WELCOME TO OUR PARKINSON'S PLACE!

I HAVE PARKINSON'S DISEASES AND THOUGHT IT WOULD BE NICE TO HAVE A PLACE WHERE THE CONTENTS OF UPDATED NEWS IS FOUND IN ONE PLACE. THAT IS WHY I BEGAN THIS BLOG.

I COPY NEWS ARTICLES PERTAINING TO RESEARCH, NEWS AND INFORMATION FOR PARKINSON'S DISEASE, DEMENTIA, THE BRAIN, DEPRESSION AND PARKINSON'S WITH DYSTONIA. I ALSO POST ABOUT FUNDRAISING FOR PARKINSON'S DISEASE AND EVENTS. I TRY TO BE UP-TO-DATE AS POSSIBLE.

I AM NOT RESPONSIBLE FOR IT'S CONTENTS. I AM JUST A COPIER OF INFORMATION SEARCHED ON THE COMPUTER. PLEASE UNDERSTAND THE COPIES ARE JUST THAT, COPIES AND AT TIMES, I AM UNABLE TO ENLARGE THE WORDING OR KEEP IT UNIFORMED AS I WISH. IT IS IMPORTANT TO UNDERSTAND I AM A PERSON WITH PARKINSON'S DISEASE. I HAVE NO MEDICAL EDUCATION,

I JUST WANT TO SHARE WITH YOU WHAT I READ ON THE INTERNET. IT IS UP TO YOU TO DECIDE WHETHER TO READ IT AND TALK IT OVER WITH YOUR DOCTOR. I AM JUST THE COPIER OF DOCUMENTS FROM THE COMPUTER. I DO NOT HAVE PROOF OF FACT OR FICTION OF THE ARTICLE. I ALSO TRY TO PLACE A LINK AT THE BOTTOM OF EACH ARTICLE TO SHOW WHERE I RECEIVED THE INFORMATION SO THAT YOU MAY WANT TO VISIT THEIR SITE.

THIS IS FOR YOU TO READ AND TO ALWAYS KEEP AN OPEN MIND.

PLEASE DISCUSS THIS WITH YOUR DOCTOR, SHOULD YOU HAVE ANY QUESTIONS, OR CONCERNS. NEVER DO ANYTHING WITHOUT TALKING TO YOUR DOCTOR FIRST..

I DO NOT MAKE ANY MONEY FROM THIS WEBSITE. I VOLUNTEER MY TIME TO HELP ALL OF US TO BE INFORMED.

I WILL NOT ACCEPT ANY ADVERTISEMENT OR HEALING POWERS, HEALING FROM HERBS AND ETC. UNLESS IT HAS GONE THROUGH TRIALS AND APPROVED BY FDA. IT WILL GO INTO SPAM.

THIS IS A FREE SITE FOR ALL WITH NO ADVERTISEMENTS

THANK YOU FOR VISITING! TOGETHER WE CAN MAKE A DIFFERENCE!

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Saturday, May 23, 2015

Depression linked to Parkinson's disease: Natural mood lifters to beat the blues

I quit Paxil antidepressant and lost depression, 100 pounds and health problems. Off the drugs and happier! 
Marilisa Sachteleben

Spring is here, so say birds, flowers, sunshine. Yet you sit depressed, wondering what all the fuss is about. Depression is no joke. It can have disastrous effects on physical as well as mental health. Live Science says a new study says depression is linked to Parkinson's Disease. Clinically depressed people are 60 percent more likely to develop Parkinson's disease later.
Scary stuff. But so are antidepressants. I used to take Paxil for PTSD, anxiety and panic attacks. It made me lose a stillborn baby. The depression didn't get better. It wasn't till I got OFF the drugs and started healing my life naturally that I got well. If you can't see the light for the clouds, try this A-Z list of natural mood lifters to beat the blues.

A is for attitude adjustment. Negativity quenches happiness. Seek out healthy sources of joy.

B is for blissings. The spelling error is intentional. "Blissing" happens when you name, count and appreciate blessings. 

