Chronicles of PD Fighter: June 2008

Monday, June 30, 2008

Speech and Parkinson's

Speech difficulty is very common among Parkinson's patients (about 80%). Unfortunately, it is also one of the most neglected areas in the management of PD. Medications are helpful. In fact, when one's voice becomes softer and less clear, it is a sign of progression of illness. In this case, adding new medications and / or increasing the dose of existing medications is helpful. Yes, speech therapy is also useful but there are probably less than twenty qualified speech therapist in Malaysia. ...

Medication and exercise

I was diagnosed as PD in the year of Sept 2005 and taking Sinemet 25/100 one tablet at morning, afternoon and evening and one Jumet 5 mg at morning and afternoon only. I did very well in my gym classes at gym centre 2 -3 hours per day from Mon to Friday as I did not feel tired and exhausted. I took part body pump, combat, cardio, spinning, Yoga and Pilate when there were available in the gym. After 2 years in the gym exercises i.e 2005 to 2006 I started tired and exh

My first encounter with PD

I wish to relate my encounter with PD disease symptoms for the past of 10 years. I understand we have so far 4 movement disorder specialists in Singapore i..e 2 in Tan Tuck Seng Hospital, 1 in General Hospital and other goes Private practice. We have only one in Malaysia. Therefore all the specialists are fully booked and have to make appointment with them for two to three weeks. All the neurologist s are not specialised in movement disorders and my PD yet to be detected. I was told that

Thirst signal leads to dehydration

Dear Friends,

Dehydration is unfortunately all too common among those with PD, especially older adults. Dehydration can have drastic consequences, ranging from urinary tract infections to confusion, dizziness, and falls. Although hot weather increases the need for water, the risk for dehydration is always a concern. The following information is important, and I hope you will all ...

Sunday, June 29, 2008

estrogen & testosterone worsen Pd?

Dear Doctor,
I read an article as follows:
I became curious as to effects of estrogen on males; both sexes seem to have varying amounts of estrogen and androgen--women have more estrogen, males have more androgen, but each has SOME of the other's primary sex hormone.
On what role estrogen may play in males' development of PD?
Can estrogen make worse in Parkinson's?
Kindly enlighten the subject and is helpful for Parkinson's
Thanks
TeoKimHoe

Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Mon Jun 30, 2008 2:12 pm Post subject:

It is unknown what effect estrogen has on the development of PD and especially unknown in males. Testosterone is converted in the body to estrogen so that is a factor that must be considered. Finally there are studies in women suggesting estrogen could be protective or have a symptomatic benefit in PD. Much needs to be researched on this topic._________________Michael S. Okun, M.D.

CAPTAIN COURAGEOUS by SC Chua

Mr. Teo Kim Hoe was diagnosed with Parkinson’s disease in September 2005. At a time when most people would sit back and enjoy their retirement lives, Mr. Teo was suddenly faced with a life altering disease. But such is life. When the worst of the storm hits and hurls your ship towards a pile of rocks, you either give up and jump ship or you summon your courage, do your best to steer the ship away from danger and say, “Is this the worst you can do?” In coping with this degenerative disease, Mr. Teo is the epitome of Captain Courageous, hence the appropriate nickname he adopted in his blog – “Hero Teo”.

Although his blog ‘movementdisorder.blogspot.com’ is not exactly Michael J. Fox’s Foundation for Parkinson’s disease, it records the extraordinary efforts that Mr. Teo has taken to combat this disease and his desire to share his knowledge with the world in the hope of reaching out to fellow Parkinson disease patients with the intention of helping them to the best that he can.

While many would stopped after knowing what is the best or latest medicine available for Parkinson’s disease and finding out the best procedure out there, Mr. Teo will not sit on his laurels until he finds out for himself the truthfulness of the representations concerning those medications and procedures. This often involves using himself as the test subject and facing the consequences of undesired side-effects, all these just to prove the effectiveness of the medication. He would then share all these experiences in his blog for the benefit of others. Captain Courageous? I have no doubt that he is.

If all his work and research would benefit and improve the life of even just one person, then Mr. Teo has achieved more than what many of us could do in a lifetime.

Yes, these articles are definitely very encouraging & they will add spice to your book. It will be a source of inspiration to other PD patients to follow in your footsteps!

Cheers,
Hooi Hoon

A new wave (Tsunami) against Parkinson's by Dr.NK Chew

Mr Teo's blog creates a huge impact on the world Parkinson's community because it contains the personal accounts of a great man who suffers from Parkinson's himself. Mr Teo is so frank to reveal and discuss his own personal and medical problems with the whole world.

Let me tell you this true story. Once, I made some honest but frank comments on a Parkinson's patient's lifestyle and medications. I told him that he should increase the dose of his daily medications as I thought that his treatment was too conservative (i.e. he was under-medicated). And I told him that he should also work harder in carrying out daily exercise programs such as morning walk and cycling at home. Finally, I told him that he was a bit too dependent on his wife in his daily activities. All I wanted was to encourage him to live a more physically active life.

This patient replied, "doctor, it is easy for you to say all these. I am the one who suffers from Parkinson's, and not you."

I was taken aback by this statement. Initially, I was a bit annoyed by this "rude" reply. But looking back, I don't think it was rude because there was a lot of truth in it.

It is easy for healthy people (including doctors) to make comments on Parkinson's patients. It is easy to say, "do this and do that". Sometimes, we tend to under-estimate or overlook the sufferings of Parkinson's patients because we (healthy people) don't feel what they feel.

The learning point from this story is that the best people to understand Parkinson's patients are the Parkinson's patients themselves. Therefore, it is important that Parkinson's patients share information and experiences with each other. One good way to achieve this is a Parkinson's blog, as the one which Mr. Teo has started.

I really hope that more and more Parkinson's patients will come up with their own blogs, and follow the footsteps of Hero Teo.

Dr Chew Nee Kong
Kuala Lumpur, Malaysia.

Dear Dr.Chew,

In response of your article Tsunami. .
It is the attitude of the Parkinson's makes the crucial differences.

They are self-conscious about Parkinson's symptom
How one reacts to PD (or anything for that matter) is of vital importance.
Thanks
Teo

Saturday, June 28, 2008

Friday, June 27, 2008

Are Vitamin supplements harmful for PD?

Posted: Sat Mar 29, 2008 5:56 am Post subject: Are vitamin supplements harmful for Parkinson's Patient?

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Dear Dr. Kathrynne Holden

Nutrition are importance for those with Parkinson Disease. Nutrition won't cure PD or slow its progression.

Why there are vitamins and mineral not suitable for Parkinson's Patients and are harmful for them to take?

There are Folic Acid, Chromium,Copper, Ferritin,Magnessium,Selerium, and Zinc

What are the normal level of these vitamins level (units)in our body?

In what level are considered harmful for Parkinson's patients and how to reduce to safe level?

How to monitor the vitamins and mineral level, periodly or yearly?

