In a silent planet, one voice can have dominion.

I used to be able to talk properly. I had no problem putting forth a case in court - piece of cake. Some of my speeches were the topic of conversation for days after, but now I stumble over the simplest sentences. I can sound like a moron. It is as if my brain slows down while my mouth tries to maintain a normal flow. I begin speaking and suddenly I can't find the word I want.I choke up, My mouth adopts a desert mode, and I end up substituting what I think is a synonym for the lost word and sometime it is, but there are times, too numerous, where the substituted word would be a synonym only on another planet.

Public speaking no longer makes me nervous. I don't do it any more.

I know I have mentioned the problem in past posts, but I keep finding out more information. What follows is a precis of an article on "Speech and Communication" by Angela Roberts-South

• PD can affect a person's ability to speak. Symptoms vary among PwP and can change as the condition progresses.
• PD affects a PwP's ability to think quickly, to manage multiple tasks, to find words or understand complex sentences
• PWP tend to speak with a flatter voice and make fewer expressive facial gestures which affect how listeners react to them
• Typically, the PWP's voice becomes softer and quieter and to some extent, unclear to the recipient

I have suffered or continue to suffer some, or maybe even all of these problems. I hate it when my brain refuses to co-operate. Fortunately, my brain keeps in stride with my ability to write. What is wrong with nature when it removes my principal form of socializing. I was a nervous speaker before PD, but now, I hardly speak at all. Roberts-South offers tips for improving communication but I am not going to list them. It is a day for complaining, not improving, but you can read the entire article at Parkinson's Disease Foundation As for my future as a public speaker, I think of what Mark Twain said, "there are two kinds of public speakers, those that are nervous and those that are liars"

To that I would add a third type "those who suffer from parkinson's and sound like morons"

Moan Zone is closed.

Fear - such an unpleasant emotion

It is not fear of the unknown that challenges us; rather it is fear of the known when you might be standing in its shadow. I am guessing not everybody reading this has PD. A few you may not be part of that club. Others may be uncertain about parkinson-like symptoms - e.g. - do I have PD? - while others may be looking for causes of PD so they can avoid the condition.

Well there is good news and bad news. The good news is that chances are you will never be subsumed by that shadow. Relatively speaking, very few people have the bad luck to become intricately acquainted with our feckless passenger. The bad news is, as you and the rest of the population ages, your chances of falling victim to some kind of degenerative brain disease increases. So you are almost immune but not so much.

What caused my PD? Who knows, I had some vicious blows to the head playing hockey and flag football (it is supposed to be a safe form of the game, but with no helmet or pads, you are asking for damage).

Nobody has a definitive answer to the question, just what is it that causes PD?

However some inroads have been made.

• Head trauma - some studies show that people who have suffered head trauma are 4x more at risk for PD than people who have never had a head injury
• If your head injury is serious enough to require hospitalization and/or you lose consciousness, the probability you will become a victim increases to around 10x compared to the lucky majority without PD.
• Heredity - both my parents had parkinson-type tremors in their old age. Does that mean my siblings have PD in their future? Probably not. Studies have found that heredity plays a role in only a few cases where the presence PD can be traced though several generations.
• There is an iota of evidence that dealing with toxic substances may be a factor.
• Finally, there is a link between PD and aging. The older you get, the better the chance you will develop the condition. But what about Michael J. Fox and other early onset cases? Are they simply outliers, unlucky patrons of a disease of the aging? Who knows.

So, did that help?

If you cant see yourself in this list, you probably no longer need fear the unknown, but it wouldn't hurt to be a little nervous.

Consider these statistics

• Between 6 -7 million of the world's population have PD.
• Approximately 100,000 Canadians and 1,500,000 Americans have the condition
• 60 is the average age of onset.
• You have a .1% chance of developing PD,
• which rises to 1% over age 65>
• and 2% over 80
• both genders and all ethnic groups have the same chances of joining our tribe

You have to be pretty unlucky to become a member of this exclusive club, but if you are still afraid, try whistling by the graveyard. Might not help, but can't hurt.

There be angels in my life

I don't have many really good friends. Never needed too many; but, over time I have gained a few, people who will watch my six and be there when needed. Citizens call them "caregivers" but we PWP know better. They are angels. They are the ones who will offer any kind of help as PD progresses. You know who you are.

Instinctively the sainted ones will know when and what to do; but, if you need a little hint, here is a excerpt from an advertisement for a gathering of the clan found on the website of the National Parkinson Foundation.

• The incidence and severity of PD symptoms vary from day to day, and even from one time of day to another. It takes skill and patience to know when to assist with a task and when to simply allow the person more time to do the task independently.
• It also takes time and ongoing education to learn the many symptoms of PD as well as the often complicated medication regimens that offer the most symptom relief and improve quality of life.
• Caregivers must closely observe the person with Parkinson’s over time to detect and respond helpfully to subtle changes in motor function (how we move) and mood (how we think and feel).
• The person you care for might not be aware of his or her changing abilities. Understanding of health risks (such as falling) may not have “caught up” to his or her actual level of risk and impairment.