C is for change. Have a change of heart. Get a positive new outlook. Maybe swap out a negative environment or relationship for a better one. This can literally unblock the sun.

D is for directed inaction. Before changing something pause a moment. Co-Anon (an off-shoot of Alanon) says wisely, "don't just do something, sit there." Think before doing impulsive, hurtful things. Look before you leap to avoid pitfalls and depression.

E is for exercise. Get moving, preferably outside. You'll have more energy and feel healthy-tired, not just mopey-lethargic. Need suggestions? Go to the playground with kids, bike rides, walks, swimming.

F is for family and friends. Reconnect with children, grandkids, siblings, parents. Make new friends and refresh old friendships. Happy relationships send the blues packing.

G is for growth. Boredom causes depression. Snatch any chance to experience, explore and expand.

H is for Higher Power. Whoever, whatever and however you worship, connect with that source.

I is for intimacy. It doesn't have to involve the s-word, but touch is good. Touch releases feel-good endorphins that dull pain. 

J is for joy. Joy and sadness aren't opposites. Kahlil Gibran calls joy "sorrow unmasked." Like empty nest syndrome--we're sad to lose what made us happy. Embrace the source of sorrow, to re-find joy.

K is for kill time and kindness. Be kinder to yourself. And learn to waste a little. Daydream. Relax.

L is for live. In the old saying "live and let live" it's often the living part that's the hardest. Don't sit by the window watching life pass. That's the "all aboard" for depression. Go. Do. Be. Try. 

M is for preventative maintenance. We aren't machines. But we both need running repairs. Take down time. Tune up.

N is for nothing. Our to-do lists are long. Yet one thing we never do enough is.nothing. Get off the Tilt-a-Whirl and just exist awhile. 

O is for organic. Which is what we are. As such, we need nourishment for soul, mind and body to prevent burnout.

P is for purge. We spring clean our homes, why not our minds? Get rid of negative. Get the old joie de vivre out of mothballs and try it on. 

Q is for quiet. Still your mind. It's okay to let cares go awhile. They'll be there when you return.

R is for relax. Hi, I'm Mar and I'm a workaholic. And that's depressing. Do something fun, just for you, not work related. 

S is for St. John's Wort--this herb is a wunder cure against depression. S is also for smile. Okay, schmaltzy, but it works. You smile at people. They smile back. Nice.

T is for turn off TV, internet, cellphone.  Quit staring at that depressing screen. Go outside. Commune with nature. Rejuvenate.

U is for unplug. Take a technology break. Go camping, fishing, hiking out of range of your devices. 

V is for real vs. virtual and vicarious. Skip video games. Play live tennis or Scrabble. Cook. Don't just watch others. There's a mood lifter plus confidence booster! Take a Facebook, Twitter, Pinterest break and visit face to face. Get off social media and socialize in real life. 

W is for weigh. Maybe you're depressed because you're facing big choices. Weigh options. Evaluate. Determine what needs to be changed, what needs to be accepted. You might also be overweight. Carrying too many extra pounds will send that depression through the roof. Work on losing weight. You'll feel physically better and mentally successful. 

X is for cross out. Uncheck memories of hurtful actions. Scribble out meanness, yours and others'. Get away from unsafe people and toxic behavior. 

Y is for why. Why are you depressed? Use the acronym HALTS. Are you hungry, angry, lonely, tired, sick--tend to those needs to heal.

Z is for Zzzz. Sleep restores body and mood.

