Friday, July 31, 2009

NPF Discussion : Leg Freezing

Anonymous
Posted: Sat Jul 25, 2009 4:44 am Post subject: Leg Freezing

My brother has freezing on his leg when his medication is wearing off.

There are way to prevent him from falling down until the freezing going off.

1. stop from going foward going backward

2. stay horizon the place where you are to release the freezing


3.Holding both leg and slap side of both knee to release the freezin.

Is it strange why the parkinson patient does not have freezing problem whilst on cycling?

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Dr. FernandezJoined: 20 Jan 2007Posts: 90
Posted: Thu Jul 30, 2009 9:48 am Post subject:

Well, the brain is an interesting organ! It is fascinating. Sometimes, we need to "trick it" to get the results we want. PD patients to well when they are cued, or there is a pattern that they need to follow, or there is a line that they need to cross, or there is a rhythm or beat that they need to in tandem with. These are some audio or visual tricks used for freezing. Spinning and cycling works the same way. IF the freezing occurs during wearing off however, they might benefit from increasing PD meds. Yours,_________________Hubert H. Fernandez

Thursday, July 30, 2009

complementary and alternative medication

Anonymous
Posted: Thu Jul 23, 2009 7:05 am Post subject: Complementary & Alternative Medicine

Due to sideeffect of the medication there are growing interest for parkinson's patients in alternative and complementary medicine or therapies who will live with disease for a longer peroid of time. The CAM offers helpful information related to non motor and motor symptoms i.e proper diet, exercise, constipation, fatigue, insomina, massage. They try to minimize their usage of medication they take to minimize the physical or mental sideeffects on them. Kindly brief their potential benefits and risks for the alterative therapies. Sometimes the best treatment plans involve a wide range of interventions with their usage of the medications.
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Dr. FernandezJoined: 20 Jan 2007Posts: 90
Posted: Thu Jul 30, 2009 8:54 am Post subject:

Sorry, I don't know much about CAM. Mainly based on my ignorance, I am always skeptical about alternative therapies. While they make wonders for individual patient reports, when studies are performed using a rigorous, blinded, placebo-controlled design, the results don't always hold up...the perfect example is intravenous glutathione. While we hear about miraculous recoveries of glutathione, when Dr. Hauser's group in Tampa performed a double-blind, placebo-controlled trial on this therapy, there was no sigiificant difference in the performance of patients who received glutathione versus placebo. So, until studies are performed and results are shown, I would always be skeptical, no matter how promising it sounds. Yours,_________________Hubert H. Fernandez

complementary and alternative therapies

Anonymous
Posted: Fri Jul 24, 2009 9:43 am Post subject: complementary and alterantive therapies

There are time when they and families feel hopless,times when feel desperate about medical situation. In these movement they tend to complementary and alternative therapies, no matter how unrealistic or far-fetched they appear or how they cost. Therefore, there are growing interest for parkinson's patients in alternative and complementary medicine or therapies who will live with disease for a longer peroid of time. The CAM offers helpful information related to non motor and motor symptoms i.e proper diet, exercise, constipation, fatigue, insomina, massage, pain managment, Tai chi, rehabilation,speech therapy,acupuncture,spa treatment & etc. As the result they try the above therapy to minimize their usage of medication they take to increase comfort or minimize effect of the physical or mental on them. Why there are some doctors who do not pleased for the above therapies as they are yet proven? Kindly brief their potential benefits and risks for the complementary/ alterative therapies Regards
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Dr. FernandezJoined: 20 Jan 2007Posts: 90
Posted: Thu Jul 30, 2009 9:00 am Post subject:

I just responded to your earlier message. But know I relaize that CAM means complimentary and alterantive therapies. The good news is that good and proper research is underway on Tai Chi and Exercise. So we will know the exact benefits of those very soon. Our preliminary data on exercise is very compelling though, so we advocate this for all our patients. As for the others, none of the current vitamins work, unfortunately. CoQ10 and creatine are still being studied. Our current (good) data are not impressive for glutathione, Vit E, vit. C, and accupuncture. I hope this helps. Yours,_________________Hubert H. Fernandez



