(68) dESTINATION dOPAMINE

BLOG STATS, JULY 2026

It's good to reconnect with you again, dear reader, after a three-month break. In order to get my mental and physical functions up to speed, and in keeping with Post 67, I've decided to sort of "review" myself. But first, a Blog post update.

In the roughly three-month period between end-April 2026 (the publishing date of Post 67)  and 01 August 2026, a total of 2,310 viewders visited my Blog. I assume the April-July 2026 viewders read my review of Miller Caldwell's compilation of Parkinson's Stories. 

And in the 6 years of publishing, I've had a grand total of 29,642 visitors! I am really pleased with this interest, and bearing in mind that I don't know whether the visitor has just viewed it or read it, I'll use the term "viewders". 

The top six countries that visited my book review comprising 2,310 visitors over a three month period, are as follows:

1. USA;
2. Vietnam;
3. Germany; 
4. Singapore;
5. Hong Kong; and
6. South Africa.

Now, back to this "review" of myself.

MY HEALTH ISSUES

Managing to publish Post 68 (the one that you're reading now) in July 2026 is a significant accomplishment for me. Let me explain.

Firstly, my Parkinson's Disease (PD) ran rampant during the first half of 2026, resulting in my wife having to assist me a few times every night for a few months. Secondly, I've been dealing with prostate cancer (PC) and have had therapy in 2025 and I'm currently undergoing further treatment. I've had to clear the PC and the PD hurdles, concurrently. Therefore, in this post, by way of a catchup, I am going to "review" the state of my health from 2005. 

PD CHALLENGES & ADAPTATION: 2013 ➙

This is a brief history of my PD. 

I was diagnosed with Parkinson's in 2013 by a neurologist DrK in Pretoria, Gauteng Province. I decided, then, not to use his recommended prescription but to seek out as many alternative approaches as I could find, be it physical, mental or chemical. 

My thought was: Could I bypass use of a pharmaceutical drug (with published, accompanying side-effects) and replace it with something else? In my teaching and research throughout my career (1977-2017), I had always sought out and found alternative solutions to most problems confronting me. I described this swashbuckling approach in Post 50, Part 1 (<-click to access that Post), where I wondered if I could find ways to challenge PD through a deep dive into literature, anecdotes and research:

"...I was a "practitioner researcher", generating personal theory from my actual practice (my PhD has this evidence). Could I challenge PD with a PhD? Could I, as a practitioner researcher, eventually generate personal theories based on my own observations of PD?"

      

For instance, Parkinson's started with "asymmetric onset" (i.e. only one side of my body was initially affected). As it had affected my right side, I was not swinging my right arm or moving my right leg smoothly resulting in colleagues asking if I had gout or had had a stroke 😖. Gradually, I noticed other debilitating issues and these forcibly channelled my creative thinking into finding solutions and/or adaptations that worked for me, and some of these are below.

• My right leg was dragging so, at work, I regularly wore a wrist weight on my right ankle (conveniently concealed under my long pants) to remind me to lift my right leg when walking;
• I was unable to slip on sandals/slippers onto my right foot but if I shut my eyes then my foot would slide in (was I bypassing the "old" muscle memory?);
• I was born right-handed but my left hand became the new dominant hand: for brushing teeth, for washing dishes, for washing the car and for holding the steering wheel while driving, etc.; 
• My right arm stopped swinging so, at work, I started wearing my watch on my right wrist (not the left) to remind me, consciously, to swing that arm when walking; and
• My right hand was unable to move my computer mouse so, gradually, I learnt to move it skilfully with my left hand.

What is fascinating is the notion of "neuroplasticity" (and "guided plasticity") (Rosén, Wijk & Björkman, 2026) to explain my shifting dexterity as a result of the Parkinson's: 

"Normal hand function relies on a finely tuned interaction between the sensory and motor systems within the central and peripheral nervous systems. The central nervous system continuously adapts to changed activity, environmental changes, learning, and injury — a phenomenon known as neuroplasticity. The neuroplasticity is a life-long ability and presents opportunities for therapeutic intervention; by directing it, lost or impaired functions can be improved through a process called "guided plasticity"."

Even more fascinating is that till today, I am still using my right hand to write and to draw and, yes, there's a body of research to explain that too. Apparently "Handwriting is a complex, overlearned motor program managed by distributed networks in the motor cortex, cerebellum, and parietal lobes, transforming abstract thoughts into fluid physical symbols", so handwriting rules! (HA!!! PARKINSON'S DIDN'T STAND A FLIPPEN CHANCE 😄...)

COMPLEMENTARY SUPPORT FOR PD: 2020 ➙

By 2020 I had started to engage with the following, below, after much reading and thought. Seeing that I was still in alternative survival mode, that included any and every possible supplementary approach to continue the fight against being parkinsed, I cast my net wide.