Best regards

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Kathrynne Holden, MS, RD

Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Sat Mar 29, 2008 7:28 am Post subject:

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Dear Friend,
People with PD have the same need for vitamins, minerals, and macronutrients as everyone else. Just as the rest of the population, they need annual physical examinations, including blood and urine tests, to determine whether any deficiencies exist.

Regarding normal levels, your doctor is the best source of information, and I recommend you discuss this with him or her.
_________________
Best regards,
Kathrynne Holden, MS, RD
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/

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Some vitamin supplements are not suitable for Parkinson's

Anonymous

Posted: Thu Jun 26, 2008 8:30 am Post subject: Vitamins

Dear Ms. Holden;

Does taking supplements (multivitamins, B12, folic acid and fish oil) after dinner or after breakfast make a diffrence to the body's activities.

Thank you

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Kathrynne Holden, MS, RD

Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Thu Jun 26, 2008 6:39 pm Post subject:

Dear Friend,
Only a few supplements are of importance in PD. Iron supplements and vitamin B6 in amounts larger than 10-15 mg can interfere with levodopa absorption; these should be taken separately from levodopa by about 2 hours.

Otherwise, the supplements you mention are fine; and all of them are best taken after meals, either breakfast or dinner should be okay. They should not interfere with any of the PD medications nor cause any unwanted PD symptoms.
_________________
Best regards,
Kathrynne Holden, MS, RD
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith

Good question!

I ran a Google search a minute ago; here's one "reliable source" (IMHO) that provides answers of sorts:

http://neurotalk.psychcentral.com/archive/index.php/t-3675.html

(snip):

Vitamin B6 in doses higher than 5 mg per day might also impair the effectiveness of levodopa, and should be avoided.42 However, if you take levodopa/carbidopa combinations, this restriction may not necessarily apply. Talk with your physician about an appropriate dose of vitamin B6.

(snip):

Other substances may also interact with Parkinson's drugs. Iron supplements can interfere with absorption of levodopa and carbidopa, and should not be taken within 2 hours of either medication.39 Amino acid supplements, such as BCAAs (branched-chain amino acids), can temporarily decrease levodopa's effectiveness, as may methionine and phenylalanine, two amino acids studied for treatment of Parkinson's disease.40,41

Hope this helps!

Thursday, June 26, 2008

My witness of a PD fighter by Rev. Bobby

My knowledge of PD (Parkinson Disease) broadened when I was involved in a PD awareness Sunday at KLBC some seven years ago when we were collecting an offering to support The Parkinson Disease Association set up by Dato’ Setia J. P Tan. He was a member of our church and was passionate to help those who are suffering from this aging disorder.

This whole subject of PD was set aside until I met Mr Teo Kim Hoe who bravely confessed to me that the doctor had diagnosed that he is suffering from PD. I was surprised that he had the courage to openly confess that he is a victim of PD. From my knowledge most people who suffer from this disease do not want to admit that they have PD in fear of rejection or discrimination. A lot of patients who suffer from this disease choose the path of denial rather than open confrontation of their sickness. But this was not so with Mr Teo as he took his predicament very calmly.

Actually as I look back, I notice some obvious signs and symptoms of PD in his speech and movement over the past three years. But as usual, I did not bring out the subject until it was confirmed. After all, I am not an expert in this field and it was best left to the doctors or specialists to make their professional diagnosis.

I would like to share some of my personal observations of Mr Teo, a victim of PD, on how he faces the new challenge that lies ahead of him when he was diagnosed as a PD victim. Over the past two years, I have seen the improvement in his sickness as well as the effectiveness of some of the steps he had taken to arrest the disease.

First of all, I must say that Mr Teo is a fighter within, as he does not give in to obstacles easily when they come his way. Instead of sitting down and mourning over his predicament, he took positive and aggressive action to deal with the sickness.

He not only sought doctors’ advice and second opinions on his sickness, he also ventured into the internet to search for information, in order to have a better understanding of the disease that inflicted him. The vast information and knowledge acquired from the net helped him to deal with his sickness comprehensively and calmly. He did a lot of research on the net that he constantly shared with me over the e-mail. I was amazed how much knowledge he acquired over a short period of time as he shared them with others who suffered the same predicament.

Besides getting to know the disease more comprehensively, he also took up physical exercise to help arrest and slow down the movement disorder from which he was suffering. He visits the fitness centre on a regular basis to exercise his muscles that are slowing down. It takes discipline and determination to do that. I was invited to join him on one occasion and I witnessed the passion and determination he put into his physical exercise, and that really put me to shame. I would say that not many people his age would have taken up that challenge, considering the fact that he is a PD victim. I admire his optimism and fighting spirit. Besides his faith in God, he is a man of action as well. He would not sit down and let his predicament take over.

It is not fair to say that Mr Teo single handedly took up the challenge to fight the disease by himself. Like all other patients, there are those who walk the rough path side by side with him, so that the path would be easier to walk. Besides God, that one person is his other half – Mrs Teo. She is a strong and supportive partner of Mr. Teo. She is there to encourage Kim Hoe to take on the challenge courageously and to remind him that he is not alone – “in sickness and in health.” As a pastor, I have witnessed many patients who lost the battle, not because there are no better medication or treatment but because of the lack of support from friends and family members. For the patient to survive, a strong support from the spouse or family members often gives the patient a push forward.

In the midst of his battle against PD, he found meaning and purpose in his struggle. I lift my hat to him when he told me that he has started a blog on the subject of PD. Now he is connecting with others who are in the same predicament – fellow PD victims. He interacts and shares all the information and his personal experiences with those who are traveling on the same path. He will be publishing his first book on PD with the intention of raising aware of this disease so that others who are diagnosed can take necessary and early action to deal with it. There is no cure for PD but there are some positive steps to arrest the disease.

I believe he is living his life to the fullest and is making the best of his time to help others as well. He is a positive model for those who feel that life with PD is hopeless and he has proven them wrong. There is plenty to live for if we look from a different angle. Last but not the least, I wish Mr Teo the best as he crusades for the cause of PD.
Rev. Bobby Lam
June 12, 2008

Jun 16, 2008 05:42AM jhowe
depression onset: 01/00
Dx: 04/08
Type: Parkinson’s disease

Teo: This is such a nice letter about your struggle in conquering the PD beast. I read this and was inspired by your strong mindset to get educated and equip yourself with knowledge and willpower. Im amazed at how your exercise program is so regimented, scheduled, and monitored. Your tracking of exercise techniques have inspired me… you are really taking this battle against PD seriously and not a day goes by that you aren’t fully focused.

You are one fine example for us. Thanks for sharing such a commendable letter about your example. We cherish strong individuals such as yourself on PatientsLikeMe. I sure wanna be a patient like you!!

