Little Monster Strikes Again

Morning Glory Buds Photo by Sherri Woodbridge
Morning Glory Buds
Photo by Sherri Woodbridge

Serotonin, norepinephrine and dopamine are all chemicals that are involved in regulating mood, energy, motivation, appetite and sleep.  In addition, the frontal lobe of the brain, which is important in controlling mood, is known to be under-active in people with Parkinson’s disease.  It’s no wonder that Parkinson’s patients may look sad.  We have every right – our brain is messed up. But looking sad and feeling sad are two different things.

PD recipients have three strikes against them in the “mood-control” department, the first mentioned in the above paragraph.  The second is – sometimes we can wear what is referred to as a ‘masked face’.  This is not an optional ‘mask’ they wear, as if going to a masquerade ball, nor is it necessarily due to the possibility of depression being present.  No, having a masked face is just one of the gifts that Little Monster (aka PD) gives to us.  Because of the disease, the PD patient has no control over the facial muscles that have decided to give in and not hold our smiles anymore.  So naturally, because the majority of the public hasn’t a clue what’s going on behind our faces (and some PD’ers I’ve met), our lack of expression can often be (and believe me, it is) misconstrued as a sign that we are sad or depressed. How that assumption saddens and depresses me, because that assumption is not true.

Beach Bikes Photo by  Sherri Woodbridge
Beach Bikes
Photo by Sherri Woodbridge

We all have another part of our brain called the frontal lobe.  It is a very important place in the brain that helps to control moods.  The problem here is that for PD patients, it is known to be under-active, which accounts for the third strike against control over our moods.

I have been asked several times, “Why are you so sad?” or, “Are you depressed?” or, “What’s wrong?”  I’m not sad.  I’m not depressed.  In addition, nothing was wrong until I was asked all those questions and then began wondering that maybe something actually was wrong.  Maybe there was something I’m supposed to be sad or depressed over and I just haven’t found out about it yet.  A surefire way to get someone feeling low (at least, for me) is to tell him or her how ‘low’ he or she looks.  Works every time.  It’s called the power of suggestion. Especially if it happens repeatedly.

Mr. Happy Photo by Sherri Woodbridge
Mr. Happy
Photo by Sherri Woodbridge

I was sitting with a friend the other day, listening to her tell me about things in her life.  As far as I knew, nothing had changed in my appearance.  She then asked, unexpectedly and interrupting herself, “Are you okay?  You look like you’re going to cry.”

I was fine.  However, then I questioned myself.  Was I fine?  Why do I look so sad to her?  Do I feel sad?  Am I going to cry?  Should I cry?  Is there something to cry about that I missed? Maybe I should cry. How long should I cry? Alas, after a thorough examination of my brain, I concluded that yes, I was fine and I wasn’t going to cry.  I didn’t feel sad, but for reasons beyond my control, I looked sad.  I chalked that up to Little Monster stealing my smile.

We can try and look on the lighter side of this issue, but for some PD’ers (and others), depression is not only very real but it is a real battle and there isn’t a lighter side for them.

Dr. Santiago, Boo's Black Doggy, and me after first programming of DBS stimulator.
Dr. Santiago, Boo’s Black Doggy, and me after first programming of DBS stimulator.

Dr. Anthony Santiago, the world’s greatest Movement Disorder Specialist (at least in Minnesota),  once told me that in some PD cases, depression is the patient’s first symptom (surprise!) of having this disease.  Through the course of living with PD, it can continue to be a symptom for the reasons stated above,  in regards to the chemical make up of our brain.  An additional reason as to why a PD patient may experience depression is that the patient is day in day out staring an ugly, chronic illness in the face.  That in itself is enough to cause depression for many.

So, what to do?

Make sure you are being optimally treated for PD.  If you’re not receiving the correct medications regarding sleepless nights, if you’re struggling with constipation, experiencing fatigue, freezing episodes and more, these can contribute to depression and need to be addressed.  That is why you need to discuss anything (that you think may be irrelevant to you or not) with your physician to get the best care.  What we think is not  associated with PD, may very likely be.

