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Showing posts with label UPDRS. Show all posts
Showing posts with label UPDRS. Show all posts

Friday, April 19, 2019

Parkinson's Day with My Doctor and Health Union



Yesterday was Parkinson’s day for me. Well, every day is Parkinson’s Day, and while this is Parkinson’s Month, an entire month where I get feted, but not given presents, ice cream cake, or ceremonial ear pulls, this was a different kind of Parkinson’s day since it began with going to the doctor’s office for a 10AM 4-month checkup.

My doctor is a good guy. He gets it, and I’ve been seeing him since September 27, 2016, which was the day that got this whole ball of neurological wax going. The point of going is to find out where I am on the UPDRS (Universal Parkinson’s Diagnostic Rating Scale). This allows the doc to adjust medications and other treatments.

At my worst, I was mid-30s (just a Parkie baby, though experienced with enough symptoms to know Parkinson's sucks). At my best, I didn’t have Parkinson’s, which was up until 2011, though it seemed to always be lurking beneath the surface, ready to explode long before the first tremors and urinary changes happened (always feeling the need to go and not having a “strong” stream).

Now, now I have Parkinson's and it's the new normal.

The last time I went to the doctor's office, it was the beginning of winter. I was at a 16. Wednesday, I was at a 20. After the winter, the doctor felt this was good. I had more of a tremor in my right hand than left hand, which was odd since I began on the left (left hand > left foot > through the head > right hand > right foot). Shaking is just what Parkinson’s does. I guess you could say, “I shake; therefore, I am Parkinson's.”



I guess that makes my wife my Princess Leia!

I’ve reached a point where, though I can still use utensils and shave, my hands pretty much shake constantly. I let them. I can stop my tremors by tightening up my arms, but since my arms from fingertips to fingertips, across the shoulder, is in permanent action figure pose of rigidity, I choose to leave my body relaxed while I can.


The biggest happiness for my doctor was being this far into the game without levodopa. Granted, I have a super spider web pattern on my legs (livedo reticularis - that's my catwalk friendly legs) from the Amantadine (a “harmless,” but “U-G-L-Y” side effect of said medication), but I’ll wear that with the pride of a lack of humility (or being too old to care about what people think if it keeps me going).

From there, I drove to Philadelphia to meet the good folks at Health Union, who were interviewing me for a podcast. A few weeks ago, I had been suggested as a candidate, and I immediately jumped at the chance. I had never met them, so I was super jazzed. It was a moment where my words of educating and advocating were going to be given a 30-minute platform to speak to people, so why not?!



Upon arrival, I met Emily Downward (pictured at the top right), who is handling the project of interviewing many of their advocates, who write and speak out on behalf of 22 different conditions. The office is on Chestnut Street (smack dab in the middle of Center City and surrounded by banners of Phillies players), and the area is bustling with traffic, both foot and driven. 

The office, too, is a hive of energy. Multiple floors house computer cubes, offices, and sofa areas, where a youthful staff write and post content, create art, manage a website, and meet to improve said Internet communications and causes. I’m not sure I knew what to think that it was, but let’s just say that running a website is kind of a big deal, and it's definitely staffed for such.

Emily escorted me to a room, and we discussed life with Parkinson’s, which should be out in June. I’ll just leave you in suspense to the details, but I’m excited about it. How can I not be? Emily runs a great interview, and she’s a great editor, so I’m sure she’ll make sense of my rambling flows. I’m sure she’ll take out the huge lost train of thought in the middle of one question, too, but alas… we all have our moments.

For those who aren’t aware, Parkinson’s train of thought takes your normal train of thought and switches it up kind of like shaking the brain and leaving the person in a pause, now and again. That’s why my doctor always asks me about my memory, which is generally pretty good, I think, though in long running trains of dialogue, it can get tripped up sometimes. Essentially, it’s like the London Underground, where there are 17 lines going at once, so it's inevitable something is going to go amiss.


These lines run all over the city. As with London’s underground. I have the Central Line, which is my main focus. I also have the Northern Line, which is my “Squirrel!” line. It can get diverted up or down by just about anything. I’ve got the music line, which is equivalent to the Piccadilly Line. I've got the Heather Line (AKA the Jubilee Line) and the family line. I’ve got 2 lines of random information that I’d like to know at any single time as well, not to mention the movie and literary quotes line and the random Jeopardy style facts line. I have 2 lines of random memories (good and bad) coming in at one time as well. They don’t all run continuously, but they’re there in much the same way as my places I have to go to line. Then, there’s the line of things that I should be noting down. There’s the voice of reason lines which belong to family, work, and society, and finally, there is the Circle Line, which is a centrally located line that runs around my brain and seems to go nowhere good since it’s my impetus to do something stupid line. Generally, I can avoid it by taking another line, but it’s there waiting just in case I choose to use it.

And yes, it does get some travel.

