Parkinson's: Exercise

Why I Love Being a Rockyette

Broadway Babes Click on photo for larger image.

 

Last September when I signed up for Broadway dance classes with the Rockyettes, I had no idea what I lie ahead.

 

The Rockyettes' last dance performance of the season was on June 13, we turned in our glittery costumes and celebrated with a good-bye lunch on June 18. Our classes resume in September, but I am down in the dumps trying to figure out how I will spend my free time. I was never good at free time and if a course was offered on “how to relax,” I definitely would fail.

 

I love being a Rockyette because…

 

I feel healthy.

While I've heard murmurings of hip and knee replacements, strokes, heart attacks, cancer and rods in backs of some of the Rockyettes, at this point, I seem to be the only one diagnosed with Parkinson’s Disease. I like their attitude. They’ve heard it all, and it’s no big deal. The show must go on regardless.

 

I feel young.

Someone in the audience, who presumably was visually impaired, asked “Who is that little girl dancing with your group?” I chuckled when I discovered she was inquiring about me. Isn’t it ironic to look like a little girl but have an old person’s disease like Parkinson's?

 

I feel tall.

In the above photo, I’m the “little girl” on the far left. With the top hats, it’s difficult to determine if I’m the shortest dancer in the group, but at 5”1” (and shrinking) it’s safe to assume that I’m not the tallest. Dancing with tall women makes me feel tall.

 

I have high performance needs and love to entertain.

The Rockyettes certainly helped with my high performance needs. With nine performances in the month of May alone, as a group we’ve had lots of opportunities to entertain.

 

I admire Ann Kennedy, the director of the Rockyettes (also the founder, producer, instructor, choreographer and costumer).

Her unfailing patience and ready smile have brought joy to our lives as well as those for whom we have danced.

 

I am blessed to be a Rockyette.

Dancing Out of Our Comfort Zones

Click on photo for larger image.

 

Broadway Babes-6-6-08 I am filled with excitement and nerves. I drive into the parking lot at the North Jeffco Community Recreation Center in Arvada, Colorado at 5:30 PM last Friday night. This is the main event of the season for the Rockyettes, a tap and Broadway dance ensemble. I am dancing tonight as a relatively new member of this group.


Earlier today, my hairdresser transformed my hair into a sassy style and put on stage makeup including the requisite red lipstick. There is something about red lipstick that encourages me to develop a different persona. I am sweating through my makeup on this hot summer afternoon.

 

I walk into the building and into the theatre where 260 chairs are set up for tonight’s performance. Fifty women dancers, mostly seniors, wait to rehearse the closing bows. Each dance group has its own timetable of when to go on stage and how to bow. The music of “Can-Can” is blaring in the background.

 

The rehearsal is over at 6:00 PM, and the doors to the public are opened. My husband, Tom drove separately. He waits in line with his two pans of homemade poppy seed coffee cake, baked from scratch by Tom himself, recipe courtesy of his late Czechoslovakian mother. This has become Tom’s signature recipe. Once people try it, they are addicted. It must be the poppy seeds.

 

My friend, Janet, calls earlier to confirm that a group of 17 people are accompanying her to tonight’s performance. I assume that the 17 are from her line dancing class. Ten other people confirm their attendance directly with me so now I am up to 27. I am stunned.

 

I am also surprised to see two men waiting in line that I knew from an accordion band that I played with several years ago. One of the men even had his accordion in tow because he was afraid that if he left the accordion in the car, the wax in the reeds would melt.

 

I proceed to the dressing room at 6:00, still astonished that so many people would choose to spend their Friday evening watching the dancing seniors. The Rockyettes performance begins precisely at 6:30 and ends exactly at 7:45. We move like clockwork, with beautifully designed costumes, different for each number. I dance in two of the Broadway dance songs.

 

When we enter the stage, I look directly into the audience. I cannot see anyone because the lights are turned down except for the stage lights, which are turned up. I see a silhouette of Tom who is snapping pictures at stage left. I dance and smile to the presumably full house, not knowing whom from those I invited are in attendance. The dancers are having fun and at that moment, everything else doesn’t matter.

 

After the finale of “Can-Can” and the closing bows, the house lights are turned on. I head off stage for the main floor to visit with friends and enjoy refreshments, including Tom’s coffee cake.

 

The biggest shock of the evening is seeing my accordion teacher and band director, Alice with her band members that I played with in my earlier Parkinson’s days. Alice conducts an accordion band every Friday night. The previous Friday, Janet (yes, the same Janet, a line dancer and accordionist who invited 17 people) informed the band that she wouldn’t be attending the following Friday because she wanted to see me dance. Alice’s and the band members immediate responses were “me too.” Alice cancelled band for the following week. In the 14 years that I have known Alice, she never cancelled band for any reason. This was a first for Alice.

 

And this was a first for me… While dancing tonight, I feel and look as though I don’t have Parkinson’s.

 

It seems like we are all dancing out of our comfort zones.

Davis Phinney Celebrates His Biggest Victory through DBS

VictoryCheck out Sports Illustrated's story by Austin Murphy entitled:

Davis Phinney Celebrates His Biggest Win (so far) at:
http://www.sportsillustrated.com/2008/writers/austin_murphy/04/28/phinney/index.html

Related Links:


Phinney hits last step of Parkinson's surgical relief plan
The Associated Press
Published: April 26, 2008
http://www.iht.com/articles/ap/2008/04/25/sports/CYC-Phinney-Surgery.php

Dancing with Parkinson's Continues to be a Hot Topic

Kate32Photo of Kate Kelsall taken by Linda Crist
Costume by Ann Kennedy
Click on photo for larger image

Dancing with Parkinson's continues to be a hot topic. On CBS Evening News on April 15, Katie Couric did a segment featuring Pamela Quinn and dancing with Parkinson's.