Read the "careMap linked to that website. It will help define the role of the "caregiver".

Of course, I don't think I will ever require a great deal of intensive care. But, if I do, I know who to call - a good friend

Friendship is a knot tied by the hands of angels

USA IN THE LEAD (STILL)

Statistics for the past 7 days:

1. USA 291
2. Canada 80
3. United Kingdom 26
4. Russia 15
5. Mauritius 8
6. France 6
7. Portugal 3
8. Ukraine 2
9. India 1
10. Japan 1

Total to date 54,073. I am grateful to all of you.

I must arise and go now. I hear a TV in the background. I find politics in our southern neighbour to be fascinating

Scary Dreams & Old men

I am sitting in an easy chair in the waiting area of a hospital, waiting (obviously) for my wife. Her appointment is going to take 2 hours. I take out my crossword puzzle (which I do to prove to myself that I am not "slipping") and within a couple of words, I drift off. After a few minutes (I think) I begin to dream and in my dream I am sitting in the same easy chair, but this time, I am in my underwear and people are starting to stare. I awake with a typical PD jerk - arms flying straight out. The elderly lady walking by was quite startled. I tried to explain "Had dream ...silly", but she was already going on her way in a manner to convince herself and any others in the audience that she neither saw nor heard me.

A typical PD dream, ultra real, with a physical reaction.

Not my fault.

You see, Parkinson's was on my mind as I had visited with a good friend who discovered in the last year or two, that he also had fallen into the embrace of our dark passenger. We ate breakfast, commiserating with each other as we told and retold our difficulties with PD. We differed only in the fact that I had the tremor dominant type of PD. He had the non-tremor. My symptoms are controlled by the drugs. His situation still presents as a painful back and a prominent limp in spite of the drugs.

"Which is better?", you might ask.

I don't know that anyone has a definitive answer to that query. I like to think tremor dominant is better but I realized we were very similar when we each had to slide to the end of our seats with some difficulty (we were in a booth) and then struggle to stand and walk stiffly to the cashier. No superiority there. We are in the same shape, tremor or not.

Later that day, I saw a poster of a camel walking through the desert with sand drifts well above its head. The poster said something to the effect that all our dreams can come true if we only have the courage to pursue them.

I don't think I will be pursuing mine any time soon. Go ahead and laugh, but the picture of an old man (me) wearing only underwear, in a crowded deli, and fighting to get up from his seat.....Heck, that scares the poop out of me. Too scary to have the courage to pursue such an image.

You can summon the courage to pursue your dreams, but as for me, I plan to stay awake as much as is humanly possible.

Standing up to the PD bully.

Einstein once said "Life is like riding a bicycle. To keep your balance you must keep moving."

I don't think he was talking about PD, but Einstein was a fairly smart guy and so, like finding meaning in poetry, we can interpret his words any way we want.

I bring up the question of "balance" because I am having small balance issues. I have had them before but of lesser magnitude. Now, when I stand, I must pause to allow a sort of dizziness to sort itself out. I often have to sit back down, an involuntary "I'm up. Nope, I'm down" moment.

My wife bought me pole for the bathroom, to help me enter and exit the tub. I have only had problems exiting a few times but with this pole, I have no problems at all. It also helps in other bathroom activities. Yesterday, I was rising from the toilet when I had one of those "Up/down" attacks. I reached out and grabbed the pole and saved myself. Looking back, I am sure I would have suffered damage if it were not for the pole. I think I will get one beside my bed. Can't hurt.

I am aware of the correct movements for success in standing. I just forget them sometimes. Here is a youtube video of an exercise to improve standing. The motion is exaggerated for exercise purposes, but for ordinary standing, lessen the exaggeration, but use the same movements. Feet apart, lean low and forward and sort of slide into the standing position. It is very easy and works every time. This is an example of ways to make life as a PWP more satisfying. It is a small thing for improving life, but isn't it always the small things that are important.

I am trying to learn all of the tricks for living with PD. When I do discover something, I will pass on the information.<(> As for the future, I think I will embody another of Einstein's pearls of wisdom, "I never think of the future - it comes soon enough."

You can't steal second while keeping one foot on first.

What does the heading have to do with PD? Well, it tells you to get on with your life in spite of any foot problems you are likely to encounter as a PWP. Maybe it doesn't say that, but you will not find a moan zone in this blog so I will take the initial interpretation.

You are aware that we gradually lose our sense of balance and our gait suffers. We are defined by our parky gait. The good ol' parky shuffle. Six years post DX, I find myself shuffling first thing in the morning. Before my first dose of drugs. Sure, we can still get around, but the parky gait might cause foot problems that you will not welcome into your life.