Adding Parkinson’s to the mix means that sometimes, someone is asleep on the train tracks, so we have to go a different way. Other times, we have work crews in progress since things are being done to make a section better. Sometimes, there’s nobody there to open up a necessary track. Finally, sometimes there’s just stuff getting at my brain, which makes it temporarily unavailable due to actions beyond its control. When things happen, as Parkinson's causes them to, the thoughts inside my head turn to confusion, irritation, anxiety, or simply being rerouted through an unlit tunnel. That’s what it feels like when you can’t get back to point C or point A from where you are around point B.
Let’s just say Emily is good at being patient while rerouting the tracks.


After the interview, I got to meet Kate Leonard (pictured left) and talk about Health Union, Parkinson's, writing, and her newborn son. It was great to meet her, too, and see some of the people who  have brought me on to make the PD DOT NET stuff happen.

We have quite a talented team of advocates that you should check out. They come from all different backgrounds. Many are younger, which for the Young / Early Onset PD crowd is an important thing (since we're rarer), though they write for everyone based on their experiences.

That said, I encourage you to check them out.

I know I'm looking forward to going to Connexion to meet up with them in October (21+22) to experience the power of group advocacy!

Thanks for continuing to support my writing. If you like this, please subscribe to my blog or follow me at my Parkinson's Facebook page  Please feel free to share, too.

Have a great weekend!


Wednesday, March 21, 2018

25 Things I Learned about Parkinson's since I Was Diagnosed.


Up until immediately after my Avalanche Day on September 27, 2016, all I knew about Parkinson's was:

1) tremors
2) Michael J. Fox
3) Muhammad Ali
4) I felt pretty uncoordinated doing the tests in my neurologist's office.
5) Being given 90% odds of having it made my wife cry. Having it made her cry again.

Since then, I have learned a lot more.

1) Despite waking up the next morning filled with strength and confidence, which are essential, I was very naive to be thinking that would be enough. There are still a lot of things that are coming down the pike to be afraid of (freezing, aspiration pneumonia, "bridge out" signs in my brain, more trips into a CAT Scan), but I have learned that life is a choice. As long as I can, I'm going to choose it in whatever form I can and keep doing the things that make me Dan (and I'm going to celebrate them! Besides, if I don't, who will?!).


2) I have learned to use People First Language for myself, and as time has gone by, I feel more conscious about talking about what I can still do in Stage 2 when some people who are in later stages and the same stage have lost the ability to do a lot of things that I might appear to be bragging about (I am most definitely not). However, I'm not going to stop doing or pushing myself to enjoy them, but I am working on empathetic understanding in writing so that I can promote positive enjoyment of life and not "I can do this; look at me! I am the most wonderful person ever!" (that said, there is a picture of the Hawk Mountain wall I climbed last summer in my bedroom to remind me about what I can push myself to do).


3) There are many great support groups out there. Unfortunately, in Stage 2, I don't have the ability to talk about things like DBS, any interest in talking about medical marijuana, or experience with where I'm going other than I read about it (in a book), which seems like what many questions online are concerned about (I'm glad there are people out there to share answers with and get them from). I do like the articles and updates people post, but with being a teacher, I have access to some serious databases as well as a wife that knows her medical information to keep me informed of what is what when my neurologist doesn't "keep it 100" in our visits. I do follow posts, but I don't always join in on the 50 people respond to a question posts. All the same, I do find them valuable. That being said, I enjoy being able to share with you and see what's going on with my fellow Parkies. When the DBS days come, I'm sure I'll learn more from others who will help me with that decision in the same way I have learned about the bad effects of some medicines.

4) I have learned about the UPDRS (Universal Parkinson's disease rating scale). After hospitalization, I went up from 4 to 37. Personally, 4 seemed like a good medicine day, but now I'm in stage 2 for realsies. Yep... here's to the gift that keeps giving. Those next 30 points are going to be a ride of fear, compensation, and adjustment.

5) I've learned that almost every symptom I have is "normal" to a Parkinson's life with its medical "gifts," stress, and depression, and yes, that sucks. Sciatica? Check. Hearing? Check. Not being able to smell my own gas? Check. My big toe hurts? We'll see.


6) My biggest sadness is how my condition affects those close to me. However, I'm not going to die tomorrow. Yes, I do like being asked how I am and offered hope and well wishes. I like people knowing that they can joke with me. I'm not going to take offense. Really. I have a strange sense of humor. I like when people can understand that and still enjoy it. There's a difference in wishing me dead and calling me "Shakes the Hiker." That said, I'm happy for the family and the love. Without them, it's a lonely world. Besides, if I accuse someone of a hate crime for calling me clumsy, it's not for real. It's just how I take seriousness out of the situation.



7) Hyperhidrosis - That extra sweat / really thirst thing, which I get really bad on the trail (and while sleeping in bed). It has a name, and it's connected to PD. I wrote about that in detail HERE.


8) I found out that getting Lyme disease at the same time as Parkinson's was not as fun as getting a free toaster with a purchase. Lyme is the great imitator, by the way. It's nasty stuff, and you can learn about it HERE.