See link:

Dancer Stays on Her Toes - Despite Disease
CBS Evening News, April 15, 2008
http://www.cbsnews.com/stories/2008/04/15/eveningnews/main4018728.shtml

Also, Pamela Quinn wrote an article in Dance Magazine in December 2007. See link:

Moving Through Parkinson's
By Pamela Quinn
Dance Magazine, December 2007
http://www.dancemagazine.com/issues/December-2007/Moving-Through-Parkinsons

Related Stories:

Rocking with the Rockyettes
http://katekelsall.typepad.com/my_weblog/2008/03/rocking-with-th.html

Dancing with Parkinson's
http://katekelsall.typepad.com/my_weblog/2008/02/dancing-with-pa.html

New York Times’ Article Reports That Davis Phinney is Having DBS at Stanford

Davis_phinney
Take a look at the article in The New York Times by Juliet Macur entitlled, For the Phinney Family, a Dream and a Challenge.

Source:
http://www.nytimes.com/2008/03/26/sports/othersports/26cycling.html?_r=1&scp=1&sq=davis+phinney&st=nyt&oref=slogin

Related Story:
Successful Surgery for Cycling Great Phinney

Rocking with the Rockyettes

Kate6

Click on photo for larger image
Rocking with the Rockyettes
Story by Kate Kelsall
Copyright © 2008
Photo by Linda Crist
Costume by Ann Kennedy

I always wanted to be a tall, long-legged dancer performing with the Rockettes at Radio City Music Hall in New York City. Hovering around five feet with short legs, I didn't quite meet the 5'6"-5'10" height requirements. Besides I live in Colorado and have Parkinson's disease (PD).

Nearly 12 years ago, I was diagnosed with PD, a chronic, progressive brain disorder that causes shaky limbs, slowness of movement, stiff joints, and poor balance. Theoretically, I shouldn't be able to dance with PD.

However, to challenge myself, I recently enrolled in a Broadway dance class. I didn't realize that the dancers in the class would be expected to perform with the Rockyettes—Colorado’s answer to the Rockettes. The Rockyettes are a Colorado dance troupe of young-at-heart women who dance and perform to Broadway show tunes. While I am learning Broadway dance, others take tap dancing lessons and the brave ones take classes in both. Ann Kennedy, the fearless and exuberant leader, wears multiple hats in her roles as director, choreographer, costume designer, and seamstress.

When I dance with the Rockyette’s, I look and feel as though I don’t have Parkinson's. I exhibit few visible signs of my movement disorder when dancing with this troupe—no tremor, no dyskinesia, and little stiffness or slowness in the dance moves. For example, when I perform to “Singing in the Rain,” my body is transformed into that of my pre-Parkinson's self. I have even heard of people with PD who have difficulty walking, but somehow manage to dance.

In addition to the physical symptoms of PD, I also suffer some cognitive difficulties. I have some problems with memory impairment, focusing my attention, getting distracted, shifting attention, and slowness of thinking. I don't have the mental flexibility that I once had. With my PD brain, it takes more than repetition to remember dance steps and recall the sequence of the dance combinations.

I tackle my PD-related cognitive problems as I would in my pre-PD days when working as a Certified Public Accountant. I scrutinize the dance video, starting and stopping the tape until I can identify the dance steps. For each song, I set up a spreadsheet on the computer with two columns—the lyrics to the song in the left column and the corresponding dance steps in the right column. Often the dance version of the song has no lyrics so I locate the lyrics on the Internet and cut and paste them to the left column.

Dance has improved my posture as well as improved my balance, body alignment, cardiovascular health, and muscle tone. Dancing boosts my brain power. My aging, PD brain is sharpened by memorizing the dance steps and particularly challenged by learning the sequences of dance combinations.

The social aspects of dancing with a group are often underrated. Practicing the dance steps on my own doesn’t provide the same social benefits I get from dancing with the group. It lifts my spirits to be a part of a community that shares its joy of dancing with others.

I’ll never be good enough to dance with the Rockettes, but I can still have fun dancing and performing with the Rockyettes. I’m letting go of my perfectionism. I’m now enjoying doing what I really want to do, for as long as I am able to do it.

Related Links:

Instructor Leading Dance Students Back Into Step
By Chris Dimick

Finding New Life Through Movement
By Dawn Fallik

Parkinson's Sufferers Get Their Groove Back Through Dance
By Anne Gehris

Dancing with Parkinson’s
By Kate Kelsall



Dancing with Parkinson’s

Kate5Photo of Kate Kelsall taken by Linda Crist
Costume by Ann Kennedy
Click on photo for larger image

I knew that I was an anomaly as a person with Parkinson’s who plays the accordion. I was hoping that I wasn’t the only one with Parkinson’s who experiences the joy of dancing. I was delighted to learn that others feel the same: patients are dancing, journalists are writing, and doctors are researching the benefits of dancing for Parkinson’s patients.


