(57) PD: staying in tune 😊

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.

😀When you pass a mirror, look into it & smile!😀

😀When you pass a mirror, look into it & smile!😀

😀When you pass a mirror, look into it & smile!😀

😀When you pass a mirror, look into it & smile!😀

(48) Parkinson's lifestyle: ball's in our court!

Parkinson's impact

As you might know, dear reader, Parkinson's Disease (PD) thrives on my inactivity, which then leads to my being tired and consequently confined to a chair for extended periods. These long periods of inactivity result in my muscles forgetting how to "work" when I need them to do so. And, yes, lowered levels of dopamine only make my muscles even more inactive. Sigh!

In contrast, athletes preparing for a game either at high school or for a national team - whether for 180 minutes of tennis or for 80 minutes of rugby - will need much heightened activity and training to perform consistently at competition level. One should also prepare for injuries, especially if they are part of the risk of playing that game! Research has found that some sport - such as American football - can result in long term damage that eventually can lead to parkinsonism and PD.

Certain lifestyle factors may have a positive impact on PD, preventing motor and cognitive functions from getting worse. Moderate consumption of coffee is able to slow the progression of PD. One study claims that dark roast coffee beans are useful in preventing Alzheimer's and PD. There are in-depth studies on caffeine, such as research by Roshan, Tambo and Pace (2016), suggesting that coffee is not necessarily preventative, but some data "suggests that PD is less common in caffeine users compared to the general population".  

Amongst physical activities that prevent PD's motor symptoms from worsening are dance, specifically Dance for PD (also active in South Africa). Sotomayor et al. (2021) reviewed the impact of Music Therapy on Parkinson's Disease and if music interests you then read neurologist Oliver Sacks' book Musicophilia. The Michael J. Fox Foundation also has an opinion on music & PD. 

Some of the negative lifestyle factors, associated with a higher risk of cognitive and motor decline, are smoking and high alcohol consumption. But data from the Fox Insight online study indicates that among American football players (Bruce, et al. 2023), a "longer duration of football play...and higher level of play...were associated with higher odds of having parkinsonism or PD".

Sport & PD

I have selected rugby as a reference point for sport and PD risk, although hockey and lacrosse (13th century) predate it historically as a sport. October 2023 is also significant on the world rugby calendar.

During the early 1800s, in the Warwickshire town of Rugby, England, a rebellious scholar called William Webb Ellis, during a few football matches, caught the ball in his arms and ran with it rather than kick it. As it was difficult to hold, the football's orb-like shape apparently evolved into the carryable, pointy shape it has today. Fast-forward 200 years, and the trophy awarded to the nation winning the international men's Rugby World Cup competition is named after Ellis.       

What is useful in the context of PD and this post, is that the 2023 Rugby World Cup competition, currently being played in France, has made me aware of a complex set of on- and off-field protocols to be followed in any suspected Head Injury Assessments (HIAs). It is reasonable to assume that this is because concussions and head injuries to players increase the risk of their developing brain trauma and brain disease. This, in turn, could lead to increased risk of PD and dementia. A similar test is done for boxing injuries and is known as a standardised assessment of concussion protocol. 

Such information on a contact sport is disturbing, so, dear reader, let's focus on the positive aspects of sport and PD. Did you know that three sporting activities that are beneficial for parkinsed people are (i) no-contact boxing training, (ii) tennis and (iii) table-tennis?  

🥊 NO-CONTACT BOXING training 

This is where I, as a person with Parkinson's, would join a boxing club for the purpose of improving my "agility, coordination and balance" through the action of punching the air around me: shadowboxing! No-contact boxing training was started in the USA in 2006 by Scott Newman who found that boxing workouts helped him manage his early-onset Parkinson's Disease symptoms. (My caregiver has developed a new boxing exercise for me - she lets me punch a giant, 20cm "anti burst" body ball, while holding it firmly in front of her.) 

So, besides the possible long-term effects of boxing, as was visible in Muhammad Ali, no-contact boxing is perfect for counteracting some of the PD symptoms. Yay!  

🎾 TENNIS 

For those people with Parkinson's, and who are still relatively mobile, we need to literally be kept on our feet to avoid festination and walking on our toes, hence, tennis. According to the Brian Grant Foundation, "Tennis exercises your brain...forcing you to stay mentally alert...improves your reaction times, which could potentially cut down on freezing episodes" in people with Parkinson's. Tennis also tests and sustains "your hand-eye coordination" so it's great therapy for Parkinson's Disease. 

And in my opinion, if you are not mobile enough but have a small garden and some grass, then you should consider getting a Dunlop Swingball set. Also, have a look at the short piece on bat and ball therapy.

🏓 TABLE-TENNIS

I played table-tennis for a high school team and then enjoyed playing non-competitively till twenty years ago, so I have an opinion. Table-tennis is fun and yet it can become a complex game. According to a study by Inoue, et al. (2021), entitled Table tennis for patients with Parkinson's Disease a "table tennis exercise program is relatively safe and may improve activities of daily living and motor symptoms in patients with PD." It may also improve motor symptoms of PD.

Besides improving coordination and social skills, parts of the brain that deal with "planning and problem solving - usually impacted by the disease - are activated" as reported in "...playing ping pong could help manage Parkinson's..."

NEWSFLASH Two members of Parkinson's ZA in Durban, Naseema Parak and Rajesh Nanjee, will be participating in the ITTF World Parkinson's Table Tennis Championship to be held in Greece in November 2023. We wish them well on this trip to an exciting event! NEWSFLASH

Concluding (happy) thoughts

A sports club in Lagos, Nigeria, during July 2023, held a five-a-side walking rugby tournament to generate awareness of PD and draw attention to the challenges of living with PD: an innovative concept! Walking rugby, by definition, is a "no-running, no-contact, no-tackling sport" and it is growing in popularity in Nigeria. Also drawing attention to the plight of people with PD is a Nigerian non-governmental organisation, the Adewunmi Desalu Parkinson's Foundation (ADPF) which is sensitising citizens on caring for those with PD. Well done, Nigeria! 

Walking rugby in Nigeria is a great partner for no-contact boxing in the USA. Till next time, dear reader...