TEOKIMHOE: THNNK YOU FOR THE INSPIRATIONAL LETTER. I AM VERY HONOR TO HAVE YOU AS ONE OF US IN THE PLM FAMILY. YOU WRITESO VERY WELL. EVERYTHING IS SO UNDERSTANDABLE. I WISH YOU ALLTHE BEST. HUGS KATHY

Wednesday, June 25, 2008

A Selfless Hero by Richard Foo

I was asked by my father-in-law, Teo Kim Hoo, to contribute an article to a book, dedicated to his struggles and fight against Parkinson’s Disease, a slow and degenerative disease that had plagued him for the past 3 years. I am more than happy to share my thoughts about this amazing person, on his determination and passion to overcome the effects of this disease.

My first encounter with Parkinson’s Disease came in 1985, when my grandmother, was diagnosed with it. I remember how her movements were slowly impaired, how she slowly lost her appetite to eat, how she eventually became bed-ridden, and more importantly, how she finally lost her zest to live her life. My impression of Parkinson’s Disease is that it not only attacks your ability to move, but patients also lose their agility, their sense of balance and their mental state of mind. I soon came to learn that sufferers of Parkinson’s Disease usually feels depressed, preferring to wallow in self-pity. Apathy is also a trademark of patients of Parkinson’s Disease. They will generally refuse medication and treatment offered. That was my general view and understanding of patients suffering from Parkinson’s Disease…..until my father-in-law came along.

Right from the moment that he was diagnosed with the disease, he took all relevant issues by the horns and dealt with them with vigour. Rather than wallowing in self-pity, he launches himself into research on all aspects of the disease. He not only seeks advice and opinions from his doctors, but also surfs the net for articles and write ups on Parkinson’s Disease. Over a short span of time, I am proud to say, that he has amassed quite a comprehensive understanding of the nature of the disease, and its effects on a person’s mind and body. Not satisfied with only the knowledge gained in respect of the disease and its effects, he even went further to research on the different medication prescribed for patients of the disease, and the side effects such medication brings to the patients. Whenever he feels uncomfortable or “different”, he would immediately ask for his doctor’s advice, and thereafter, follow up with a slew of research on the internet. Suffice for me to say that most of the time, he could link the side effects to the medication he had taken. Armed with such knowledge, he will normally request for other medication to counter the side effect, if available. He took me aside one day, and told me that certain medication causes patients to suffer from low blood pressure, particularly when the patient has been sitting down for quite some time. He requested for, and obtain medication to increase his blood pressure, to offset the effect of fainting spells caused by low blood pressure. Here is one person who is not only interested in overcoming the disease, but also on how to improve the quality of life of those on medication for the disease.

If his efforts in acquiring knowledge of the disease and its medication is astounding, what he does on the physical side is nothing short of unbelievable. My father-in-law took up a strict fitness regime to help arrest the advance of his movement disorder, brought about by the disease. His passion and determination is astounding as he puts in approximately 2 to 3 hours of physical activity daily, for six days in a week, under the supervision of a professional trainer. His exercise regime not only consists of cardio activities like running/jogging on the treadmill and riding the bicycle, but also includes stretching and balancing exercises like yoga and pilates, and strength training exercises. Apart from his strict exercise regime, he will sometimes join in group exercise classes for fun. He does kick boxing classes and also spinning classes (a cardio class, based on the use of a racing bicycle. As a result of his efforts, he definitely appears to have no signs of the movement impeding disease he is suffering from. I myself am very active in the gym, and I attend group exercise classes (with some very strenuous ones) very frequently. I have exercised with him before, and everyone of my friends at the gym could not believe that he is nearly 70 years old, let alone, a patient of Parkinson’s Disease. How many 70 year olds out there will actively take part in a kick boxing class? Not to mention one who has been diagnosed with the disease? I think not many. Not even those who are younger than him. He has been doing his exercises faithfully for the past 3 years since the day he was diagnosed with the disease, and there is no sign of him slowing down at all. All this needs effort and determination. It doesn’t come easy at all. Credit must definitely be given to him for being able to fight the general feeling of apathy normally associated with patients of the disease, and launch himself into physical activity, to his benefit.

The energy of this man doesn’t just stop there. I think the most amazing thing demonstrated by my father-in-law, is his passion, and his heart, in sharing his experience with other people. He wants people who are in the same predicament with him to be aware of the disease and how it affects their body, their movement, their state of mind, the medication involved, the various side effects that comes together with the medication, and most of all, how to fight and arrest the advancement of the disease. His greatest gift to the public is his blog, “Chronicles of a PD Fighter”. You can access his blog at movementdisorder.blogspot.com. He writes about his experience as a “fighter” of the disease, and gives a very detailed description about the symptoms of the disease, the causes, the medication involved and all other aspects in respect thereof. He also provide links to useful sites related to the disease, and also all the articles he had researched on. This goes to show how self-less this man can be, as far as educating the public on this disease is concerned. I am sure the public can benefit from his blog so that a greater understanding can be achieved on Parkinson’s Disease.

My father-in-law is definitely not your so called run-of-the-mill patient diagnosed with Parkinson’s Disease. In fact he doesn’t even look like a patient at all. His glow, and zest for life is attributed to his determination, and passion, in not only overcoming the disease, but also in educating the public, particularly those who are in the same predicament as him, on all aspects of the disease. I think this is very noble of him. It shows how selfless he is in his “quest” to increase the awareness of the public on the disease. And if anybody thinks that he is just a flash in the pan, and his interests will wane over the years, think twice. Unlike a lot of cases of waning interests, or as what the popular Malay phrase goes, “Hangat hangat tahi ayam”, my father in law’s interests in the disease certainly seems to be growing by the day. Continue with your good work, Daddy. I am soooooooo proud of you!!!

Richard Foo

Yes, these articles are definitely very encouraging & they will add spice to your book. It will be a source of inspiration to other PD patients to follow in your footsteps

Hooi Hoon

A New Wave Against Parkinson's? by Albert

Foreword byAlbert Lim Tow Sun(Son in-law to Mr Teo)
Ever since I had known Mr. Teo through his eldest daughter, who is now my beloved wife of almost 16 years, I have always found him to be an ever inquisitive person with an insatiable appetite in debate as well as in the search of knowledge in the fields he is interested in at various times of his life. There were seasons where he would be debating in politics, economics or religion. As to religion, he eventually embraced Christianity after giving much headache in debate about it to his eldest daughter who was the first Christian in his home. Lately, his favourite two subjects would be Exercise in its various forms, Body Combat, Pilate and Yoga, as well as Parkinson Disease (PD).