The following is list of what I've discovered so far:


Articles:

Striking a Chord
By Anthony A. Davis
Apple Magazine, July-August, 2006, pages 26-30
http://www.calgaryhealthregion.ca/apple/2006_july-aug/apple_magazine_july-aug2006.pdf

Parkinson's Sufferers Get Their Groove Back Through Dance
By Anne Gehris
Columbia News Service Nov. 1, 2005
http://jscms.jrn.columbia.edu/cns/2005-11-01/gehris-parkinsondance

Finding New Life Through Movement
By Dawn Fallik
http://markmorrisdancegroup.org/press_releases/61?set=company_recent

Why Exercise Helps People With Movement Disorders
By Dawn Fallik
Neurology Now, Jan/Feb 2007
http://www.neurologynow.com/pt/re/neuronow/fulltext.01222928-200703010-00017.htm;jsessionid=HkpRLC2xSQDhHHWylPH2DGSD3vRGrkLLJNpn6M27G20TXGyD2gBR!238297732!181195628!8091!-1

Getting Their Groove Back, With Help from the Magic of Dance
By Rosyln Sulcas
New York Times August 25, 2007
http://www.nytimes.com/2007/08/25/arts/dance/25park.html?ei=5070&en=989d2d27ebaf65e2&ex=1189396800&adxnnl=1&adxnnlx=1189278084-bNgL9RX5+NOguENtaVGBxQ&pagewanted=print

Mark Morris Dance Class Aids Parkinson's Sufferers
By Joyce Shelby
New York Daily News, Oct. 23, 2007
http://www.nydailynews.com/ny_local/brooklyn/2007/10/23/2007-10-23_mark_morris_dance_class_aids_parkinsons_.html

Tango Improves Balance, Mobility In Patients With Parkinson's Disease
http://www.nwpf.org/news.asp?item=2107

Dancing: Could It Provide a Clue to Curing Parkinson’s?
By Cynthia Ross Cravit
http://50plus.com/Health/BrowseAllArticles/index.cfm?documentID=9680

Moving Through Parkinson's
By Pamela Quinn
Dance Magazine, December 2007
http://www.dancemagazine.com/issues/December-2007/Moving-Through-Parkinsons

Dancer Stays on Her Toes - Despite Disease
CBS Evening News, April 15, 2008
http://www.cbsnews.com/stories/2008/04/15/eveningnews/main4018728.shtml

Book:

Musicophilia: Tales of Music and the Brain
By Oliver Sacks
http://www.amazon.com/Musicophilia-Tales-Music-Oliver-Sacks/dp/1400040817/ref=pd_bbs_sr_1?ie=UTF8&s=books&qid=1201985986&sr=1-1

Blog:

Parkinson's Patients: Yes We Can Dance
http://parkinsonsdance.blogspot.com/

Related Story:

Rocking with the Rockyettes
http://katekelsall.typepad.com/my_weblog/2008/03/rocking-with-th.html

What‘s the Scuttlebutt about Yoga and Parkinson’s

SkuttlebuttThere's been a lot of talk about the benefits of exercise and Parkinson's. I started taking yoga classes for managing my Parkinson’s about ten months ago. I'm excited about its enormous benefits. I've experienced: More frequent periods of calmness and relaxation
Better sleep
Less stiffness and rigidity in body and learning yoga exercises to help manage these symptoms
Better posture
Better balance
Friends and neurologist say “You don’t look like you have Parkinson’s.”

Some of the resources I've discovered include:

Articles by Paul Zeiger, one of my yoga teachers and an expert on yoga for Parkinson's. He currently leads a yoga class for people with Parkinson's at Scheitler Recreation Center in Denver, Colorado on Wednesdays at 11:00 a.m.

Yoga and Parkinson’s
http://katekelsall.typepad.com/my_weblog/2007/05/yoga_and_parkin.html

Why Yoga Can Be Helpful to Those Living with Parkinson’s Disorder
http://katekelsall.typepad.com/my_weblog/2007/12/why-yoga-can-be.html

Considering Yoga as a Parkinson’s Disease Exercise
http://myparkinsonsinfo.com/articles/considering_yoga_as_a_parkinsons_disease_exercise

Other Resources:

The Book of Exercise and Yoga for Those With Parkinson's Disease (Plastic Comb)
by Lori Newell

http://www.amazon.com/Book-Exercise-Those-Parkinsons-Disease/dp/0976588102

Parkinson’s Disease and the Art of Moving
By John Argue

http://www.amazon.com/Parkinsons-Disease-Moving-John-Argue/dp/1572241837/ref=pd_bxgy_b_img_b

Yoga and Parkinson’s Disease
http://www.iayt.org/site/publications/parkinsons.pdf

Moving On With Parkinson’s
By Peggy van Hulsteyn

http://www.yogajournal.com/health/2515

Yoga for Parkinson’s
By Jeanette Macturk

http://www.positivehealth.com/article-view.php?articleid=70

Why Yoga Can Be Helpful to Those Living with Parkinson’s Disorder

Paul_zeiger_20070725_006Click on photo of Paul Zeiger and his wife, Carolyn, for a larger image

Why Yoga Can Be Helpful to Those Living with Parkinson’s Disorder
By H. Paul Zeiger, Ph.D.
Yoga Instructor, Anusara-Inspired™
Copyright © 2007

Controlled experiments on the use of yoga with Parkinson’s Disorder, although so far small, have shown highly statistically significant positive results. The following observations are distilled from my own experience with the effects of Parkinson’s and yoga on my body and those of my yoga students.

1. My body (and most bodies, I believe) adapts very quickly to anything I do not ask it to do. If I don’t use a certain range of motion, it goes away; if I do not challenge the strength of some muscle, that strength goes away; if I do not engage in actions requiring a certain coordination of muscles, that coordination goes away, and with it the actions. The above adaptation to disuse is normal, and was always there, but Parkinson’s has accelerated it.

