews my chance of slowing the beast named Parkinson’s.
My daily mantra is to never give up; I refuse to surrender to Parkinson’s.

“Keep your thoughts positive because your thoughts become your words. Keep your words positive because your words become your behavior. Keep your behavior positive because your behavior becomes your habits. Keep your habits positive because your habits become your values. Keep your values positive because your values become your destiny.” Mahatma Gandhi

Cover photo credit: https://c7.staticflickr.com/9/8615/16157237102_f15e505c19_b.jpg

 

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The Evolving Portrait of Parkinson’s

“Aging is not lost youth but a new stage of opportunity and strength.” Betty Friedane

 “If we own the story then we can write the ending.” Brené Brown

Précis:  To showcase the amazing art/photography/videography of Anders M. Leines who lives in Norway, which gives me the opportunity to voice an opinion about the emerging picture/image of Parkinson’s today.

World Parkinson Congress (WPC) Promo Video: Please watch this video, it’s powerful; “This is Parkinson’s” a WPC Promo from Anders M. Leines (either view it below or click here).  Anders is a videographer and cameraman who works in Oslo, Norway; he’s been diagnosed with young onset Parkinson’s. One of his goals is to change the view about how Parkinson’s is perceived by the world.  One look at his video reinforces this notion.  A very nice article about Mr. Leines was recently posted in “Parkinson’s Life” (click here to read this story).  Anders also shares his story with his own blog “This is Parkinson`s” – The Exhibition.  The pictures, the script, and the music accompanying the WPC 2016 Promo by Mr. Leines says more in 1 min 42 sec about Parkinson’s than someone could likely summarize by writing a blog post, but nonetheless I’m going to try.

A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.” Christopher Reeve

The Historical Perception of Parkinson’s: Sir Richard Gowers, in 1886, used this drawing (below left panel) to depict a person with Parkinson’s. When you perform a Google search for a ‘picture of Parkinson’s disease’, these sorts of images are still very prevalent. Yes, the average age of someone with Parkinson’s is 60 years of age and older. And yes, Sir Gowers does accurately show the Cardinal signs of Parkinson’s: tremor, rigidity from muscle stiffness, bradykinesia (slowness of movement), postural instability, and masking (reduced facial expression).  Furthermore, Dr. Charcot’s  drawings, from 1888, also depict a typical Parkinson’s patient compared to an atypical patient with Parkinson’s (bottom right panel).  While these drawings are accurate, these images portray to many who see them that all people-with-Parkinson’s must look and act like this. 

PD_History

“In all human affairs there are efforts, and there are results, and the strength of the effort is the measure of the result.” James Allen

The Emerging Perception of Parkinson’s: The reality today is that available treatment strategy and approach to life for someone with Parkinson’s are very different than what was possible for the people portrayed by Sir Gowers and Dr. Charcot. Today, we have well-trained neurologists that are specialists in movement disorders. We have a growing appreciation and understanding of the pathology and biology of Parkinson’s disease.  We have learned about vital lifestyle changes needed to thrive in the presence of this disorder. We have a growing list of therapies [both traditional and complementary and alternative medicine (CAM)] to treat Parkinson’s; we even have deep brain surgery (this surgical technique itself is undergoing new advances and is further evolving in its attempt to control/modify symptoms). We have an increased awareness of the importance of exercise to try to slow progression of this disorder. There is clearly a subset of people with Parkinson’s that present at an earlier age than 60 years old (and this is what Mr. Leines and his exhibition is highlighting).   No doubt, we are living longer and we are likely healthier than someone from the 1880’s; however, that also implies we’re living more years with our Parkinson’s.

This is not saying that Parkinson’s today is either a benign or a tame disease; in fact, it’s an insidious disorder.  Having Parkinson’s is like trying to get rid of cockroaches in your house.  You’ve done all you can to eliminate the roaches from your home, and you don’t see them for weeks; subsequently one day, they’re back. Likewise, Parkinson’s creeps around in the background of your daily life by stealthily altering physical/movement functions, by slowly uncoupling your crucial autonomic nervous system, and surreptitiously in ~50% of people with the disorder, they can develop psychotic tendencies.  The image of Parkinson’s today is clearly evolving due to improved treatment, better understanding of the disorder itself, and improved strategies for living with it; however, under any guise it is still a disagreeable disorder.

“With everything that has happened to you, you can either feel sorry for yourself or treat what has happened as a gift. Everything is either an opportunity to grow or an obstacle to keep you from growing. You get to choose.” Wayne Dyer

A Change is Happening in Our Perspective of Parkinson’s Today:  It is my belief that the perception of Parkinson’s today has changed and is becoming much different than the historical views as described above. I truly believe that the effort most people are using to handle their disorder puts them in a healthier and better lifestyle to manage their symptoms. An emerging predominate picture of Parkinson’s today is a person striving to live strongly. They’ve embraced the appropriate lifestyle, and they are trying their hardest to not become as depicted by the images from the 1800’s. When you do a Google search for ‘images of Parkinson’s disease 2016’, you will likely find more positive and dynamic pictures of people similar to those portrayed by Mr. Leines.

“Let me tell you the secret that has led me to my goal. My strength lies solely in my tenacity.” Louis Pasteur

A Personal Perspective of Parkinson’s Today: With the “This is Parkinson’s” video from Anders M. Leines as an inspiration, I’ve included two sets of pictures of my life with Parkinson’s (photos are below). If my disorder fully progresses, and it is a progressive neurodegenerative disorder, in advanced age (I’m currently 62 years old) I may possibly appear like the drawings above from Sir Gowers and Dr. Charcot. However, as a research scientist, I truly believe in the words of Dr. Claude Levi-Strauss who said “The scientist is not a person who gives the right answers, he is one who asks the right questions.”  I am trying to improve my own knowledge about Parkinson’s; after all, there are still so many questions I want to ask, there are so many new scientific advances that I need to better understand, and there are some emerging treatment strategies that I’d be willing to consider in the future. In other words, Parkinson’s is a reluctant and unwelcome visitor in my body and I’m doing as much as I can to manage the disorder.

With substantial effort, I’m going to do all I can to resist progression; I’m going to stay hopeful, be positive, and remain persistent for many years to come. Importantly, I will take time to stretch every few hours and really make an effort to exercise every day. I will try harder to get an adequate amount of sleep every night.  I am also trying to be mindful and live within the moment by not fretting about what the future could bring.

Thus, this is what I consider to be true of myself (many other people with Parkinson’s would also fit this description): I’m a healthy person that just happens to have Parkinson’s. As I’ve said before, we both have much left to accomplish. We are both still here. Stay focused and stay hopeful.

new.PD

new.PD.3e

“We live in a time when the words impossible and unsolvable are no longer part of the scientific community’s vocabulary. Each day we move closer to trials that will not just minimize the symptoms of disease and injury but eliminate them.” Christopher Reeve

Cover photo credit: http://epod.usra.edu/.a/6a0105371bb32c970b015438c5312a970c-pi

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