The Plurality of Parkinson’s

I am suspicious of autoimmune diseases with their curiously wide array of symptoms amongst various individuals. Perhaps this umbrella term is masking multiple diagnoses and processes that science hasn’t clarified. How can one disease do so many different things within the body? I was asked to compare a dad and daughters symptoms to discuss the differing disease expressions for two people given the same diagnosis: Parkinson’s.

When Tom (Dad) was diagnosed at 81, he’d always been soft-spoken. As his neck and throat muscles weakened, he became quieter and since these muscles also assist with eating, food became a potential aspiration hazard. His handwriting changed to a shaky version of his already microscopic scrawl. Freezing episodes occurred when walking from one surface type to another (e.g.: carpet to tile) leading to rapid blood pressure drops (known as Autonomic Dysfunction) and fainting. We’d walk in a row: the maroon wheeled walker, Tom plodding stiffly behind and the Plan B wheelchair driven by one of us, ready to grab him as necessary. He never experienced associated pain, nor oddly much of a visible tremor. This is one version of Parkinson’s disease.

At 51, his daughter Joyce’s symptoms began with right foot cramping after a twisting stretch on a colleague’s inversion table, caused a bolt of shooting pain to zip down from right low back to right foot. In the last nine years, involvement has extended to visible cramping and spasticity of her right calf with extension into the entire right side along with a generalized binding of the entire body, especially the torso. At random intervals, the right foot angles outwards and the left big toe stiffly tenses upwards towards the ceiling. Otherwise, she walks and turns smoothly without any of the classic Parkinson’s rigidity or stuttering movements.

These symptoms have built to multi-daily debilitating pain attacks lasting 15 to 45 minutes until the current medication dose can “get on board.” The varieties of discomfort include: a generalized tightening or what she describes as an ace bandage or blood pressure cuff over areas of her body to pulling, ripping, tearing, shredding and burning pain. There have been times wants to amputate her leg off. In the past year, she has been tracking her symptoms every two hours to gather information for her doctors about medication effectiveness and symptom control.

My spouse and I once attended a local conference geared for Parkinson’s patients and family. In the crowd were young folks in wheelchairs, those dealing with rigidity, tremor, spasticity and blunt facial expressions or dementia and all from just one supposed disease. Could a mix of genetics, diverse environmental inputs like chemical exposures, lifestyle factors and gut microbiota health working in combinations create an end result of multiple disease states with false similarities?

I look forward to receiving your feedback.

Dr. Valerie

MIRACLE TREATMENTS

Advertisers shout and dance about how easy your life will be with one little pill. Supplements claim to make the pounds melt off or make you more of a man with a “free” trial bottle and inflated shipping and handling fees. My suspicious mind asks that if a pill actually worked that effectively, safely and quickly, wouldn’t there be more proof out there? Also, wouldn’t the pharmaceutical companies with all their means have jumped on it already? Years later, I’ll read independent, scientific studies showing no measurable affect with those miracle treatments.

I also suspected that a typical TV ad was not cheap, but was unsure of the numbers. A cursory online perusal estimations for the medium-sized market which I live (Cleveland metro area population 1.2 million), an ad charge runs between $5-$45 CPM (cost per thousand viewers). The price is determined by time slot and frequency of ad runs. This does not include the cost to hire actors, crew, equipment and space to film. So, if something costs a large sum to produce, red flags go up for me when I see a company “giving supplements away.”

Of course, all is not what it seems in the world of advertising. We may already know that in one part of our minds, but may be unaware of how egregious the missteps may be. I remember reading the account of an athlete who discovered his personal before & after online photos being misused by a company trying to sell pills promising similar results in 30 days. In actuality, he went from scrawny to buff in……4 years! This change, of course, took diet and steady weight training. Always question the source. Thankfully, there are real people, who have successfully changed their bodies, who can tell you how to go about it safely.

I’m amused by vintage ads: “Guinness beer for Strength”, Celluloid (clothing) Starch to “protect against contagious diseases” and “Dr. Batty’s Asthma Cigarettes” which also allegedly handled hay fever and foul breath. In these old ads, we can more easily detect the deception. When the ad content is current and relatable, our brains may conclude that the ad must have some truth in it or else it wouldn’t be in the newspaper or TV, etc. I can’t imagine the length of time and expertise required if every magazine and media venue were required to sufficiently research each ad for proof of medical accuracy, effectiveness and safety. By watching ads of a bygone era, perhaps it will help us distance us from the pull of the promise today. Hey, do you think that might also work for politics?