Yoga has been refined over centuries to work against each of the losses listed above. A yoga practice with a sufficient variety of poses challenges, and therefore builds, muscles all over the body together with the range of motion of all limbs plus the spine. Each pose also challenges and builds coordination by working certain muscles in concert with each other, others in opposition to each other.

2. Many common actions require coordinating a large number of little-noticed muscles. A good example is reaching out for something. Moving the upper arm and shoulder calls for the coordinated action of at least thirteen muscles. Parkinson’s compromises this (unconscious) coordination, but sometimes conscious coordination can replace it. Examples include consciously lifting feet and swinging arms when walking.

Yoga practice promotes awareness of the actions of muscles, and the ability to isolate the actions of some muscles from others. This enhances the ability to coordinate by conscious effort that which was formerly coordinated automatically.

3. Parkinson’s compromises balance.

Yoga provides many poses for practicing balance. Many of them have modifications employing walls, chairs or assistants that make the balance poses accessible to those whose balance is already compromised. My experience with yoga for those in their 70s and 80s, and also with my own body, is that the ability to balance responds well to practice – even more quickly than strength and range of motion.

4. I inherited certain mild postural misalignments. They have tended to worsen with age, and Parkinson’s has accelerated the worsening.

The refinement of yoga over the years has resulted in poses that work particularly strongly against common postural misalignments. A good example is the rounded shoulders plus head forward posture promoted by both deskwork and Parkinson’s. Many back bends and shoulder openers work specifically on this alignment. Another example is habitual over or under arching of the lower back. Either of these tendencies can lead to strain and pain in the lower back. Certain yoga poses teach awareness of this alignment, and enhance control over it so that the lower spine can be protected in every day use.

5. Often, an apparent, but not real, lack of range of motion is caused by the lack of muscle strength or coordination to put the body part there. This can be detected, and sometimes countered, by (carefully) putting it there with external forces.

When an action cannot be accomplished, not due to lack of range of motion, but due to lack of muscle or control to make it happen, an experienced yoga instructor can sometimes bring about the action through external aid using blankets, blocks, straps, or hands-on assistance. This gives the student a start on feeling the action and perhaps learning to accomplish it without the external aid.

6. Parkinson’s tends to interfere with breathing in subtle ways.

Yoga emphasizes awareness of the breath and maintenance of healthy breathing throughout the performance of poses.

7. No regimen is likely to be practiced often enough and regularly enough to be helpful unless it is reasonably safe and reasonably fun. In this regard I have been blessed with inspired teachers. They have made my practice fun through good fellowship, humor, and enjoyment of a pose done well. They have also taught non-competitiveness and the intelligent substitution of easier poses for harder ones to create a safe practice while maintaining a beneficial level of challenge.

These same teachers have maintained an infectious positive, openhearted attitude throughout each class, and have ended each class with a period of deep relaxation that encouraged a continuing peace of mind. I aim to create a similar environment for the students in the classes I teach and for myself in my own practice. This has allowed me to maintain a varied and widely beneficial practice into my 70’s, and appears to have greatly slowed the effects of Parkinson’s on my ability to perform daily tasks.

8. Finally, neurologists are strongly recommending exercise for their Parkinson’s patients, but report that few actually exercise. Many with PD believe that yoga will be too challenging and uncomfortable. In therapeutic yoga the poses are adapted to the needs of the individual, thereby creating a program that is both doable and beneficial, while also a positive experience.


See Paul's other article on blog entitled Yoga and Parkinson's.

Lifting the Weight of Parkinson's

Neil_pd_benchpress_4

Lifting the Weight of Parkinson's
By Neil Sligar
Copyright © 2007

I'm a sixty one year old Australian man who has exercised vigorously for nearly eight years despite Parkinson’s disease. I have no formal medical or paramedical qualifications so other than for some safety tips, my remarks are descriptive rather than advisory.

My exercise regime is not alternative medicine. I visit a neurologist and take the medication he recommends. He’s aware of my exercise habits.

At Christmas 1999 in an exchange of emails with a friend, I learnt that she had advanced breast cancer but was getting out each day and running as far as her energy permitted. Mary reminded me that long ago I’d been very fit.

Fit no longer. I was now flabby, overweight, and with little stamina after sitting down for most of the past twenty-five years to thirty years.

It was time to pull myself into line. Getting PD had been beyond my control. Succumbing to heart disease or stroke was largely within my control. For the latter conditions, we know we should eat less, lower the proportion of fats in our diet, and devote regular time to physical activity.

I knew that Parkinson’s disease was as yet incurable but wondered whether anything I could do might delay its symptoms?

In January 2000 my lifestyle changed. I located a gym and introduced myself. Michelle, the gym manager took seriously my wish to train hard. She certainly obliged me on that score. When she called for ten repetitions of some exercise, it was made clear that ten was not the same as nine. Michelle mapped out a program based on improved flexibility, improved stamina, and improved strength. She assessed my capabilities then set targets requiring near-maximum effort.

My routine was, and remains, based on improving flexibility, stamina, and strength. I speculated that stretching should ameliorate the rigidity of PD, running or riding would maintain my heart and lungs, and strengthening my body may delay a stooped posture. Regardless of its impact on PD, exercise could only be good for my general health.

As for anyone starting afresh on vigorous exercise it’s mandatory to ensure through a medical practitioner that our hearts are up to it.

