(8) PD & dexterity: go left, right?

Why is it right?

QUESTION: Does my right hand know what my left hand is doing? ANSWERS: (i)Yes. (ii)I suppose so. (iii)Maybe. So, what about dexterity?

The Latin word sinistere refers to "left"or "improper". In English sinister means something "evil". When considering hand dominance, there's also mixed-handedness (where one can play sport with the left hand but write with the right hand) which leads to the notion of dexterity. But, let's return to the matter at hand, namely, how Parkinson's Disease (PD) hijacked my dexterity! A geneticist or neurologist could shed light on prevailing theories on hand dominance.

At varsity, a student in class had an accident just before exams. She fractured her right hand, her writing hand. She sat for exams a few weeks later but wrote with her left hand. She was the very first ambidextrous person I had come across and I was impressed. However, there was a time when she would have been discouraged from doing so because of the "sinistere" stigma.
 
I was born right-handed. At high school, StephenF and RenukaV, both of whom were left handed, always gave me a run for my money when we played table tennis. As a right-handed player I had to be shrewd as a ball returned by a left-hander would spin differently. I had to be observant. Fast-forward to 2016 and I noticed something else regarding dexterity and hand dominance.

PD & shifts in dominance

Sometime during 2016, I observed that my right side was struggling, so that my right hand and leg actions were less fluent. At the time I did not consider PD tests, including a dexterity test, such as the simultaneous tapping of the thumb and forefinger. Currently, I am only able to sustain such a tapping movement, at regular and increasing speed, with the left hand. My right hand is able to start the tapping, but, after a few seconds, the action falters and stops.

A good idea for parkinsed people is for a social worker to assess their level of independence. If you have not done so, then please consider the possibility. I did so a few months ago and wondered why I had not done so earlier. I was probably in Egypt, in denial (pun...).    

I have observed hijacked dexterity when washing pots, plates, dishes and cutlery. For the past few years I have used my right hand to hold items to be soaped and the left to hold the soaped sponge. However, pre-PD, I used to hold items to be washed in my left hand while soaping them with a sponge in the right. With the advent of my PD, it has been deemed necessary by the command centre - my brain and other systems - that my hand dominance should be shifted, probably to make more efficient use of the remaining systems.

Another example of hand dominance shift is my driving a vehicle with automatic transmission. My wife observed a few years ago that my right hand had gradually become passive and often rested on my right thigh while the left hand controlled the steering wheel. One-handed driving is an unsafe technique especially long distance. Putting on a shirt provides another challenge: first I put my left arm into the left sleeve followed by a gargantuan struggle for the right shoulder and arm to get into the right sleeve. By 2019 my wife needed to help me get my arms into sleeves. 

PD doesn't have to cost an arm & a leg 

The onset of PD and increase of right side involuntary tremors has meant that tremors in my right leg and arm have also increased in intensity. This has also meant that my right side coordination and muscle activity has also started to decrease, leading to loss in muscle tone and strength. I believe this has also resulted in a generally painful right shoulder and upper right arm. I was aware of the onset of Bradykinesia but not of the shift in dominance.          

I discovered recently that my sore shoulder could be sorted through Biokinetics or regularly attending Dance for Parkinson's sessions. During my search for drug-free remedies I came across Sensoria's work on smart socks that also attracted the Michael J. Fox Foundation to sponsor their clinical trial. The idea of smart socks telling one to lift up heels or toes led me to a simpler option, namely, wrist weights on either wrists or ankles. They did not cost me an arm and a leg and work 70% of the time.

TIP FOR ME: I realised that when walking, the PD hijacking of my internal communications had resulted in me dragging my right foot. One remedy was spending a few thousand rand on Sensoria socks while another would be to wear a wrist weight. Wearing such a weight on either my right foot or leg on alternating days of the week is a physical reminder for me to lift up my right foot or to swing my right arm when walking. This is done in conjunction with corrective messaging described in a previous post. This works quite well most of the time. These weights are not allowed aboard a plane but may be in one's stowed luggage. Wearing my watch on my left wrist also reminds me to swing my arm but is less effective because it is lighter in weight.       

With apologies to Beyoncé 

TIP FOR ME: to the right! American singer Beyoncé Knowles has a song called Irreplaceable, the introduction to which has the now popular phrase: "To the left, to the left: everything you own in a box to the left". During the past two years one of my dexterity corrective messages when washing dishes has been: "To the right, to the right...". However, I have discovered that reliance on corrective messaging is not always effective, so I wash with left dominance and rinse with right dominance. Also, during rinsing I ensure that my right hip is forward and closer to the sink than the left one. 

When driving I use the corrective message "both hands on the wheel" when I notice any one handed driving. So far that has helped. 

Till next time when I'll share my thoughts on why typing and the cold weather may be a challenge for parkinsed people.