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Showing posts with label dopamine. Show all posts
Showing posts with label dopamine. Show all posts

Saturday, 1 August 2026

(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 ๐Ÿ˜–. 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") (Rosรฉn, Wijk & Bjรถrkman, 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 ๐Ÿ˜„...)


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 10Post 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.



Sunday, 15 December 2024

(57) PD: staying in tune ๐Ÿ˜Š

Dopamine & my happy triggers

A recent article on what are regarded as "feel-good transmitters*" by Watson (2024) entitled Dopamine: The pathway to pleasure is an informative, easy-to-read piece of writing, particularly for us People with Parkinson's (PwP). It touches what is at the heart of today's post, namely, what makes me happy! But first, dear reader, some context so we can all connect the dots.  [*NB Besides dopamine, there are three other feel-good transmitters: serotonin, endorphins and oxytocins.]

According to Watson, dopamine also helps us "...feel pleasure as part of the brain's reward system. Sex, shopping, smelling cookies baking in the oven — all these things can trigger dopamine release...[and] this feel-good neurotransmitter is also involved in reinforcement [so] once we try one of those cookies, we might come back for another one (or two, or three). The darker side of dopamine is the intense feeling of reward people feel when they take drugs, such as heroin or cocaine...". Dopamine shortage in PwP has been covered in previous posts so I shan't repeat the obvious. Sadly, in my present parkinsed life, the 'sex' and 'shopping' are absent but other pleasure factors that are still alive and well are music and photographs and my family

Music

I learnt to play the piano and to read music when I was at high school - more than 50 years ago - during which time I also spent four years as a drummer in a band. After I left high school I discovered the joy being able to play by ear - i.e. without sheet music - and that ability has given me much happiness on my own. Unfortunately, during the last few years, my right hand has become inactive and stiff resulting in my not being able to play my electronic keyboard with both hands. So, what are alternative happy triggers?
 

Five years ago I bought a versatile and compact music centre (similar to the one in the pic) which has a record/vinyl player, cassette player, CD player, bluetooth capability as well as a FM radio. The sound quality is not great but quite acceptable.  

Naturally, I still have collections of long-playing records (LPs/Vinyls), audio-cassettes as well as compact discs (CDs). They range from rock to R&B to classical/orchestral to jazz to blues, from South Africa and from the rest of the world. Now that I am unable to play my keyboard, my wife regularly plays these CDs, LPs or cassettes. 

Music brings me much joy and warmth and always, temporarily, counters the Parkinson's zone which often engulfs me. Music can be powerful, and an equivalent of an over-the-counter drug! 


BREAKFAST I used to start every weekday by watching TV news for at least 90 minutes while having breakfast. My wife observed that, too often, the news would be depressing and cause me to become moody. So, two years ago, I changed my habit to starting my day and breakfast with one of many DMX music channels available on DSTV (cable TV). I start my weekday with an hour of DMX "Beautiful Instrumentals" (DSTV channel 784) or "Contemporary Instrumentals"(DSTV channel 785). Besides starting my day on the right note :-), I now recognise subtle differences in artists' signature styles, e.g. between pianists Richard Clayderman and Floyd Cramer. 

GENERAL Over weekends we tune into LM Radio (DSTV channel 821) historically one of the older Southern African music radio stations now also available online and broadcasting from Gauteng. Their focus, seven days a week is exclusively music from the 1960s-1990s. I am always happy when listening to familiar sounds of Tom Jones, Engelbert Humperdinck, Cliff Richard, Santana, Herb Alpert, The Beatles, Herman's Hermits, The Flames, The Dealians, etc.  

During the afternoons and some evenings, I listen to a local Kwazulu-Natal music radio station called East Coast Radio (DSTV channel 836) that plays mainly contemporary pop. While cycling, I generally listen to "Smooth Jazz" (DSTV channel 785). 

INTERPRETATIONS Whilst at high school, a friend came across a rock band called Emerson, Lake & Palmer (ELP). Around 1971 they released an album of a live concert called Pictures at an Exhibition and we - a group of five - were hooked. We listened to it over weekends for months and knew each of the ten pictures and accompanying tunes quite well. 

A few years later - long before the internet - I stumbled across Russian music composers one of whom was Modest Mussorgsky and discovered that he was the original composer of a piano suite describing an exhibition of ten of Viktor Hartmann's original Pictures at an exhibition. ELP rose in my esteem!