Setting small targets has been critical to my improved performances. Focus on tiny gains in the near future rather than big goals in the long term. You can surprise yourself how far you reach. For example in 2001 I would have worked hard to bench press 60 kilograms (132 lbs.). By 2005 I’d achieved a bench press of 105 kilograms (231 lbs.). I weigh around 87 kilograms (192 lbs.).

My training regime has never been shaped specifically as therapy for Parkinson’s disease. Flexibility, stamina, and strength are as relevant for someone without PD as someone who has PD. Further, when exercising I work out vigorously. You’d get a very dark look if you told me to “take it easy.”

Specific weights exercises are not repeated at the next session nor are weights lifted on consecutive days. This helps prevent muscle soreness through overuse and helps retain enthusiasm. Each activity has a required time, resistance, or number of sets and repetitions. Discrepancies are marked when a target is significantly overachieved or underachieved. When a target is exceeded, the level reached becomes the new target. Around every six weeks, I analyse my performance on each routine, set new goals, and change some of the exercises.

I broke with this discipline for several months after shifting to a new gym this year. Performances were recorded without targets being set. Attained levels suffered. I’ve resumed the target-setting discipline that’s served me well.

My sessions last for around an hour. Typically, I stretch for around five minutes. Then I might take up to five to ten minutes “loosening up” with push-up variations or sit-ups on a fitness ball. For example, I’ll do three sets of push-ups, 25 being performed with feet on top of a 65 inch fitness ball and hands on the floor, 25 done with feet on a weights bench, then as many as possible done in standard position. Half an hour follows with weights, working on different areas of my body. I finish with around fifteen minutes on the treadmill or bike. The treadmill is my weakest exercise area. I run at 10 km./hr. for up to eight minutes before fatigue through shaking and rigidity in my right arm causes me to walk. I’ve set a goal is to run for ten minutes by the end of next month.

Whatever activity you choose, it has to be something you’ll enjoy. We’re not talking of a 10 week weight loss program or a 10 week program to make you look great in swimming attire. We’re talking of a lifetime habit that’s as normal as a daily shower. I go to a gym. You might prefer walking long distances, swimming, dancing, or something else. Just do it as vigorously as you can.

If increasing strength is an essential part of an exercise program then it’s just as important for women as men. Lifting weights as outlined here won’t make women look like Arnie.

If gym activity is your goal, gain advice on appropriate exercises and technique from someone qualified and working at a gym belonging to the relevant professional association.

Safety must be paramount.

· With a new weights exercise, commence with a weight well short of what you feel you can lift. Increase from there.

· Always ask that a “spotter” (an assistant) stands ready to help in lifts where the weight could fall on you. Pick a spotter who can lift more than you can. Otherwise, pick two.

· Never lift free weights above you when you’re alone in the gym.

· If you have problems with balance, hold on when on the treadmill or any other equipment from which you could fall.

· If it hurts, don’t do it. Stop immediately.

· If you become dizzy, stop. Find out why you became dizzy.

· If a muscle is sore, give it a rest.

Some tips I’ve found helpful include:

· Stretch at the beginning of your session.

· If you wish to emphasise the aerobic side, then do your cardio before the weights. If your focus is on beating your lifting targets, then do weights first but don’t ignore the cardio.

· Begin slowly with the cardio or lightly with the weights. My experience suggests that starting with lighter weights may be even more important for someone with PD. Our muscles are more rigid and may require more gradual stressing. Start at, say, 50% to 60% of your maximum. For example, my bench press routine is 8 x 60% of maximum, 6 x 70%, 5 x 80%, 3 x 90%.

· Don’t ignore resistance level when riding the static bike. Anyone can ride quickly downhill. On bikes with a resistance scale of 1 to 20, my default position is an rpm of close to 80 (it tends to wobble between 78 and 82) at a resistance of 12. I take three or four minutes to build up to 80 rpm. This default rate applies to me only. Other people will differ. My default hasn’t decreased in my years at the gym.

· Aim to strengthen a number of parts of the body during each session rather than concentrating on one area (e.g. arms). This should assist in preventing muscle soreness from overuse.

· Don’t bench press, leg press, or squat your maximum lift (the most you can do in one set of one repetition) more than once every 3-4 weeks. Our rigid muscles seem more prone to strain and may take longer to recover from peak stress.

· Work near your maximum. As a rule of thumb, an appropriate weight would be a level at which you fail at the end of three sets of eight to ten repetitions. As you become more experienced, you may increase the weights but lower the number of repetitions at your heavier weights.

· Record your performances. You will then more easily note whether there’s a problem through fatigue, medication off period, or something else. I have difficulty writing, so my targets are typed in 16 point size. I only write a notation when a target is over or underachieved.

· Don’t compare yourself with others in the gym. Your best effort is as good as someone else’s best effort.

· Wear clothing that is comfortable, clean and appropriate for what you’re doing.

In a report handed to Parkinson’s Australia in June 2007, Access Economics noted that death attributed to respiratory diseases had a 50% higher incidence in people living with PD than in the general Australian population. Deaths specifically from pneumonia and influenza were at double the rate of the general population. (Access Economics, Parkinson’s: Economic Impacts and Positive Steps, 2007). The report can be found at:
www.parkinsonsnsw.org.au > About Parkinson’s Disease > 2007 Report on PD (Access Economics)

This is confirmation enough for me that a little regular huffing and puffing is important for those of us with PD.