Anonymous
Posted: Thu Jul 30, 2009 8:48 pm Post subject: Exercise benefits

Doctor, I wish you guys would study pilates for pd patients. My husband takes pilates twice a week. He takes 60 minute solo lessons and he really gets his butt kicked. It's not classic pilates but more of power pilates. During all moves, he is encouraged to inhale deeply and give a forceful exhalation upon exertion. Most of the moves require balance from the core. I know it has decreased his falls. Every muscle group is worked and stretched. I know his instructor is especially talented but I truly believe it should be a basic for PD patients. My husband has moderately severe to severe PD and has been doing pilates for 2 years. I hope we never have to rely on PT because insurance only pays for 8-10 sessions then the patient has to decline to receive another PT order. With pilates, we don't have to experience the decline except for the normal progression of pd.
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Fri Jul 31, 2009 10:57 am Post subject:

Thanks for the wonderful comments. I have a number of patients who also swear by pilates. I think the exercise must be tailored to the person and what they can handle and suspect the research will show many effective strategies._________________Michael S. Okun, M.D

Anonymous






PostPosted: Fri Jul 31, 2009 2:54 pm Post subject: alternative and complementary medicine Reply with quote

My own experience yields at least one winner and it is evident, for me at least, in two to four days. I know that this is anecdotal but my grant check has not shown up yet. ;-)

The combination of alpha lipoic acid (400 mg) and acetyl-l-carnitine (3 g) boosts me across the board, purportedly by improving mitochondrial function. Dr. Bruce Ames has published on this a dozen or so times and the effect is impressive.
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Dr. Okun



Joined: 19 Jan 2007
Posts: 251
Location: University of Florida

PostPosted: Sat Aug 01, 2009 7:15 pm Post subject: Reply with quote

Thanks for the nice comments.

I have patients who take these supplements and swear by them. We just don't know if they are effective in PD, or against symptoms of PD as we don's have the data. We are therefore not recommending patients expend dollars on them, but at least in my practice I do not object if they would like to try them.
_________________
Michael S. Okun, M.D.
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Sunday, July 26, 2009

PNF Forum:Leg Freezing

teokimhoe



Joined: 03 Mar 2007
Posts: 144
Location: Malaysia

PostPosted: Sat Jul 25, 2009 8:02 am Post subject: Leg Freezing Reply with quote

When you have leg freezing whilst walking instead going forward going backward it is to prevent a fall.

Holding both leg and slap side of both knees to release the freezing

Stay horizon the place where you are to release the freezing.

The reason why you have leg freezing because you are under medication and it is wearing off.

It is strange why the parkinson patient does not have leg freezing problem whilst on cycling?


Is it we walking we concentrate our movement to balanc?


Is it cycling we paddle up and down with one leg after the other?
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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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Rogerstar1



Joined: 14 Mar 2007
Posts: 416

PostPosted: Sat Jul 25, 2009 10:36 am Post subject: Reply with quote

It has been my experience that at least in the early years one's voluntary movements (typing, throwing a ball etc.) are affected most during 'off' periods. Autonomic movements like breathing, ducking to avoid or blocking a ball thrown at your face by instinct, moving a leg forward or back to maintain equilibrium and 'break' or prevent a fall are involuntary and hindered only after lengthy disease progression. Thus. willing myself to step off a curb or into a closed hallway or room is sometimes a problem if 'off'. Catching a fall by moving a leg to balance is still mostly an automatic reaction that I simply ...do. But, alas...that ability is slipping away, too. Best to you Tee-Man.

Rogerstar

bernard shaw



Joined: 19 Aug 2008
Posts: 321
Location: Austria Late UK

PostPosted: Sun Jul 26, 2009 12:42 pm Post subject: Bern Leg movements. Reply with quote

I too have these stupid periods where one leg will suddenly stop right in the middle of a step. I have used a walking stick for the last twenty five years and I am sure that it is the stick that stops me falling flat on my face. My last fall nearly a year ago I not only broke the little finger of my right hand but had to undergo an hours operation to fix the break and put the finger lesion back into place and five stitches to close the wound. Painful to say the least. I wish you much luck with your medication, my Neurologist increased my sinemet retard 200/50 by one extra tablet since then the leg movements are better. Keep smiling best regards from Bern
_________________
If your face wants to smile, Let it.
If it doesn't, Make it.
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Saturday, July 25, 2009

leg freezing

When you have leg freezing whilst walking instead going forward going backward to prevent a fall.

