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Wednesday 17 June 2020

(12) SHORT PD BREAK...

(12)  PD BREAK

Dear Reader
I will be away and without access to the internet till early July when I'll do my next post and share PBM insights - till next time, stay safe.
Ari

Saturday 13 June 2020

(11) PD and PBM

NB I am sukkeling to sort the comments section 😒  - if you want to comment, then please sms me at 079 5085170 or email ari.naidoo@gmail.com

Lockdown reward


After I was diagnosed with Parkinson's Disease (PD) in 2013 my life became increasingly constrained, both psychologically and physically. While I occasionally justified an "off" day using my age, unfit state or hypertension, this was not realistic. So, in February 2020, I contacted the neurologist who featured in a December 2019 Carte Blanche documentary mentioned in my last post. The earliest appointment at the Durban Neurolaser Clinic was mid-June 2020. 


I was told by the receptionist that an initial assessment by the neurologist would be followed by a series of roughly one-hour laser therapy sessions. However, as the Coronavirus lockdown period resulted in his many patients not being able to travel to KwaZulu-Natal, I was able to secure an earlier assessment followed by the initial phase of therapy. (His busy schedule indicated public interest in the approach.) The neurologist explained that I would need to complete a series of ten carefully spaced treatments and then take a months' break. 


What I noted from that first assessment interview was that it would be up to me, as the patient, to do the pre- and post-treatment assessments. These comprised physical tests of gait (walking) and fine motor skills (finger and hand actions) using videoclips. I decided to add writing, typing and hand dominance. As a practitioner researcher - this was described in an earlier post - his "subjective" evidence approach suited me: I would have to evaluate what was happening to me.


Simply red, in black and white


As a result of our being in stage 4 of the lockdown period during my therapy, the Durban Neurolaser Clinic sent me a permit to travel and as their rooms are at a hospital, I felt relatively safe going there. I was instructed to wear a mask and to bring gloves. There were stringent precautions at the hospital entrance before entry with two staff recording each patient's details, body temperatures and sanitising before allowing entry. Every one of the members of staff inside the clinic wore full personal protective equipment (PPE), consisting of a white onesie, white booties, white masks and white goggles. "Area 51" often crossed my mind and made me smile.


For the first week of therapy, besides working out gender, I had no idea of who was assisting me as they all looked singularly similar except for their height. This was a tad confusing as I was making notes after each therapy session regarding what exactly occurred, who did what and how. All I was aware of was four voices, accompanying accents and their varied approaches to initiating therapy. For obvious reasons, I had opted not to wear my hearing aid, which made things doubly difficult.   


Photobiomodulation


The primary treatment apparatus consisted of being exposed to a flexible pad, about 30 cm long and 10 cm wide (as shown above) while the secondary treatment apparatus consisted of tracing by two laser probes, one red and one black. During the secondary treatment, I had to wear special dark glasses. 


The primary pad contained a combination of super luminous red and low level Infrared diodes combined into a single diode. This pad was placed on various parts of my cranium, base of the skull and once on my stomach. During each day's treatment, the pad was used in three different areas for about 12 minutes each, depending on the programme. That was followed by about 10 minutes of the two hand-held lasers (manipulated by "Area 51" staff) meticulously tracing patterns around the front, top and back of my skull.  


The total treatment time for PD - thrice with the pad and twice with the red and the black probes - depending on the programme, was just under an hour per day for ten days. The recommendation was for the first five therapies on consecutive days and the remaining five on alternating days.  


From what I have read, the function of the diodes is for light energy to penetrate the skull through the radiation so it may be absorbed by cells' membranes. The resulting complex reactions are physiological in nature. Seeing that the blood vessels are dilated during treatment I always felt warm during therapy. In the 10th post, I cited an excerpt from an article regarding scepticism in the field of photobiomodulation (PBM) that, hopefully, piqued your curiosity. I will not attempt to further fine-tune what occurs. If you're interested, then do use Google or Safari or Duckduckgo or other search engines, dear reader.


Next time I'll share what I feel like after the first couple of weeks of PBM for PD.   


Saturday 6 June 2020

(10) PD, no lights, no action

Seven years' dark days

Since my diagnosis in 2013, I have avoided taking any Parkinson's Disease (PD) medication, a decision reinforced after viewing the movie "Awakenings" and the GDNF trial documentary, both of which have been reviewed in earlier posts. In both instances, I was made to understand that little can be done to reverse PD, neither by (a) PD medication nor by (b) invasive surgery. Hence, it was reasonable to assume that an alternative approach that does not include (a) or (b) - for which there is anecdotal evidence, but few large-scale clinical trials - would be an avenue to investigate. The Australian trial stopped data collection in 2019 and I hope their results will be published soon.   

When I decided to trust in the power of the original me to cope with darkening days, what I could not foresee was the force with which my body and mind was to be hijacked by the intruder. This takeover has been especially noticeable in the shift in my hand dominance and becoming more of a threat than I thought it would be. One of my few remaining pleasures, driving our car, has gradually also become a challenge. I might have to stop long distance road trips by 2021, because of worsening motor control (excuse the pun!). So, what now? 

Observations made by Palfreman (2013) (the L-dopa Conundrum appeared in an earlier post) regarding motor complications (MCs) are significant. An important one is that the presence of some MCs and possible side-effects on patients taking PD medication result in their having a few "off" days per week, when MC's prevail and symptoms can worsen. This is offset by having symptom-free "on" days. As a parkinsed person, I also have "on" and"off" days, but, without chemical dependency. 
 

Some light

In December 2019, M-Net's Carte Blanche broadcast a documentary regarding the use of low-level Infrared (or near Infrared) light to treat those with PD. The ten minute programme described therapy that was not invasive, caused no physical damage to the brain and was available in South Africa! I will describe aspects of the treatment that, hopefully, will make sense.

According to the Durban Neurolaser Clinic laser therapy is "the use of light from a Low Intensity Laser Diode or an array of Superluminous Diodes to eliminate pain, accelerate healing and decrease inflammation...[and is] also known as...low intensity laser therapy or photobiomodulation therapy." The clinic also treats neurological conditions, such as PD. Naturally, I was curious about this therapy, so I did some online research, and found pros and cons.

Photobiomodulation therapy for PD

The general scepticism of photobiomodulation expressed by medical experts (including some of my own parkinsed friends who subscribe to drug therapy) relate to the absence of clinical trials and accompanying evidence. As one who has been parkinsed and who is not a medical doctor, again, I assume that the pharmaceutical industry and medical science would be sceptical of any PD therapy where no drug is present to address the problem. 

According to Hamilton, et al. transcranial photobiomodulation therapy yielded positive results on PD patients and their tremors, gait and writing. There was significant improvement in most patients in their sample. These writers' view of medical scepticism regarding photobiomodulation is based on their belief that "the concept of light inducing chemical and metabolic change in neurones appears difficult to accept by some colleagues, although they have no trouble accepting the concept that a drug can induce a change..." (Hamilton, et al. page 1739).  

Should I consider transcranial photobiomodulation therapy? More about this next time, dear reader.