Monday, November 2, 2009

Paths to meaning, salvaging quality of life with PD



Parkinson's Disease is no walk in the park. Unless your park is home to a mysterious debilitating assailant who steals up to you and attempts to slowly rob you of your life.

Diagnosis is devastating to the person getting the verdict. The words "Disease" "progressive" and "incurable" are toxic enough when used together to render the gentlest, most well-meaning words of comfort hollow-sounding. Following my diagnosis, I appreciated words of comfort and predictions of spiritual growth as well-meaning administrations of an emotional placebo. A sugar pill offered to fend off painful reality.

The pain of Parkinson's is real. There is physical pain and fatigue that arise from involuntary muscle contraction and stiffness. There is the embarrassment of loss of control of your body. Tremor and drooling are not the skills one cultivates to become one of the glitterati. Slurring of speech, falling and sexual dysfunction? Those amount to many of the downsides of being drunk with none of the upsides. At least drunkenness wears off after a time.

There is financial pain. The meds are not cheap. And if you're lucky enough to have decent insurance where you work, guess what. Parkinson's is likely to take your job, too. The tentative financial security that most of us live with, or are trying to establish can go *poof* with Parkinson's.

It makes a person want to scream. Oh, sorry, more bad news, your voice also goes. Tell you what. Instead of screaming, just whisper loudly. What's that you say? Come again? Oh. Whispering isn't a satisfying substitute for screaming? Not for me either. The line forms here for a literal life of quiet desperation.

I could go on, but the picture should be clear. What we have here is a one-way ticket to the sewer. The sad fact is that this is so clear that a recent study found a person with Parkinson's Disease is five times more likely to commit suicide than a person without. Unsurprising. I considered killing myself when I first found out that I was heir to all that Parkinson's had to offer.

It would have been a monumental mistake. If you're a little lucky, if you're willing and able to junk what you can no longer carry, if you're willing to take new paths to meaning, you'll be surprised at what you can salvage of life. And at what you might find that you were unable to see before.

How does one live with, much less claim acceptable quality of life in the face of the Parkinson's parade of horribles? From my experience, I found a long list of things. Here are some that are critical. This list should be read with the understanding that it is only made possible by all that others have done to advance the treatment of PD, and the hope of future advances.

First, there are worse things than simple PD. Parkinson's is slow, and furthermore with modern medications and surgery the worst effects can be held at bay for an indefinite time, certainly a long one. There are forms of "Atypical Parkinsonism" more pitiless than normal Parkinsons that do not respond to present medications and bring on helplessness and dementia with a ferocity that is as frightening as it is senseless. (to see the blog of one man's courageous journey into this dark territory, look here)

We've all lost friends and loved ones to quicker killers like cancer. In the years since I've been diagnosed I've seen the sun rise over 2000 times. I've watched my son grow into promising manhood. I've shared love, music and travel with my wife. This is certainly better than not having this span of time. Yes Parkinson's will take it all from you, but there is a certain satisfaction in making the bastard work for it.

Second, if you're depressed (and if you're thinking of killing yourself, you are depressed) get help. You're not alone. Nearly half of people with PD are suffering depression. This is an area in which pride can become a stumbling block.It's hard to admit that you are not in charge of your emotions. Cut yourself some slack, you've got Parkinson's Disease. Depression is part of the beast. You want to resist the beast. The pills certainly help me.

Third, exercise. This is worth a whole post in itself. I've even written such a post, several in fact, here, here, and here, for example.

Fourth, Don't stop doing things you enjoy. I still ride my bike, not as aggressively as I used to, but still with enjoyment. I still make music and draw, in some ways better and in other ways worse than I used to. I still bake, read, enjoy movies. No reason you can't too.

Fifth, get involved with your support group. Life needs meaning, especially when it feels damaged. You are uniquely qualified to benefit others who share your plight. You are a Parkinson's Disease expert. In helping others you will help yourself. I have tested this theory and am surprised at how well it works. You'll get tired and exasperated too, but these are signs of life.

Sixth, take care of your care partner if you have one. They deserve it. And more important, they need it. Gestures of affection and help around the house may seem like small things, but anyone who knows even a little of what you are going through will appreciate that you are working on a different scale.

Seventh, cultivate hope. Ask anybody who has been around this disease and they'll tell you that the last twenty years have seen a tremendous rise in the understanding and care of those with Parkinson's. We're in a position now to see the day when Parkinson's, if not cured, can at least be treated as something to manange, instead of something merely to be endured. And a cure remains a tantalizing possibility that will become reality someday.

