August 27, 2014

More Thoughts about Parkinson's and Robin Williams' Suicide

Robin Williams' suicide affected many people. There has been intense media and internet scrutiny... and speculation. These two commentaries resonated with me.

1) Former Time Warner Chairman Jerry Levin Comes out of the Parkinson's Closet
In an interview last week with Deadline Hollywood, Levin disclosed for the first time that he has Parkinson’s disease. He was diagnosed eight years ago.

What follow are verbatim quotes and paraphrasings of Levin's remarks.

Levin’s “coming out.” The death of Robin Williams led Levin to acknowledge his own PD: 
Basically the reason I really wanted to start talking about it now was, to raise awareness and understanding that there may be a million souls in the U.S. who have Parkinson’s, but there are probably many more who are undiagnosed. There is a lack of research and actually a relative lack of practitioners who are versed in Parkinson’s. Probably one quarter of those who have Parkinson’s are being treated by a specialist. The rest are not. For me, it’s not a question of philanthropy, it’s really a question of awareness. That’s why I think what Robin represents is so critical.  
We see the effects of addiction, we know what clinical depression means, but when you put it together with this debilitating disorder that slowly takes away your ability to function and to express . . . and we haven’t even covered the autonomic impact on your ability to sleep or your ability to swallow. Once the diagnosis is given, there is an enormous psychological shift and you tend to view the world from that prism. It is so hard to distinguish what’s normal anymore, what’s Parkinsonian.
Williams' Parkinson's Diaganosis: Turning to the subject of the Parkinson’s diagnosis and its impact on Williams, Levin notes that one of the telltale signs of Parkinson’s is what’s called the Bland Effect; facial expression begins to dissolve into a lack of emotion, no vibrant expression. It’s almost blank and it’s quite noticeable. Your smile is barely discernible and artificial.

August 26, 2014

Pomegranate for Alzheimer's and Parkinson's?

The continuing saga of pomegranate magic has again lit up the internet over the past few days.

This time, the story focuses on punicaligan -- a polyphenol found mainly in the skin of pomegranate fruits – which scientists at the University of Huddersfield in West Yorkshire, England, think may slow the progression of Alzheimer’s (AD) and Parkinson’s. Their findings were just published in the journal Molecular Nutrition and Food Research.

The report claims that this punicaligan compound could slow down the inexorable progress of AD by inhibiting inflammation in specialized brain cells known as micrologia. That inflammation, when unchecked, enables the continuing destruction of brain cells typical of people with Alzheimner’s… and Parkinson’s, too.

As the buzz reverberates about pomegranate’s anti-inflammatory qualities, Huddersfield scientists have begun a new effort to develop drugs – mimicking the efficacy of punicaligan – that treat neuro-inflammation.

Pomegranante Benefits Not New
Lead researcher Dr. Olumayokun Olajide is quick to tout the benefits of pomegranate. "We do know that regular intake and regular consumption of pomegranate has a lot of health benefits – including prevention of neuro-inflammation related to dementia," he said. 

Olajide -- who became interested in the anti-inflammatory effects of natural products as a med student in his native Nigeria -- says pomegranate has been of interest to Alzheimer's researchers for some time. Previous studies have suggested it can help break down plaque that builds up in the brain and brings on the beginnings of the disease.

There may also be applications for punicalagin compounds to treat conditions that involve general inflammation – not just neuro-inflammation – such as rheumatoid arthritis and even cancer.

August 25, 2014

Just To Show I Didn't Spend the Weekend in Bed with the Covers Pulled Up Over My Head

After Robin Williams' shocking suicide last week, we learned from his wife that he'd recently been diagnosed with Parkinson's disease.

I wondered if that new information had affected his decision to kill himself. And it made me think more about my own final exit.

Reading those grim thoughts in the blog last week, some of my nearest and dearest expressed concern that I might be speeding into a serious depression.