1. Photobiomodulation: in December 2019 a relative referred me to to a Carte Blanche documentary on television during which they had interviewed people who had had low level laser therapy sessions to alleviate movement disorder issues. Unfortunately neurologist Dr Bhanjan at the Durban Neurolaser Clinic was the only practitioner in South Africa so the earliest appointment I could get was in late in 2020. However, by March 2020 Covid19 (?fate?) had struck South Africa resulting in a travel lockdown so people from outside KwaZulu-Natal had to cancel their travel and their appointments: I was able to see the neurologist almost immediately. I reflected on my positive experience with low level infrared light therapy and PD in Post 10, Post 11 and Post 13 (<-click to read those 2020 posts).
2. Parkinson's ZA workshops started in Durban, KwaZulu-Natal Province, in 2022 as a weekly meeting of People with Parkinson's together with some carers. Their plan was to explore a multidisciplinary model of care for two hours, weekly, consisting of occupational therapy, physiotherapy, speech therapy and exercise, etc. as supplemental to the conventional drug-based treatment of Parkinson's. Attendance is free of charge as it is funded by a large India-based movement disorder support society. I attended their meetings for three years until 2025 when my prostate cancer treatment became an issue. 
3. Walking, Cycling & Cueing. Since 2022, I have been walking around our large apartment complex (including inclines and stairs) and cycling indoors (on a stationary cycle). These activities provide effective, physical stimulation for people in need of an accessible form of exercise. Cueing, on the other hand, is often ignored (click on the term above for an explanatory video) yet is essential especially for us People with Parkinson's. 
4. Biokinetics, "focused on improving physical health...through...human movement and customised exercise programs" has become a welcome, weekly activity since May 2026. My wife and I are fortunate to have a biokinetics practitioner, ZP, visit us at home. 
5. Ayurveda regime for Parkinson's. I started consulting an Ayurvedha specialist in 2022 and was happy with the intervention that included a natural dopamine substitute. (Extract below from Post 63 <-click to read:) 

"There was a lifestyle change involving the following: a diet avoiding certain flour and bread; avoiding stimulants such as coffee and alcohol; avoiding certain milks; avoiding processed food; deep breathing exercises; PD stretches/exercises; and meditation. Eating should be carefully paced and enjoyed rather than rushed.

In addition there were herbal remedies to take daily: two capsules daily to relieve stress (Ashwagandha); two capsules daily for anxiety and to assist the memory (Brahmi); and three capsules daily to assist with dopamine replacement (HP500).    

Unfortunately, the HP500 only worked for me from January 2002 till March/April 2025, when I stopped taking it. (In Post 64 {<-click to read} I will elaborate why I stopped.) However, I am still taking the other two herbal remedies, I meditate, I am doing the breathing exercises and still avoiding certain foods and ingredients." 

CONCURRENT CONDITION: 2024 ➙

In 2005 I had my first prostate wake-up call in the form of minor surgery in a doctor's consulting room when he performed a biopsy to remove tissue from my prostate gland to test if it was cancerous. 

Three more biopsies and medication followed over the years as did  overnight hospital stays until I was asked to also have a PET scan (that included being injected with a mild radioactive substance) in 2025. The outcome: I had prostate cancer (PC)! 

An Oncologist and a Urologist were engaged and saw me regularly both for examinations as well as treatment. This included two treatment regimes.

1. In 2025 I had 5 months of Hormone Therapy comprising 6 injections to lower my testosterone levels as prostate cancer apparently feeds off one's testosterone! An unfortunate side-effect has been permanent hot flushes (I normally perspire profusely) and another is weight gain.
2. In January 2026 I also had a Brachytherapy procedure during which my prostate was injected with tiny radioactive beads to provide internal, direct radiation targeting the prostate gland only. This radiation has a life span of about 10 months from its maximum radiation capacity in January 2026. The complication was during the first few months when I was forced into self-isolation because I posed a "danger" to particularly my/any grandchildren and any young/pregnant women.

While there is no recorded interaction between my Parkinson's Disease (PD) and the PC and their respective medications, I did feel poorly for at least 2 weeks after each Hormone Therapy jab. And I guess a lot of the accompanying trauma was in my head! 

MOVEMENT DISORDER SPECIALIST 2025: ➙

By April 2025 my Ayurvedic medicines were not working. I was barely able to move and had become my own worst nightmare: a sedentary seventy-three year old person with Parkinson's. My family physician, Dr RSP shares consulting rooms with a Movement Disorder Specialist, Prof VP. I was encouraged to see him, so an appointment was made in May 2025. 

His examination was thorough and he made fewer glib generalisations than the other specialists I had seen over the years. I was at my wits end. My dopamine was neither flowing nor functioning and neither was I. 

So, after actively avoiding a Parkinson's pharmaceutical drug for 12 years I decided to take the plunge: he gave me a script for medication during the day (3 X Sinemet) and overnight (1 X Pramipexole ER) and I accepted. Naturally I was to start my Hormone Therapy sessions two months later so I was concerned. 

It may be useful to examine, briefly and simply, why the absence and presence of dopamine is significant in Parkinson's. Below is what Kimberly Holland (2026) states in Healthline:

  

"What Role does Dopamine have in  Parkinson's Disease?

 

*Dopamine is a neurotransmitter that supports smooth, controlled movement. In Parkinson’s disease, dopamine drops, causing movement to become shaky, slow, or stiff.

*Symptoms often begin after major dopamine loss, sometimes when 60% to 80% of dopamine-producing cells are gone. Early signs can include poor coordination, trouble concentrating, stooped posture, and loss of smell.

*Parkinson’s treatments aim to raise brain dopamine levels or improve response to dopamine. Treatment options include medications like levodopa and procedures like deep brain stimulation."

According to the website, Sinemet "...is used to treat symptoms of Parkinson's disease, such as muscle stiffness, tremors, spasms, and poor muscle control. Parkinson's disease may be caused by low levels of a chemical called dopamine..."

Regarding the cause of PD, it is stated that the "...exact cause of PD is not known. It may be caused by a problem with how your brain works. A chemical called dopamine helps your brain control your movement, thoughts, and feelings. PD causes brain cells that make dopamine to die, so they cannot make enough dopamine."

Enough said. I believe I've presented a reasonably thorough review of my health from 2005-2026. Sigh!

CONCLUSION: now you see me, now you don't

I have found the impact of Parkinson's Disease (PD) and that of Prostate Cancer (PC) quite different and  quite scary. 

The effect of having PD is physically manifested so I can see and feel my tremors, freezing, light-headedness, heavy legs, weak knees, and so on. However, during that window period after I have taken my medication during the day, the Sinemet magic occurs and I feel "normal". And accordingly, anyone watching will be able to see my PD when my Sinemet dose wears off. That's how a movement disorder works, right? It's often so visible!!!