"Why is that? What causes the foot problems?" I just heard one eager student ask.

Well, my sycophantic doppelganger, our feet maintain an intimate touch with the ground more often than those "other ones". You know, the ones without PD who heel and toe as a matter of habit. We don't have that luxury so a few problems you might encounter are:

• Shuffle Along: I try, unsuccessfully, to concentrate on maintaining a "heel to toe" stride but my failure to do so results in a flat-footed shuffle. You can hear me coming and going. I will never be a ninja. Flat-footing leads to pain in my feet and legs and I have read, it can often cause knee problems
• Gator Skin: You remember "the beast", that spawn of the devil, the mother of all muscle cramps in the calf? I have read that the beast can make it harder to flex the ankles. Without that flexibility, the foot's ability to absorb the shock of contacting the ground can lead to too much hard skin on the soles of the feet.
• The Rebal Digit I have one toe on my right foot that is continually making me uncomfortable. It has a mind of its own and is impervious to drugs. It is constantly twitching and trying to curl into a ball. If I think about it, I can stop it, but I have other things to think about. Stop concentrating and it starts again. I am developing a callus on the top of my toe as a result of its constantly contacting my shoe and believe me, it hurts.
• Oh Goody - Another Enemy:Many times when the beast appears, he is accompanied by its evil assistant, the sub-monster that attempts to turn my foot inwards and upwards. The pain is excruciating, Fortunately, the duo rarely appears these days. It's the drugs. I love the drugs!

The joys of PD are endless. However, we shouldn't spend our days feeling sorry for ourselves. There are people worse off than we. In the words of Stephen Wright,"I was sad because I had no shoes. Then I met a man who had no feet so I said to him 'Got any shoes you're not using?'"

Announcement - a DNA test has revealed that our family is 1% Ashkenazic Jew. Mazel tov readers, Mazel tov.

Family: a link to our past & a bridge to our future.

In the words of the Spanish-American philosopher, George Santayana, "Family is one of nature's masterpieces."

We had a family reunion this past weekend. It was held at our cottage, with families from Toronto, Winnipeg and Vancouver. 31 of us in total. I was touched by the affection we all have for each other and how sweet the young children were. Not a serial killer among them. It was sad to have it all come to an end and I miss them already. But as my brother said, "Let's not get maudlin."

OK, let's not get maudlin; after all, this a blog about parkinson's. So let's get on with it.

My sister, who has children with ADHD (great kids - no hyperactivity) wondered if there was a connection between ADHD and PD because of the role of dopamine in both conditions. I was interested, so I googled "ADHD" and "dopamine" and discovered this:

Previously it was thought that the elevated number of dopamine transporters in people with ADHD was part of the pathophysiology but it appears that the elevated numbers are due to adaptation to exposure to stimulants.[107] Current models involve the mesocorticolimbic dopamine pathway and the locus coeruleus-noradrenergic system.[101][102][103] ADHD psychostimulants possess treatment efficacy because they increase neurotransmitter activity in these systems.[102][103][108] There may additionally be abnormalities in serotoninergic and cholinergic pathways.[108][109] Neurotransmission of glutamate, a cotransmitter with dopamine in the mesolimbic pathway,[110] seems to be also involved.[

Hmmm, interesting. Of course you realize I have no idea what it means, except, I think it says dopamine and ADHD are in some form of relationship.

That begs the question, "Is there a relationship between ADHD and parkinson's?"

The answer is "I don't know. Maybe, The articles I read are not conclusive; some hint at a relationship, some deny it." So, let's see if the riddle can be solved by comparing ADHD and PD symptoms (a simple, probably too simple analysis)

1. emotions - ADHD sufferers can be moody. Depression not uncommon. PD - emotional, at times weepy, 25% of us will suffer from depression.
2. Memory problems - PWADHD have problems learning due to poor memories, the cause of which I don't understand. PWP also have memory problems. I can attest to that. My word finding abilities are rapidly deteriorating.
3. Movement problems - PWADHD nearly constant movement somewhere in their bodiew, inability to remain still for long periods. PWP's lack of dopamine produces tremors, twitching and muscle cramping.
4. Inattention - PWADHD are, well, attention deficit. PWP If you are like me, you have a problem focusing. I have trouble reading the newspaper. I just want to get on with the article and find myself searching for the writer's conclusion in the last paragraphs. From there, I can figure out the gist of the article

All right. My comparisons could not be less scientific. Notwithstanding that little detail, I find myself thinking there is a connection between ADHD and PD, but I could change my mind if confronted with an iota of evidence to the contrary.

My thoughts are like butterflies; they land in all their beauty but easily fly away. The problem is I am easily distracted by shiny things, Isn't that the definition of ADHD? and I have PD. Coincidence? I think not, or maybe, or.....Who the hell knows.