(30) The Good, The Bad, The Smugly: reflections

PD: The Bad

In my last post (29) I emphasised the importance of MOVEment for those of us who are parkinsed and I will do it again at the end of this post. When we're inactive for extended periods then our joints become stiffer, we lose the confidence to move and, after what is often unnecessary rest, we are in the grip of inaction. Well, that's certainly what happens to me! This thought (inaction: when an action is expected but doesn't happen) got me thinking about recent events. In post 30, I will unpack specific occurrences: firstly, after my Covid vaccinations and secondly, when I've had alcohol. 

COVID VACCINATIONS: the first occurrence of my Parkinson's Disease (PD) worsening was immediately after my first Covid vaccination. Besides having a sore arm and slight headache, I observed later that the vaccinations appeared to have protected me from severe Covid, which was good.

However, my PD symptoms also appeared to worsen, which was bad. For about a week after the vaccinations my tremors were severe. I was unable to exert partial control over the tremors as I am generally able to do.

Also, my right leg was more immobile than usual as I was dragging my right foot (NB: my PD started on the right side) when walking and I appeared to be freezing more regularly when attempting to rise from a seated position. I would literally be glued to my seat. Naturally, this generated much anxiety, resulting in more frequent freezing of such movements. I started to believe I was in a downward PD spiral and maybe my ten-year drug-free regime had been a huge mistake. 

After subsequent Covid vaccinations I observed the same results: increased tremors and temporary freezing of my right side. The Covid vaccines appeared to have triggered something that affects my conscious control over some of my PD. 

ALCOHOL: I have observed that whenever I had my favourite tipple my legs and arms would start to freeze while I was seated. The impact was the same as having a Covid vaccination: glue and seat! To ensure that I did not go to bed in this state I used to drink alcohol late in the afternoon rather than at night. My current Ayurvedic regime has made me more cautious about alcohol. I have also cut back on another favourite, my daily coffee, now opting for it weekly.

PD FALLS: in tennis, "unforced errors" are when players lose points as a result of their own, personal pressure resulting in their making errors when there's indirect opponent pressure. So, I will adapt that for PD. If I have fallen as a result of my foot being caught on a table leg then it is a "forced fall" and my fault. However, if I fall as a result of my PD causing me to be off-balance, then it is an "unforced fall" and not my fault. Whilst being parkinsed I have had an equal number of both "forced" and "unforced" falls. My last was an "unforced fall" a few weeks ago - that resulted in a sore shoulder, sore bum and a severely bruised ego - and the previous fall was 18 months before that, so 👍...

PD: The Good

After years of ignoring suggestions that I consider yoga - mainly because I am stiff, overweight and unfit - I have listened to my Ayurveda doctor who has recommended two yoga breathing exercises. In addition, my brother has recommended chair yoga. I do this chair yoga on alternate days and the two yoga breathing exercises twice daily and Dance for PD in between. The chair yoga is ideal for PD people so I am envious of the Kruger National Park giraffes below because as browsers they are able to move their necks, knees and spine in a way I cannot.

 

👌  CHAIR YOGA, specifically Gentle chair yoga has been a revelation. The 25 minute session of a range of muscle stretching and controlled breathing is becoming a powerful part of my tool box of confidence. I believe that although I am only 60% successful at completing each action, immediately after completing a chair yoga session I have had consistently greater success and confidence with the following: walking; putting on my sandals; rising from a seated to a standing position; or turning onto my side in bed. When I am unable to execute any of these four actions, what follows is freezing, tremors and unnecessary anxiety. And freezing, tremors and anxiety should be experienced as little as possible when one has PD. 

👌  YOGA BREATHING EXERCISE: the alternate nostril breathing technique is useful - if you are curious, then the short video link provides a brief introduction. Alternate nostril breathing can lower stress and improve your lung capacity. Therefore, your oxygen intake increases as does the amount of air exhaled. Breathing in and out through the nose is generally healthier than inhaling/exhaling through the mouth. 

PD: The Smugly

I have become unashamedly smug about the following four focus points in my life so I will share them.

PHYSICAL EXERCISE: my current walking action is my default stance of slightly bent knees and a slight stoop (no, dear reader, not a doorstep or threshold). The chair yoga appears to be correcting this for a few hours after exercising, so I am hopeful. I believe the yoga breathing is part of a long term plan to relax and assist my nervous system. All these are attempts to counter the effects of PD. Wish me luck!

HYDRATION: since my prostate reduction surgery in May 2021 that allowed me to stop taking two chronic medications (yay!) and weaning myself off regular coffee and alcohol I am drinking a lot more water (yay!).

MENTAL EXERCISE: reading, doing word games and crosswords as well as writing these posts - this is my 30th post (yay!) - has kept me sane and mentally fit. 