It is his inherent nature of being inquisitive that has led him thus far to delve more into the subject of Parkinson Disease than most who has suffered the disease, whether it be in Malaysia or worldwide. With the ease of information gathering and sharing thru the internet and emails and subsequently thru blogging, Mr Teo has emerged as one of the foremost in the world to have shared in depth his experience without the shame that many PD sufferers are inflicted with in addition to their PD infliction. The very fact that he has opened up, has caused the medical profession to better understand PD. It is his hope that PD sufferers around the world would read his blog and will be awaken by the fact that PD is no longer a taboo subject which must be put away and hidden as much as is possible, but on the contrary, to be open up even more so that the medical; profession may be able to understand it fully and therefore be more equipped in attending to the multi-facet issues that comes with PD. Mr. Teo hopes that this book, in addition to his blog, will spring a new awareness in PD, so that a new wave, a tsunami of knowledge in the subject may be trigged to bring accurate diagnostic and treatment to PD sufferers in the near future.

Both are very good articles. They will certainly add another sparkling dimension to your book.

Hooi Hoon

Tuesday, June 24, 2008

What is meant by treatment wearing off?

Posted: Mon Jun 23, 2008 8:11 am Post subject: What is meant by treatment wearing off?

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Is wearing off refer the worsening of a parkinson's disease symptom occurring two or three hours after a dose of levodopa medication?

As parkinson's disease is a movement disorder attention has focussed on problems with movement.

However there are symptom are not related with movement they are classified as non-motor symptoms.

Some non motor symptoms may interpret as part normal course of disease. However they are bothersome than motor symptoms.

Non-motor symptoms can include changes in thoughts and feelings, sensations and sense of well-being and changes in autonomic nervous system functions (e.g. sweating).

Kindly elaborate

TEOKIMHOE

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Dr. Fernandez

Joined: 20 Jan 2007
Posts: 90

Posted: Mon Jun 23, 2008 5:18 pm Post subject:

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I think you explained it pretty clearly, Teo.

Thanks!
_________________
Hubert H. Fernandez

Monday, June 23, 2008

Is PD the end of life?

Anonymous

Posted: Sat Jun 21, 2008 10:37 am Post subject: Is Parkinson the end of life?

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As PD not a disease by itself but rather a syndrome therefore parkinson is not the end of life.

It is not the illness and not a"going away" disease. It progresses with time.

Therefore we have to have a knowledge of the disease a power to counter the disease to slowdown from its progression.

Medication and exercises are important to activate your mobility and align your movements. Discipline yourself on your physical activities help you to have a quality of life. Diet and supplements are helpful for body maintance .

TEOKIMHOE

To stay Single

To be single
Posted on June 23rd, 2008 by heroteo
Anonymous
Posted: Sun Jun 22, 2008 8:40 am Post subject: To be Single ?

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There are 15% of PD patients who are diagnosed to have PD before the age of 40 years, some of them still be single.Therefore marriage is a very delicate issue in PD. It is a tough decision to make.

Teo Kim Hoe

New interest in an old disease?

Anonymous

Posted: Sun Jun 22, 2008 5:55 am Post subject: New interest in an "old " disease ?

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Dear Doctor,

Is it a shame in the medical world?

Why Parkinson is an old disease since eighteen century still a subject to discuss as to heal/ cured or slowdown from its progression?

Why a sudden surge of interest and publicity in the world?

Why suddenly Parkinson's disease is not an old age disease as there are recently more young Parkinson's patients ?

Why exercises for Parkinson's suddenly a hot topic to be discussed to slowdown the disease ?

TEOKIMHOE

Is PD a "no hope" illness ?

Anonymous

Posted: Sun Jun 22, 2008 8:32 am Post subject: Is PD a' no hope' illness?

Despite vast improvement in PD treatment there are many reasons that some patients are still plain ignorance.

They consider PD to be "no hope" illness and whither away slowly. they lack of fighting spirit (born fighter) as they cannot accept the fact they cannot live a normal life as other healthy people. They feel embarrassed and isolate themselves from the community as some people in the society regards PD as being" crippled".

TEOKIMHOE

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Dr. Okun

Joined: 19 Jan 2007
Posts: 251
Location: University of Florida
Posted: Sun Jun 22, 2008 10:11 am Post subject:

Thanks for the comment.
_________________
Michael S. Okun, M.D.

Anonymous

Posted: Sun Jun 22, 2008 5:28 pm Post subject:

I had a bad reaction to artane which handicapped me greatly last October, though I've recovered for the most now. Before the reaction I had mild shaking that you probably wouldn't notice unless standing behind me in a line, but I was very self-conscious about it. After the reaction it took me many months to be able to go outside and I needed a walker and barely had use of my left hand. However, I was no longer as self-conscious - not that I don't get anxious in public - but I was happy to be able to get around and proud of the fact that I wasn't letting it hold me back. I used public transit etc while shaking quite a bit.

Funny how things change.... :)

Jim

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Dr. Fernandez

Joined: 20 Jan 2007
Posts: 90

Posted: Mon Jun 23, 2008 5:10 pm Post subject:

Not at all, Jim! I don't think PD is a "no hope" illness. And I am not saying this because I carry the obligation of keeping all of your optimistic, but because I trully believe so.

There are however, some less lucky people. You happen to be one of them. The good news is that if your set back is due to medication side effect, or due to less optimal use of medications available, this is usually correctible ones it is recognized.

Artane is a hit or miss...it is a good drug for tremor, but not for the other features of PD. The reason why I don't like it too much is because it can cause mental dullness, confusion, memory loss, blurred vision, constipations, urinary problems, etc. And, there are other better tolerated drugs that can help tremor also.

Good luck!
_________________
Hubert H. Fernandez
Anonymous

Posted: Tue Jun 24, 2008 12:40 pm Post subject:

Thanks for the response Dr. Fernandez, but I was saying that I don't believe PD is "hopeless", but that attitude makes the crucial difference. Before I had the bad reaction I was self-conscious about my minimal Parkinson's symptoms, however, after the artane reaction I became much less self-conscious. As you know, how one reacts to PD (or anything for that matter) is of vital importance.

Jim

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Dr. Fernandez
Joined: 20 Jan 2007
Posts: 90

Posted: Sat Jun 28, 2008 10:35 pm Post subject:

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I agree!

The good news is that there are lots of other drugs and we discover more and more strategies every day....so don't lose hope!

Yours,
_________________
Hubert H. Fernandez

Anonymous
Posted: Tue Jun 24, 2008 12:40 pm Post subject:

Thanks for the response Dr. Fernandez, but I was saying that I don't believe PD is "hopeless", but that attitude makes the crucial difference. Before I had the bad reaction I was self-conscious about my minimal Parkinson's symptoms, however, after the artane reaction I became much less self-conscious. As you know, how one reacts to PD (or anything for that matter) is of vital importance.

Jim

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Dr. Fernandez

Joined: 20 Jan 2007
Posts: 90

Posted: Sat Jun 28, 2008 10:35 pm Post subject:

I agree!

The good news is that there are lots of other drugs and we discover more and more strategies every day....so don't lose hope!

Yours,
_________________
Hubert H. Fernandez

Sunday, June 22, 2008

Do the doctor have a license to heal or kill?