Can you hear the bird song now? Feel the sunshine? Not yet? Keep practicing these activities till you do! It really is that simple. For more on health visit my blogs Emotional Health Help and Health Help 4u.
http://www.examiner.com/article/depression-linked-to-parkinson-s-disease-natural-mood-lifters-to-beat-the-blues

Study suggests depression is precursor to Parkinson's disease


Posted: Friday, May 22, 2015 12:00 pm
People with depression are at significantly greater risk for Parkinson’s disease than the general population, and those with severe depression are especially vulnerable, according to an article published online this week by Neurology, the journal of the American Academy of Neurology.
Researchers reviewed data on more than 560,000 people in Sweden and determined that those with depression developed Parkinson’s at a rate nearly three times that of the other study participants. The more severe the depression, as measured by hospitalizations and other types of treatment, the higher the risk of Parkinson’s.The authors said the findings suggest that depression is a warning sign or early phase of Parkinson’s, a nervous system disorder characterized by tremors, slurred speech, stiffness, an unusual gait and other symptoms. The findings come less than a year after the suicide of Robin Williams, who had battled depression and was in the early stages of Parkinson’s at the time of his death.
Carol Schramke, a clinical psychologist at Allegheny General Hospital who was not involved in the study, said the research underscores previously known links between psychiatric and neurological disorders.
“These are the kinds of things I tell the residents and medical students,” said Schramke, the hospital’s director of behavioral neurology. When a patient has depression or symptoms of depression, she said, there could be other brain-related problems — Parkinson’s perhaps but also Alzheimer’s, epilepsy or multiple sclerosis — involved.
The possibility of a second disorder is particularly strong when a person’s first bout of depression comes later in life, she said.
The findings of Wednesday’s study did not surprise Audrey Daniels, a psychiatric nurse practitioner with Milestone Centers Inc., which provides services to people with mental health disorders and intellectual and developmental disabilities.
“My own father had a form of Parkinson’s disease and suffered from depression I would say about 10 years prior to our being clear about exactly what was going on with him,” she said, citing the need to treat both disorders for maximum improvement of either one.
Now, there are no treatments to prevent or cure Parkinson’s. But if preventive measures one day are developed, Schramke said, the Swedish study identifies the type of patient who might be targeted for intervention.
While the findings aren’t entirely novel, the study advanced the link between depression and Parkinson’s in a powerful way, said Alessandro Di Rocco, professor of neurology and chief of the Division of Movement Disorders at New York University School of Medicine and NYU Langone Medical Center. He said the large number of participants and long period over which participants were tracked — as long as 26 years — provided strong support for the findings.
He said the study highlighted the complex interplay between the disorders and the need to view Parkinson’s disease as having a continuum of symptoms.
http://health.einnews.com/article/266987406/6tfqM9cRf0V8lK8y