It goes without saying that regular exercise is an important part of being at your best, not only physically, but emotionally and mentally as well.  I find that if I’m striving for better health and begin to or increase my exercise, I tend to make better choices when it comes to food.  I look at it like – I just walked a while and I’m not eating that yummy cold Chocolate Chip Mint ice cream and cancel out what I just accomplished. (I’ll save it and eat it the next day.  Hopefully by then, someone else will have found it and I won’t half to be tempted, but hopefully not.)

It’s a proven fact that if we get up and get going we’ll feel better mentally.  Depression means just how it sounds.  It depresses the individual within whom it dwells.  It saddens them, makes them feel discouraged and disheartened.  While this is happening, the individual often focuses on wanting to feel better, to feel something.  More often than not, the individual struggling with depression focuses on himself and how bad he may feel. It is an emotional battlefield.

Chip Ingram , former Walk Thru the Bible president, once told a story of a doctor he knew who was treating a patient for depression and that nothing he seemed to be doing was working.  The doctor finally told his depressed patient to go to a certain room in the local hospital and read to the cancer patient in there each afternoon.  Within a week, his depressed patient’s spirit, emotional well being and mental outlook had improved dramatically.  By taking his eyes off himself and putting them on another and getting involved helping other, the once depressed patient realized there were others worse off than himself.

Sunshine on a Stick Photo by Sherri Woodbridge
Sunshine on a Stick
Photo by Sherri Woodbridge

There are many cases of depression that don’t fit neatly or easily into that theory of treatment, some due to chemical imbalances or injuries that are difficult to treat, even with the medications that are available.  Sometimes there are just no easy answers for treating depression and since each case is individual and unique, so are the treatments.

If you feel you tend to get depressed at times, or are feeling sad, think about joining a support group, if you haven’t already done so.  Start a hobby.  Get involved in a recreational or social activity.  Dance is becoming more popular and well known for its benefits to PD patients, (in terms of exercise) and is a great way to meet new people.  I’ve never met a depressed person who was dancing (or singing).

Many effective and safe medications have been used to treat depression in people with PD.  If you haven’t already, discuss your concerns with your doctor and ask if another treatment might suit you better.

Be Content
Be Content

Remember, as a PD patient, caregiver, or friend, progress is being made every day towards finding a cure.  Until then, get the best treatment you can, tailored to you.  Your doctor can only treat you as well as you amount that you are willing to confide in him with what you are experiencing.

Journeying with you – sherri

Signs and Symptoms of Early Onset Alzheimer’s Disease

IMG_9195.JPGYou cannot find your keys.  It could happen to anyone. Happens to me often. It happens to someone else I know all the time (but I’m not naming names).

You forget where you parked your car.  Happens to me if I’m along for the ride. Or the driver.

Life is stressful, harried, and  most of the time we have a lot on our minds and just aren’t paying attention.   A common occurrence. No big deal.

It’s January and you are sitting at the kitchen table and staring out the window as the snow falls gently on the ground and try as hard as you might, you cannot remember what season it is. ‘Spring?’ you think.  ‘Does it snow in the spring?  For heaven’s sake girl, it doesn’t snow in the spring.  Fall then – it must be fall.  It’s cold in the fall.  That’s it.’

That’s a sign to take seriously that you or a loved one may be experiencing the early onset of Alzheimers.  The inability to recognize or track dates or seasons is one of the first symptoms of early onset Alzheimer’s disease, which occurs in 5 to 10% of people under the age of 65.  It is not uncommon to see people in their 50’s with signs of early onset Alzheimer’s (EOA), but like Parkinson’s disease – not impossible.

A lack of motivation or sticking to a task can be mistaken at work as laziness when, in fact, EOA could very well be the culprit.  Instead of being properly diagnosed as an EOA patient, the individual suffering with symptoms in which they have no control over may result in being dismissed from a good job, associated with mental problems, or other consequences and/or misjudgments.  Relationships (especially the loss of intimacy) may also begin to deteriorate when one or both parties do not understand the connection to something greater at fault.