On the other hand, besides the weight gain and hot flushes, no-one will have any idea that I have PC. It's only when I visit a Cancer Centre to see my Oncologist or sit in a room filled with people having their chemotherapy that I am aware that I too, have cancer. It is dangerous, quiet and deadly. It's invisible!!! 

But I'm still here and dealing with life, courtesy of my wife and my carer. Till next time, dear reader, stay well and safe.

(67) REVIEW: "PARKINSON'S STORIES"

COMPARING RESEARCH ARTICLES & SHORT STORIES

Dear reader: apologies for the long Blog silence since December 2025 - I needed to recover from major surgery involving my prostate - I am a lot better now...Ari 

In Blog post 67, I am going to examine one difference between research articles and short stories, then offer an overview of Miller Caldwell's recent short stories' publication: "Parkinson's Stories". 

Within the research context and according to Hiebert, et.al. (2023) in the prologue (p.xvi) of their book, 'What Is Research, and Why Do People Do It?", educational research is: 

"the process of anticipating claims and checking if they are correct [and is] part of scientific inquiry, a research process used across all disciplines...and checking claims is formulating, testing, and revising hypotheses... [also] we define “hypothesis” as a potential explanation for something based on what is currently known but not yet proven, or as a tentative explanation for reported observations..."

Let's revisit the idea of a hypothesis as described by Hiebert, et.al (2023) above, namely, 'a potential explanation for something...currently known but not yet proven, or as a tentative explanation for reported observations'. Such 'reported observations' are exactly what Dr James Parkinson had observed, then presented in 1817 in "An Essay on the Shaking Palsy". They could also be what we see when we observe other People/Person with Parkinson's (PwP): therefore we have working hypotheses, right?

Let's reconsider the 'hypothesis': if I wrote my Blog posts as journal articles, then my potential audience would be mostly other academics in search of info and data on PD, and my hypotheses. However, I believe that my Blog audience is generally non-academic PwP, who would rather read about support systems and success stories from PwP. In other words, I should provide a simple description of events instead of a complex scientific explanation? Now, if the Blog posts are not journal articles testing hypotheses, i.e. 'a potential explanation for something...currently known but not yet proven', then they could be short stories that describe simple, working hypotheses, okay?

According to Ryan O'Neill (2023) in Writers on Writiing 

"... the length of the short story teaches discipline and economy in expression. Writing a novel is like flying a 747, with plenty of time for take-off, flight and landing. Writing a short story is like trying to get a plane off the ground as you are in the process of building it."

The absurd graphic of people building a plane while it is flying (courtesy of Shutterstock) attempts to illustrate the challenges of writing a short story compared to a novel, as described by O'Neill. In a short story (i.e. O' Neill's plane), the writer does not have the luxury of many chapters to develop the storyline as one would in a novel (i.e. O'Neill's 747). However, the power of a short story is in its length as the writer needs to pack a lot of content into a few pages. The short story focuses on description and on the "outer" appearance rather than a research article's scientific explanation, that generally focuses on "inner" detail. I hope that makes sense, dear reader.

So, Miller Caldwell's PD publication of short stories is an ingenious way of presenting a series of working hypotheses and simple descriptions - in the shape of short stories by PwP - to the worldwide community of PwP in an accessible format. Well done, Miller!

  

MILLER CALDWELL'S PD SHORT STORIES

An author of more than two dozen published novels, Miller Caldwell, was diagnosed with Parkinson's Disease a few years ago. He decided to compile a collection of short stories by individuals who have PD. Author selection would be based on responses to specific questions (see Request below) regarding the life of the PwP before PD, after diagnosis, and during the onset of PD, which provided a framework for each story. This Request for contributions was circulated online and internationally. 

The result has been a Miller Caldwell 2026 publication called "Parkinson's Stories". It is a charity book for Dundee University's Parkinson's Group generated by Troubador Publishing.               

Miller's Request served as a framework for contributors and it appears below. 

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REQUEST FOR STORIES (book, p.ix)

This book gathers stories from the Parkinson's community. With more than 40 symptoms, no two Parkinson's sufferers seem the same, even each day. I decided to make this book a useful expression of Parkinsonian experiences. I have asked these questions to people with Parkinson's Disease:

1. What did you do before you were diagnosed with PD?
2. Recall the moment you were diagnosed.
3. Were you working at the time and, if so, did your work put in place any adjustments?
4. How are you coping now?
5. What can you still do?
6. What cant you do now?

Please finish your narrative with a section entitled CURIOUS FACTS about yourself or your experiences. If you are willing, send a photo of yourself too. Please send them to me, and the book will emerge. Thank you to all who have contributed. 

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Below is another excerpt from the book that provides a brief overview of the book's content and appears on the Troubador Publishing site.

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SYNOPSIS (from the Troubador Publishing site)

"A delightful collection of Parkinson’s stories from first diagnosis to brain surgery and creative cures.

Contributions from South Africa, Canada, the Netherlands, America, and many parts of the UK inform, entertain, and enlighten readers about this universal ailment.

In his Foreword, Professor Miratul Muqit speaks of the need for the medical profession to hear the responses and listen to the concerns of Parkinson’s sufferers.

This book is essential for all newly diagnosed cases. It explains how we adapt to our illness.

‘I have learned and continue to learn that each person is vital for determining treatment options to maximise response and quality of life. We also know a great deal more about the underlying biology that explains why brain cells in Parkinson’s may succumb with a promise of new treatments that could slow the disease that has to date remained elusive.’