In Malaysia the doctors have a license to heal or kill the patient so we (the ministry) have to ensure that our doctors are well-trained and safely receive treatment.
_________________
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families

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pokermid
Anonymous

Posted: Wed May 28, 2008 11:58 pm Post subject:

??????????????????????????????

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pokermid
Anonymous

Posted: Thu May 29, 2008 12:18 am Post subject:

?

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leonard

Joined: 04 Mar 2007
Posts: 193

Posted: Sat Jun 21, 2008 6:38 pm Post subject:

I certainly agree with you if you mean that in many places the doctors are part of the "death" process i.e. in the
US there is concern about doctors being used in the designing of death procedures for prisoner's slated for capital punishment. And they are also used to verify death at execution.

Leonard

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Wednesday, June 18, 2008

PD is not a disease by itself but rather a sydrome

Posted: Sun Jun 15, 2008 8:27 pm Post subject: PD is not a disease by itself but rather a syndrome?

Is PD not a disease by itself but rather a syndrome ?

In order to understand the parkinson's disease we have to understand the disease before knowing how the neurologist makes a diagnosis of PD. Therefore PD is not a disease by itself, but rather a syndrome

Kindly elaborate.

TEOKIMHOE

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Dr. Okun

Joined: 19 Jan 2007
Posts: 251
Location: University of Florida
Posted: Tue Jun 17, 2008 1:45 pm Post subject:

That is correct. It is a cluster of symptoms and signs that may greatly differ from patient to patient. There are also multiple known and unknown causes!
_________________
Michael S. Okun, M.D.

Monday, June 16, 2008

The selfless warrior

Posted: Sun Jun 15, 2008 5:41 am Post subject: The Selfless Warrior

The Lloyd Tan Trust Fund has been set up to provide financial assistance to Malaysian Parkinson's patients who need the Deep Brain Stimulation (DBS) surgery.

The DBS surgery is a very much needed treatment for patients who are in the advanced stage of illness, when the effects of medications have diminished. At this stage, even with optimal medications, many patients have significant physical and mental sufferings. Currently, the DBS surgery is the only other effective treatment option which can help these patients regain an almost normal quality of life.

Of the estimated total of 15 000 Parkinson's patients in Malaysia , about 1000 Parkinson's patients (who are in the advanced stage of illness) need DBS surgery. Unfortunately, the cost of the surgery is very expensive, and almost all Malaysian Parkinson's patients cannot afford it. In Malaysian government hospitals, the cost is RM80 000 for the first surgery, and RM60 000 for the battery replacement once every 3-5 years (this cost includes the hardware only).

We can help our Parkinson's patients by buying a copy of the Selfless Warrior (RM 200 each). All the proceeds from the sale of this book are donated to the Lloyd Tan Trust Fund.

For more information, kindly refer to the attachment.

Dr Chew Nee Kong
Consultant Neurologist
Kuala Lumpur, Malaysia .

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Dr. Okun

Joined: 19 Jan 2007
Posts: 251
Location: University of Florida
Posted: Sun Jun 15, 2008 2:21 pm Post subject:

Thanks for the post.
_________________
Michael S. Okun, M.D

Jun 16, 2008 05:48AM jhowe

What a touching story!! I especially love this quote from the website:

"If my brain can conceive it, and my mind can believe it, then I can achieve it." - Anonymous
(Mr. Lloyd Tan's favourite quote)

POWERFUL!!

Thanks for sharing...

BTW, is this guy somehow related to you??

Did you read the part about the "Iron Lady"? Also very inspirational. I hope I'm like her 10 or 15 years down the road.

When are the days of medication wearing off and on?

Posted: Sat Jun 14, 2008 4:40 am Post subject: When are the days of medication wearing off and on?

--------------------------------------------------------------------------------

As PD is on " not going disease' i.e. a slow progression and is different from other disease i.e a self -limited sickness or injury that temporarily impact their lives as inconvenience or comfort

When are the days of PD medicine wearing off and on ?

What are the symptons wearing on or off on the PD medicine on the patients
_________________

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Dr. Fernandez

Joined: 20 Jan 2007
Posts: 90

Posted: Sun Jun 15, 2008 1:37 pm Post subject:

--------------------------------------------------------------------------------

You are correct that PD is not a "static" illness. It is a slowly progressive illness and gradually gets worse over time. We are try our best to find a drug that will slow the disease progression...and we are optimistic!

I am not sure what you mean by "when are the days of PD medicine wearing on and off"?

As the disease progresses, the "therapeutic window" for which the medications work on narrows slowly, so the same dose and timing of medications that used to control the symptoms of PD may not give the same long lasting benefit. That is what we mean when we say "wearing off"---the meds don't last the same way the used to and the doses are no longer connecting.

On and off are terms we use to describe the patients parkinson state. When ON, the patient generally feels good--s/he is less stiff, less slow, and tremors are lesser or absent. Wen OFF, the patient does not feel the effect of the medications and s/he has worse tremors, or stiffer, or slower with increased freezing. Sometimes the off spell is manifested by non-motor symptoms such as slower thinking, fatigue or increased depression, anxiety and panic attacks, which all get better or disappear when the patient is ON.

I hope this explanation helps somewhat.

Yours,
_________________
Hubert H. Fernandez

Sunday, June 15, 2008

Checklist to evaluate your Doctor's effectiveness in your care team...

Developing an effective relationship with your physician

Use the checklist below to evaluate your relationship with your physician. If your doctor is not currently meeting your needs or expectations, talk with him or her about changes that could improve your level of satisfaction. You are a consumer of your health care, and you should work to ensure that you are receiving the quality of care you deserve.

____ Are you comfortable with your doctor? Does he or she make you feel at ease?

____ Does your doctor understand your personal priorities? Does he or she take them into consideration when making recommendations about your treatment?

____ Does your doctor listen to your concerns and take them seriously?

____ Does your doctor ask you about the impact of symptoms and side effects on your daily life?

____ Is your doctor respectful of your opinion and the opinion of your family caregiver? Does he or she see you and your family caregiver as equal partners in the management of your PD?

____ Does your doctor explain his or her recommendations in a way that is easy to understand?

____ Does he or she give you thorough instructions regarding medications or other treatment options?

____ Does your doctor recommend nondrug treatments in addition to medications (exercise, diet, attention to emotional well-being)?

____ Does your doctor inquire about aspects of your health that fall outside of his or her specialty? Does he or she talk to, or share files with, your other physicians?

____ Is your doctor or a member of his or her staff available to answer your questions or address your concerns between office visits?

____ Does your doctor arrive for your appointments in a timely manner? Does he or she allow enough time for a thorough examination and to answer your questions?

____ Does your doctor educate you about PD on an ongoing basis? Does he or she refer you to additional resources or support groups?