Eighth: Keep your sense of humor. This is what it's for. There's nothing funny about someone with no problems, unless you mean "funny strange". But Parkinson's? That's a hoot! The slapstick alone around my house is at least Three Stooges quality, and did I ever tell you about Pam's idea for the Parkinson's Bobble-Head Doll?

That's my list. It works for me at least. Does it amount to nothing more than a complex version of the Placebo Effect? It might. But a placebo that lasts this long this effectively is better than most medicines.

Sunday, October 11, 2009

Movement disorder doc on the move

Heads up, Alaska Parkinson's Patients, Our visiting movement disorder specialist Dr. Alec Glass is Anchorage bound in early December. Dr. Glass will be hosted by Alaska Neurology Center, LLC 3841 Piper Street Suite T345 (Providence) Anchorage, Alaska 99508

Main Phone 907-565-6000

This is a great chance for you to consult with a trained Parkinson's Disease specialist without the expense of traveling outside. You can read more on Dr. Glass here.

Festinate forward!

Pete

Friday, October 9, 2009

Flash Molasses #10

Sunday, September 20, 2009

I walk the line




TO SEE THE TINY PRINT, CLICK ON THE DRAWING

Wednesday, September 16, 2009

Don Giovanni, Carmen and Parkinson's


Don Giovanni, Carmen and Parkinson's? Those of you who can scratch your heads no doubt are scratching them right now, wondering what the connection is. But in fact Parkinson's is now the subject of an opera Gravity and Grace.

An opera about a disease that can leave you unable to move or speak, much less sing? It's a surprising choice of subject matter, but rife with dramatic possibilities. I have no clue how the story of this production goes, but I could easily write a story for a PD opera of my own.

One can imagine the hero shuffling onstage and singing at barely audible volume as other singers keep repeating "What? What?" Mystified by his condition, the hero goes to a series of doctors who misdiagnose him until the climax of the first scene when a movement disorder specialist informs him that

"You've got Par-har-har-harkinson's disease, my friend! It's progressive!"

(Chorus: "PROGRESSIVE!")

Doctor: "Incurable!"

Chorus: "INCURABLE!")

Doctor: "And practically unendurable!"...

(Chorus "UNEDURABLE! UNENDURABLE! UNENDURAAAAAAABLE!")

Doctor: "But a handful of these magic beans will see you through the next few scenes, they may result in sex compulsion or cause you strange unwanted motion. And when at last you cannot maintain, if all goes well we'll put a wire in your brain."

Chorus: "And come the day you can't maintain, you'll hope for wire into your brain, your brain, your gray defective brain"

Our hero clutches his head as the lights fade to black and the curtain falls on scene one.

Whew! Just contemplating the possibilities for scene two, the mind boggles at the operatic potential as the hero fights depression, financial ruin, family crises, and the loss of all that is known of normal life and everyday expectations. The possibilities for tragedy and redemption are there for anyone involved with this disease to see.

The question goes from "An opera about PD? How can you do that?" to "Why didn't I think of that first?" Followed by the realization that if I had thought of it first, I'd never have the momentum to get it off the ground. So here's congratulations to the authors for imagination and passion. Break a leg.

Monday, September 14, 2009

Yes, Once Again It's MEETING TIME!

Hello friends, fans and followers of the spectacular Anchorage Parkinson's Disease Support Group (Screaming, hysteria from wildly enthusiastic crowd). I want you to know that it is once again... MEETING TIME! (crowd erupts in massive cheer, several people faint) It's all happenining this Saturday, September 19th at 1:00 back at the spacious, gracious ANCHORAGE SENIOR CENTER!!!

What's in store for our intrepid band of northern Parkies? This meeting will feature a panel of highly-qualified PD experts giving us TIPS and TRICKS to help manage this disease. Who are these experts? I'm glad you asked because it's YOU! I'd like everyone to come prepared to share one or two small but helpful tips they have found useful in managing daily life with Parkinson's. Each of us is an expert because we live this disease every day. Together we have decades of experience. We'll share that this Saturday! See you there!

Peter

Tuesday, September 8, 2009

Sink Your Teeth Into Parkinson's Disease



My friend Dave, a neurologist with Parkinson's Disease, is always on the lookout for ways the PD populace at large can manage their disease better. One way he thinks that we can take some of the teeth out of the beast is to eat more healthily. (Dave is also a great believer in exercise. I get the impression sometimes that he thinks we should exercise while eating. Have you exercised today? Maybe you should stop reading this and do a few laps around the block.)