- Professor Miratul Muqit, Dundee University"

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CONTENTS

"A delightful collection of Parkinson’s stories from first diagnosis to brain surgery and creative cures" is an accurate description of what you will encounter, dear reader, in the context of Parkinson's: mostly pieces of writing where most describe a set of working hypotheses and a few are scientific explanations of elements of PD and even foreseeing a cure.   

*There are 30 stories: 23 PwP from the UK (21 from Scotland & 2 from England), 3 from the USA (including a columnist), 2 from South Africa, 1 from Australia & 1 from Canada. Some of the professions of PwP represented are a poet, academics, medical personnel, sportsmen, a herbalist, farmers, researchers, landscapers, textile industrialists, and an author...

*Among the 29 contributors' gender, 8 are female and 21 are male.

*There is also a 2024 report from the American Parkinson's Disease Association regarding their advocacy for PD at government level.

What I found useful and in support of my earlier distinction between stories 

and research articles is the presence of 26 stories, 3 research reports (stories 28, 29 & 30) and a PD organisational report (story 9) all in one publication. An unlikely set of "bedfellows" to be found in a single book. 

In addition two stories are by senior spokespersons of Parkinson's UK and Alzheimer's UK both of whom are PwP. 

A useful addition in this book, especially for those newly or recently diagnosed PwP, is A BRIEF SUMMARY OF PD (pp xi - xiv) that includes a useful section of ADDITIONAL FACTS!

CONCLUSION

  
Where one might normally have to consult a "Parkinson's Disease Handbook" on how to treat and/or recognise PD - and it is likely to also contain technical language and/or jargon - Miller Caldwell's compilation of Parkinson's Stories contains an informative and entertaining collection of stories and information from PwP, as well as thoughts from a few medical researchers and a neurologist, for good measure!! And the stories' length varies from 1 page to 15 pages long.

An excellent book for anyone with or interested in reading about Parkinson's Disease...  

(66) PD BLOG: NEWS & STATS

PERSONAL UPDATE

😔 I'm struggling with two health issues, dear reader. I have been responding well to my anti-Parkinson's drugs since mid-2025. (Remember, my diagnosis was in 2013 but I opted for a drug-free complementary approach till 2025.) BUT now, I've been diagnosed with and being treated for prostate cancer, AND together, they regularly create chaos in my body. Hmmm, PD and PC...

 

Currently, I'm half way through the first part of my cancer therapy and will soon know if there's going to be a second part, that is, radiation therapy. I live in hope.

😁 However, I'm also celebrating the fact that I was chosen - along with a few dozen others, worldwide - to contribute to a book on People with Parkinson's (PwP). We were asked to write a short reflection on our life journeys before and after Parkinson's Disease (PD). The compiler is renowned and prolific author, Miller Caldwell, who is also a PwP. 

The book is entitled "Parkinson's Stories" and published by Troubador Publishing (<- select Bookshop and type the book name in the search box). Many other publishers will also have them available soon. This publication was released on 26 November 2025. 

BLOG UPDATE, December 2025

It is about 5 years since the launch in March 2020 of this Blog, parkinsed.blogspot.com. Out of curiosity, I reflected in Post 42 on the stats and viewders' countries of origin in April 2023 when there were a few thousand "viewders" (I was unable to distinguish between viewers and readers, so I combined the two words). I repeated this exercise earlier in 2025 in Post 60 and discovered there were thousands more. So, I was amazed when I checked on the numbers yesterday...! 

🥁🎺🥁 The total number of viewders since the 2020 launch, is now = 22,940.🥁🎺🥁

Wow! Thank you, viewders, this is most heartening when I consider that it was a mere 2,138 in 2023 which grew to 13,700 early in 2025.  

I am really pleased because the Blog name "parkinsed" is not a conventional one such as "Parkinson's Disease". This means that a 'viewder' would have done a specific search for information regarding this movement disorder to have come across my "parkinsed" Blog site.  

Naturally my posts are from within a South African context so I expected the local readership to have constituted the majority. Two local organisations (Parkinson'sZA as well as Movement Disorders Support) have added my Blog to their websites thereby boosting local interest and my ego.

WRT the top six countries' viewders (and they constitute a total of 18,917 viewders) who have been reading this PD blog, in order of viewdership size, they are as follows:

1. South Africa;
2. Hong Kong;
3. Brazil;
4. Singapore; 
5. USA; and
6. Vietnam. 

In addition, I am impressed with the spread of countries - that now includes Brazil, Indonesia and Ecuador - as compared to their actual numbers: another encouraging indication. But more interesting is a glimpse of the five year overview below together with their numbers. 

Again, I am pleased with this overall spread that could indicate a general, worldwide curiosity about Parkinson's Disease because of its growing impact. Remember, the current estimate is that, worldwide, about 12 million people are living with Parkinson's Disease! This general interest in my Blog may be followed by, I assume, a specific interest in what I have been sharing in my Blog posts. Hence, I assume that 'viewders' have found it useful to read about my years of personal strategies, tips and tricks of coping with this movement disorder as described in many  of my posts, both pre and post anti-PD drugs.

BLOG STATS, ALL TIME (Mar 2020 ➜ Dec 2025)

The spread of countries becomes more interesting (compare the previous stats in Post 60) when looking at a 2025 overview. The details below were sourced in December, 2025 from blogger.com's statistics.

Under the heading "TOP LOCATIONS" in Blog Stats, I found the following information, for this Blog for the period ending December 2025. A breakdown of the total of 22,940 viewders  according to the country and their viewdership.  

• South Africa--- 6,170
• Hong Kong---- 4,190  
• Brazil----------- 3,007        
• Singapore----- 2,390
• USA------------ 1,600
• Vietnam------- 1,560
• Germany-------- 406
• France----------- 336
• Austria----------- 308 
• Argentina-------- 245
• Russia------------180
• UK-----------------161
• Australia----------152
• Mexico------------146
• Indonesia--------128
• Ecuador----------127 
• Finland-----------122
• China-------------116
• India--------------- 74
• Other---------- 1,398

The "OTHER" which generally represents a host of small value viewders (single and double digit numbers) is also significant as it constitutes 13% of the total of 22940. Do compare these numbers with Posts 46 and 60 referenced earlier in this Post. 