Not yet. But I'm now looking for a therapist who specializes in end-of-life issues. Even if I didn't have Parkinson's, this 85-year-old thinks it might help to talk with a counselor about these important matters. 

Sunday, Not in the Park, but at the Farmers Market

I love my Palisades neighborhood. On most Sundays, you'll find me here at our farmers market. It's just a five-minute drive from home on familiar streets, one of the few destinations I'll permit myself to get behind the wheel to visit. 

That's Gloria standing with me. She manages the market on Sundays, and serves as a valued caregiver to a friend who's pretty far down the Parkinson's road.

August 22, 2014

My Final Exit: Suicide by Starvation and Dehydration, or Assisted Suicide in Switzerland?

Into the Parkinson’s disease homestretch, and prompted in part by the recent suicide of fellow Parkinsonian Robin Williams, I spent time this past week thinking about -- and planning -- my final exit.

This disease is idiosyncratic; I could live independently for several more years, or I could take a fatal fall tomorrow. Both my neurologist and my physical therapist recently reported seeing little decline in my physical condition. But I've seen signs that I'm on the verge of dyskinesia, the involuntary movements that tend to occur when the levodopa medication starts to wear off. In addition, my response to this medication has become erratic.

Yesterday, my neurologist suggested I get back on Azilect, the costly medication that can smooth out and extend the performance of the levodopa medication. There’s something else, too: I just saw reports that a particular variety of curcumin – the active ingredient in the Indian curry spice turmeric -- is especially effective here. I’ll report more on this next week.

So… that's my life on the Parkinson's rollercoaster. Up and down and round and round we go.

Parkinson's Disease Progression
Parkinson's symptoms progress idiosyncratically – for some people, fast; for others, slowly. People diagnosed early in life typically see a slower progression. Leon Paparella -- my Parkinson's support group leader -- was diagnosed 27 years ago. Today, at 69, he continues to function well, and has outlived many group members who received their diagnoses at age 60 or beyond… as most PWPs do.

To give PD patients an idea about the progress of their disease, many doctors use the Hoehn and Yahr scale, which describes the stages this way:
  • Stage one: Parkinson's disease symptoms affect only one side of the body.
  • Stage two: Symptoms begin affecting both sides of the body, but balance is still intact.
  • Stage three: Parkinson's disease symptoms are mild to moderate and balance is impaired, but the individual can still function independently.
  • Stage four: People at this stage are severely disabled, but they can still walk or stand without assistance.
  • Stage five: The patient becomes wheelchair-bound or bedridden, unless someone is helping him.
I'd place myself at stage 3 now. While there are signs I may be heading for stage 4, there's no way to know the timetable.

I could probably deal with stage 4. But as of today, I'd like to exit before I move into Stage 5.

August 21, 2014

Electronic Monitoring Gizmos Help Seniors Stay in their Homes

Staying in one’s own home – called “aging in place” – is way up there on seniors’ priority lists, along with “keeping my mind.”

The issue is important to me, and I’ve written about it frequently. Recent posts include:
As we might expect -- well into the 21st century -- a new way to help seniors stay safely in their homes involves "electronic high tech."

A recent article on MSN’s science and technology page outlined the new electronic techniques available to more closely monitor seniors at home. Here are a few of the new advances designed to keep seniors safely in their own homes.

Motion Sensors Around the House
Families and caregivers can place motion sensors in key locations – front door, refrigerator, favorite living room chair, bathroom door – to monitor activity. If there’s little or no activity logged at these key locations after a prescribed interval, the software will send an alert to family, caregiver, and/or nurse.

Sensors under the bed mattress can detect if the senior is sleeping normally. For example, they can monitor pulse and respiratory patterns to keep tabs on a senior’s heart disease… and send appropriate alerts even before the senior knows she’s becoming short of breath. The sensors will detect if a senior is getting out of bed more regularly than normal – raising a red flag for possible urinary track infection.