10 Tips for Managing Drooling in Parkinson’s: by Dr. De Leon


Sialorrhea or drooling as is commonly known refers to pooling of saliva in the mouth. It occurs around 50-80% of all Parkinson’s patients particularly in men. The excess saliva then begins to literally spew out because of difficulty swallowing. Normally we produce about a liter of saliva a day which helps us break down food and keep our mouths moist and protect against bacterial infections in the gums. Ordinarily, we swallow such quantities without giving it a second thought. However, as Parkinson’s disease advances and our swallowing muscles become stiffer and slower it is sometimes difficult to keep up with the enormous production and some of it unfortunately ends up around the outside of our mouths or spilling unto our clothing causing great social embarrassment. But also because it lingers in the corners of our mouths it can cause sores and tissue break down as well as give us halitosis (bad -stale breath). Worst if we develop a large amount of pooling of saliva we can accidentally swallow a big bolus or gulp in to the lungs causing “aspiration pneumonia” landing patients inadvertently into the hospital.
Therefore, it is extremely important that if you are experiencing excessive saliva or drooling that you discuss with your physician immediately to avoid aspiration, anxiety, or social embarrassment. You no longer have to be ashamed or self conscious in public while eating, talking or going out because you have to carry around a try or feminine pad as several of my patients have done in desperation in an attempt to collect all the excess saliva.
This dramatic sight ingrained in my brain permanently is the reason why I write about this so no one has to suffer this type of humiliation any further.
 Here are some helpful tips & treatments options to help with this pesky and often overlooked problem in hopes of returning patients to a normal life.
1) First and foremost, there needs to be a medication adjustment – typically an increase of medication (levodopa or dopa agonists) to improve stiffness and slowness of muscles involved in swallowing including tongue, lips etc.
2) speech therapy to strengthen muscles around the lips and also swallowing should also be instituted concomitantly particularly to avoid aspiration.
3) physical/ occupational therapy along with increase medications should also be considered  to improve posture because the tendency to stoop forward with head forward and chin outward (typical Parkinson’s stance) causes pooling of saliva to front of mouth along with the help of gravity easier. The team of expert therapist will help instruct on proper sitting techniques as well as cues to-try to keep head up so that saliva naturally drains to the back. Sitting upright also helps saliva go down so once again cues can be thought to remember to do this at all times.
4) medications like Levsin may help to reduce drooling. However, these may not be used if severe constipation or extremely slow gut motility is present.
5) Tricyclics medications (e.g. Elavil) because of its side effects especially tendency to dry mouth are sometimes good starts and frequently used but these have to be used with caution because in the elderly or those that have problems with orthostatic hypotension, severe constipation this class of medication can make things worse for those people.
6) extremely important is to review medication list with your physician because some medications are known to cause increase salivation like some antipsychotics such as Clozapine.
7) keep hard candy in mouth (sucking it) sugar free preferably to avoid cavities and also because sugary foods increase production of saliva. Therefore, minimize sugary types of foods. If you must have chocolate try sugar free- Godiva has some excellent choices! You may also suck on ice chips to decrease drooling.
8) drink fluids more frequently to “wash down” saliva; preferably drink water which will also help decrease constipation.
9) do lip exercises to improve lip seal and prevent saliva dripping out – hold a wide smile (bet you makes you feel better too!) then pucker lips like you are going to blow a kiss or whistle- do these several times a day. Or suck from straw when you drink.
10)  Anticholinergic drugs (e.g. Artane or antihistamines) may also be use. However, not everyone is able to use these because of cognitive problems it can cause so if someone is already. confused, forgetful or hallucinating this will not be a good choice.
****Best remedy I have found however is injection of Botox into salivary gland …this is local treatment with little or no side effects especially systemic ( will not interfere with other medications) and duration of Botox last anywhere from 3-6 months sometimes longer. Now, fortunately we have different types of botulinum toxin so you have many choices. In past, with severe cases there have been reports of radiation to salivary glands to make less effective or surgically removing salivary glands. But, I don’t commend these drastic techniques with all the other treatments unless everything has failed and drooling extremely severe causing aspiration especially in light of fact that we need saliva to aid in digestion, lubrication of our mouths and throat and prevent plaque buildup. If our mouths become too dry (Xerostomia) as I mentioned in another blog this can lead to severe pain (‘burning mouth syndrome’). I have had excellent results with Botox injections over the years without need for more drastic measures. *******
Finally, brush your teeth regularly after each meal to reduce probability of infection that may set in due to stagnant saliva.
Nevertheless, all of these treatments are subject to your own physicians discretion and do not recommend making any alterations to your medicines without first discussing with your doctor or healthcare provider.
FYI -20% of PD patients also experience post nasal drip (dripping of mucous into throat) worst at night causing cough, sneezing, and interfering with sleep. By drying out mucous with these medications and remedies this problem most likely will be resolved as well. Sometimes your doctor may prescribe a decongestant as well.
——————————————————————————————————————–
Dr. M. De Leon is a movement disorder specialist on sabbatical, PPAC member and research advocate for PDF (Parkinson’s Disease Foundation); Texas State Assistant Director for PAN (Parkinson’s Action Network). 

Friday, May 22, 2015

THE PLACE OF DEATH IN PARKINSON'S DISEASE


21st May 2015 - New research






Most people prefer to receive end-of-life care in familiar surroundings rather than in hospital. This study examined the variation in the place of death for people dying from Parkinson's disease in European and non-European countries. They used death certificates for deaths with Parkinson's Disease as an underlying cause.
The proportion of deaths in hospital ranged from 17% in the USA, which was the lowest, to 75% in South Korea, which was the highest. Hospital was the most prevalent place of death in France (40%), Hungary (60%) and South Korea (75%).
Nursing homes were the most prevalent place of death in New Zealand (71%), Belgium (52%), USA (50%), Canada (48%) and Czech Republic (44%). Home was the most prevalent place of death in Mexico (73%), Italy (51%) and Spain (46%). The chances of dying in hospital were consistently higher for men (Belgium, France, Italy, USA, Canada), those younger than 80 years (Belgium, France, Italy, USA, Mexico), and those living in areas with a higher provision of hospital beds (Italy, USA).

