October 27, 2015

Doidge on Brain Neuroplasticity and Pepper on Conscious Walking: Intriguing But Flawed Books

In my last two posts before taking a week off, I wrote about these two books:
  •  "The Brain's Way of Healing," the recent bestseller by Dr. Norman Doidge about the new science of neuroplasticity, which asserts that for conditions ranging from autism to stroke to Parkinson's disease, we can use conscious habits of thought and action to stimulate the brain to "rewire itself."
  • "Reversing Parkinson's Disease!" by John Pepper, who is featured in Doidge's book as an example of rewiring the brain by his developing and practicing "conscious walking." That activity works so well for John that he was able to discontinue his Parkinson's medications.
I spent a good bit of time last week researching and reflecting on the concepts put forth in the books.

Dr. Doidge and "The Brain's Way of Healing"
I read several reviews of Doidge's book. The most thorough and thoughtful in my opinion came from The Guardian, which did three separate stories: an initial review, followed by a write up on Doidge that includes an interview with him, and a final review.  Here are a few excerpts from these reviews:
Doidge is persuasive and curious as a writer, and rigorous as a thinker, what he writes about is the edge of our current understanding of mind and body.
While reading "The Brain's Way of Healing" I had a clear sense of other readers being divided – – some turning its pages with a hardening edge of skepticism, some with a growing feeling of wonder. Chapter by chapter, I jumped constantly between the two.
 . . . His next tale, from South Africa, is that of John Pepper, a man diagnosed with Parkinson's disease more than 20 years ago who has managed to reverse all of its symptoms using "neuroplastic techniques." Pepper, through trial and error, and an understanding of how Parkinson's typically acts against sequences of muscle memory, taught his body, first through entirely conscious relearning of the sequences involved in walking, and then in all other actions, how to think differently. Pepper had found, Doidge suggests, "through conscious walking, a way of using a different part of his brain to walk . . .  by "unmasking" existing brain circuits that had fallen into disuse.
Doidge believes that many of these cures are derived from “ancient Buddhist ideas,” but he argues that they can all be explained in terms of “western science,” as long as neuroplasticity is taken into account. For all I know, he may be right, but I would trust him more if he reined in his rhetoric . . . The idea that “the brain is part of the body”, that “the body can be used to treat the brain” and that “the mind can alter the brain” sounds not so much innovative as inane. And when Doidge offers his explanations of the physiological basis of neuroplastic medicine – telling us that neurostimulation can “power up the cortex” and “reset” the brain, empowering you to “turn off your fight-or-flight reaction” and “turn on your social engagement system” – his approach strikes me as figurative and flashy rather than phlegmatically factual. As for his much-repeated injunction to “rewire your brain,” it sounds like knockabout comedy rather than responsible medical advice.
 While recognizing that Doidge's book is based on stories, not scientific studies, I nevertheless find the subject of neuroplasticity fascinating and believe it offers a lot of potential for human healing.

John Pepper and "Reversing Parkinson's Disease"
I'm a member of two forums where people with Parkinson's communicate with each other. One is part of patientslikeme.com based in Cambridge Massachusetts. The other is part of HealthUnlocked, the largest social network for health information in the United Kingdom.

Pepper and I are members of HealthUnlocked's forum on Parkinson's disease. In both the UK and U.S. forums, I'm what's known as a "lurker." I don't participate on a regular basis since I have my own Parkinson's support group meetings here in DC every week.

After posting my report on Pepper's book, I decided to check out the HealthUnlocked forum because on my earlier visits there I had sensed that Pepper's views had provoked some controversy. So I put "John Pepper" in the search box and hit "Go". Wow! I ended up spending several hours reading and making notes on all the back-and-forth.

Pepper has been a frequent contributor to the forum discussions and hasn't been shy about expressing his views. Many of the responses from others have been laudatory and supportive. But Pepper has not wanted for critics. And he responds with no holds barred.

Everyone seems to agree that Pepper's promoting his "conscious walking" is great, particularly when it gets the rest of us off our duffs and out there walking. The criticism comes from his unrestrained rhetoric and for other claims he makes that are dubious at best.

This note to me (I'm "Gleeson" on the healthunlocked.com forum) from John is a good example of John's inspirational enthusiasm and of how his rhetoric can go too far, e.g. "with medication nobody has ever got better!".
Hi Gleeson. Thanks for your inspired writing. You make me sound like a superman but I'm afraid that I am far from that. I do have this burning desire to get people away from depending on medication that is not able to slow down the progression of their Pd. and get them to take up the FAST WALKING that has been proven in proper scientifically controlled studies to reverse the symptoms of Pd. 
This way there is HOPE and the more you put into it the more you will get out of it. With medication nobody has ever got better! Why even start taking the medication when the best it can do for you is hide a symptom or two but not actually stop the Pd. from getting worse. 
I show people how they can walk normally, immediately, and carry on walking and start getting better. Who else offers this and at no expense? 
Come on guys, it is all real! All you have to do is get up off your tail and start exercising. The improved health makes you want to do more and that makes you feel even better! 
Thanks again Gleeson.
I'm a big advocate of "less is more"when it comes to taking pills. The only prescribed medications I take are Sinemet (carbidopa levodopa, the most common Parkinson's medication) and the fluticasone proptonate nasal spray. My only supplements are curcumin, 5-HTP and vitamin D.