____ Does your doctor encourage you to get a second opinion or refer you to a specialist when appropriate?

____ Does your doctor stay up to date on research findings about PD and new treatment options?

____ Does he or she inform you about clinical trials in which you may be eligible to participate?

*Taken from Moving Forward printed by Azilect

5 |

Saturday, June 14, 2008

The Amazing Grace by May

I have the privilege to join the Care Group held every Wednesday night, at the home of Mr. Teo Kim Hoe a.k.a. HeroTeo since September 2007. During this short span of time, I have found HeroTeo to be very inspiring in terms of determination to help oneself as well as his outlook in life.

HeroTeo has a burning desire to understand and the determination to fight PD with the help of experts’ consultations and advises instead of waiting for the disease to overpower him. A lesson I have learned from HeroTeo is to neither fall into the doldrums of self pity nor prolong a feeling of helplessness but rather, to know ones weakness and set to counter the problem.

Besides helping himself to fight PD, HeroTeo is also determined to share his experiences with other PD sufferers. I remember of a recent mild stroke which HeroTeo suffered, after being discharged from the hospital the following day, he spent hours blogging about his stroke experiences and its symptoms to bring awareness to his fellow PD sufferers at the soonest possible time. This is the commitment HeroTeo has pledged to help in the PD sufferers’ community.

HeroTeo is also blessed with a very supportive wife, Rosalind Teo. May the Lord continue to shower His Blessings on HeroTeo and Rosalind.

I wish HeroTeo all the success in his mission to help in the PD sufferers’ community.

Poon Mei Chee, May.

llyodfan trust fund

Posted: Thu Jun 12, 2008 6:48 am Post subject: llyodtan trust fund

Kindly visit website

http://www.lloydtan-trust.com/index.php?page=home

Mr. Lloyd Tan is the icon and hero of
the Parkinson’s community. His spirit
lives in us forever. Let us feel his energy
as he guides us to live with Parkinson’s,
reaches out to us to give hope and
inspiration.

Dr. Chew Nee Kong

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Dr. Okun

Joined: 19 Jan 2007
Posts: 251
Location: University of Florida
Posted: Thu Jun 12, 2008 8:36 pm Post subject:

Thanks for posting.
_________________
Michael S. Okun, M.D.

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Thursday, June 12, 2008

Brain Surgery in Parkinson's by Lasar Therapies

Dear Doctor,
Brain Surgery in Parkinson's disease becomes a hot topic in the Brain Surgery World.
Is it possibility surgery by Lasar?
Is it less pains and complication if it done by lasar surgery?
More Parkinson's patients will receive the DBS Surgery by Lasar as it saves costs and avoids the complication rates on serious adverse event i.e surgical morbidity rate.
We hope the day would come

What are the risks of DBS Surgery?

Posted: Mon Jun 09, 2008 5:30 am Post subject: What are the risks of DBS Surgery?

It is normal we take risks when we receive any surgeries therapies . Therefore for a major DBS Surgery there are serious potential risk. Bleeding in the brain is common in the DBS Surgery thus producing a stroke. The effects of stroke range from mild to severe , intellectual impairment or death. the second risks is infection , it is life threatening if it is serious. Besides hardware may break or eorde with normal usage, requiring it to be replaced. There are complication rates in the first 30 days after DBS. There are death on pneumonia, pulmonary embolism in older patients. Teo Kim Hoe
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Dr. FernandezJoined: 20 Jan 2007Posts: 90
Posted: Wed Jun 11, 2008 10:08 pm Post subject:

That is correct. But not all Centers are the same, just like no 2 surgeons are identical. In general, Centers who do DBS in a true multidisciplinary fashion tend to do better, and obviously, the more experienced the Center is, the more comofortable they are with the proceedure and the lower their complication rates are. Yours,_________________Hubert H. Fernandez
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Wednesday, June 11, 2008

ANXIETY AND MEDICATION

Posted: Tue Jun 03, 2008 5:51 pm Post subject: Anxiety ?

In view of the anxiety I receive two treatments either one dosage of Seroquel 25mg 0r one dosage of Seroxar (paroxetine hydrochloride) and two dosage of ATivan 0.5mg to be increased to 3 dosages at bed time. At present my Parkinson's medications are 10 mg Requip, 2 dosages of Sinement 25/100 and 10 mg Jumex daily. Kindly advise TEOKIMHOE
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Tue Jun 10, 2008 9:18 pm Post subject:

Thanks again for your question. We have determined based on your many questions that you must have a complex case and therefore you are best served by discussing these issues directly with your doctor. Anxiety often requires a team including a neurologist, a psychologist and a psychiatrist. Dopamine is given frequently to avoid wearing off and maybe a SSRI or benzodiazepine will help. If you have a generalized anxiety disorder this may be very difficult to treat._________________Michael S. Okun, M.D.
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Tuesday, June 10, 2008

Are there any surgery with minor stroke?

Questions for my blood clot

1.Patient been once with blood clots, is it at risk (or increase) of heart attack, stroke or pneuminia? 2.What are precautions to take to reduce the risks from another blood clot? 3.Will exercise or sex increase the risk of suffering from another blood clot? 4. Is this a permanent condition? Can it be cured? 5.As antiplatelet therapy is not for people with a history of liver or asthma. peptic ulcers, bleeding disorders what are the medication available? 6. Are there any surgical available to treat the blood clot as there are high risks suffering with another stroke? Kindly brief.

Nutrients and Parkinson's

Nutrition are importance for those with Parkinson Disease. Nutrition won't cure PD or slow its progression. Why there are vitamins and mineral not suitable for Parkinson's Patients and are harmful for them to take? There are Folic Acid, Chromium,Copper, Ferritin,Magnessium,Selerium, and Zinc What are the normal level of these vitamins level (units)in our body? In what level are considered harmful for Parkinson's patients and how to reduce to safe level? How to monitor the vitamins and mineral level, periodly or yearly?

Posted: Tue Jun 10, 2008 7:15 am Post subject: Nutrients and Parkinson's

Nutrients and Parkinson’s Nutrition are importance for those with Parkinson Disease. Nutrition won’t cure PD or slow its progression. Why there are vitamins and mineral not suitable for Parkinson’s Patients and are harmful for them to take? There are Folic Acid, Chromium,Copper, Ferritin,Magnessium,Selerium, and Zinc What are the normal level of these vitamins level (units)in our body? In what level are considered harmful for Parkinson’s patients and how to reduce to safe level? How to monitor the vitamins and mineral level, periodly or yearly

TEOKIMHOE

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Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com

Posted: Tue Jun 10, 2008 8:09 am Post subject:

Dear Friend, ALL essential vitamins and minerals are necessary for people with PD. None of these are "optional" -- they are absolutely vital to maintain life and health. Your doctor should conduct an annual physical examination that includes bloodwork; this will show whether any deficiencies exist, and the doctor will then determine the best way to make up the deficiency. Other than this, I cannot generalize; health needs are highly individualized and specific to each person. Your doctor is the best person to address personal issues regarding blood levels of minerals._________________Best regards, Kathrynne Holden, MS, RD --