CONCLUSION

Now that typing is becoming a challenge, I need to investigate alternative forms of input for this Blog for 2026, besides typing. So, that's my new project. 

I hope your PD or Movement Disorder or ailment eases during this holiday period. Stay well and safe, dear reader. AND ThAnK YoU for your support, everyone!

(65) PD: FINDING YOUR FEET.

SOMETHING'S AFOOT

In line with sharing thoughts on Parkinson's Disease (PD), I wish to make my feet a feature of this Post and lay bare, foot issues. While we inch forward with gusto, I'll be banging on a conundrum about my ugly hammertoes, problematic flat feet (=overpronation) and unsightly bunions, thereby providing food for thought for sole-food consisting of "'unions", tomatoes and potatoes...(huh?).

Unfortunately, dear reader, I am unable to kick the habit of punning, so, if you wouldn't mind toeing the line with me, we can slowly shuffle forward together. Otherwise, you can buzz forward like a mosquito...(okay, okay, I'll reboot). 

I have been making use of foot specialists since I was 50, across three provinces in South Africa, because of my problem feet. This was also long before my Parkinson's diagnosis.

First, I became self-conscious of my bunions (similar to pic ➠), those bumpy outgrowths on the side of the big toes. In 2002 I discovered that an Orthopaedic surgeon could surgically remove my hallux valgus but, as such a procedure is expensive and can be painful, I didn't proceed with it. 

I may have worn inappropriate footwear when I was growing up which might have caused my bunions and the hammertoes, where the ends of some toes are bent downwards. However, because my parent had bunions and a sibling has overlapping toes as a result of flat feet, like I do (similar to pic ➠), our bunions are likely to be hereditary. Also, bunion removal would have been cosmetic as they weren't painful. 

Next, in 2005, I tried to fix my flat feet, which is when the undersides of one's feet do not have arches, and that's when I discovered medical Orthotists/Prosthetists. Prosthetists (⇽ see video) are those miracle workers who provide artificial limbs (prostheses), for soldiers or accident victims or others who need to be mobile and functional again. 

Orthotists are healthcare professionals who analyse your gait, i.e. the way you walk, either using a laser scan with computerised analysis, or conducting a simple visual inspection or even just making you walk barefoot over powder on the floor (I've done them all). Based on their bio-mechanical assessments, their diagnoses enable them to generate customised, inner soles or shoe inserts. One should have regular assessments to determine any foot changes, something I have sometimes neglected :-(.  

The function of my orthotic inserts - as well as regular reassessments by an Orthotist - is an attempt to realign and support my flat feet through re-formation of my arches. My inserts attempt to correct overpronation, which is where my feet, incorrectly, "roll inwards" when I walk, which has resulted in a gradual flattening of my arches over time. I have been wearing orthotics since 2005. 

Another specialist worth seeing if PD is affecting your gait, as well as the general condition of your feet and ankles, is a Podiatrist. I am fortunate to have a caregiver who's skilled at footcare issues. I used to have swollen ankles and ingrown toenails regularly, until my caregiver, LM, started working on them :-). A pedicure with a Podiatrist or nail technician is worth the effort and expense! 

*NB: attend to your feet when you're young - it will be much harder when you're older.*

BACK, KNEEE AND FOOT PAINS

As I have mentioned, my PD sometimes distracts me from keeping track of all my health issues, so my last visit to a medical Orthotist was in 2002 and I thought my feet were fine. So recently, in October 2025, I consulted JK, who runs a Medical Orthotist and Prosthetist practice in Durban, for an assessment and new orthotic inserts. I had also been struggling with the following: 

1. Since August 2025, I have had painful ankles and heels  (especially the right foot) and I have been wondering why;
2. I have also noticed my knees are flexed and point forward rather than being straight;
3. My back, on either side of my spine, (I've checked my kidneys and they're fine), is often sore during the day; and
4. Of equal concern was that my festination is becoming more prominent and less controllable.

So, I analysed the above problems (feet, knees, back, gait) by noting possible causes before conducting an online search and I came up with three possibilities.

 

1. EXERCISE  

• I have been cycling on a stationary cycle for at least 20 minutes daily. Could that have been the cause of painful knees and ankles. Am I cycling too much? I have been cycling for many years, so why is it suddenly causing a problem?
• Also, the pedals of my stationary, Threshold Mini bike, have adjustable straps above each pedal:  could these have been hurting my feet?

2. AGEING 

• I am 73 years old and have a slight stoop. Could there be spinal changes, together with weakening muscles and poor posture, resulting in my body adapting to improve my balance. 

3. FOOTWEAR 

• I regularly wear slippers that do not offer firm support for my heels and ankles.
• I have been wearing the same sandals (I have two pairs so I can alternate!) since 2023. They are comfortable and easy to put on and to fasten, but offer little arch and ankle support.
• I also have a good, lightweight pair of shoes. While they offer good ankle and foot support, they are difficult to put on, nowadays laces are difficult to tie and I need to wear socks (difficult to put on). 

MY OBSERVATION All three possibilities above (1.Exercise, 2.Ageing and 3.Footwear) could have resulted in my sore back, knees and ankles. By the week of 13 October, my caregiver, for a whole week, had to rub my feet and my lower back with a cannabis-infused "butter". There was some relief during the day but little overnight. By Wednesday 22 October, my wife had to rub my back again with the cannabis-infusion during the night because I was in pain. 

