Wellness

Diet & Nutrition

A healthy diet can help us achieve or maintain normal body weight, increase our energy level, boost our immune system, decrease risk factors for certain conditions or illnesses, and reduce constipation.  

It can be particularly helpful for people with PD to pay close attention to issues of diet and nutrition as poor nutritional status can result in, and contribute to, many of the common complaints associated with PD.  For example, difficulties with swallowing can prevent people with PD from getting adequate nourishment, which can lead to a worsening of motor symptoms and increased weakness resulting in falls.  

People with PD may also find that certain medications, or medication side effects, have an impact on their diet or nutrition.  Any time you are prescribed a new medication, it is a good idea to ask your physician about any dietary restrictions and whether it is best to take the medication with or without food.  This is particularly important with PD medications because certain food groups as well as the timing of meals can interfere with how quickly or fully your body is able to absorb the medication.

If you have concerns about diet or nutrition, or simply want some assistance developing the healthiest diet given your particular lifestyle and circumstances, you may want to consult a "dietician" or "nutritionist."  These terms are often used interchangeably, but there is a difference.  Registered dieticians are regulated and must meet certain educational and professional requirements before they are able to use the title.  Anyone can call himself or herself a nutritionist, even if he or she has no special education or certification in the field.

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Nutritional Issues in Parkinson's Disease, by Michael Rezak, MD, PhD
   

Exercise

Currently, exercise may be one of the most powerful tools at our disposal with which to fight PD and its degenerative nature.  In addition to promoting overall physical and emotional health and well being, exercise tends to minimize some of the primary and secondary symptoms of the disease.  Though exercise is not a cure, it can help people with PD maintain muscle tone and function, remain flexible, and improve overall mobility.

While the precise role exercise plays in delaying the progression of the disease is still being researched, studies consistently report that those with PD who exercise regularly tend to do better than those who do not.  When it comes to exercise, being younger has its advantages.  Younger people are usually stronger and better able to maintain a regular exercise program over time.  

Many young people with PD have found that they are able to combine their exercise with grass roots fundraising efforts.  From the well-known Walk-a-thons held across the country to the young men and women who have walked marathons to raise funds, finding sponsors who will cheer you on every step or mile can help you remain committed to an exercise plan.

Of course, marathons aren't for everyone!  Choose the type of exercise that works for you.  Whether you are walking around the block, riding a bicycle, swimming, or taking Pilates, tai chi, or yoga classes, any form of physical exercise that keeps you strong, increases your endurance, balance, or flexibility can help you manage your PD.   

Always check with your physician before you begin a new exercise program, and do your best to avoid injury by reviewing Parkinson's Disease exercise and safety tips.      

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Exercise: A Helpful Parkinson's Treatment (New)

Physical & Occupational Therapy

Most of us are referred to a physical therapist at one time or another. Whether you are experiencing disability as a result of pain, injury, or illness, physical therapists provide physical therapeutic intervention (as opposed to medical or surgical intervention) with the goal of preventing or minimizing disability.

Occupational therapists intervene in similar ways, but they focus on more specific goals related to functioning.  In other words, occupational therapist help us "function" (i.e., accomplish the tasks of daily living) to the best of our ability. For people with Parkinson's disease, routine tasks such as walking, running, standing up from a chair or moving into and out of bed can become difficult; occupational therapists are trained to evaluate these kinds of difficulties and help the person and/or the environment adapt as needs and abilities change.

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Exercise & Physical Therapy for Parkinson's Disease
Parkinson's Disease: Physical and Occupational Therapy (New)
  

Speech Therapy

Most of us, when we think of Parkinson's disease, think of symptoms such as tremor and slowness of movement.  Perhaps less well known are the speech, swallowing, and communication difficulties many people with PD experience.

Speech, for example, may be less loud or less clear.  People with Parkinson's sometimes do not even realize their speech has changed, but may notice that others are asking them to repeat themselves much more frequently than in the past.  Non-verbal communication can be affected as well.  Referred to as "facial masking," people with PD may find that they are less able to move their facial muscles which can compromise their ability to communicate effectively with others.  This can be a very frustrating symptom because you may look uninterested, even angry, when you are not. 