Holding both leg and slap side of both knees to release the leg freezing

Stay horizon the place where you are to release the freezing.

The reason you have leg freezing because you are under medication and it is wearing off.

It is strange why the parkinson patient does not have leg freezing problem whilst on cycling?


Is it we walking we concentrate our movement to balance ?


Is it cycling we paddle up and down with one leg after the other?

Sunday, July 19, 2009

Saturday, July 18, 2009

secret recipe behind the mask

Secret recipe behind the mask

I often smiled as I watched the video recording of my kick-boxing exercise which I have uploaded to YouTube a few weeks ago. My trainers and videographer told me the same thing – “You do not look like a Parkinson’s patient at all”. Even my doctor shook his head in disbelief and said, “This is shocking. I can’t imagine a 70-year-old Parkinson’s patient doing such a strenuous exercise such as kickboxing. I am sure that you are the only Parkinson’s patient in Malaysia who is doing the kickboxing exercise.”

As early as 1998, I already had both the motor and non-motor symptoms. Since my diagnosis in 2002, I went through a period of depression, anxiety, denial and anger. Subsequently, I bounced back after discovering a secret recipe for fighting Parkinson’s, which consisted of: knowledge (is power), exercise, medications, nutrition / supplements and prayer. In my quest for knowledge, I browsed various Parkinson’s websites, raining them with questions, questions and questions. I even started the first Parkinson’s blog in Malaysia (http://www.hwroteo.com/). I tried to learn everything about Parkinson’s in order to overcome all complications - the Chinese heroes won their battles by understanding their enemies first.
.
Animal experiments showed that exercises may be neuroprotective. Rats which were forced to exercise had a lesser degree of brain damage after they were exposed to poison. In mice which were made to undergo treadmill exercises, there was increased production of dopamine.

Parkinson’s patients are comparable to the car. The medications are needed to help patients to start walking, while fuel or battery is needed to help start the car engine. Exercises are needed to improve the patients’ physical mobility and endurance, while driving helps to recharge the battery. Thus, exercises help our “engines” warm up before leaving home and keep the “cars” going everyday. Even healthy people such as Bruce Lee, the Chinese kungfu master, know that exercises are beneficial.

As such, since 2005, I decided to “get physical”. I am spending 3-4 hours everyday at the California Fitness gym, doing a wide range of “heavy” exercises such as kick-boxing, weight-training and spinning (indoor cycling). Twice a week, I do yoga exercises at home with the guidance of a trainer.

Since this year, my physical condition has drastically improved. I sleep and eat well (I eat to live a healthy and good life). I enjoy driving around the Kuala Lumpur city with my wife everyday and going overseas for holiday. I managed to reduce the daily dose of Parkinson’s medications recently. Sometimes, I wonder whether I am just a “normal person” behind the mask.


Am I a Parkinson’s patient? – Try taking my “killer” punch and you’d wonder whether I really have Parkinson’s.





I know that it is technically difficult to prove that exercise has neuroprotective effect in Parkinson’s patients. Despite this, I believe that exercise has slowed down my disease progression. I hope that my video recording will bring hope and happiness to all Parkinson’s patients in this world, by reminding them that they can still live a physically active life.

Mr. Hero Teo, Kuala Lumpur, Malaysia
10th July 2009.



Hua said...
Hero,You certainly don't look like a Parkinson's patient. Keep up the good work!I'm Hua, the director of Wellsphere's HealthBlogger Network, a network of over 2,000 of the best health writers on the web (including doctors, nurses, healthy living professionals, and expert patients). I think your blog would be a great addition to the Network, and I'd like to invite you to learn more about it and apply to join at Wellsphere.com/health-blogger. Once approved by our Chief Medical Officer, your posts will be republished on Wellsphere where they will be available to over 5 million monthly visitors who come to the site looking for health information and support. There’s no cost and no extra work for you! The HealthBlogger page (http://www.wellsphere.com/health-blogger) provides details about participation, but if you have any questions please feel free to email me at hua@wellsphere.com.Best,Hua
July 31, 2009 10:33 AM