massage and PD patient
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Dear Doctor,
Parkinson's disease destroys dopamine-producing cells, therefore patients have dramatically low-levels of the neurotransmitter.
.
A simple massage can significantly improve the quality of life of Parkinson's sufferers, say experts. Researchers at the University of Miami Touch Research Institute have found that massage helps patients' to sleep as well as improving their ability to perform normal day-to-day activities.
Best regards
TEOKIMHOE
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Dr. Fernandez
Joined: 20 Jan 2007
Posts: 90
Posted: Mon Jul 30, 2007 5:53 pm Post subject:
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Thanks!
_________________
Hubert H. Fernandez
Tuesday, July 31, 2007
Monday, July 30, 2007
Speech difficulties in PD
Posted: Sun Jul 15, 2007 1:26 am Post subject: Speech Difficulties in PD
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Dear Doctor,
I understand about half of all people with PD are likely develop difficulty with speech. The speech changes that occur are due to inco-ordination and reduced activities of muscles that control the speech mechanism.
The main difficulties I have experience are:
Loss of volume, pitch, range and intonation in the voice.,
speech being either too fast or too slow
uncontrolled repetitions of sounds, words or phrases;
slurred speech;
difficulty initiating speech;
reduced facial expression and natural gesture; and
a harsh, breathy voice.
Is it related with Jaw tremor or trauma (the shock caused by unpleasant and upsetting experience )?
Is it related to tongue-tied/twister(difficulty to speak quickly) caused by neurological disorders?
Is it related with the drooling of saliva from the mouth ?
Best regards
TEOKIMHOE
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Kathrynne Holden, MS, RD
Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Wed Jul 18, 2007 7:04 am Post subject:
--------------------------------------------------------------------------------
Dear Teo,
Once again, your questions are very good, and relevant. However, this is outside my scope of practice as a dietitian. NPF has an excellent forum, however, that addresses speech concerns. Please go back to "Discussion Corner," and scroll down to "Talk To A Speech Clinician." Post your question there for an answer by experts in the field.
_________________
Best regards,
Kathrynne Holden, MS, RD
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/
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Anonymous
Posted: Sat Jul 28, 2007 5:31 pm Post subject: Speech Difficulties in PD
--------------------------------------------------------------------------------
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. There should be greater awareness on the important role of speech therapist in the management of PD.
Dr Chew Nee Kong, Kuala Lumpur.
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Kathrynne Holden, MS, RD
Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Sun Jul 29, 2007 4:01 pm Post subject:
--------------------------------------------------------------------------------
Many thanks to Dr. Kong, for an illuminating and considerate response. I agree, the topic of speech difficulty, and diminished ability to communicate, is among the very important concerns with PD; and it is under-addressed here in the U.S. as well.
_________________
Best regards,
Kathrynne Holden, MS, RD
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/
--------------------------------------------------------------------------------
Dear Doctor,
I understand about half of all people with PD are likely develop difficulty with speech. The speech changes that occur are due to inco-ordination and reduced activities of muscles that control the speech mechanism.
The main difficulties I have experience are:
Loss of volume, pitch, range and intonation in the voice.,
speech being either too fast or too slow
uncontrolled repetitions of sounds, words or phrases;
slurred speech;
difficulty initiating speech;
reduced facial expression and natural gesture; and
a harsh, breathy voice.
Is it related with Jaw tremor or trauma (the shock caused by unpleasant and upsetting experience )?
Is it related to tongue-tied/twister(difficulty to speak quickly) caused by neurological disorders?
Is it related with the drooling of saliva from the mouth ?
Best regards
TEOKIMHOE
Back to top
Kathrynne Holden, MS, RD
Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Wed Jul 18, 2007 7:04 am Post subject:
--------------------------------------------------------------------------------
Dear Teo,
Once again, your questions are very good, and relevant. However, this is outside my scope of practice as a dietitian. NPF has an excellent forum, however, that addresses speech concerns. Please go back to "Discussion Corner," and scroll down to "Talk To A Speech Clinician." Post your question there for an answer by experts in the field.
_________________
Best regards,
Kathrynne Holden, MS, RD
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/
Back to top
Anonymous
Posted: Sat Jul 28, 2007 5:31 pm Post subject: Speech Difficulties in PD
--------------------------------------------------------------------------------
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. There should be greater awareness on the important role of speech therapist in the management of PD.
Dr Chew Nee Kong, Kuala Lumpur.
Back to top
Kathrynne Holden, MS, RD
Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Sun Jul 29, 2007 4:01 pm Post subject:
--------------------------------------------------------------------------------
Many thanks to Dr. Kong, for an illuminating and considerate response. I agree, the topic of speech difficulty, and diminished ability to communicate, is among the very important concerns with PD; and it is under-addressed here in the U.S. as well.