Swallowing can also become difficult because the muscles that help perform this activity can experience tremor, stiffness, and slowness just as the other parts of the body do.  Difficulty swallowing can lead to serious problems such as malnutrition, so attending to it is important (see Diet & Nutrition).  

Speech and Language pathologists (SLPs) are trained to evaluate and treat these very difficulties.  A SLP can help by developing a program to help you stretch and strengthen the muscles involved in speech, expression, and/or swallowing or by teaching coping strategies that will make communication or swallowing easier. 

Some SLPs have been trained in a technique called Lee Silverman Voice Treatment (LSVT), a speech and voice therapy that was developed  specifically for people with Parkinson's disease.  The LSVT®LOUD program can make a difference in quality of life for people with Parkinson's.  It is an intensive program, one that involves 16 sessions during a one-month period, so it may be helpful to think ahead and schedule this type of therapy when you are able to devote the time and energy necessary to achieve the maximum benefit.  To find out more about LSVT or to find a SLP who is trained in the technique, visit http://www.lsvt.org.   

LEARN MORE
Parkinson's Disease:  Speech Therapy
Communication and Parkinson's Disease (Fact Sheet)
Live Life LOUD: Improving Your Life with Lee Silverman Voice Treatment by Samantha Elandary, MA, CCC-SLP (Recorded presentation from the 2009 Young Onset Parkinson Conference)
   

Complementary & Alternative Medicine

A growing number of people with Parkinson's disease, particularly those diagnosed young who will live with disease for a longer period of time, are interested in alternative and complementary medicine (CAM).  Some find that CAM offers helpful information related to proper diet, exercise, and stress or pain management.  Others turn to CAM to help them address some of the secondary symptoms of PD such as constipation or fatigue.  Some people pursue CAM in an effort to minimize the amount of medication they take and delay the long-term side effects like dyskinesia (involuntary movements) associated with some convential medications. 

If you are considering CAM therapies, consult with your neurologist or primary care physician, or seek the advice of an integrative medicine physician.  It is important for all those involved in your treatment to be working together to some extent.  If you are thinking of taking any supplements or herbs, inform your physician as some of them can interfere with conventional drug treatments.  Avoid practitioners who claim to “cure” Parkinson’s disease, and any who advise abruptly stopping or weaning off prescription medications (unless you have first spoken with your physician).    

It takes time to investigate and prove the safety and efficacy of any treatment.  In recent years, researchers have begun to focus more specifically on CAM therapies and we will continue to learn about their potential benefits and risks.  In the meantime, discover what is best for you by Being an Informed Consumer.  Sometimes the best treatment plans involve a wide range of interventions.    


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CAM Basics

Managing Stress

Everyone has stress in their life, and a little stress can be a good thing.  It can motivate us to accomplish tasks and avoid procrastinating.  It is when stress becomes the norm, our baseline, that it can be a drain on us physically and emotionally.  Finding ways to manage stress is important for us all, but especially for people with Parkinson's disease because stress can lead to a worsening of some of the symptoms of PD. 

If you are young and have PD, you are likely to feel pulled in many directions at once.  How can you fulfill all of your different roles and responsibilities, take care of yourself and those who may be depending on you, and at the same time keep from feeling too stressed?  It may sometimes feel as though managing your stress is simply one more stressor!

There is no one solution to the problem of stress.  Some people will find that it is in their best interest to reduce the number of responsibilities they assume, others may maintain the same level of responsibilty but allow themselves more time to accomplish the tasks associated with each of them.  Keeping the "Ws" in mind, may help you analyze a situation from a variety of perspectives and be more creative in figuring out how to manage stress effectively.  For example, you may have no control over the source of your stress (the who or what), but you can make certain decisions about how it will impact you (the when, and where).  


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Coping with the Emotional Aspects of Parkinson's Disease