Patient Corner
* ZOOM SHARING MEETINGS FOR PERSON WITH PARKINSON'S DISEASE
* SAFE SWALLOWING GUIDELINES
* OPTIONS FOR SAFER WALKING
* HINTS FOR FREEZING ISSUES
* MANAGING SYMPTOMS OF PARKINSON'S DISEASE, NEW
* SAFE SWALLOWING GUIDELINES
* OPTIONS FOR SAFER WALKING
* HINTS FOR FREEZING ISSUES
* MANAGING SYMPTOMS OF PARKINSON'S DISEASE, NEW
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Zoom Sharing Meetings for Person with Parkinson's Disease
Besides our monthly meetings in person, we are offering an opportunity via Zoom for the Person with Parkinson's (PWP) to share with other patients. The 1 PM meeting is open specifically for only patients, with Dr. Stu Gillim facilitating. Below is the information you need to enter the Zoom meeting. For each 2nd Wednesday of the month at 1PM, the link is the same for all of 2024. We suggest you save the link.
Copy and paste the Meeting Code below to join meeting.
https://us02web.zoom.us/j/84266002257?pwd=a0xjZmdjSEFHUW01ZHFQcjUwZUlvUT09
Safe Swallowing Guides
As the muscles in the throat decrease their natural response, some methods need to be used to aid in swallowing so as not to choke. You might want to try these suggestions from Jessica Zumbo, Speech Therapist.
1. Sit upright at the table or counter when eating or drinking and remain sitting up for at least 30-45 minutes after eating.
2. Take small bites and/or sips during a meal. CHEW COMPLETELY !
3. Eliminate distractions during meals such as watching TV. You might inadvertently lift your head while chewing or swallowing causing choking.
4. Tuck your chin before swallowing: liquids or solids.
5. Alternate food and drink during a meal
6. Avoid mixed consistency foods such as soups. If an item like soup is on the menu, ask your care partner to strain out the liquid from your serving, so you only have the main meat, vegetables, and possible starch such as rice/noodles.
7. If you hear a gurgly voice from yourself, clear it before you continue eating/drinking.
8. If you're having trouble with pills, mix them with applesauce to help swallowing them.
Options for Safer Walking
Please open the following link for the 4 tips for walking safer by Phil Horton who lives in Colorado Springs and who has been diagnosed with PD since 2014. We were not allowed to merely copy the 4 tips, but we could include his link in our website. We strongly recommend you check out this site.
www.brainandlife.org/the-magazine/online-exclusives/strong-voices-4-tips-for-improving-walking/?utm_source=Informz&utm_medium=Email&utm_campaign=21-BL&utm_content=Parkinsons-Spotlight-2
Put the "Freeze" on Freezing
Besides the tips below, go to the following 2 sites for additional U-tube information on freezing.
www.youtube.com/watch?v=BcSANzeSPD8
Are there any tips to use for freezing? - YouTube
1. Try another movement – raise an arm, touch your head, point to the ceiling; then re-start
2. Change direction: if you can’t move forward, try stepping sideways first, and then go forward
3. Carry a laser pointer in your pocket; when you freeze – shine the laser in front of your foot and step on the light – this visual cue can help you re-start.
4. Visualize an object on the ground in front of you and try to step over it.
5. Wear a metronome on your belt or carry a small one in your pocket – turn it on and the external beat can help you re-start.
6. Try humming a song and time your re-start with the beat of the music
7. Count “1-2-3-go” and then step forward
8. Shift your weight from side to side to help initiate taking a step
9. March in place a few times and then step forward
10. Don’t fight the freeze by trying harder to step forward – shift your attention from moving the legs to moving the arms – then resume walking forward.
Zoom Sharing Meetings for Person with Parkinson's Disease
Besides our monthly meetings in person, we are offering an opportunity via Zoom for the Person with Parkinson's (PWP) to share with other patients. The 1 PM meeting is open specifically for only patients, with Dr. Stu Gillim facilitating. Below is the information you need to enter the Zoom meeting. For each 2nd Wednesday of the month at 1PM, the link is the same for all of 2024. We suggest you save the link.
Copy and paste the Meeting Code below to join meeting.
https://us02web.zoom.us/j/84266002257?pwd=a0xjZmdjSEFHUW01ZHFQcjUwZUlvUT09
Safe Swallowing Guides
As the muscles in the throat decrease their natural response, some methods need to be used to aid in swallowing so as not to choke. You might want to try these suggestions from Jessica Zumbo, Speech Therapist.
1. Sit upright at the table or counter when eating or drinking and remain sitting up for at least 30-45 minutes after eating.
2. Take small bites and/or sips during a meal. CHEW COMPLETELY !
3. Eliminate distractions during meals such as watching TV. You might inadvertently lift your head while chewing or swallowing causing choking.