In several countries a substantial proportion of deaths from Parkinson's Disease occurs in hospitals, although this may not be the most optimal place of terminal care and death. The wide variation between countries in the proportion of deaths from Parkinson's Disease occurring in hospital indicates a potential for many countries to reduce these proportions.

Reference : BMC Palliative Care [2015] 14 (1) : 28 . [Epub ahead of print] (K.Moens, D.Houttekier, L.Van den Block, R.Harding, L.Morin, S.Marchetti, A.Csikos, M.Loucka, W.A.Naylor, D.M.Wilson, J.Teno, M.Cardenas-Turanzas, Y.Rhee, F.J.Garcia-Leon, L. Deliens, J.Cohen) 

Complete abstract : http://www.ncbi.nlm.nih.gov/pubmed/25990567
http://www.viartis.net/parkinsons.disease/news/150521.pdf mail@viartis.net
©2015 Viartis 

Improving Quality of Voice in PD: By Dr. De Leon


singing
We have all experienced a change in our voices as Parkinson’s has taken over our lives. It can be extremely frustrating for both the person with Pd as well as the caregiver to constantly be asking to reiterate what he or she said. This is because family thinks we either mumble or slur or words when we speak which only escalates the frustration when trying to have a conversation especially in noisy places.
First you must remember that your voice is produced by muscles in your throat which are also getting stiff and slow so you must take care of them.
Ways to Care for your Voice:
1) Do not strain them by shouting over loud noise when you speak. I often get severely hyphophonic (soft voice), aphonic (no voice) even dysphonic (difficulty producing sounds) if I have to force myself to speak very loud for a long time in a loud environment.
2) Rest your voice when is tired and cover your throat with a scarf, the warmth is not only soothing but heals it when has been over worked.
3) Make sure you don’t have heartburn because this can injure your vocal cords.
4) Drink plenty of fluids especially water.
5) Avoid caffeine and alcoholic beverages.
6) I recommend that everyone should be evaluated by a speech therapist and undergo the LSVT (Lee Silverman Voice Treatment) program with a certified professional to improve output and projection of voice.
Another great exercise for maintaining your voice is singing! Join a choir or sing at home or join a PD singing group some of which are beginning to pop up around the country like the “Spokane Tremble Clefs.” people singing
But don’t strain your vocal cords; gently reach for both high and low notes while singing the lyrics as clear as you can. I guarantee that not only will your voice improve but your spirit will soar.
***One interesting scenario***
My daughter had a wonderful end of year music program in which I was so very proud to see her blossom. She put many hours of preparation at home singing. She was so excited that on one occasion she asked me to join in on the more popular songs. As we started to sing I quickly experienced spasmodic dysphonia. Although this was pretty funny to my daughter, we continued to sing. Then I switched to singing in Spanish since they were also popular in my native tongue what I discovered was something fascinating. I could sing perfectly well in Spanish (with a beautiful voice); yet I could no longer hold a tune in English. I knew that since my diagnosis with PD my voice had altered. Never had I noticed that it was only in my second language.
As a neurologist, I had witnessed many times bilingual patients suffering strokes in the areas of speech losing only their second language but never notice same type of phenomena occurring in my PD patients. There is something to be said for learning more than one language and brain’s ability to compensate for loss. So keep on singing and learning …if you already speak other languages give your PD voice a rest by switching languages or better yet learn a new one!
Sources:
Johnson, Marjorie L. National Parkinson’s Foundation- “Parkinson’s Disease Speech and Swallowing.”
http://defeatparkinsons.com/2015/05/18/improving-quality-of-voice-in-pd-by-dr-de-leon/

Thursday, May 21, 2015

The Dirty Dozen (Plus Clean Fifteen) Infographic

When it comes to buying produce, I often shy away from organic because these items are expensive (it can be twice as expensive) and add a lot to my credit card bill every month. But after reading the article about the dirty dozen from the Huffington post and Health Trekker, it somehow changed my views because of the risks pesticides causes to our health. 

