Tips and Pointers on Some Parkinson's Symptoms

Soft voice, slurred speech and masked face

Parkinson's patients have difficulty with voice and speech. We have shortness of breath. We don't speak loud enough. Our speech is almost unintelligible. Our face is expressionless ("poker-face"), so people thought we are not interested or unhappy, even though that is not truly how we feel.

In order to solve these problems, there are ways to improve the muscles around the mouth:

Use tongue in your mouth to massage the muscles around the mouth.
Gargle with water full on your throat and blow air through it without swallowing, twist your mouth to the extreme left, right, up and down, to strengthen the facial muscles.
Blow air deeply into balloon to exercise the muscles around the mouth.

Do it 3 to 4 times a day.

Small (micro) handwriting

As our Parkinson's progresses, our handwriting becomes smaller and unrecognisable. The bank had trouble recognising my signature on the cheques that I issued. Often, the bank had to call me to verify that I had indeed issued those cheques. Once, I even had to go to the Commissioner for Oaths to authenticate a document that was signed by me.

In order to solve this problem, I have relegated all signing of cheques to my wife.

Unstable walking posture

Due to our weak and stiff muscles, Parkinson's patients have an unstable walking posture, hence, often resulting in falls, which cause bone fractures or concussions.

I would like to share my experience in discovering that one of the reasons for my unstable walking posture was that both my arms were rigid (not swinging) while walking.

I tried to correct it and make it a habit to swing both arms when walking, in order to give a better balance for my body.

Besides doing arms stretching, walking upright and swinging the arms, I go down to the swimming pool's shallow end (3 feet depth) in order to immerse my body below the surface of the water and massage my own body muscles for half an hour daily, accompanied by a helper in case I need help.

Make it a habit and you will enjoy a good quality of life.

Muscle cramps

I have frequent muscle cramps, stiffness, tightness and pain on my hips, thighs, shins, ankles, hamstrings (tendons behind the knees), cheeks, shoulders and neck for the past of 20 years, before I was even diagnosed with Parkinson's. It comes and goes a few times a day, either when walking, standing or seated.

I used to go for physio-therapy and massage. Now, I realised that the muscle cramps are caused by the disorders in my nervous system, due to the lack of dopamine. Dopamine is a neurotransmitter, a type of chemical that helps messages travel between nerve cells, including our brain cells. Brain cells need dopamine to send messages to other parts of our brain, and to nerve cells and muscles throughout our body. With the lack of dopamine, messages were not transmitted adequately, causing my body muscle movements to be disrupted and not running smoothly. Hence, the muscle cramps developed. Muscle cramps are also caused by reasons other than Parkinson's.

To solve the problem of frequent muscle cramps, I do the following:
· Take the optimal dosage of Parkinson's medications to supply the much-needed dopamine to the brain cells.
· Do physical exercises at least 2 hours daily.
· Have a healthy diet.
· Have proper intake of supplementary nutrition.
· Have a body massage once a week to stretch my neck, back, arms and legs up and down, left and right.
· Place a hot/cold pack on the affected muscles to ease the pain from the cramps.
· On my own at home, I also stretch my legs. I place one leg against the wall in order to stretch my leg up and down, front and back, 20 times for each leg. I do this many times daily.

Hamstring pains

Muscle pains are common in Parkinson's. I have hamstring (tendon behind my knee) pains and have difficulty standing on my right leg. I find it difficult to do the "tree posture" in yoga, when I have stand on one leg. I am fortunate that I have no problem with the other leg (left).

In order to solve the hamstring pains, I place one leg against the wall in order to stretch my leg up and down, front and back, 20 times for each leg. I do this many times daily.

After stretching, I place hot/cold pack on the hamstring and joints. Besides that, I ensure that I take optimal dosage of medications, have a healthy diet and have proper supplementary nutrition.