Monday, June 9, 2008

Deep Brain Stimulation Surgery

Brain surgery in Parkinson's is stranger for everbody,'
It is frighten. It becomes a hot topic in the brain surgery world. It is a new surgery for PD oatient to slowdown the PD from its progression as the PD medication are not helpful for them.
Besides Brain surgery there are deep simulation and brain cell transplatation.
Kindly elaborate what are more safe surgery for PD patient i,e less complicate and self maintance. How long for a PD patient to live after doing the surgery? At what age and stage of PD are suitable for the Brain Surgery? Could lead them good qaulity life after the surgery as it does not cure PD?
TEOKIMHOE

Dear Teo,

Brain surgery (Deep Brain Stimulation) is an effective treatment for Parkinson's patients. It does not cure PD, but the quality of life of Parkinson's patients is improved, as well as the symptoms (slowness of movement, tremor) and dyskinesia. The benefit of DBS has been observed to last up to seven to ten years after surgery. Yes, DBS is a hot topic nowadays because its discovery has been one of the most dramatic advances in medicine. Timing of surgery is an important issue. DBS is generally indicated for patients who are in the advanced stage of illness (i.e. beyond 10 to 15 years of illness), when the quality of life is significantly impaired despite maximal medications. However, for the relatively young Parkinson's patients (age < name="15102">Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Thu Jun 12, 2008 8:04 pm Post subject:

This is a great post, thanks. A few things to clarify from my point of view. There is no hard and fast rule about how many years you need to have PD before surgery. Greater than 5 is a good idea to avoid levodopa responsive PD look-a-like syndromes. There are people who have on-off fluctuations and other serious issues that cannot be managed effectively with meds---these are potential candidates but they need multidisciplinary screening by a neurologist (on/off UPDRS), a neurosurgeon, a neuropsychologist, and in some cases a psychiatrist. After screening only a percentage will be eligible for surgery and only levodopa responsive symptoms will be helped by STN or GPi DBS. The surgery also does not in general get people back to work, or keep them at work. Perhaps in the future we will learn how to pick patients who surgery may accomplish this feat; but at this time it does not guarantee that hope. It is great there is money for those who need the surgery!_________________Michael S. Okun, M.D.

Blood test to detect Dopamine?

http://forum.parkinson.org/forum/viewtopic.php?t=4714

REQUIP (Ropinirole)

Posted: Sun Jun 01, 2008 3:58 am Post subject: REQUIP (Ropinirole)

I refer to my email dated May 06 08 regarding the sideeffect of Dopamine Agonists Requip that have done good job for my physcial mobility. However I have Low Blood Pressure recently after taking Requip more than nine months. In order to find out the causes of the low blood pressure I stop all the vitamin supplements and hormone therapy I then discovered it is not the Requip that cause me low BP. I now continue taking the Requip by increasing to 10 mg with 2 Sinement 25/100 and 10mg Jumex daily; There are nothing wrong with Requip medication on me. I feel sorry about it. Kindly elaborate why some vitamin supplements and hormone therapy causing irregular BP on Patients after taking years? TEOKIMHOE
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Sun Jun 08, 2008 11:02 am Post subject:

Every medication has potential side effects. Thanks for the post. I have no further details based on your message. Have a great day._________________Michael S. Okun, M.D.

Brain Surgery in Parkinson's by Lasar Therapies

Posted: Sun Jun 01, 2008 4:28 am Post subject: Brain Surgery in Parkinson's by Lasr Therapies?

Dear Doctor, Brain Surgery in Parkinson's disease becomes a hot topic in the Brain Surgery World. Is it possibility surgery by Lasar? Is it less pains and complicated on patients done by lasar surgery? What is the success chances of Brain Surgery? Is it worsen after the brain survery? Could young PD suitable to receive brain surgery treatment? At what stage of PD are suitable to receive the surgery treatment?
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Sun Jun 08, 2008 11:05 am Post subject:

There are currently no approved laser therapies for PD. We have a nice book at http://www.parkinson.org/ that you can download for free from NPF. It goes over all relevant material you will need. There is information at mdc.mbi.ufl.edu Also, new procedures are on the What's Hot column also at http://www.parkinson.org/ Most people are opting for DBS these days, but specific and interdisciplinary screening at an experienced site is needed as the surgery is not for everyone._________________Michael S. Okun, M.D.

Sunday, June 8, 2008

ANXIETY

I am doing well with Requip 4 mg / 4 mg / 2 mg, Sinemet one / half / half and Selegiline 5 mg bd. My blood pressure is no longer low. In fact it has gone up to 150 / 80 in the late evening. In the evening, I also feel tired and tense. I know that my Parkinson's is well controlled, but I am often worried about the possibility of recurrence of TIA. I can fall asleep easily with Lorazepam 1.5 mg at night, but often wakes up early (4 am). After that, I can't fall asleep anymore. Kindly advise.

Posted: Sun Jun 08, 2008 11:15 am Post subject:

I have no further tips on TIA's and PD and I would refer you to your general doc and your neurologist for an in person discussion. Good luck._________________Michael S. Okun, M.D.

Joined: 02 Mar 2007Posts: 470Location: MI
Posted: Mon Jun 09, 2008 6:23 am Post subject:

Dear Teo Kim Hoe, Welcome to the 4:00 am club, I was there for a while. See if your doctor might prescribe a sleeping pill rather than the lorazepam. Lunesta works for me--I'm now in the 6:00am club! I don't know if your Selegiline limits your choices, but you seem to have a good doctor who will know. Best wishes, Sue W.

Friday, June 6, 2008

DBS Surgery

Dear Dr. Chew,

Kindly enlighten me the risks of DBS Surgery:-

What kind of risks the patients taking after they received the DBS Surgery?

What kind the risk the patient taking during the DBS Surgery?

What is the successful rate?

After the DBS Surgery do the patients continue the PD medication?

Thanks

Teo Kim Hoe

Thursday, June 5, 2008

Seroquel and Paroxetine

Dear Mr Teo Seroquel helps to treat hallucination and abnormal thought process (paranoia). Paroxetine is a medication that helps elevate the mood (anti-depressant). DR Chew
Date: Mon, 2 Jun 2008 18:32:16 -0700From: teokimhoe@yahoo.comSubject: seroquel and ParoxetineTo: nkchew33@hotmail.com
Dear Dr. Chew,

Is there any difference on treatment between Seroquel and Paroxetine hydrochloride medication?