9) Bradykinesia - I've learned that anything that can go slower on me will... except for frequent urination. I'm as confused as you. That said, this leads to #10, which is my second biggest fear (by the way, #3 is my tremors going nuts when I'm having to deal with a serious issue with a student).

10) Parkinson's Mask - I wrote about this really well HERE. Nothing like being accused of having resting bitch face / being a moody bastard when it's not true.


11) Dystonia / Restless Leg - I wrote about this a lot more thoroughly HERE. Important note: My left foot is pretty messed up and I visually walk "oddly," but with tight shoes + hiking boots, I manage a lot better. Other people's dystonia is much more severe. These solutions won't help those people.

12 ) Cognitive Issues - My only experience with this was the side effect of a medication I quickly quit. That sucked. Additionally, it scares the bejesus out of me to think more is coming, someday. My mind is important to me as a writer / teacher / human. I'd like it to function well for a while.

13) Lethargy / Apathy / Depression - All those great plans... yep. If only I don't feel too tired to make it happen. It's "normal" for Parkies, so know that we have to motor through it.

14) Substantia Nigra / dopamine / Lewy bodies - Without all of the technical terms, I learned about how the body makes dopamine, which is a WD40-type pathway protector / happiness maker. Sometimes, the body's defense mechanisms (genetics) are messed up and the body goes after these dopamine neurons like they were zombies. Interestingly enough, after this attack takes place, the body is filled with zombie-type cells (Lewy bodies). In a way, we could say they go wild and mess up their prey, leaving zombie-nastiness in the brain. I wonder if this is how The Walking Dead will end.


15) MAO Inhibitor (Monoamine Oxidase Type B) - Azilect is my go to medicine, and it works, but it's expensive without insurance. Nevertheless, without it, I'm toast. All that stuff in 14 is pharmaceutically dealt with by this.

16) Dopamine Agonist - Ropinerole (fake dopamine) is what keeps my tremors under control. So far, it's doing well. All that stuff in 14 is pharmaceutically dealt with by this.

17) Livedo Reticularis - not a pretty side effect I had from one of my meds. Because of this, I had to stop it. This isn't my legs. It can look worse than this. Mine were just beginning to turn purple.


18) Aspiration pneumonia - the number one killer of Parkies. Really. A story in 2 parts, which begins HERE and ends HERE. Knowing what will most likely take us out is damn scary. As I go for more doctor visits for sleep apnea and a real deal swallow study, I'll be talking about this and dysphagia a lot more.


19) Hallucinations / Sleep issues - Now I know why I have wild dreams and crazy sleeping habits. That said, I really like Eternal Sunshine of the Spotless Mind. Who knew it would stream in my head while I sleep? I also wrote about DREAMS and COMMUNICATION WITH MY DECEASED GRANDMOTHER in past posts.



20) The best is yet to come, even if there are some rough things to come, too. Guys like Jimmy Choi are living proof of Muhammad Ali's attitude when he said, "It ain't bragging if you can back it up." Choi still runs marathons and competes in American Ninja Warrior despite his PD.




This is the same attitude that baseball great Ted Williams had when he didn't sit in the final game of the 1941 season to preserve his .400 season batting average. Instead, he went "Beast Mode" in the final doubleheader to take it to .406. Here, all of us Parkies can raise our game a little bit and find ways to enjoy life, even if we can't do a lot of this.

If you choose to enjoy the following video of the Baseball Project celebrating Ted Williams, remember it's NSFW.


21) My whole body is super-warm these days EXCEPT my toes. Go figure. Here's to wool and heavy hiking socks to keep me warm.

22) Man, I hate the feeling of being overloaded mentally. When things are out of synch in a cacophony or flashing world of lights, I go out of control with them quickly. Ugh. Not fun or my favorite at all! I wrote about this feeling HERE.

23) You'd be surprised what you can give up if it means being alive while staying on the straight and narrow world of what Parkinson's and its meds take from you. I know there are things in my identity, which I will lose someday; however, until that day comes, I'm going to choose to experience them if I can. In the meantime, I wave goodbye to alcohol, sleeping in the same bedroom, clipping my own fingernails, going shooting with my dad, the speed of my typing, sleeping at normal times, not needing a disclaimer, not having to worry about what things to avoid, not worrying about the Parkinson's process on pretty much every one of my body's functions, not knowing that my condition will cause people sleepless nights, and holding a camera steady while shooting video, to name but a few. Obviously, the list above is an iceberg, but you get the point. In the end, happiness is other things.

24) Speaking of disclaimer explanations, HERE'S MINE.

25) That whole thing about a big vacation bucket list...
A) San Francisco is up next with the Yosemite waterfalls.


B) The Great American Petroglyph Tour to see the Great Gallery before dystonia ends long walks for good.


C) Italy


D) Washington / Oregon


E) Yellowstone


Of course, there are other vacations and trips with people that don't involve walking like those will, and they're on there, too, but yeah... there's something about sharing beautiful images with people we love, especially if the bomb inside that went off before is going to go off worse in the future, but for now, there are things to do and "miles to go before I sleep."

I just want MORE TIME to get to them.