So I did some research and came up with this infographic to guide you when to go organic or conventional. Also I have bonus tips at the end of the infographic on where you can buy affordable organic produce in your area and much more, so make sure to scroll all the way down.

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There is a lot of debate about the negative effects of pesticide, critics of the dirty dozen say that these effects are minimal and should not be taken too seriously but as I dug deeper in my research I found some startling facts that should not be ignored, particularly if you’re an expecting mother.
Over a billion pounds of pesticide is used every year in the United States along and most of these have one common ingredient – organophosphates. According to an article by Dr. Mercola, exposure to this chemical has been linked to diseases like Alzheimer’s and Parkinson’s disease, even with minimal exposure because it all adds up.
Direct exposure to organophosphates has a terrible effect on pregnant women and their unborn babies. In a CHAMACOS study done, they followed pregnant women who live in Salinas Valley – a large agricultural land where half a million pounds of organophosphates sprayed every year. They found out that women experienced shorter pregnancies and their children suffered poor neonatal reflexes, lower IQ, shorter attention spans and poor cognitive function.
Pesticides are also known to be carcinogenic which can lead to diseases like cancer. Ever wonder why more and more people suffer from cancer every year? It’s because of the environment we live in – we are bombarded with pesticides from the air we breathe to the food we eat, if we can minimize our exposure to these chemicals, the better our chances of avoiding cancer.
The dirty dozen list helps us by ranking the foods with the most and least amount of pesticide residue on it. This serves as a guide for us shoppers on which foods to buy organic and which ones we can get away with buying conventional.
If you think buying organic is expensive, I’ve listed 5 tips on the infographic that’ll help you find affordable organic produce. By the way, if you’re looking for more tips head over to Foodbabe’s site where she has a monster list of 75 ways on how to go organic on a budget. Another great resource on money saving shopping tips is Bankrate where they list down 17 tips on buying organic on the cheap.
If you’re into eating raw foods or juicing you’d have to be more careful because pesticides with go into your system at full strength in the absence of heat from cooking. As always, right produce selection is paramount and don’t forget wash it well even if it’s organic.
Spreading the word!
Finally, please spread the word about the dirty dozen and clean fifteen so more people are educated when it comes to knowing which produce has most pesticide content so that they can make an informed decision whether to go organic or not.
For more information about this, check out these sources:

Let’s talk about sex (and Parkinson’s)


HEALTH & FITNESS 

 

Author: Gila Bronner & Orna MoorePublished: 9 April 2015

Let's talk about sex and PD
Sexuality and intimacy are huge challenges that face people with Parkinson’s and their partners. But as specialists Gila Bronner and Orna Moore explain, open channels of communication are essential for a decent quality of life
Intimacy is an important aspect of human behaviour that involves communication, physical and emotional closeness, and interpersonal interaction.
Sexuality is one of the primary manifestations of intimacy. It is a complex process that is influenced by the interaction of biological, psychosocial, economic, political and cultural factors. Sexual dysfunction, meanwhile, is a problem that affects a person’s health, as well as their emotional and physical wellbeing.
In Parkinson’s, disturbed sexual function is commonly associated with motor disturbances, emotional and cognitive difficulties, sleep disorders and the side effects of medication. Each of the disease’s symptoms can create further emotional, physical and cognitive difficulties, which may be expressed in changes to the intimate interactions between the person with Parkinson’s (PwP) and their partner.
Facing the reality
Living with Parkinson’s involves dealing with a variety of motor and non-motor symptoms that may affect relationships and sexual lives, and result in frustration, sexual inadequacy and sometimes loss of self-esteem. While some couples easily accept limited intimacy or the cessation of sexual activity, for others it can lead to a significant reduction in their quality of life.