In health,

Dr. Valerie

Altered Anatomies

I couldn’t help stoop to using wordplay on the 1980’s sci-fi flick about entering altered dimensions called Altered States. It’s plot involves one isolation tank and lead scientist experimentally weaving in and out of our existential plane. Aside from his changing body, that is where the similarities end. My alternative titles: risks benefits of surgery or why going “under the knife” doesn’t equate to instant relief, were less inspiring. Wouldn’t a quick fix be great, though? You’d go into an anesthesia, ailments are fixed, then awaken brand new. Science fiction depict tales (usually a rich) man placing his body in cryotherapy for alterations when medicine is more advanced.

Oddly enough, anything which we have tried to create, has come in a poor second to our basic body fibers which are stronger and longer lasting than most synthetics. Also, our body systems are integrated and interact with each other. For instance, muscle and fascia are so closely linked, they seem to wind around each other like two perfectly attuned ballroom dancers. Tightness and cramping in one area of the body can feel like the pain is suddenly spreading out and affecting others. At that point, some throw up their hands and proclaim “I’m falling apart!” That’s not necessarily true but points to the body’s natural interconnectedness.

Our nervous system is like a giant connector. Nerves from our spinal column emerge like cords on a central power strip. During an asthma attack, nerves at the corresponding spinal cord level branch both to the lungs and muscles associated with that level. The bronchial tubes constrict and rib cage muscles contract simultaneously in response to an asthma trigger, despite the trigger only directly affecting the lungs. Individuals with asthma can have some mighty tight back and chest wall muscles over time.

You alter one area with surgery along with its connections to others. My stance is not to convince you out of surgery. Many are life, and quality of life, saving. I believe that it’s better to know ahead of time what’s typically in store then wake up to a surprise. Ideally, surgery is non-emergent which gives time to train your body into the best possible condition prior to alteration. Training involves your body and mind. Satisfying high nutrient meals, cardiovascular, strength and stretch conditioning as well as mood elevation with reading or viewing hilarious and inspiring content are part of the mix.

Prior to my mother’s knee replacement surgery, she looked like she was having a blast during pre-rehab. That encouragement was vital to her. She did PT exercises in a gym, dribbled and threw basketballs into a net and stretched. A good friend demonstrated swimming exercises. This was out of her comfort zone and something she couldn’t see herself doing before. She hadn’t been working out in some time and the tissues around her knee (in this case) had both weak (unused) and tight (overused) structures requiring different techniques. Gradual stretch and massage of tight areas and strengthening of weak ones were the basic approaches. Rehab after the surgery was still a long slog and she’s not moving to get the other one fixed any time soon.

I encourage to spark your curiosity and search out as many tips and tricks that helped others to become stronger, more flexible and relaxed before and after surgery. The hospital environment is foreign for many of us. Make this temporary room your own. I’ve heard of people bringing ear buds, calm music and guided meditations to listen to instead of beeps of medical machinery. Seek out guidelines for bringing in personal items on the hospital or facility’s website. Relaxing lotions can be a gateway to ask for hand or foot rubs along with having soothing smells. Funny short videos or images can help you smile. Wearing soft, cozy clothing can be a godsend. I for one would probably have organic veggies and dark chocolate in a little cooler on hand after getting an OK by my doctor to boost nutrient intake and serotonin levels. Seek out a way to create a sense of ease and home to your strange surroundings.

In health,

Dr. Valerie

It’s all about the PARTICLES Baby!

It’s easy to get worked up about masks. That thing on your face; so annoying. and hey, didn’t I hear that they “didn’t work?” I say, refocus. Stop scrutinizing the mask; it’s all about the particles or micro droplets in science speak. You might not remember the awesome high speed photo catching a man mid-sneeze. His face is all screwed up and particles ejected around him like a geyser. (Search: high speed photo sneeze images) Pretty cool stuff for a nerd like me. I especially like the other photos using the same technique. There is stopped motion of a bullet through a tennis ball and a cat licking milk with tongue tip diving down and towards it’s mouth rather than the expected scooping upwards like a spoon. I digress.

What makes things tricky, is that most particles aren’t visible. We might feel the large droplets on our face and think Ewww when someone speaks-spits at us. But the smaller ones are not felt. German researchers placed a subject in a room with equipment to monitor these droplets’ with & without masks so particle spread could be visualized. https://youtu.be/P27HRCIMf2U Similar data was collected in a Japanese study. www.youtube.com/watch?v=hau4J2DfTK8 So, the short answer is that masks are effective enough to decrease spread and exposure of particles. I say effective enough, because 1 single viral particle is highly unlikely to infect with COVID, but an accumulation of particles or infection dose that can tip you into illness. Therefore, masks do not have to be 100% effective to keep you well. While an onslaught of particles assaults us with coughs or sneezes, just plain old breathing and talking sends out plenty.