_________________
Best regards,
Kathrynne Holden, MS, RD
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/
Sunday, July 29, 2007
Massage and parkinson disease
Posted: Sat Jul 28, 2007 3:31 am Post subject: Q: Massage and Parkinson disease
--------------------------------------------------------------------------------
Dear Doctor,
I wish to use this forum to share the benefits of Massage on PD patients.
Parkinson Disease destroys dopamine-producing cells therefore patients have dramatically low levels of neurotransmitter, massage normally increases dopamine level. Patients who receive massage increase quality of life, sleep well as well as improving their ability to perform normal day to day activities and decrease stress hormonal level in people with Parkinson disease.
Parkinson symptoms are reduced by massage therapy and progressive muscles exercise i.e progressive stiffness, rigidity of voluntary muscles.
TEOKIMHOE
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Kathrynne Holden, MS, RD
Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Sat Jul 28, 2007 8:31 am Post subject:
--------------------------------------------------------------------------------
Dear Teo,
Thank you for bringing up a very important consideration. Massage is very helpful to those with PD, for all the reasons you state, and I do encourage regular massage therapy if at all possible.
_________________
Best regards,
Kathrynne Holden, MS, RD
--
--------------------------------------------------------------------------------
Dear Doctor,
I wish to use this forum to share the benefits of Massage on PD patients.
Parkinson Disease destroys dopamine-producing cells therefore patients have dramatically low levels of neurotransmitter, massage normally increases dopamine level. Patients who receive massage increase quality of life, sleep well as well as improving their ability to perform normal day to day activities and decrease stress hormonal level in people with Parkinson disease.
Parkinson symptoms are reduced by massage therapy and progressive muscles exercise i.e progressive stiffness, rigidity of voluntary muscles.
TEOKIMHOE
Back to top
Kathrynne Holden, MS, RD
Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Sat Jul 28, 2007 8:31 am Post subject:
--------------------------------------------------------------------------------
Dear Teo,
Thank you for bringing up a very important consideration. Massage is very helpful to those with PD, for all the reasons you state, and I do encourage regular massage therapy if at all possible.
_________________
Best regards,
Kathrynne Holden, MS, RD
--
Tuesday, July 24, 2007
Speech difficulties in PD
Posted: Sun Jul 15, 2007 1:26 am Post subject: Speech Difficulties in PD
Dear Doctor,
I understand about half of all people with PD are likely develop difficulty with speech. The speech changes that occur are due to inco-ordination and reduced activities of muscles that control the speech mechanism.
The main difficulties I have experience are:
Loss of volume, pitch, range and intonation in the voice.,
speech being either too fast or too slow
uncontrolled repetitions of sounds, words or phrases;
slurred speech;
difficulty initiating speech;
reduced facial expression and natural gesture; and
a harsh, breathy voice.
Is it related with Jaw tremor or trauma (the shock caused by unpleasant and upsetting experience )?
Is it related to tongue-tied/twister(difficulty to speak quickly) caused by neurological disorders?
Is it related with the drooling of saliva from the mouth ?
Best regards
TEOKIMHOE
Dear TEOKIMHOE,
Thank you for writing with these excellent questions. It is actually more than 50% of people with PD who have difficulty with speech and communication. The data tell us that it is actually closer to 85%. You are partially correct about the underlying causes of the speech problems. PD is caused by decreased dopamine in the central nervous system. The lack of dopamine also causes changes in control of the muscles that produce speech.
Typically, the motor speech changes are characterized by rigidity, weakness, difficulty in initiating movement, and difficulty making large movements. In addition, a critical component of the communication changes is the perception on the part of people with PD that they think they are speaking loud enough when, in fact, they are speaking at a low volume that also makes it difficult to understand them.
The result is that speech changes occur just like you described in your email: low volume, slurred speech, reduced intonation, alteration in rate, and changes in voice quality such as sounding breathy or harsh. These symptoms are caused by the PD. Sometimes people with try to compensate for these changes in ways that can make speech more difficult.
Unfortunately, the medications that can be so beneficial for limb symptoms have not been shown to have the same positive effect on speech and swallowing. However, there is a behavioral voice treatment that has been shown to help 80% of people with PD who complete the program. It is called LSVT. You can learn more about LSVT and find a certified clinician in your area by going to www.lsvt.org.
The last thing you mentioned is that you notice more drooling. There has been a lot of discussion about whether people with PD drool more or swallow less well. It seems the majority of the data point to the latter. People with PD swallow less frequently and with less strength and efficiency of muscle movement. One thing that can be done about this is to consciously tell yourself to swallow more frequently especially when in a social situation.