A mould of my feet was made to construct a new orthotic insert, and on Friday 24 October 2025, I collected my new orthotics from JK, a medical Orthotist I had consulted. This was 11 days after the cannabis massage started. I tried on my new inserts that day and that night my feet were sore, a standard response to a new orthotic insert. And then there was gradual relief... 

PD & FEET

MY OBSERVATIONS 

• The indirect effect of Parkinson's Disease, particularly my tendency to stoop and hunch forward, results in an imbalance of my weight. That stoop, in turn, puts pressure on my knees, ankles and heels. The orthotic insert, attempts to correct my flat feet by creating a slight arch that shifts my stance and balance by making me straighten my knees. This moves my centre of gravity slightly backward. By Friday 31 October most of the pains had subsided. YaY, new orthotics!
• Over the past 20 years I have taken the humble orthotic insert for granted, until 2025. Now I respect its presence and the expertise of the medical Orthotist.   

OTHER OBSERVATIONS

• A research project in Spain on foot health, by Navarro-Flores, et al. (2022) examining 62 patients with PD, concluded that Parkinson's "...presents a greater negative impact on foot health and quality of life which appears to be related to the chronic neurodegenerative disease." While this project used a small sample, in the context of my Blog, this conclusion is significant for me and my experience, in the context of Parkinson's.

• Linked to foot health, is the incidence of falling as researched by Creaby and Cole (2018) in their research where they concluded that "Falls represent a significant problem for people with idiopathic Parkinson's Disease (PD), with ∼60% of people with PD falling per year." I have been very conscious of preventing myself from falling, especially at home, where there is furniture, sharp edges and other natural hazards. Any walking inside or outside is to be taken seriously by us PwP. Also, I try to do outside walks after having taken my anti-PD meds.

CONCLUSION

My prosthetist, JK, said to me "joints love movement". I paid attention to his comment, hence this topic. 

According to physiotherapist Ramaswamy in the Parkinson's UK Magazine, the ankle and foot have 26 bones, 33 joints and more than 100 muscles, tendons and ligaments. That would explain why it was so difficult to address my recent foot and ankle pains (as described above) with a standard massage. 

Also, according to Ramaswamy, "The heel striking the ground is the body's signal to the brain to generate the power to push forward." With PD and the sometimes accompanying festination, the heels do not play a major part in shuffling. Now I understand the importance of the cue 'heel-toe-heel-toe' for motion and balance.

I have renewed "respect" for the presence and impact of this bl)0@£y movement disorder!

Till next time, dear reader, stay well and safe.

ADDITIONAL READING

1. How orthotics helped one patient with Parkinson's walk 18 miles pain-free = Podiatry Clinic UK 
2. Choosing the right shoes for Parkinson's = Parkinson's UK
3. The effect of personalised shoe insoles on Parkinson's = ARTICLE
4. Impact of footwear and foot deformities on patients with Parkinson's = ARTICLE 
5. Parkinson's foot pain: problems and treatments = info
6. Effect of foot health and...patients with Parkinson's Disease = ARTICLE 

(64) Hindsight for Foresight (Phase 4)

PHASE 4: LIFE, PARKINSON'S & ME

Personal Theory

I have had a number of challenges in my life since birth and I would like to think that, over time, I have learnt something from each of those experiences: but, learnt what? In my honest opinion (IMHO), often, I think that my learning is only complete, if:  

1. There is a demonstration by me, as the learner, of what I have learnt; as well as 
2. Some form of test to check if I understand what I have learnt. 

So, challenging Parkinson's, IMHO, may be doable if the person or people with Parkinson's (PwP) - that's me - tries to learn how such a disease reveals itself, what my analysis of it tells me, and then, can I do anything about it? The big question would be: do I tolerate it or do I fight it? |f I feel I am up for this challenge, then I can observe it and analyse it, find defence strategies and then fight it. Only once I have started this process can I consider the testing phase. All this is gradually revealed in this Post. 

I will start my demonstration of what I have learnt by asking you, dear reader, to watch the short video below, on Parkinson's as a movement disorder. 

📖  Unfreezing with Cueing 

In this short (2m 31s) YouTube video sourced from a respected medical research journal, The Lancet, is the Freezing of Gait (FOG), where "gait" is to be seen in the context of Parkinson's Disease (PD) and refers to the way of walking that's exhibited by most people with PD. 

This video presents a carer with a PD patient during his OFF period (i.e. when the effects of medication have worn off so PD symptoms such as tremors and freezing are at their worst) as well as during his ON period (i.e. when PD medication is effective and symptoms are controlled). Also, there is visual and auditory cueing at work.

 

1. (TIMER 0 - 1min38) The OFF period presents the PwP with the greatest challenge of PD when his muscle memory/forgetory (see 2020-2025 notes below) is at its worst and he is most vulnerable. This is evident in his shuffling gait and small steps. The video then shows how difficult it can be for him to be able to turn around 360°. But then, most of us PwP experience this daily, right? 
2. (TIMER 1min39 - 2min04) Although he is still in his OFF period, see how differently he moves when there is external visual and auditory cueing. I have been using external (voicing) and internal (silent singing and prompting) cueing for many years (2013-2025) especially while I was not on medication and this strategy has been very effective for me (➣ SEE my Post 27, as well as Post 42).
3. (TIMER 2m05 - 2m31) Compare the effect of cueing above during the OFF phase with his ON phase when PD effects not visible as symptoms are under control. Look particularly at his gait control in relation to cueing during the OFF phase in PD.  

📖 January 2022: Ayurveda

After being Parkinson's-drug free since my diagnosis in 2013, and finding alternative approaches such as exercise routines, ankle/wrist weights and biokinetics, all of which worked relatively well, I tried a complementary therapy to challenge Parkinson's: Ayurveda. After a lifestyle change and three months of dietary preparation in 2021, I started the new Ayurveda approach in January 2022.