“Depression, anxiety and self-esteem frequently contribute to sexual dysfunction and impaired sexual fulfilment”

Motor impairment such as rigidity, tremor, immobility in bed or difficulty in fine finger movement may impair the touch needed for intimate moments (hugging, kissing, caressing) and sexual activity. Other symptoms of the disease such as excessive sweating, drooling and gait disturbances make people feel less attractive, while masked faces can be interpreted as showing a lack of affection or desire. Movement disorders may also cause patients to be sexually passive, thus imposing a more active role on the spouse.
According to our clinical experience, spouses often feel rejected and insulted when their partners with Parkinson’s ignore them intimately and sexually. On the other hand, PwPs may refrain from making intimate advances themselves due to the fear of rejection or failure. 
Coping with motor and non-motor symptoms
Non-motor manifestations of Parkinson’s can often be more disabling than the motor symptoms. They may include bowel dysfunction, drooling, urinary problems, hallucinations, fatigue, cognitive impairment and dementia, sweating, and skin problems. Some of them, such as olfactory dysfunction, constipation, depression and rapid eye movement sleep behaviour disorder (RBD), can precede the motor symptoms. Others, especially cognitive symptoms such as hallucinations and dementia, tend to occur in the later stages of the disease.
Three out of four PwPs suffer from constipation. Bowel dysfunction and constipation can cause feelings of irritability, heaviness and pain. It is obviously very difficult to be intimate under such conditions.
Bladder problems are also common – in fact, they affect one third of PwPs. The most common problem is an overly active bladder, the symptoms of which include getting up to urinate at night, frequently passing urine and a sense of urgency when needing to go. These types of urinary problems, including incontinence, can damage a person’s self-esteem, leading them to feel less attractive and sexual as a result.
In addition, depression, anxiety and self-esteem frequently contribute to sexual dysfunction and impaired sexual fulfilment. Again, these issues affect one third of PwPs. Even those people who are moderately depressed lose interest in pursuing sexual activity and are very difficult to seduce and arouse.

“Some people with Parkinson’s are unaware that their sexual dysfunction is related to their condition or treatment and, as a result, they do not raise these issues with their neurologist”

The medications used for depression and anxiety will also have an effect on intimacy and sexual function. While an improvement in mood may result in the ability to communicate intimately and become sexually active again, antidepressant medications may also cause erectile dysfunction and difficulty reaching orgasm.
Elsewhere, sleep disorders and excessive daytime sleepiness may lead to bed separation and reduced opportunities for intimate touch and sexual activity. Partners may be nervous, impatient and tired, and their anger and frustration regarding these sleep disorders can have a serious impact on the relationship. Meanwhile, couples who used to talk and share their feelings might find that speech problems decrease the opportunities for further intimate communication.
Let's talk about sex and PD 2
The contradictory role of the partner-caregiver
Under these difficult circumstances, the carers of PwPs frequently face contradictory roles. On the one hand, they are partners or spouses with their own natural feelings and needs for intimacy and sexual activity. At the same time, however, they are required to function as caregivers who cope with the implications of a chronic progressive illness. These obligatory tasks are often expressed with overwhelming feelings of frustration, depression, fatigue and a sense of loss. The consequential build-up of unresolved stress factors, therefore, can contribute to undesirable characteristics within relationships.
It is important to remember that caregiving demands a lot of time, attention and energy. Consequently, PwPs and their caring partners may spend too much time together. All healthy relationships require some space and distance, which means that each couple needs to allocate time for separate activities in their weekly schedule to do things they enjoy – such as exercising, meeting friends or going to the cinema. These separate experiences will enrich the relationship, create some much-needed space and promote better sexual closeness.
The role of the professionals
PwPs frequently feel embarrassed about their sexual needs. They may fear that their interest in sex is inappropriate – especially when many are so ill or so old. Some PwPs are also unaware that their sexual dysfunction is related to their condition or treatment and, as a result, they do not raise these issues with their neurologist.
It is essential, therefore, for healthcare professionals to be aware of the sexual changes that occur as a result of the disease and its treatment, and to acknowledge the importance of sexuality to their patients. If sexual problems are left unresolved, the PwP’s self-esteem decreases and it becomes harder to adjust to changes of body image or bodily functions.