COMMUNICATION: I try to stay in touch with family (mostly in Durban), friends and acquaintances (in the country and abroad) because their presence is present. What a gift.  

Move it!

In the animated movie, Madagascar, there's a song called "I like to move it..." - in keeping with my present drive here's a YouTube video clip to make us smile. Till next time, dear reader...

(29) PD: not rooted to the spot

Stand tall and walk tall

I took this picture of a tree in the northern Drakensberg in December 2021. I was fascinated with its sideways growth compared to other trees in the area. Plants respond to gravity and so, generally, roots grow downwards and stems grow upwards. However, I am guessing that constant winds sweeping across the mountain, temperature shifts and the altitude could have resulted in its angle. 

Accordingly, dear reader, many people live relatively normal lives till they are eighty years old, unless they have Parkinson's Disease (PD). This tree reminds me of someone with poor posture and Parkinson's Disease (PD) but who is still trying to stand tall. Like me! 

Tips to take away

Until 2015 I used to walk regularly and was conscious of staying reasonably fit and healthy. Prior to that I used to do power walking and enjoyed it. Then my body's "visitor" (a.k.a. PD) started to make its presence felt and I started to slack off, slow down and lack interest. This is probably happening to many of us parkinsed people. 

The tree in the picture above is alone at the top of this slope. There are no other trees with which to share chemicals or signals or to provide support. Interestingly, there is growing evidence that such exchanges between trees exist. I am reminded of the fact that there is no face-to-face support group for parkinsed people in the Durban area. So, I am on my own. Fortunately, I belong to an online support group based in Gauteng that is called Movement Disorders Support (MDS). 

There has been significant growth in the MDS membership that has provided a steady stream of useful links. For instance, through them I have discovered Nordic Walking, a useful walking technique for those with PD, using two hiking poles or sticks. The walking action is best done on a solid surface. I have tried this on grass - I was not impressed with my progress - so, a hard surface is better. Essentially one is emulating a natural walking action and gradually introducing the poles to support and propel oneself forward. 

Something that has also helped is regularly checking my posture in a full length mirror. I'm constantly embarrassed by my slight stoop, so, I try to stand tall and constantly remind myself of this posture. Since last month, the bent tree in the Drakensberg has become another reminder of my stoop. Sorry, tree... 

Make an Obvious, Visible Effort = MOVE

We parkinsed people need to move every day, otherwise, we become stiff and immobile. So, last year I started a daily three-minute routine of doing a gradual stretch of my right arm and right shoulder, two parts of my body that struggle to move. I raise my right arm twenty centimetres higher each time starting with floor level and aiming for the ceiling. This is similar to the movement of the second hand on a clock, where I slowly raise my outstretched hand starting with the 6 position (floor level), then 7 and ending with the 12 (the ceiling). This stiffness is another sign of PD and started five years ago (the first signs of PD appeared in my right thigh ten years ago). Often, I used to have right shoulder discomfort but, since my "clock" regime, that discomfort has become a rarity. Yay! 

Last year I started to experience leg cramps at night in bed when attempting to turn onto my side. I was advised to consider doing yoga. I ignored the suggestion because I am overweight and unfit. Standing and stretching would be too much of a challenge due to my growing lack of confidence and poor balance. A few months ago my brother shared a yoga website with me and it led to my exploring and doing the 25- minute Gentle Chair Yoga Routine weekly. Now I'm challenging myself thrice a week. There are many chair yoga sites on the internet. 

When I lived in Gauteng I used to attend a weekly Dance for Parkinson's (DfP) class with a qualified instructor. The DfP classes originated in New York city. The interpersonal communication during and after classes led to some post-class socialising. Unfortunately, retiring to KwaZulu-Natal put an end to that face-to-face activity. Also, the nearest face-to-face class is at Howick, more than an hour's drive away. So, I have opted for the Covid approach and found these classes online. Local DfP online classes may be found at Dance for Parkinson's South Africa. The New York City DfP site is also available online.

The need to be moving everyday and also checking my posture in the mirror got me thinking about the importance of seeing what I am doing in order to reinforce the action. So, my 2022 focus is the acronym for Make an Obvious, Visible Effort = MOVE ! The Obvious is to ensure I understand the nature and angle of the movement in which I am engaged. The Visible is to ensure that the movements are as exaggerated as possible, especially when it involves my right hand or right leg. This works for me.

Concluding thoughts

The fact that brain plasticity exists is a comforting thought, as I described in post 28. It means that parkinsed people are able to make their brains adapt to deal with the presence of the "visitor". It requires a shift in thinking, a change in lifestyle and a new set of goals. 

Trees have some qualities that we should emulate, such as retaining connections with family and friends. I am grateful for the growing readership of my blog that shows many of you out there, dear readers, are interested in my structured rambling. Remember, if you have PD or are ageing, continue to MOVE . Till next time.