The daily transcendental meditation and Yogic breathing were familiar as I have been meditating for many years and was introduced to alternate nostril breathing as a teenager. My Ayurveda doctor (TRG) added a few additional exercises he thought would help me to adjust. In addition, there was daily plant-based medication specifically to help me cope with Parkinson's Disease (PD): 

1. HP500 (3 capsules daily) a natural substitute for levodopa that contains Mucuna Pruriens; 

2. Ashwagandha (2 capsules daily) to reduce stress and help with sleep; and 

3. Brahmi (2 capsules daily), regarded as a "cognitive enhancer". 

I stuck with the PD defence programme suggested by Dr TRG and I was fine for over three years, until 2025, but more of that later, dear reader: let's get back to my timeline and unfolding events.

📖 May 2022: Residence

My wife and I retired to a large apartment complex in Durban in March 2020, where we had an already refurbished, third-floor apartment prepared for our retirement. It overlooked a race course, which was cool, but the challenge was that we had to walk up six flights of stairs to reach the front door. At the time, 2020, we were still based in Pretoria.

Fate took charge in March 2020 when COVID-19 prompted a national lockdown while we were on holiday and, as we were unable to travel back to Pretoria, we decided to start our retirement in Durban. By this stage of my PD, having to climb six flights of stairs (48 steps) to access our new apartment was good exercise but not safe for me and my dodgy balance. So, in 2022, a few years later, we moved to a road level apartment in the same complex. Now, I only have two stairs to climb up from the road: Yay!

📖 June 2022: Caregiver

My wife sourced and hired a caregiver, Ms NM who had been working with PwP for a number of years. Prior to her arrival, I had had a few daily routines that suited my ego but had not established anything specifically focused on challenging PD or actively working against its impact. 

I was not engaged in constructive activities to strengthen my brain, my body and my attitude towards PD. NM changed my daily lethargic slumps with specific stretching routines. I suffered with swollen ankles since 2019 but her regular foot massages have gotten rid of those swellings.   

📖 August 2022: Parkinson's ZA

Late in 2022, a new PD support group called Parkinson's ZA (PZA) was launched. They had established a partnership with an India-based organisation known as the Parkinson's Disease and Movement Disorder Society (PDMDS). Subsequently, they launched a PDMDS support group in Durban, the first of its kind in KwaZulu-Natal. 

The PZA approach is to facilitate a "Multidisciplinary 'Model of Care' established by PDMDS in 2001." Such an approach is rooted in rehabilitative treatment as well as lifestyle management for PwP rather than on a purely pharmaceutical approach. They draw on various therapies, on dance, on the creative arts, etc. to address the needs of and to support those PwP. I joined them in 2022. They offer free, weekly two-hour support sessions always facilitated by the PZA staff in conjunction with a consulting professional. There is also weekly table-tennis for those who are able to attend. Another way to challenge this onslaught of PD! 

Their weekly two-hour sessions include warm-up and warm-down exercises that supplement specific activities. These include a focus on countering PD symptoms such as targeted stretching of the torso and limbs, music and movement, accompanied with some theory and illustrated handouts. A few times a year there are drawing and writing sessions, social gatherings, visiting specialists, as well as focussed sessions especially with the caregivers who are present.

📖  FAST-FORWARD TO 2025...

📖 2025: MUSCLES & MEMORY

Early in 2025 I started to feel quite weak both physically and mentally. The areas affected physically were my shoulders, arms (upper and lower areas), midriff (torso/tummy area) and my legs (from knees to ankles). I felt mentally exhausted too and I was depressed as I thought I had reached the final stage of life. And there was much FOG.

I believed the physical and the mental might have been linked. How? Well, let's engage in more hindsight (or speculation :-) and the presence of my muscles...

I had been thinking about the negative effects of muscle memory since early 2020 in Post 5 when I wrote about correcting the unclear messaging that was leading to poor coordination, all courtesy of my PD. I decided it was the result of lowered dopamine levels caused by the impact of having PD. I believed that I needed to adapt the nerve and muscle code and introduce new "corrective messaging" to improve my coordination. (Later I discovered my concept of "corrective messaging" existed but was referred to in the literature as "cueing".) So, my PD resulted in unclear messaging being sent and received in my body. A challenge!

My speculation was that if I could encode an "amended message", then my brain, nerves and muscles might be able to decode it. Once received and activated, that amended code should jog my now PD-infected memory into action allowing me, for instance, to effectively move a limb. In Post 6, I wrote, tongue in cheek, about the likelihood of this lowered dopamine and 'unclear messaging' in my body leading to faulty muscle memory. I speculated that such a fault should then be regarded as "muscle forgetory" :-), and that it had probably led to my poor coordination and bumbling gait. 

The presence of muscle memory is to allow muscles to repeat specific contraction and stretching actions after a period of non-activity. Neural pathways in the brain are strengthened when there is repetition of an action. My interpretation, is that there is a sort of diagram, inside a body's internal mapping system that is stored and is retrieved when required. Then there is also the notion of automaticity, when the action of swallowing food or playing a musical instrument may occur automatically without conscious thought. These are unconscious support systems that are attacked by PD. 

However, the presence of PD generates the gradual and systematic depletion of dopamine resulting in weaker and weaker messaging being relayed. So, instead of a clear message instructing me, for example, to "Walk, by first placing my right foot forward", PD probably results in a garbled message instructing me to "Wak, by fit plcn my rgh fot fowd". The result is confusion in the decoding department of my body and the consequent freezing of actions. Hence, I have tried and believe that using my own forms of internal (counting, singing or humming silently) or external (music or the equivalent of a metronome) cueing (or what I had called "corrective messaging") is an invaluable substitute whether internally or externally generated. Cueing is a conscious support system for us PwP.   