While losing your keys once in a while or forgetting where you parked your car can be absolutely normal, misplacing things consistently and not being able to retrace your steps to find them could be a sign of EOA.  Making a bad decision from time to time, missing a payment once a year on utilities, and forgetting a word to describe what you are trying to say – all normal.  However, continually having poor decision making abilities, having a hard time holding or having a conversation, or the inability to manage your budget – these are big players in early onset Alzheimer’s and need to not only be taken seriously, but action should be taken for a diagnosis as to why these symptoms are occurring.
Alzheimer’s does not happen overnight, regardless of age.  It takes different degrees of progression, depending on each individual.  A person of any age will experience a few to several symptoms.  Common symptoms are:

  • forgetting information learned recently
  • asking to repeat information over and over again
  • inability to remember without help (notes, family members intervention, etc)
  • trouble following familiar recipes
  • lack of or difficulty in concentration
  • difficulty doing familiar tasks (heating in a microwave, TV controls, etc)
  • taking a walk and losing your way
  • visual images are confusing (difficulty in reading and judging distance)
  • difficulty speaking or being part of a conversation due to forgetfulness when trying to form words
  • misplacing items and inability to retrace steps (not uncommon to accuse others of stealing)
  • judgment decreases in regards to handling money
  • personal hygiene may suffer
  • removal of one’s self from normal activities; becomes more introverted
  • mood and personality changes may occur (suspicious, depressed, etc)

It is important to remember that a person may be experiencing some of these symptoms and not have any connection to having EOA.  A proper diagnosis needs to be made by a knowledgeable physician.  It is also important to remember that if diagnosed with early onset Alzheimer’s disease, a person may only experience a few of the symptoms listed above while another, several.  Just like Parkinson’s disease and most every other disease, each person is unique and the disease is unique to each person, although similar in many ways.  The best advice when determining whether you or someone you love may be experiencing EOA is to see a physician.

 

Dystonia and Bear Hugs

imageDystonia.

A neurological movement disorder that deals with sustained muscle contractions, causing twisting and repetitive movements or abnormal postures and can be a part of having Parkinson’s disease.

Symptoms of dystonia can include disturbed sleep patterns, tiredness, depression, poor concentration, change in vision, and more.  Normal activities can be more difficult to carry out.  Dystonia mimics other diseases as well, making it extremely important to not self-diagnose.  Neurologists and Movement Disorder Specialists are physicians specializing in various areas such as dystonia and Parkinson’s Disease, with the ability to clearly differentiate (although sometimes difficult in doing so, depending on how the disease manifests its symptoms) the similarities of diseases with commonalities such as these.

As well as the experiencing the symptoms listed above, dystonia tends to lend itself to continuous pain, cramping and muscle spasms. Because of the areas that can be affected, penmanship may become altered, dropping items becomes common, turning pages becomes a struggle.  The list can go on.

Focal dystonias are the most common types of dystonia are known as focal dystonias.  Another – Cervical dystonia – affects the neck muscles, whereas blepharospasm dystonia is known to affect the muscles around the eyes.  When the jaw and tongue muscles are affected, it is known as oromandibular dystonia.  The voice can be affected, causing a ‘crackling’ sound and is known as spasmodic dysphonia. When a patient suffers from both blepharospasmodic contractions and oromandibular dystonia, it is referred to as cranial dystonia, also known as Meige’s syndrome.

imageWhile some cases can worsen over time, some can almost be mild in their degree of symptoms and their affects on the body. Many drug treatments have been successful in managing symptoms, but recent treatments using botox have proven extremely successful for 3-6 months when injected into the affected areas.  Many PD treatments, including deep brain stimulation, are used for treating dystonia and are quite promising in helping the patient to cope with the disease.

What may seem like an odd treatment may actually be one of the best received and most helpful… a big hug. It has been proven that when encased in a tight ‘bear hug’ the tension and tightening of the contracted muscles are often released when squeezed tightly.

There aren’t many diseases (if any, that I am aware of!) that respond to such a simple, welcomed treatment. So – the next time you’re struggling with stiffness, spasms, and pain associated with having Parkinson’s disease and/or dystonia, ask a loved one to give you a tight bear hug and hold you for a few minutes.  You’ll  not only feel better physically but in every other way as well and so will they.  There is healing in a hug – for everyone involved.