Recently, when searching for background music I came across a piece called The Hall of the Mountain King by Grieg which was familiar to my ear. I wondered if there had been a modern interpretation of it and sure enough, Apocaliptica had a rock version of The Hall of the Mountain King. Such interpretations will allow for a greater audience appreciation of music, both classical and contemporary. You too, dear reader, should keep an eye and ear open for such examples as those two above. 

JAZZ And I would like to share another example of how musicians are able to reshape their craft. I am a jazz lover and a huge fan of American quartet Fourplay. At least two of the band members - pianist Bob James and bassist Nathan East - have also produced a few solo albums. I was fortunate to have seen them live in South Africa. I was even more impressed when I came across their 2013 Live in Tokyo concert performing by themselves (Act I) for the first 34 minutes. Then (Act II) they performed with the New Japan Philharmonic which included some original compositions. They are truly creative craftsmen. 

Conclusion

I still have a few DVDs of music concerts that are my all-time favourites: Celine Dion live in Las Vegas; Santana Supernatural live; The Shadows - The Final Tour. And if you are/were a Cliff Richard & The Shadows fan here is a link to their Final Reunion 2009.

We PwP, as regularly and as often as possible, need to remind ourselves to be happy. Keep the dopamine flowing. And I will continue to listen to music every day. Till next time, dear reader: HaPpY HoLiDaYs.

๐Ÿ˜€When you pass a mirror, look into it & smile!๐Ÿ˜€
๐Ÿ˜€When you pass a mirror, look into it & smile!๐Ÿ˜€
๐Ÿ˜€When you pass a mirror, look into it & smile!๐Ÿ˜€
๐Ÿ˜€When you pass a mirror, look into it & smile!๐Ÿ˜€








Thursday, 9 December 2021

(28) NEUROPLASTICITY & MY PD

RECAP In Post 27, I shared some ideas around my freezing and subsequent use of trigger words to initiate internal cueing to assist faltering movement. Many of us with Parkinson's Disease (PD) are reliant on such a strategy to attempt to kickstart dormant motor learning in order to make our limbs move. One example of re-initiating motor learning is overcoming my difficulty - as a PD person - of moving from a seated to a standing position, as illustrated below.

In Post 27, I also focussed on strategies for the re-execution of movement. What is interesting is that while this cueing strategy is supported by the combined effort of a body's muscular, skeletal and nervous systems, I've ignored the fact that the brain has an unfathomable capacity to adapt under extreme circumstances. Let's briefly explore neuroplasticity and my PD.

 

PD: I'm the dope with depleted dopamine

I have PD. I have been told this condition exists because of dwindling levels of dopamine, a complex chemical in my brain. This 'dwindling' has probably occurred over an extended period of time. If that's so, then it could have been triggered by a traumatic brain injury when I was a child (1956) and other specific traumas I can pinpoint during my adult life (1999, 2007, 2012).

From what I've read, dopamine is manufactured in my brain and functions as a neurotransmitter to send messages across my nervous system to deal mostly with movement. For a brief, scientific explanation of dopaminesee the 2 minute video. Besides being a chemical messenger, dopamine is a hormone: it plays a role in mediating rewards in my brain, both as the "excitatory" hormone responsible for my feel-good times, as well as the "inhibitory" type. But it also plays a role in regulating chronic pain, amongst a host of other functions. So, dopamine is no dope!    

What I've learnt about my PD since I retired end-2017 is that, firstly, I have a movement disorder that plays havoc with my muscle confidence. This disorder, coupled with my tremors, instills the constant belief that I need to rest. As a result, I rest more than is required leaving my muscles over-rested and underused. So, I am unable to do simple tasks, although my muscular, skeletal and nervous systems are functional. 

Secondly, being over-rested means my muscle memory converts to muscle-forgetory (see Posts 6, 15 & 16)  making me believe I am incapable of moving "normally". This appears to be a powerful function of my brain, namely, to adjust the body's functions to suit what is the strongest. When my right side started weakening due to the impact of PD my left-hand automatically took over (see Post 8 regarding dexterity) and dominated certain right-hand functions. 

And thirdly, because my nervous system controls my sense of temperature, as a parkinsed person, I am now more sensitive to temperature shifts, both hot and cold. In Post 9 I referred to "trevers" i.e., tremors + shivers, when it gets cold. 