Whether or not vigorous exercise has slowed progression of my PD symptoms, I don’t know. My situation is that at 61 years of age, nine years after diagnosis, I remain working full time from my home office. I take one medication only, Sinemet, 100 mg. levodopa, 25 mg. carbidopa, at six tablets per day. I belong to my local Parkinson’s support group and served on Council of Parkinson’s New South Wales for two years until 2007.

I work out at Aquafit gym at Campbelltown, New South Wales at:
http://www.cathclub.com.au/index.cfm?page_id=1079

Generous assistance has been given to me in exercise nomination and technique by gym staff. I’m also indebted to the excellent website of Krista Scott-Dixon in Toronto at: www.stumptuous.com

This article has been written as general observations only. Seek professional advice for your own situation.

Neil Sligar
Sydney, Australia

Dialoguing with Disease: Part II or Rockyettes not Rockettes

I thought I had reconciled with Parkinson’s (PD) when I posted Dialoguing with Disease. But the saga continues in today’s entry in my journal.

Kate: I woke up this morning, and I felt your presence with my shaky hands. I haven’t noticed that tremor of yours for a while.

PD: Yeah, you haven’t noticed me for a long time! I was trying to get your attention.

Kate: Well, you got it! You had my attention before with the dyskinesia, your involuntary flailing of my arms. But now that the dyskinesia has subsided with the expert programming of Dr. Olga, your tremors returned and woke me this morning out of my sound sleep. What are you trying to say?

PD: I am trying to get you to notice me with my metronome-like, rhythmic tremors. You walk around with your snooty attitude as though I don’t exist.

I overhead you boast to Tom: “When I look at myself in the mirrors at my Broadway dance class, I don’t look or feel like I have PD.” And then you signed up to dance with a group called the Rockyettes* because you always wanted to dance with the Rockettes. And you didn’t tell Ann Kennedy, the leader of the Rockyettes that you had Parkinson’s until after she asked you to join her group.

Kate: That’s all true. I’ve always wanted to dance, and outside of a couple of years of jazz dance lessons during the honeymoon stages of you and me and PD, I haven’t pursued it.

I was always one of those kids who was never good at sports. But now as an adult with PD, I have a different attitude toward fulfilling my dreams. I’ll never be good enough to dance with the Rockettes, but I can still have fun dancing with the Rockyettes. I’m letting go of my perfectionist standards of “having to be good enough” to perform. I’m now enjoying doing what I really want to do, for as long as I am able to do so.

PD: You have a point. I’ve heard that dancing can really help those with PD loosen their stiff joints, improve their balance and increase their overall movement. And just getting out of the house and being a part of a community, can lift your spirits.

Kate: And I only told Ann, the leader AFTER the first class because I was afraid that she wouldn’t allow me to join. Quite the contrary, once I told her about having PD for eleven years, she continued to be supportive of me participating (She must have been desperate for dance members!). In fact, Ann said that she wouldn’t have known that I had PD, but she should have known because her brother also has PD.

PD: As long as Ann knows about you having PD and you are monitored, I guess it’s okay.

Kate: It looks as though “I’m in” as I was measured for my dance costumes. So for now, I’ll pretend you, PD, don’t exist, and I'll keep on dancing.


*Note: The Rockyettes are a Colorado dance troupe of young-at-heart women. They dance and perform to Broadway show tunes and hits from the 40’s and 50’s. Ann Kennedy is their fearless and exuberant leader, who wears multiple hats in her roles as director, choreographer, seamstress and costume designer.

Pedaling Past Parkinson’s

I have a fantasy that one morning I will wake up and a researcher will have discovered a CURE for Parkinson’s (PD). We all want a cure, not just a temporary Band-aid on the PD symptoms.

As I was resting on my yoga mat this afternoon, my ears perked up as I heard the lead into a story on TV about a CURE for PD.

The story on TV featured neuroscientist, Jay Alberts, Ph.D from the Cleveland Clinic, who used "forced exercise" (forced to exercise at a rate that’s faster than one’s voluntary rate) on a tandem bicycle to treat PD. Today’s story on TV featured Parkinson’s patient, Steve Derman.

In my pre-PD days, my husband Tom and I enjoyed bicycling in the Canadian Rockies, and took week-long bicycle trips in California, Vermont and Wisconsin. Since being diagnosed with PD in 1996, my bicycle riding has almost come to a halt.

Why this study fascinated me:

During a bike ride across Iowa in 2003, Dr. Alberts rode on a tandem bike with Cathy Frazier, a person who had Parkinson's. The patient was forced to pedal much faster than she would have normally – between 80 RPMs and 90 RPMs (revolutions per minute) as opposed to between 50 RPMs and 60 RPMs.

Then in 2006, Dr. Alberts rode again with another Parkinson's patient and also a neurologist, Dr. David Heydrick. This patient depended on a surgically implanted device called deep brain stimulation to control his symptoms. If the device was turned off, his symptoms returned immediately. Dr. Alberts and the patient went on a 50-mile tandem bike ride with the stimulator turned off, and to their delight, the patient had no symptoms.

In his clinical study at the Cleveland Clinic, Dr. Alberts has patients come in over a period of eight weeks, three days a week for a one-hour tandem bike ride session. Results show after the eight weeks, patients have on average a 30-percent improvement in their symptoms. Two weeks after the study is over, patients still have about a 20-percent improvement.

Dr. Alberts says with medication patients typically have slightly less improvement. And with deep brain stimulation, patients have between about 30 and 40 percent improvement, which is about the same.