If you are already noticing signs of drooling there could be other changes in swallowing taking place. It would be a good idea to discuss this with your physician and seek an evaluation with a speech-language pathologist who has experience in evaluation and treatment of people with PD. Swallowing difficulties can potentially interfere with the ability to take pills and swallow safely and it is important to be vigilant.
I hope you will get treatment for your speech changes since communication is so important to quality of life.
Back to top
lmahler
Dear Doctor,
I understand about half of all people with PD are likely develop difficulty with speech. The speech changes that occur are due to inco-ordination and reduced activities of muscles that control the speech mechanism.
The main difficulties I have experience are:
Loss of volume, pitch, range and intonation in the voice.,
speech being either too fast or too slow
uncontrolled repetitions of sounds, words or phrases;
slurred speech;
difficulty initiating speech;
reduced facial expression and natural gesture; and
a harsh, breathy voice.
Is it related with Jaw tremor or trauma (the shock caused by unpleasant and upsetting experience )?
Is it related to tongue-tied/twister(difficulty to speak quickly) caused by neurological disorders?
Is it related with the drooling of saliva from the mouth ?
Best regards
TEOKIMHOE
Dear TEOKIMHOE,
Thank you for writing with these excellent questions. It is actually more than 50% of people with PD who have difficulty with speech and communication. The data tell us that it is actually closer to 85%. You are partially correct about the underlying causes of the speech problems. PD is caused by decreased dopamine in the central nervous system. The lack of dopamine also causes changes in control of the muscles that produce speech.
Typically, the motor speech changes are characterized by rigidity, weakness, difficulty in initiating movement, and difficulty making large movements. In addition, a critical component of the communication changes is the perception on the part of people with PD that they think they are speaking loud enough when, in fact, they are speaking at a low volume that also makes it difficult to understand them.
The result is that speech changes occur just like you described in your email: low volume, slurred speech, reduced intonation, alteration in rate, and changes in voice quality such as sounding breathy or harsh. These symptoms are caused by the PD. Sometimes people with try to compensate for these changes in ways that can make speech more difficult.
Unfortunately, the medications that can be so beneficial for limb symptoms have not been shown to have the same positive effect on speech and swallowing. However, there is a behavioral voice treatment that has been shown to help 80% of people with PD who complete the program. It is called LSVT. You can learn more about LSVT and find a certified clinician in your area by going to www.lsvt.org.
The last thing you mentioned is that you notice more drooling. There has been a lot of discussion about whether people with PD drool more or swallow less well. It seems the majority of the data point to the latter. People with PD swallow less frequently and with less strength and efficiency of muscle movement. One thing that can be done about this is to consciously tell yourself to swallow more frequently especially when in a social situation.
If you are already noticing signs of drooling there could be other changes in swallowing taking place. It would be a good idea to discuss this with your physician and seek an evaluation with a speech-language pathologist who has experience in evaluation and treatment of people with PD. Swallowing difficulties can potentially interfere with the ability to take pills and swallow safely and it is important to be vigilant.
I hope you will get treatment for your speech changes since communication is so important to quality of life.
Back to top
lmahler
Monday, July 23, 2007
Difficulties in PD Speaker
Posted: Sat Jul 21, 2007 4:53 pm Post subject: Difficulties in PD speaker
Dear Doctor,
I understand about half of all people with PD are likely develop difficulty with speech. The speech changes that occur are due to inco-ordination and reduced activities of muscles that control the speech mechanism.
The main difficulties I have experience are:
Loss of volume, pitch, range and intonation in the voice.,
speech being either too fast or too slow
uncontrolled repetitions of sounds, words or phrases;
slurred speech;
difficulty initiating speech;
reduced facial expression and natural gesture; and
a harsh, breathy voice
Speech difficulties can and do cause embarrassment and burden of career.
Best regards
TEOKIMHOE
Back to top
Dr. Rodriguez
Joined: 22 Jan 2007
Posts: 92
Location: Gainesville, Fl
Posted: Sun Jul 22, 2007 4:22 pm Post subject:
--------------------------------------------------------------------------------
You may benefit from an evaluation by a speech pathologist, using the Lee Silverman Voice Therapy or other as deemed necessary.
_________________
Ramon L Rodriguez
Dear Doctor,
I understand about half of all people with PD are likely develop difficulty with speech. The speech changes that occur are due to inco-ordination and reduced activities of muscles that control the speech mechanism.
The main difficulties I have experience are:
Loss of volume, pitch, range and intonation in the voice.,
speech being either too fast or too slow
uncontrolled repetitions of sounds, words or phrases;
slurred speech;
difficulty initiating speech;
reduced facial expression and natural gesture; and
a harsh, breathy voice
Speech difficulties can and do cause embarrassment and burden of career.