Difficulty swallowing

Chew a piece of chewing gum or hard candy in the mouth to encourage swallowing. Use sugarless gum or candy so as not to cause tooth decay. It is also helpful to stop drooling and dry mouth. It also maintains a good oral health.

It is cheap and has no side effects.

Eye problems

Parkinson's does not affect the eyes' ability to see but there can be some eye-related concerns. Due to the problem of masked (stiff) face in Parkinson's, there can be a decreased rate of automatic blinking. There could also be a lack of eye coordination due to the motor (physical) disorder symptoms, causing double vision when looking in a certain direction. I have these eye problems. As a result, my eyes feel tired easily and I cannot see clearly when driving at night or during rainy days.

I use eye drops a few times a day and I avoid driving at night or during rainy days.

Dehydration

I suffer from dehydration. It is a side effect of levodopa and the dopamine agonist medications for Parkinson's. Dehydration is a loss or deficiency of water in our body tissues. This condition may result from inadequate water intake and/or excessive removal of water from the body, i.e. from sweating, vomiting or diarrhoea.

Symptoms include great thirst, nausea and exhaustion. Thirst leads to dehydration. In order to prevent and solve the problem with dehydration, I do the following:
· Drink two litres of water daily, as I am doing strenuous physical exercises daily.
· Apply "Biotane" gel to moisturise my dry lips.
· Chew "Biotane" gum to minimise dryness in my mouth.
· Use "Biotane" mouth wash to minimise rough and sticky tongue.

Anxiety, depression and stress

Due to death of neurons that make dopamine, Parkinson's have non-motor (mental) disorder symptoms, such as anxiety, depression, tension, stress and insomnia. Side effects of medications could also give rise to these symptoms.

Unknown to most Parkinson's patients, non-motor disorder symptoms are even more complicated and difficult to treat than the motor (physical) disorder symptoms. It affects the feelings and moods of the Parkinson's patients and the entire family. I have had my share of mental problems that caused upheavals and tears in my family. You can read the story written by my son-in-law in the inset panel.

This is how I relieve my mental disorders:
· Concentrate on other issues and pastimes that I enjoy or have interests in.
· Indulge in physical exercises, which is very effective for me because:
- I am able to let out the pent-up frustrations and anger inside me;
- I am able to feel totally relaxed, through a deep breathing technique.
· Study the Bible and get involved in the church activities.
· Take medicines at the optimal dosage in order to counter the Parkinson's symptoms and the effects of emotional disorders.
· Have the attitude that I am not alone and that there is still life after Parkinson's.
· Giving and serving others will bring more happiness than receiving and being served.
· Participate in online discussion forums with other fellow Parkinson's patients and medical practitioners, such as PatientsLikeMe, National Parkinson's Foundation (NPF) and Parkinson's Discussion Forum (PDF).

The deep breathing technique (to feel relaxed) is achieved from strengthening the core (body trunk) muscle:

While doing physical exercises, inhale and exhale deeply, with the stomach tucked in and out according to rhythm of breathing.
The core muscle lies roughly between the rib cage and the hips, in the abdomen, lower back and pelvis. A strong core muscle protects the spine and straightens our body posture. Our exercise movements become more powerful, stable, balanced and coordinated and we will not fall down easily.

In short, we can use the technique above in all exercises in order to deal with our overall health, both mentally and physically, because when we feel relaxed while doing our physical exercises, it becomes more effective and fulfilling. Some examples of exercises which incorporate deep breathing are tai chi, yoga, pilates, running and cycling.

When not doing exercises, we can also do deep breathing, anywhere and at any time:

Take 5 to 10 deep breaths in and out slowly (to a count of 5 each time), while relaxing your body.
At the same time, pick one word or phrase (some people call it a "mantra") to repeat as you breathe in, and again as you breathe out. It helps you to concentrate on your breathing, and distracts you from the stressful situation.

The basic benefit of this type of breathing is, more oxygen gets into your body and will improve your ability to think clearly, thus helping you to cope better with the situation at hand.

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