“By providing support, professionals can help couples understand the way Parkinson’s affects a PwP’s abilities, allowing them both to adjust accordingly”

Most PwPs and their partners value the opportunity to talk about sex and intimacy with trusted healthcare professionals. however, many would welcome some guidance on how and when to share their feelings, and would prefer their physician to initiate the discussion. They want to describe how it feels to have a chronic illness, how it has affected them psychologically and physically, and how much their personal life has been affected by the disease.
Talking about sexuality and intimacy enables people to adapt to an ongoing illness that involves body changes, altered sensory patterns and fatigue. By providing this support, healthcare professionals can help couples understand the way Parkinson’s affects a PwPs’s abilities, allowing them both to adjust accordingly.
While every PwP should be given the opportunity to explore issues of intimacy and sexuality, couples should also be encouraged to raise sexual issues with their healthcare professionals and become a driving force for better treatment of sexual dysfunctions. Such a patient-centred approach can lead to significant improvements in quality of life.

Gila Bronner is a certified sex therapist. She is the director of the Sex Therapy Service at the Sexual Medicine Center, part of the Sheba Medical Center in Israel. She can be contacted at gilab@netvision.net.il
Orna Moore is a Parkinson’s disease and movement disorders nurse specialist. She also manages the Memory and Attention Disorders Center’s Department of Neurology in the Tel-Aviv Medical Center, Israel. She can be contacted at ornam@tasmc.health.gov.il 
This article originally appeared in EPDA Plus.
http://parkinsonslife.eu/lets-talk-about-sex-and-parkinsons/#.VVcy8KAgJmA.facebook

Wednesday, May 20, 2015

Depression may be linked to Parkinson's disease, long-term Swedish study finds

COURTESY NYU LANGONE MEDICAL CENTER

Dr. Alessandro Di Rocco, director of the NYU Langone Parkinson’s & Movement Disorders Center


Wednesday, May 20, 2015, 4:00 PM
Depression may be an early indicator or a risk factor of Parkinson’s disease, a long-term new Swedish study has found.
Researchers discovered 1.1% of people suffering from depression developed Parkinson’s, while 0.4% of those who did not have depression developed the progressive nervous system disorder.
The 26-year study of more than 400,000 Swedes over 50 was published Wednesday in the medical journal Neurology.
Those with more serious cases of depression were more likely to develop Parkinson’s — people who were hospitalized five or more times were 40% more likely to develop the disease than those who had been hospitalized only once.
While the vast majority — 98.9% — of people with depression did not develop Parkinson’s, the study showed a strong link between the two conditions, experts said.
“This observation has been made before, but it has never been made so powerfully. This is really an important study,” said Dr. Alessandro Di Rocco, director of the NYU Langone Parkinson's & Movement Disorders Center.

Depression may be an early indicator or a risk factor of Parkinson’s disease, a long-term new Swedish study has found.

Depression may be an early indicator or a risk factor of Parkinson’s disease, a long-term new Swedish study has found.

Rocco said that along with the physical impact of Parkinson’s — such as tremors and loss of motor control — the disease causes changes in hormones and neurotransmitters in the brain, like dopamine and serotonin, which can trigger depression.
“This is part of the disease, it’s a manifestation of the chemical imbalance and can develop early on,” he said.
Actor Robin Williams, who committed suicide last summer, was privately dealing with the early stages of Parkinson’s as well as depression and anxiety.
Williams’ conditions may have been linked — and gone beyond a depressive reaction spurred by his upsetting diagnosis, Di Rocco said.
“The story may be a little different. The story may be that the depression was part of the Parkinson’s, biologically,” Di Rocco said.
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