Best regards
TEOKIMHOE
Back to top
Dr. Rodriguez
Joined: 22 Jan 2007
Posts: 92
Location: Gainesville, Fl
Posted: Sun Jul 22, 2007 4:22 pm Post subject:
--------------------------------------------------------------------------------
You may benefit from an evaluation by a speech pathologist, using the Lee Silverman Voice Therapy or other as deemed necessary.
_________________
Ramon L Rodriguez
Sunday, July 22, 2007
Psychiatric and Cognitive disorder
NPF Home Help Search Register Log in
Psychiatric and Cognitive disorder in Parkinson's disease Posted: Sat Jul 21, 2007 7:22 am
--------------------------------------------------------------------------------
Post subject: Psychiatric and Cognitive disorder in Parkinson's disease
Dear Doctor,
I have known PD as an illness of the "body,mind soul"
Cognitive disorders are common in PD - anxiety, depression, uncertainties, emotional disturbances etc.
With the drastic improvement in the treatment of the movement problem in PD, I often find that the cognitive disorders are actually more difficult to treat than the movement problem.
Thanks
TEOKIMHOE
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Dr. Okun
Joined: 19 Jan 2007
Posts: 251
Location: University of Florida
Posted: Sat Jul 21, 2007 7:23 am Post subject:
--------------------------------------------------------------------------------
You are on target here. As PD progresses gait, speech and cognition in particular become a large challenge. We are focusing our research and development in these areas.
_________________
Michael S. Okun, M.D.
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Psychiatric and Cognitive disorder in Parkinson's disease Posted: Sat Jul 21, 2007 7:22 am
--------------------------------------------------------------------------------
Post subject: Psychiatric and Cognitive disorder in Parkinson's disease
Dear Doctor,
I have known PD as an illness of the "body,mind soul"
Cognitive disorders are common in PD - anxiety, depression, uncertainties, emotional disturbances etc.
With the drastic improvement in the treatment of the movement problem in PD, I often find that the cognitive disorders are actually more difficult to treat than the movement problem.
Thanks
TEOKIMHOE
Back to top
Dr. Okun
Joined: 19 Jan 2007
Posts: 251
Location: University of Florida
Posted: Sat Jul 21, 2007 7:23 am Post subject:
--------------------------------------------------------------------------------
You are on target here. As PD progresses gait, speech and cognition in particular become a large challenge. We are focusing our research and development in these areas.
_________________
Michael S. Okun, M.D.
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Friday, July 20, 2007
PD Progression with times
Posted: Wed Jul 18, 2007 4:22 am Post subject: PD progression with times
--------------------------------------------------------------------------------
Dear Doctor,
My doctor Dr. Chew Nee Kong told me PD is a body,mind and soul diseases.
PD is very unique compared with all other nervous illnesses-
the patients have a lot of misunderstandings, emotional disturbances and uncertainties.The illness itself is highly technical especially medications. As such, inter-patient and doctor-patient communication is extremely relevant in managing this illness.
In this connection I was told by him that my body (movement,/agility's) would aggravate with the times progression . No medicine would halt from it's progression.
PD would come to every part of body movement due to neurological disorders. It is also to your non motor movement i.e. vision, speech, breathing, digestion, drooling of saliva, urinate , emotional disturbances and uncertainties.
TEOKIMHOE
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Dr. Fernandez
Joined: 20 Jan 2007
Posts: 90
Posted: Thu Jul 19, 2007 8:33 am Post subject:
--------------------------------------------------------------------------------
I agree.
_________________
Hubert H. Fernandez
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--------------------------------------------------------------------------------
Dear Doctor,
My doctor Dr. Chew Nee Kong told me PD is a body,mind and soul diseases.
PD is very unique compared with all other nervous illnesses-
the patients have a lot of misunderstandings, emotional disturbances and uncertainties.The illness itself is highly technical especially medications. As such, inter-patient and doctor-patient communication is extremely relevant in managing this illness.
In this connection I was told by him that my body (movement,/agility's) would aggravate with the times progression . No medicine would halt from it's progression.
PD would come to every part of body movement due to neurological disorders. It is also to your non motor movement i.e. vision, speech, breathing, digestion, drooling of saliva, urinate , emotional disturbances and uncertainties.
TEOKIMHOE
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Dr. Fernandez
Joined: 20 Jan 2007
Posts: 90
Posted: Thu Jul 19, 2007 8:33 am Post subject:
--------------------------------------------------------------------------------
I agree.
_________________
Hubert H. Fernandez
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