I have discontinued the blood pressure and cholesterol pills that I'd taken most of my adult life because of growing support from medical researchers for the proposition that those of us in our 80s who have never shown signs of coronary problems could safely ditch them. I'm happy to be rid of these pills, but I would never say, "with medication nobody has ever gotten better."

John often touts the fact that he no longer takes any medication for his Parkinson's, and he is particularly critical of Sinemet, the medication that most of us with Parkinson's take. For example, in an exchange with another forum member, Pepper asked, "Are you aware that Sinemet does nothing at all to slow down or stop your PD?"

Well, I've got three steno notebooks filled with records I've made as a result of constantly monitoring my blood pressure and my symptoms. I probably average 10 BP readings a day. This databank clearly shows that my blood pressure bounces up and down depending upon how much dopamine I'm getting from my Sinemet pills. If I miss taking a pill, my BP readings begin moving into the danger zone for a stroke. I'm one of about 30% of people with Parkinson's who don't have the tremor, which makes it a little more difficult for me to to know when I'm in an "off" period (when the Sinemet is not working as well). But I make notes of times when I'm experiencing cramped handwriting and shortened strides when walking. These clearly show that Sinemet does help with my PD symptoms.

While not believing in Sinemet, Pepper recommends MAO-inhibitors like Azilect, which he used until he stopped all PD medications in 2002. The neurologist I've consulted suggested using Azilect with Sinemet. But Pepper used an MAO-inhibitor similar to Azilect alone and has commented that it "causes your brain to retain more of the dopamine you already have" so that you won't need Sinemet.

In exchanges with members seeking advice, Pepper has advised against taking half a pill of Azilect, commenting "Azilect has to be one pill or nothing. It does not work half a pill". Three different neurologists I've consulted have suggested I start off by trying half an Azilect pill.

In reviewing the exchanges on HealthUnlocked, I noted one in which a member, while being supportive of Pepper's advocacy of "conscious walking", said that he had gotten similar benefits from a "cross fit" program he was taking "under the watchful eye of a personal trainer." Pepper responded with an overkill message that was highly critical of just about everything the cross-fit guy had said. As might be expected, this prompted an overkill response from the cross-fit guy.

In reviewing all the messages that I could find involving Pepper, I came across several mentions, both by Pepper and others, that he had been suspended recently for three months from participating on HealthUnlocked.

I came away from my review of all these exchanges regretting that Pepper didn't rein in his "stop Sinemet" rhetoric. Since my tendency is to take the good ideas of others and adapt them, warning bells go off for me when John seems to prescribe doing conscious or fast walking exactly as he prescribes.

Sinemet has worked for me, although I certainly regret the serious side effects it can produce. One of the most serious problems in medical treatment in the U.S. these days is the tendency to prescribe medicines and treatment based on "one-size-fits-all." I like Pepper's exercise program, but I think other programs -- CrossFit or interval training or fast cycling on a tandem bike -- could well produce similar results. The more choices the better, as far as I'm concerned.

Nevertheless I Admire Pepper and Support His Efforts to Promote Conscious Walking
 John Pepper already has had a positive impact on my life. I used to love walking but when I found myself hobbling around on a cane, I cut way back. Reading about his conscious walking and communicating with him resulted in my taking a closer look at what I was doing. I realized that the cane just added to my Parkinsonian tendency to lean forward when walking. I've stopped using the cane for regular walking and I'm trying to walk more erect, shoulders thrown back, and mentally calling out "heel-toe" and "swing those arms" as I consciously walk with longer strides. I try to concentrate my efforts on getting my right arm to swing and on getting my right foot to "heel-and-toe" as well as my left foot does. My PD afflicts the right side of my body.

Moreover, I picked up some good suggestions for handling several other Parkinsonian problems from his book "Reverse Parkinson's Disease".

November 16 Update
In the three weeks since I first posted this, I've been practicing my amateur version of conscious walking. I've become an addict. I'm feeling much better. I'm sleeping amazingly well most of the time. I'm stretching out the time intervals between my Sinemet pills. Others are commenting on my improved posture and how I just seem to be in better health.  

So thank you John Pepper!


Anonymous said...

mr schappi ----- you've been so very tough on dr mary newport's promotion of coconut oil for alzheimer's. seems like you're giving pepper an easier time. how come?

Anonymous said...


Anonymous said...

You mention your intention to write more on JPepper. Perhaps as a part of that you might comment on your observations on those most attracted to his message. An observation, He has a loyal group of followers ?believers, (including it seems a sizeable group of older women) who appear to find the directive confident tone of his posts reassuring. A leader not a collaborative style? They do not get involved in any depth in scientific debate and filter out any contrary information.
The clinic consultation style of posting he uses online I have not noticed used by a member on any other forum .