So if my muscular, skeletal and nervous systems are okay, then what is the problem? Probably the decreasing amount of dopamine in my Substantia Nigra (see 2 minute video). Some of this is speculation on my part, so in keeping with my speculative stance I will look at the positives such as my shifting dexterity and cueing to re-initiate my motor learning. Besides the three systems just mentioned, dear reader, let's not forget the brain and its plasticity. 

What is neuroplasticity?

There was a time when scientists believed that the creation of new neurons (i.e. neurogenesis) stopped shortly after birth but that has been proved to be incorrect. The notion of neuroplasticity - also called brain plasticity - is based on evidence first recorded by a Polish neurophysiologist, Jerzy Konorsky, in 1948. He wondered if it was possible to alter existing neural connections in the brain through conditioning (naturally, Skinner and Pavlov were also in this think tank). Later it emerged that new experiences linked to change could influence the brain to reorganise most neural pathways and even generate new ones throughout one's life. Neuroplasticity is a combination of the essence of the nervous system (i.e. neurons) and the brain's capacity to be remoulded (i.e. plasticity) in the face of an individual's challenges. 

One example of 'remoulding' is the ability of a musician such as Ray Charles to excel at tasks generally achievable by a sighted person. He was not born blind and his musical ability as a singer and pianist was superior to that of many of his sighted contemporaries. It could be said that he was able "to perform non-visual tasks better than those with sight". I had the privilege of attending one of his live performances in the nineties and his musical performance together with his piano stool antics made it unforgettable! 

Another example is the phenomenon of phantom limbs where an amputated limb still appears to exist in the mind of the amputee. This supports speculation that every person's brain contains the equivalent of a detailed diagram of all bodily functions and accompanying support systems to sustain the idea of neuroplasticity. Below is an illustration of brain plasticity. 


How experience changes brain plasticity

Regarding the principle of plasticity, it is possible that my advanced internal cueing leans towards functional plasticity. According to Psychology Today plasticity makes it "possible to change dysfunctional patterns of thinking and behaving and to develop new mindsets, new memories, new skills, and new abilities". 

A brief deviation: my advanced cueing for dressing, walking and climbing stairs would be similar to creating a learning strategy called a mnemonic. This allows one to remember a series of words or names in a specific order. For instance, when trying to remember the colours of the rainbow in order, I remember this mnemonic: Richard Of York Goes Battling In Vain. Each first letter is the first letter of word representing a colour, namely red, orange, yellow, green, blue, indigo, violet. The silly sentence about Richard is a primary trigger that takes me to the source, the actual colours. 

This seemingly long process is, in my experience, how successful remembering can occur. So, my shift from saying "toe-toe" to counting from 1-6 when climbing six stairs is my way of creating a sense of continuity (from a green light to amber - see Post 27) in my stilted movement. Maybe, the fact that it works is my brain telling me it has accepted an amended cue and indicating that a form of learning has taken place. Hmm...evidence of plasticity?   

This perspective of neuroplasticity is an enlightening one for me as a parkinsed person. I have scratched the surface of this phenomenon to provide food for thought, dear reader. There is also recent research on exercising and neuroplasticity that I have included below to further whet your appetite. 

Neuroplasticity and exercise: more food for thought...

Research published in 2019 found that the impact of aerobic exercise resulted in positive change in the brain plasticity of subjects with PD (see EXPANd trial article no. 2 in Resources below). The article focuses on two groups, (1) a HiBalance and (2) a HiCommunication group. Their broad focus area was on exercise as a form of non-medical intervention for those with PD, particularly in the light of the unpredictable nature of current pharmaceutical "remedies". 

Another strand of research also published in 2019 is on healthy subjects without PD and the impact of extreme aerobic exercise on their brain plasticity (see "Exercise-Induced Neuroplasticity..." article no. 1 below). It focuses on exercising among healthy individuals and indicates that "fit individuals show greater neuroplasticity induction than unfit individuals". 

Happy Holidays, dear reader, and thank you for visiting this blog. Till we connect in 2022.

