August 6, 2014

Travel Health Issues for this 85-Year-Old with Parkinson's

I thoroughly enjoyed my recent vacation: two weeks cruising up and down the coast of Norway, and a couple days in Copenhagen, where the adventure began and ended. Nonetheless, my time away had its health issues, too; no surprise in light of my age and my Parkinson's disease.

I brought with me the same ailments I have at home, of course. But I got some new insights, too.

Jet Lag, Insomnia, and the Blue Pill
Insomnia is nothing new to me. I’ve wrestled with it for years; just enter "insomnia” in the search box at right. The serotonin booster supplement 5-HTP has kept the problem at bay these past five years since my PD diagnosis. It has also helped with the other two typical Parkinson’s side effects: depression and constipation.

But insomnia resurfaced when we arrived in Copenhagen. During earlier travels, I used (and abused) Tylenol PM and other acetaminophen products. Before I left this time, a friend recommended Unisom (generic: doxylamine succinate).

I took Unisom for the first few days in Europe and again when I got home. But I'm not going to do what  formerly did and continue using the little blue pill. I'll do anything to avoid another "summer from hell" -- a horror story from several years ago when I abused sleeping pills.

I've dealt with this issue for several years -- not all that unusual for an 85-year-old who had his prostate removed 20 years ago and received his Parkinson’s diagnosis five years ago.

I worked with the physical therapist a year ago, but haven't been very faithful doing the Kegel exercises. On this cruise, I spent lots more time with other people than I do at home, and the incontinence became a more embarrassing problem.

Incontinence is a big -- and under-discussed -- issue for many seniors, particularly women. I'll explore the issue in a future post.

Orthostatic Hypotension
As many of 20% of all people with Parkinson's experience orthostatic hypotension, often called postural hypotension. It's a sudden drop in blood pressure that typically occurs when a person stands up. Sufferers experience dizziness, sometimes to the point of passing out.

I don’t encounter this problem when I stand up. It happens to me when I am exerting myself in hot, humid weather -- so typical of Washington summers.

I had hoped it would be much cooler in Norway and Denmark. As it happened, they were having something of a heat wave while I was there. It got warm enough that I began to feel those familiar sinking spells.

But I came up with a simple remedy that seemed to work:

I grabbed a handful of these salt packets at a restaurant in Copenhagen and began carrying one in my wallet on daytime outings. If I felt a sinking spell coming on, I'd swallow the packet's contents with lots of water. On particularly warm days, I'd ingest a precautionary packet around 11am.

Damned if it didn't work. No dizzy spells during the three weeks we were gone.

A New, Possibly Fatal Problem
Sharing nightly dinners at the table with my travel mates on this trip, I noticed I was always the last one eating. It was a new experience for me; through most of my life, I was usually the first person finished at mealtimes.

On the ship, I realized I was slowing down because I needed to chew my food very carefully.

After a little online research, I came across an article from the National Parkinson's Foundation with this attention-grabbing headline: "Difficulty swallowing can be fatal for people with Parkinson's."

When I shared that headline in a blog post, my physical therapist zapped me an email, and said she could help with this new issue. I'll see her on Monday.

I mentioned the swallowing issue to my internist during my Medicare physical exam today. She gave me a referral to a speech-language pathologist who works in the same department at Georgetown Hospital as my therapist.

I'll share what I learn from these meetings in a future post.

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