But as he points out, "If you stop taking medication, the disease symptoms come back within a few hours, and these often have side effects. And with deep brain stimulation, you turn the stimulator off and the symptoms come back almost immediately." He's excited by the fact that the symptomatic improvement from tandem exercise is sustained for weeks.

Patients are working the lower half of their body – yet symptoms in their upper half improve. Dr. Alberts says, "That suggests that we’re changing the way the brain is actually functioning."

I wonder what Davis Phinney would say about this approach to treating PD.

In the meantime, Tom and I will try to rig up something in the basement to simulate “forced exercise” on our exercise bike at a rate of 80-90 RPMs.


Related stories at following links:

Motor Function Improvements with Tandem Bicycling-NeuroTalk Communities
http://neurotalk.psychcentral.com/showthread.php?t=22265

Researchers Study Power of Pedaling to Dull Parkinson's-National Parkinson Foundation
http://forum.parkinson.org/forum/viewtopic.php?p=4646&sid=3cc4f94c2cb6f52cf3281b39c30462db

Researchers Study Power of Pedaling to Dull Parkinson's-The Plain Dealer
http://www.cleveland.com/news/plaindealer/index.ssf?/base/news/1181550647206850.xml&coll=2

Doing Handstands

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Photo: Copyright © 2007 Deborah Fryer, www.lilafilms.com


When I grew up in Kansas City, I was a geeky, goody-goody girl who was never athletic. I was the last one chosen for volleyball in the sixth grade gym class. I suffered through many years of swimming lessons, but never quite mastered the basic crawl stroke.

Surprisingly, I morphed into an athletic woman. Prior to my diagnosis of Parkinson’s Disease (PD), my husband Tom and I hiked, cross-country skied, ran, and biked in the US and Canada. But with PD, I slowed down and once again became a non-athlete until I discovered yoga. I was delighted to experience yoga’s benefits. My neck and back pain began to subside with yoga stretches, and my balance improved with yoga poses.

After taking yoga classes for three months, the instructor asked if we wanted to learn handstands. I surprised myself when I quickly volunteered, while many of the able-bodied were afraid to try. My strong yoga hands maneuvered my body up against the wall to the handstand position. Although my legs were propped up against the wall, it was a handstand, nonetheless. For a 57 year old woman with PD for eleven years, this was a major feat. Others later confirmed that this was indeed an accomplishment because most people with or without PD are uncomfortable being upside down. After having Parkinson’s and brain surgery, nothing much scares me anymore.

Handstands today, who knows what's in store for tomorrow.

No Cartwheels…Yet

I’m impressed, and I’m not easily impressed.

Some have criticized me for being unrealistic. Others have said that my expectations are too high and that I should lower them.

But today, I was impressed with myself. I did a hand stand at my yoga class. Mind you, it was a hand stand with my legs against the wall, but it was a hand stand nevertheless. For a 57 year old woman with Parkinson’s Disease for eleven years, this was a major feat. Many of the able-bodied in the class didn’t even attempt it. I wondered if I would have tried a hand stand last week, and if I would have been successful.

I had another impressive experience this past Monday when I had my first programming session with a Deep Brain Stimulation specialist who I affectionately call Dr. Olga. I’ve had a half dozen sessions in the past, but this was the first programming session with her.

I was convinced that the programming on my neurostimulator (similar to a pacemaker to the brain) was not optimally set. Within 20 minutes, Dr. Olga figured out the problem. The setting that affected the right side of my body was much too high and caused dyskinesia (involuntary writhing and flailing of arms and legs and head-rolling movements). The setting that affected the left side of my body was much too low and caused rigidity and stiffness. When Dr. Olga tested the results of her adjustments, she asked me to perform exercises such as the hand movements of the chicken dance, wave like the queen and tap the heel of one foot as high and fast as possible.

Dr. Olga, my husband Tom and I couldn't believe the dramatic improvement in my left side with the new settings. All three of us spontaneously said in unison, "It's amazing. It's amazing."

Dr. Olga kept the meds at the same level (with the goal of eventually reducing them), but now I take them every five hours instead of every three hours. I felt like a prisoner who was released from jail with this newly found freedom. Previously I was on a short leash, needing to be home every three hours, in case my Parkinson’s symptoms kicked in.

Dr. Olga was impressive, and I was grateful. I have reason to celebrate. I’ll let you know when I do cartwheels.

Yoga and Parkinson's

In the last several months, I’ve discovered yoga and have added it to my repertoire in managing the symptoms of Parkinson’s Disease. I’ve been blessed to experience a reduction in back, shoulder and neck pain as a result of the yoga stretches. I am a yoga newbie and do not know enough about yoga to adequately explain it. But one of my yoga instructors, Paul Zeiger, eloquently explains it in the following article. As with any exercise program, please consult your doctor before beginning yoga.


Yoga and Parkinson’s
A Report from the Inside
H. Paul Zeiger, Ph.D.
Yoga Instructor, Anusara-Inspired®
Copyright © 2007

There is mounting evidence that yoga is helpful to persons living with Parkinson’s disease (Yoga Journal, February 2007, p92) (International Journal of Yoga Therapy, No.15 (2005), p81). This paper is intended to add to the anecdotal evidence in ways that suggest techniques to be tried. I qualify as an insider due to my long experience practicing and teaching yoga and my experience living with my own Parkinson’s Disorder the last few years.