I had another revelation years ago while struggling to get a foot into a sandal. As the PD had started on my right side, my right foot gradually become less responsive to instructions, such as sliding feet into footwear. My right foot would freeze and the longer I stared at that foot the less responsive it would become! I was concerned that, after regular occurrences, the slowed action of sliding my right foot into footwear would be reinforced and stored as the new normal. This might gradually slow down to a freeze. 

One morning, out of sheer frustration, I shut my eyes, cursed loudly and my right foot slid slowly into the right sandal without any freezing of my right foot! A moment of serendipity! I discovered that I could slip on my sandals simply by keeping my eyes closed: wow! Try closing your eyes. It works, even in the loo!

📖 Jan-Feb-Mar-Apr 2025

After years of what I think of as protection from the extreme effects (i.e. "objective", observable impact of PD such as my limb tremors and freezing of gait) as well as the symptoms (i.e. the "subjective" impact of PD such as my tiredness or my sore body) I think I have developed a cloak of immunity. This might be Harry Potterish, but it's what I believe...

However, after years of so-called immunity/protection from Parkinson's via, amongst others, my Practiced cueing, PZA support, New homes, Caregiver support, Wife support and much Blog reflection on being parkinsed, my immunity was shattered. Over a few months, my PD crept up on me surreptitiously and then slowly throttled me during February/March/April 2025! 

Well, in my defence, dear reader, in March 2025, I had just turned 73, and I had been diagnosed with PD when I was 61, so... 

PERSONAL THEORY  During the post-diagnosis years (2013-2021), while I had been challenging PD without herbal remedies or pharma products, something happened inside me. Like immunity, I was developing a form of resistance against some symptoms of PD. 

I believe I had started to generate a cloak of physiological and psychological stubbornness. This would be similar to accepting that our bodies can be a placebo, as presented in Dispenza's "You are the Placebo" (⇦link to a pdf copy)! Or believing in the power of the mind and body and our ability to fight cancer as described in Brandon Bays' The Journey (⇦ link to her audiobook).

So, in 2022 when I started with the Ayurveda regime, my body and mind accepted the natural, non-pharmacuetic approach for those few years. I believed in the effect. My mind and body accepted it. But continuous loss of dopamine and my age made the PD difficult to control...     

📖 January 2025

Besides my weakening body, January started with weekly bouts of constipation, initially occurring on alternate days. I decided neither to stress over it nor to ask my GP to help me. Instead I relaxed and allowed my tummy to work when it could rather than force it. 

I had had conversations with my friends at the weekly PZA workshops and many were taking daily doses of laxatives because constipation was a side effect of taking anti-Parkinson's drugs (a-Pd). So maybe it was either my diet or growing anxiety.   

📖 March 2025

Since 2017 I had been falling a couple of times a year. These were the mandatory PD falls :-). Fortunately, these falls left me with cuts, bruises and scrapes but, luckily, there were never any broken bones as a result of my annual falls. Then I had a fall on the night of 03 March and it drew my attention both to my age and the need to be more cautious. Since our move to Durban in 2020, our GP, Dr RSP, was constantly reminding me of the dangers of PD and that I should consider taking an a-Pd. Naturally, I was not keen, not until my March 2025 fall, just before going to bed. 

That fall left me lying flat on my back, on the floor, and my wife was unable to lift me up. I lay there, thinking, and then realised that I needed to roll over onto all fours (onto my hands and legs, tummy on the floor). Then, from the floor, I would be able to push myself into an upright position, in order to drag myself onto the chair my wife had pushed into position near me. The entire episode (the fall, the solution and standing up) took 15 minutes, but represented a lifetime's worth of anxiety and learning. 

📖 April-May 2025 RELIEF

So, when I went to Dr RSP on 30 April for a checkup and repeat scripts, I mentioned the fall. He immediately recommended that I see a neurologist, Prof VP, a movement disorder specialist. They shared consulting rooms over weekends and so my GP made the appointment for me. When we arrived (Saturday morning, 03 May), I was already weak, I could barely get out of the car and was unable to use my walking stick. It took ten minutes to get out of the car, to walk up ten stairs and to seat myself in the waiting room. 

When Prof VP ushered us into his consulting room, I was unable to lift myself onto his bed for the examination, so he and my wife had to lift me up. An hour later he had completed his examination and was ready to prescribe my first anti-Parkinson's drugs: I was to try a daily drug and an overnight one.

CONCLUSION

I started the anti-Parkinson's drugs on 06 May and, so far, they have been working for me. I hope to get a few years' joy from this intervention! Currently, for my PD, I am on a chronic prescription of Sinemet (thrice daily) and Pramipexole overnight. I am still taking the daily dose of Brahmi and Ashwagandha as well as a chronic med for hypertension, something I have been taking for many years.

😃BSERVATIONS

UPSIDE 

• My recovery since 06 May has been extraordinary. I walk upright without stooping, without a walking stick, and swing both arms during a brisk walk. YaY! 
• Our complex has about 100 apartments and many residents have commented on my recovery, my walking action and my upright stance. 
• For most of the day my gait is almost normal.
• Seldom do I experience freezing of actions. 
• This ON period lasts for most of the day, so far, and I pray it lasts. 
• Also, I am seldom constipated!
• A few fine motor skills have returned.
• My GP has noticed the physical change in me.
• (Together with the a-Pd I have to exercise daily and cycle regularly.)

DOWNSIDE

• I am unable to walk around barefoot.
• The PD medication is not always available.

I am a happy chappy since the 03 May appointment with Prof VP and the recommended a-Pd regime since 06 May. What a rollercoaster ride since 2013. Phew! Till next time, dear reader...