4. Tuck your chin before swallowing: liquids or solids.
5. Alternate food and drink during a meal
6. Avoid mixed consistency foods such as soups. If an item like soup is on the menu, ask your care partner to strain out the liquid from your serving, so you only have the main meat, vegetables, and possible starch such as rice/noodles.
7. If you hear a gurgly voice from yourself, clear it before you continue eating/drinking.
8. If you're having trouble with pills, mix them with applesauce to help swallowing them.
Options for Safer Walking
Please open the following link for the 4 tips for walking safer by Phil Horton who lives in Colorado Springs and who has been diagnosed with PD since 2014. We were not allowed to merely copy the 4 tips, but we could include his link in our website. We strongly recommend you check out this site.
www.brainandlife.org/the-magazine/online-exclusives/strong-voices-4-tips-for-improving-walking/?utm_source=Informz&utm_medium=Email&utm_campaign=21-BL&utm_content=Parkinsons-Spotlight-2
Put the "Freeze" on Freezing
Besides the tips below, go to the following 2 sites for additional U-tube information on freezing.
www.youtube.com/watch?v=BcSANzeSPD8
Are there any tips to use for freezing? - YouTube
1. Try another movement – raise an arm, touch your head, point to the ceiling; then re-start
2. Change direction: if you can’t move forward, try stepping sideways first, and then go forward
3. Carry a laser pointer in your pocket; when you freeze – shine the laser in front of your foot and step on the light – this visual cue can help you re-start.
4. Visualize an object on the ground in front of you and try to step over it.
5. Wear a metronome on your belt or carry a small one in your pocket – turn it on and the external beat can help you re-start.
6. Try humming a song and time your re-start with the beat of the music
7. Count “1-2-3-go” and then step forward
8. Shift your weight from side to side to help initiate taking a step
9. March in place a few times and then step forward
10. Don’t fight the freeze by trying harder to step forward – shift your attention from moving the legs to moving the arms – then resume walking forward.
Managing Symptoms of Parkinson's Disease: Notes from Dr. Stu Gillim's November 2023 Presentation
1. Educate yourself about symptoms and how to manage them. Be alert to new symptoms (they might not be from PD). Look for a pattern: when you take your meds, when and what you eat, when and what you are doing. Write down what you notice (Journaling).
2. Seek treatment by a multidisciplinary health team (movement disorder specialists) if possible.
3. Educate yourself about drug effects, side effects and interactions (www.drugs.com).
4. Improve symptoms without drugs
a. Physical activities such as those below have been shown to slow the progression of PD.
Activities that raise heart rate (cardio), strength training, physical therapy, treadmill training (intervals), stationary bicycling (intervals), dance, yoga, massage therapy, boxing such as Rock Steady Boxing, Tai Chi for balance, rowing, walking with walking poles, speech therapy such as LVST-big, or Speak Out helps swallowing and prevents aspiration, possibly acupuncture (although it has had mixed reviews regarding its usefulness)
b. Psychosocial activities:
Enjoyable group activities, family support, support groups, relaxation therapy, mindfulness, social connections, music therapy. Cognitive Behavioral Therapy performed by psychologist, psychiatric social worker, or psychiatrist in person or on line is very effective for anxiety, depression, insomnia, impulse control disorder with no side effects.
c. Dietary choices may slow progression.
Correct the microbiome by increasing dietary fiber (fruits, vegetables, whole grains, nuts), yogurt (active culture), and fermented foods (sauerkraut, kimchee, sourdough bread, kombucha) but eating fewer saturated fats and complex sugars. Data on probiotics as to their slowing PD progression are mixed.
*Microbiome: the community of micro-organisms living together in a particular habitat, such as the human body.
d. Insomnia: Maintain regular sleep hours. The suggestions below should help decrease insomnia so a person can get
6-9 hours of sleep a night.
Don’t exercise in the late afternoon or evening, do not take in caffeine or alcohol in the evening, reduce fluid intake late in the day, avoid “screens” (television, computer, tablet, cell phone) late in the day unless they are low blue light models, avoid “screens” in the bed room ( using the bed only for sleep or sex), limit napping
during the day to 15 minute “cat naps”, start relaxing 1-1 ½ hours before bedtime, keep the bedroom cool around 65 degrees, use a “light box” for 30-60 minutes once or twice a day to reduce daytime drowsiness and
help insomnia.
e. Constipation: Besides following dietary guidelines as noted in “c”above and taking in adequate hydration, the use of the following could help.