I have been practicing yoga for over 20 years, and teaching it for the last 16. My first teachers were from the Iyengar tradition, and for the last 10 years I have studied in the Anusara tradition, with over 280 hours in trainings led by John Friend. For the last 6 years I have led classes of devoted and highly disciplined students most of whom are in their 70s and 80s; they have demonstrated that there is much to be gained by a regular practice for people in that age bracket even, perhaps especially, if they have never done yoga before. These students have also given me a great deal of practice in modifying a pose to work around a student’s physical limitations while preserving the essence of the pose.

Several years ago I began to have a variety of subtle symptoms that did not appear to fit any coherent pattern. They included loss of sense of smell, oily skin, profuse sweating, daytime apathy, intermittent anxiety, and frequent interruptions of sleep. Then, little less than two years ago, after some weeks of difficulty sleeping, I awoke in the middle of the night to find that I could breathe or sleep, but not both at once. I was also urinating every 15 minutes and shaking like a leaf. I underwent a large battery of tests, and the doctors concluded that the only thing wrong was severe sleep apnea, which was treated with moderate success. But my wife (a Ph.D. psychologist) and I knew there was something deeper wrong. She asked for a Parkinson’s evaluation, but the physicians were convinced that sleep apnea was the whole story. Three months later she spotted the dragging feet and lack of right arm swing (not noticeable to me) that even more strongly suggested Parkinson's. Two more symptoms did get my own attention: handwriting going tiny, and loss of ability to kick up into handstand at the wall. A visit to a neurologist resulted in a positive diagnosis based on manifestation of all the primary symptoms.

Why did I not initially show the tremors and problems in moving that more often characterize early Parkinson’s? It could of course just be a variation in the form of the disorder from one person to another, but it also could be that yoga delayed the onset of the skeletal symptoms, so that the first symptoms to show up were in the autonomic nervous system. This possibility is supported by the experience of John Argue, author of the book, Parkinson’s Disease & the Art of Moving, who has been teaching motion skills to Parkinson’s patients for over 20 years; his students have been very successful in standing off the decline of motor skills.

An established yoga practice can serve as a medical diagnostic tool. My experience of losing Handstand is an example of this. About the same time Wheel pose (Urdva Danurasana) went away. Both poses require shoulder mobility, upper body strength, and coordination (to get up), and Parkinson’s was compromising all three. Interestingly, arm balances, like Crane pose (Bakasana), were relatively unaffected, indicating that difficulty getting straight arms over head was a key issue. With careful work I got both poses back, but Wheel was a lot harder, and was helped substantially by Parkinson’s medication. This example shows how yoga and conventional medical treatment can work together; it also illustrates the role of yoga as a diagnostic tool: my recovery of the pose indicated that the medication was working.

There is some debate at present regarding whether an early diagnosis of Parkinson’s is of any use, given that there is no known way of slowing the disorder’s progress. My experience suggests that early diagnosis would at least give one the opportunity to get a solid exercise program in place before the symptoms became onerous. It is generally easier to maintain a capability than to recover it, let alone develop it from scratch with a body that is already compromised. Early signs are more evident to those who have sharpened their awareness of the body by yoga. Continuous, close-up observation is powerful for early warning: my wife suspected Parkinson’s at least a year before any neurologist was willing to commit to that diagnosis. There are also early symptoms still being discovered. One that I and at least one acquaintance experienced might be called “amplified anxiety,” that is, a lot of anxiety in situations that would normally produce just a little.

Parkinson’s compromises certain physical abilities more than others. Therefore it calls for special emphasis on poses that support those characteristics. I have already mentioned shoulder mobility, which calls for backbends and shoulder openers. Then there is inner hamstring tightening, which calls for poses related to Wide Leg Forward Bend (Prasarita Padottanasana), and balance issues, which call for Tree pose (Vrkshasana) and its variations. I have also benefited from a modified Tree done with eyes closed and fingertips lightly touching the wall in order to tune up proprioceptive feedback.

There is a case for sprinkling mini-practices throughout the day. Even though nominally retired, I manage to fill up my days with commitments that compete with holding full 1 to 2 hour practices every day. In addition, I find it uncomfortable to go for long without some mild physical challenge. For both these reasons it has been useful to design little sequences of 2 - 6 poses that can be done without changing clothes and without preparation. Particularly useful are one sequence that can be done right in bed, immediately after waking up in the morning, in order to make the inherently difficult process of getting the body up and running quicker and pleasanter, and another, 5-pose, sequence that can be done in any clothes throughout the day and which lightly hits the whole body.

Yoga may provide resources for working around emotional, in addition to physical, symptoms. Having identified the amplified anxiety described above, I am now on the watch for it as well as for other amplified emotions, like anger or depression. Many such emotions, at a low level, are common in everyday life. (Response to an attempted and failed household plumbing repair springs to mind.) Most schools of yoga foster taking emotions seriously, but not unquestioningly, and that is a good way to treat amplified emotions: take note of them and act on them, but only if appropriate, and only at an appropriate level, not the amplified one. Of course, just knowing about the phenomenon of amplified emotions already softens their impact somewhat.

I believe in yielding no capacity before its time. Yoga, medication, and Jin Shin Jyutsu® (delivered by my wife, and that is another story) continue to be my principal tools for doing that in the presence of Parkinson’s Disorder.


For further information, Paul Zeiger can be reached by email at paulzeiger@aol.com or by phone at 303-954-8595.


See Paul's other article on my blog entitled Why Yoga Can Be Helpful to Those Living with Parkinson’s Disorder at:
http://katekelsall.typepad.com/my_weblog/2007/12/why-yoga-can-be.html

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