Kindly elaborate

TeoKimHoe

Deep Brain Stimulation Surgery

Dear Mr Teo Brain surgery (Deep Brain Stimulation) is an effective treatment for Parkinson's patients. It does not cure PD, but the quality of life of Parkinson's patients is improved, as well as the symptoms (slowness of movement, tremor) and dyskinesia. The benefit of DBS has been observed to last up to seven to ten years after surgery. Yes, DBS is a hot topic nowadays because its discovery has been one of the most dramatic advances in medicine. Timing of surgery is an important issue. DBS is generally indicated for patients who are in the advanced stage of illness (i.e. beyond 10 to 15 years of illness), when the quality of life is significantly impaired despite maximal medications. However, for the relatively young Parkinson's patients (age < 50) who are still working, DBS may be carried out at an earlier stage of illness (i.e. less than ten years of illness). This is because for these young patients, one of the main objective of DBS is to help maintain their careers. Realizing that DBS is an essential treatment for PD, we have set up the Lloyd Tan Trust Fund (Lloyd Tan was the founding father of the Malaysian Parkinson's Disease Association, who passed away in 2007) in May 2008, which helps to provide financial assistance for patients opting for DBS. Dr Chew Nee Kong, Kuala Lumpur.

Dear Dr.Chew,
Brain surgery in Parkinson's is stranger for everbody,'
It is frighten. It becomes a hot topic in the brain surgery world. It is a new surgery for PD patient to slowdown the PD from its progression as the PD medication are not helpful for them.
Besides Brain surgery there are deep simulation and brain cell transplatation.
Kindly elaborate

How long for a PD patient to live after doing the surgery?

At what age and stage of PD are suitable for the Brain Surgery?

How would lead them a good quality life after the surgery as it does not cure PD?
TEOKIMHOE

Posted: Sun Jun 08, 2008 11:12 am Post subject:

We have a complete forum on surgery at www.parkinson.org- called ask the surgical team. We update new surgeries on the What's Hot column. There is a free book from NPF at www.parkinson.org on DBS. DBS is the approved therapy but it is only for a minority of well selected and well screened patients performed at experienced centers. Duodopa is a dopamine pump, spheramine is a transplantation therapy and there are a few viral gene therapies, and other experimental surgeries being done...for research only!_________________Michael S. Okun, M.D

Tuesday, June 3, 2008

Blood sample on patients

Posted: Mon Jun 02, 2008 5:35 pm Post subject: Blood sample on patients

There would be a "blood sample" on antioxdant and vitamins & mineral profile as well as hormone therapies on patients who receive the treatment on appointment. TEOKIMHOE
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Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Tue Jun 03, 2008 8:45 am Post subject:

Dear Teokimhoe, I am certain that any physician prescribing hormone therapy would do so on the basis of thorough labwork and any other appropriate tests. You state that your doctor is monitoring your progress, which is sound medical practice. It appears that you are in very good care, congratulations

A Miracle by Rev.John Kok

Words by Mr Teo’s Pastor
Rev John Kok

I have known Mr Teo Kim Hoe for almost 18 years. He started attending Kuala Lumpur Baptist Church with his family the time I was appointed as the Pastor-in-charge of the Church in 1989. He together with his wife, were baptized in our church on April 11, 1993. They were faithful and God’s loving members of the church. They even opened their house for a Care Group to meet and I was the leader of that group. Even now, even though I am no longer the leader of their Care group, his house is still open for the Care Group to meet once a week.

I know Mr Teo very well as we share, talk and have many meals together. He has a strong faith in God and is a very optimistic person which came in handy when in his later years he was diagnosed as having Parkinson disease. He did not allow it to affect him personally or in his service to God. He began to do his own study and discovery about Parkinson disease which later he was encouraged by his doctor to start his own blog to share his own experiences how he fought his own Parkinson disease. Often time he would forward to me his article to read and also to pray for him.

Just a few months back I received a call from his wife informing me that he had a minor stroke and was admitted to the hospital. My wife and I rushed to the hospital to visit him and was surprised that he could still be in his jovial self to talk about his condition and his excitement about writing his book on Parkinson disease to encourage people. He never stopped talking despite us and his family telling him to stop and to rest. We prayed for him and all his Care Group members also prayed for him when they heard that he was admitted to the hospital. God is good. He heard our prayers and Mr Teo was discharged from the hospital the next day. It was a miracle and even his doctor said it was a miracle he could recover so fast.

Today Mr Teo is still driving around town and still the optimistic and confident person I knew when he first came to the church. I pray that his book will be an encouragement to all who read it on how God can use someone like him without any medical knowledge of Parkinson disease to be a blessing to many.

Unsafe Vitamin supplements and hormone therapies

Posted: Sun Jun 01, 2008 4:26 pm Post subject: Unsafe Vitamin supplements and Hormone thereapies?

Dear Doctor, Why some vitamins supplement and Hormone therapy aree unsafe for taking for a certain times? There are sideeffect that cause your Blood Pressure level and others and to be monitored by doctor regulary.I am one of the sufferers. Kindly brief them Thanks TEOKIMHOE
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Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Sun Jun 01, 2008 6:21 pm Post subject:

Dear Teokimhoe, You need to be more specific. Please list the particular vitamins, supplements, and hormone therapies of concern to those with PD and I will answer if able._________________Best regards, Kathrynne Holden, MS, RD -- For a Parkinson Tip of the Day visit: http://www.nutritionucanlivewith.com/
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Anonymous
Posted: Sun Jun 01, 2008 8:26 pm Post subject: Vitamin supplements and Hormone therapies

The Hormone therapies are DHEA-S, PSA,Testosterine,Estradiol,Free T3,T4 and TSH. Vitamin supplements and mineral are Boron, Chromium (blood),Copper(blood), Manganese, Vanadium, ,Selenium, Zine(blood). The Doctor has to monitor the BP level on patients who recieve the treatment. Sideeffect would be on patients for certain times. Kindly eleborate TEOKIMHOE
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Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Mon Jun 02, 2008 6:21 am Post subject:

Dear Teokimhoe, Some hormones may cause edema (fluid retention in the tissues) which can increase blood pressure; thyroid hormone can have many possible side effects, including a rise in blood pressure. The minerals you name would not ordinarily be expected to cause a rise in blood pressure; I assume your doctor is monitoring your overall condition and considers these a factor. PSA, as I understand it here in the west, is not a hormone, but the name of a laboratory test called Prostate Specific Antigen. T3 and T4 are also the names of tests, used to determine thyroid function, not hormones._________________Best regards, Kathrynne Holden, MS, RD

Posted: Mon Jun 02, 2008 5:18 pm Post subject: Unsafe Vitamin supplements and Hormone thereapies?

I also do not routinely recommmend heavy metals (copper, manganese) to my Parkinson's patients. There is no firm evidence that this treatment helps in Parkinson's. In fact, exposure to heavy metals is known to be one of the predisposing factors for Parkinson's. Dr Chew Nee Kong, Kuala Lumpur
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Anonymous
Posted: Mon Jun 02, 2008 5:21 pm Post subject: Unsafe Vitamin supplements and Hormone thereapies?

Dear Mr Teo I am not sure whether these hormone therapy has any effect of lowering your blood pressure. But what is certain is that I do not recommend such treatment to my patients if they do not have any hormonal disorder. Dr Chew Nee Kong, Kuala Lumpur
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