Bearing in mind such processes as oxidation and cell death, he went looking for foods that would counter these and other factors that contribute to Parkinson's progression. He found that the best way for people with Parkinson's Disease to eat is to follow the Mediterranean Diet. He just sent me a link to a updated version of the Mediterranean Food Pyramid, which you can find here.

Bon Appétit!

Saturday, September 5, 2009

Back from the undead



It happened again just last Friday. We were at an opening for a show of collaborative drawings and paintings by my friends Joe and Catherine Senungetuk. I hadn't seen either in quite a long time. Catherine noticed a difference "You look so much better!" She exclaimed. It was not the first time I'd heard this since the operation, but I especially took this instance to heart. Catherine is trained as both a nurse and an artist. When she says I look better, chances are I do.

She struggled to put her finger on what the actual improvement was. Everything from my color to my affect came up. Attempting to sum things up, I offered the description "More... lifelike?"

Catherine guffawed, and we moved on to other topics.

But there have been many similar observations. My dental hygienist was delighted with the new me, "You actually smiled!" She reported as I settled into the chair. And my neurologist offered the supreme compliment "I haven't seen you looking this good in years." All of which is music to my ears of course, except for one disturbing implication.

After a while the repetition of these words of encouragement from so many different people brought me to an inevitable conclusion: I must have looked like crap before the operation.

Curious and apprehensive I put the question to my family. Wiley was quick to offer helpful info. "You looked like this, Dad" he said, curling his shoulders forward in a slump. His arms hung limp and still in front of his trunk. "Like a zombie" he added.

We had a brief argument about exactly what a zombie looks like, but there was no escaping the larger point. It can't be good to look like anbody's idea of a zombie.

Sad truth, as a Parkinsonian, you're not even going to be a good zombie.

CUT TO: Townspeople barricaded in home. Our hero, John Strong parts a drawn curtain and squints through

Strong: "They... they are coming."

Joey, 13-year-old neighbor: "What do we do? what do we do???"

Strong:
"Well, the ones that aren't frozen in place are shuffling incredibly slowly and falling down. Let's heat up some dinner, then catch a nap, and then think about fleeing."

I can hear the test-audiences nodding off and snoring as I write. So I'm glad to be a former zombie. But to all of you who stood quietly by me while I went through my b-movie monster phase, thanks for putting up with me, and believe this: You'll always look great to me.

Friday, August 28, 2009

Build Your Parkinson's word Power, part 3

One of the overlooked symptoms of Parkinson's disease is the appearance of new and imposing words in the daily life of the patient. Today we return to the great big world of great big Parkinson's words. Let's start with an obscure but compelling one: Akathisia.

What the heck is akathisia? It is a disorder that causes one to feel restless, to have an inexplicable desire to get a move on, to be, in the words of Steve Martin "A ramblin' guy". This just another example of the perverse nature of Parkinson's Disease: Strip a person of the ability to move, and then inflict restlessness on the poor soul. With Parkinson's you'd like to ramble, but you can't because you're frozen, and besides, you might fall down.

Which brings us to postural instability. This means you have difficulty balancing. Postural instability is an example of medical science taking something for which there is a perfectly serviceable phrase, impaired balance, and replacing it with something that has a more cerebral and clinical ring. What can we do about this? Learn from it! When the bank calls to tell you that your last few checks have bounced, don't say your bank book is badly balanced, say it is a victim of postural instability.

Another Parkinsonian condition that can interfere with the need to ramble is dystonia. Dystonia, the involuntary contraction and cramping of a muscle is a disease all in itself. But in Parkinson's it's just one of many miseries this hard workin' disease inflicts. Examples of dystonia might include painful curling of the fingers or toes. Dystonia can sometimes be held at bay with botox, so if you are going to catch it, try to get it where botox injections will leave you with a younger, less lined look. Just because you have PD doesn't mean you can let yourself go to hell.

Our final term for the day is multiple personality disorder. This is not caused by Parkinson's, but is instead a description of it. Parkinson's can progress slowly or quickly, can cause involuntary movement like tremor, as well as paralysis, and where other diseases are content to have one main symptom, Parkinson's can manifest in many ways. It's just a shame that with all those personalities, it couldn't have come up with at least one likeable one.

Note: Installment 1 of this series can be found here, and number 2 of this series can be found here.

Monday, August 24, 2009

Pete's Parkinson's Portaits: Actor Jim Backus