I am comfortable for my 12 hour shift wearing first a medical mask that crimps at the nose and a softer cloth mask over that that snugs around my face. This decreases the gaping that can occur with either mask alone. I keep my masks comfortable and secure, so I don’t need to touch or adjust my masks during the day and this mask combo is my go-to when doing errands. I suppose I’ve accepted mask wearing, because it makes me less anxious about all the horrible news I’ve heard about younger people in their 40’s having significant problems such as multiple brain blood clots (strokes) and those in their 20’s & 30’s having persistent, significant shortness of breath and fatigue which limits their ability to be productive. I wish for all of us to be safe and at peace with our world. A small part may be seeing the invisible with gross pictures of people sneezing to encourage us to wear masks. I won’t spew on you and vice versa. My new motto could be: keep your spew to you! That’s terrible, but here’s hoping your days are anything but.

In health of all varieties,

Dr. V

COVID-19: The New Invisible Man

Creating Safety.

In theaters recently was an updated version of the Invisible Man. It was impressive with superb acting, effects and reasonably explained tech that satisfied this life-long science fiction reader. Horror is not my bag, a comment which reveals my late 70’s upbringing. You get two options and both involve death.

I stopped watching anything with a hint of scary after a short time period of sibling bonding over early Godzilla and other gory flicks. The images left me panicked at night for months. To be fair, my Mother had five children within a seven year span and was reasonably unaware of the oldest two watching early morning tv on the weekend.

Recently, after a day of much productivity, my spouse and I decided to check out available movies. Action tropes make me skittish like I need to simultaneously be on a treadmill alongside the running heroine and romantic stories’ unremitting tension and longing is a strain. Nothing else looked interesting at the local theater. That leads me back to the Invisible Man.

sibling bonding over early Godzilla flicks.

The characters fight against an unseen enemy which involves wild punching and lashing out into apparent emptiness, usually with a knife. The fear is palpable and attempts at self-protection seem ineffectual. This beast of a virus, Covid-19 works similarly. It is unseen, hiding in plain sight, and kills people. So, how do I stay sane and safe in this universe?

I recognized that creating a safe haven started in my mind. Below is my plan of action. Yours will be different based on your specific circumstances. My goal: make decisions that decrease stress. It’s about honoring what you need to feel safe. I review daily up to date information from trusted sources, like the CDC, but I limit the time spent. I look for useful information that changes my plan of action, not inundate myself with repetitious and stressful images.

Viruses are tiny, replicating and mutating quickly, but they have their weaknesses. You have to be exposed to a certain amount of viral particles to cause disease and have a body that is susceptible to that particular virus. Many live on surfaces for 72 hours and their entry into bodies is through orifices: eyes, nose, mouth and hands as the freeway delivery system. So, I guard my entry points. I consider my hands “contaminated” until they’re washed and face unsafe until it’s covered. You also wear a mask as a courtesy to others, so you won’t spread your stuff around. Don’t be the carrier that makes the susceptible person sick.

I’ve decided to make my body stronger so it can protect itself better by using with the data that is known: add veggies and greens. All around the world multiple studies show this, but how? I hide my veggies. Dr. Wahl’s (Wahl’s Protocol,TM) cooks amazing skillet meals with onions, garlic, oil and handfuls of greens and veggies. Yum. I put handfuls of spinach leaves in my coffee smoothie – can’t taste the greens. I can’t stand squash but after heated and pureed into spaghetti sauce, I don’t notice a thing. I make hearty, easy meals. Check out online Powerhouse Foods, by Jennifer DiNoia. Add in the good stuff. Yes, I have cravings and I tell myself, “don’t stop and get something you’ll regret”. You can find a healthy version online.

Complicated systems create stress. During a conversation about how best to protect yourself, a friend was nitpicking about all the choices she makes in deciding when and where she should wear a mask or wash her hands. I simplified things. I leave the house; I wear a mask. I make sure my mask is comfortable and secure, so that I don’t have to fuss with it. I don’t move the mask unless I wash or sanitize my hands before & after. I wash my hands (front, back, in between fingers and nails) regularly with soap that is gentle, so it doesn’t rip up my skin. You get into a routine, then don’t have to think about it. It’s a good practice anyway.

You may ask: everything is opening up; is it safe? I personally still wear a mask and practice the same precautions until we are truly in the clear. I will review new cases to determine when I am comfortable not wearing “gear.”

This pandemic also got me thinking. What if we all wore masks and religiously hand washed every winter (Flu Season)? Perhaps the thousands that die from the flu yearly wouldn’t need to, because the carrier to susceptible transmission rate, us, was blocked. What do you think?

COVID-19 may seem like the frightening Invisible Man lurking silently in plain sight, but we don’t need to be consumed with fear of it. A cloth mask and some plain old soap and water are proven weapons in defeating this tiny foe. Healthy eating provides that extra layer of armor.