Resources

Neuroscience: click on desired link & when site opens scroll down for short video.
  1. This journal article focuses on the effect of exercise on healthy individuals without PD. If you're bored, then only read the Abstract (at the beginning) and the Limitations and Conclusion paragraphs (at the end). "Exercise-induced neuroplasticity: a Mechanistic Model and Prospects for Promoting Plasticity." by El-Sayes et.al. (2019). Available as a PDF.
  2. This journal article focuses on individuals with PD"The EXPANd trial: effects of exercise and exploring neuroplastic changes in people with Parkinson's disease: a study protocol for a double- blinded randomized controlled trial. By Franzรฉn, et.al." (2019). Available as a PDF. 
  3. How our brain adapts to impairment: "Loss of Sight and Enhanced Hearing: a Neural Picture." 
  4. A blog site for PD people like me: "Fighting Parkinson's Drug Free."
  5. A useful easy read on brain plasticity in a South African publication "Psychology Today."  
  6. What is neuroplasticity? Positive Psychology
  7. This chapter: Neuroplasticity after traumatic Brain Injury by Su, Veeravagu & Grant, focuses on traumatic brain injury and neuroplasticity. If you're bored then just read the introductory paragraphs, the section on Neuroplasticity and the Conclusion.

Saturday, 25 April 2020

(5) PD, my theory & my corrective messaging

Name & tame 

Parkinsons's Disease (PD) is a 'progressive disease of the nervous system'. It is 'neurodegenerative' and arises as a result of 'a dopamine deficiency'. The jargon does not help me understand why, as a parkinsed person, I struggle to stand, to walk, to put on underwear or footwear, or to eat. Actually, it is just a miserable movement disorder.

Let's put this struggle into context. As a baby I learnt to roll over from my back onto my tummy and back, then to crawl and finally to stand unsteadily before attempting to walk. Such actions would have required a good sense of balance. All of this was positively reinforced: physically through my repetition and emotionally by my parents and others. Gradually, my muscles would have remembered what to do in order to complete these actions. It is likely that as a new walker, my age, weight and capability would have been key calculations that needed to be stored as some form of memory.

Similarly, as an active adult who gyms, jogs or is part of amateur team sport, I would need regular practice to stay fit and competitive in order to gradually improve. If I were injured or went on an extended work-related trip, such regular practice would lapse. Consequently, I would have become unfit but, once healed or back at work and old routines, I should have been able to return to previous levels of fitness. Here, the notion of muscle memory would have been a critical part of my fitness and recovery plan.

So, what happens to parkinsed people? Why can't my muscle memory save the day?

My PD theory 

It is reasonable to assume that lowered dopamine levels have led to my bumbling gait, loss of coordination and poor balance. Dopamine is the so-called 'messenger molecule' actively assisting in my body's general communications, feeding into and supporting the nervous system. So, my lowered dopamine levels have led to unclear messaging or even its absence. Years ago, computer programmers would have called this garbage-in-garbage-out: I'm unable to walk as I used to because my body and infrastructure cannot apply corrective measures, hence the bumbling gait!

Nowadays, my nervous system recognises my bumbling walk as my normal walk. My poor sense of balance, especially when going from a seated to a standing position, attempting to walk backwards or walking forward in cluttered spaces, has also become normal. And without corrective messages from my nervous system, I believe this data is stored in my muscle memory as the new normal. 

As a PD drug-free person, I assume that the range of PD prescription drugs available will attempt to regenerate such messaging in the body of one who has been parkinsed.

Some rehabilitation

In the past two years I have attempted to correct my awkward walk by speaking silently to myself regarding a step by step (pun intended) procedure. It started with my repeating "right-heel two-three toe-two-three, left-heel two-three toe-two-three" when I started to use a walking stick in my left hand. (I am using a collapsible, camera monopod that doubles as a walking stick: a tip from a buddy in Bali.) It is important to note that I first had to see my abnormal walking, in order to reintroduce the mechanics of my walking differently.

This process was assisted first by my counting to develop a rhythm and then by silently humming a waltz tune in order to sustain my "new" walk. Fortunately, I often have tunes playing in my head, so this has been easy. I guess this procedure simulated a kind of rehabilitation in the form of corrective messaging. In confined spaces, which is most of the inside of our flat, I still walk by dragging my right foot. However, when there's some space, for instance down the passage leading to the front door, I walk as a retiree. Shopping malls, while tiring, offer the perfect straight-line spaces.   

Also, I have observed that my Biokinetics regime is a hundred percent better with the appropriate equipment and under personal supervision, compared to doing it on my own at home. There is a strong need for emotional reinforcement, like I probably received as a baby trying to stand, balance and walk. 

Next I'll analyse then unpack my tips and tricks for dressing and for balance. Till next time and the next post, dear reader.