A fiber supplement (start low and slowly increase); polyethylene glycol (eg. MiraLax) taken daily and adjusting the dose; stimulants (eg. senna) use occasionally; glycerine suppository if having trouble initiating a bowel movement (sphincter discoordination)
f. Urinary symptoms and suggestions:
Most common: urgency, frequency, incontinence , nocturia (waking from night time sleep once or more times to void) caused by overactive muscles. Decrease fluids in the evening, avoid alcohol and caffeine in the evening, schedule urination during the day (every 2-3 hours), do pelvic floor exercises (Kegel) and pelvic floor stimulation.
Less common: slow stream, incomplete voiding caused by underactive muscles
Have your prostate checked, see a urologist.
g. Low blood pressure: Loss of normal diurnal (day time) fluctuation which should be lower in the AM and higher in the PM
Increase fluid intake in the AM and early PM, sleep with head of bed elevated, pump legs and feet before getting out of bed or chair, increase salt intake (unless advised not to because of other medical conditions), avoid very hot baths or showers, wear compression stockings.
h. Cognitive impairment:
Make sure your hearing is OK and get hearing aids if necessary. Otherwise, simplify your daily activities, organize those activities, write things down (calendar, journal), and delegate: asking others to help you.
1. Educate yourself about symptoms and how to manage them. Be alert to new symptoms (they might not be from PD). Look for a pattern: when you take your meds, when and what you eat, when and what you are doing. Write down what you notice (Journaling).
2. Seek treatment by a multidisciplinary health team (movement disorder specialists) if possible.
3. Educate yourself about drug effects, side effects and interactions (www.drugs.com).
4. Improve symptoms without drugs
a. Physical activities such as those below have been shown to slow the progression of PD.
Activities that raise heart rate (cardio), strength training, physical therapy, treadmill training (intervals), stationary bicycling (intervals), dance, yoga, massage therapy, boxing such as Rock Steady Boxing, Tai Chi for balance, rowing, walking with walking poles, speech therapy such as LVST-big, or Speak Out helps swallowing and prevents aspiration, possibly acupuncture (although it has had mixed reviews regarding its usefulness)
b. Psychosocial activities:
Enjoyable group activities, family support, support groups, relaxation therapy, mindfulness, social connections, music therapy. Cognitive Behavioral Therapy performed by psychologist, psychiatric social worker, or psychiatrist in person or on line is very effective for anxiety, depression, insomnia, impulse control disorder with no side effects.
c. Dietary choices may slow progression.
Correct the microbiome by increasing dietary fiber (fruits, vegetables, whole grains, nuts), yogurt (active culture), and fermented foods (sauerkraut, kimchee, sourdough bread, kombucha) but eating fewer saturated fats and complex sugars. Data on probiotics as to their slowing PD progression are mixed.
*Microbiome: the community of micro-organisms living together in a particular habitat, such as the human body.
d. Insomnia: Maintain regular sleep hours. The suggestions below should help decrease insomnia so a person can get
6-9 hours of sleep a night.
Don’t exercise in the late afternoon or evening, do not take in caffeine or alcohol in the evening, reduce fluid intake late in the day, avoid “screens” (television, computer, tablet, cell phone) late in the day unless they are low blue light models, avoid “screens” in the bed room ( using the bed only for sleep or sex), limit napping
during the day to 15 minute “cat naps”, start relaxing 1-1 ½ hours before bedtime, keep the bedroom cool around 65 degrees, use a “light box” for 30-60 minutes once or twice a day to reduce daytime drowsiness and
help insomnia.
e. Constipation: Besides following dietary guidelines as noted in “c”above and taking in adequate hydration, the use of the following could help.
A fiber supplement (start low and slowly increase); polyethylene glycol (eg. MiraLax) taken daily and adjusting the dose; stimulants (eg. senna) use occasionally; glycerine suppository if having trouble initiating a bowel movement (sphincter discoordination)
f. Urinary symptoms and suggestions:
Most common: urgency, frequency, incontinence , nocturia (waking from night time sleep once or more times to void) caused by overactive muscles. Decrease fluids in the evening, avoid alcohol and caffeine in the evening, schedule urination during the day (every 2-3 hours), do pelvic floor exercises (Kegel) and pelvic floor stimulation.
Less common: slow stream, incomplete voiding caused by underactive muscles
Have your prostate checked, see a urologist.
g. Low blood pressure: Loss of normal diurnal (day time) fluctuation which should be lower in the AM and higher in the PM
Increase fluid intake in the AM and early PM, sleep with head of bed elevated, pump legs and feet before getting out of bed or chair, increase salt intake (unless advised not to because of other medical conditions), avoid very hot baths or showers, wear compression stockings.
h. Cognitive impairment:
Make sure your hearing is OK and get hearing aids if necessary. Otherwise, simplify your daily activities, organize those activities, write things down (calendar, journal), and delegate: asking others to help you.