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The Five Most Important Actions Needed to Take Control of Parkinson’s Disease
I am not a doctor, I am a Parkinson’s Patient with 51 years of experience. These are the actions, which have helped me:
1. Regular Energetic Exercise
2. An MAO-b Inhibitor as the only Medication
3. Learn how to Take Conscious Control of all movements
4. Manage Stress Levels
5. Adopt a Positive Attitude
John Pepper
Take a Walk in The Park
04/28/2013
Walking improves stamina, energy, heart health, strength, and balance. As a form of exercise walking may even alter the physical and brain changes that occur with Parkinson’s over time. Walking can also help the mind and the soul. Research tells us that exercise including simply just walking, can protect our thinking abilities as we get older and protect from disease…
· Reduce cognitive decline that can happen with aging
· Reduce the risk of developing Alzheimer’s disease a form of dementia that attacks memory and thinking skills
· Reduce the decline executive function in Parkinson’s. (Learn more about executive function.)
Walking can also be good for our emotions and our soul. We have long known that exercise can help our mood and treat depression. A walk in the park is like getting a double dose of therapy.
John Muir, a naturalist and nature lover once wrote,
“In every walk with nature one receives far more than he seeks.”
In a time when many of us are flocking to gyms, joining exercise classes or getting on the treadmill to get in ‘their exercise’, we may be missing an opportunity to move and feel well. Researchers evaluating the effect of walking on our mood showed that a walk in the park improved mood more than a similar walk in the shopping mall. Our environment affects how we feel, think, move and behave. Think about a walk in the park on a beautiful sunny day and the feeling and experience that comes to mind
· The fresh air sharpens the senses and clears the mind of clutter
· The marvel and good natured fun of watching nature
· The stress dissolving effect of the peaceful calm of a gentle breeze
· The sense of hope and anticipation that comes with the first spring buds.
· The reflection of days past and what brings joy to us in life as we watch the sun set
· The challenge and sure footedness of walking that is gained from walking on uneven ground
· The chance to slow down, share your walk and connect with a loved one
· The energizing feel of the sun
· The joy and reminder that little things like a bird’s song or child’s laughter are important in life
· The soothing effect of the sun’s warmth on our back
The benefits of nature are available to us all. The power of exercise in Parkinson’s, healthy aging and emotional wellbeing are undisputed. Enhance this power by taking your next exercise activity outdoors. Whether you take a stroll in your wheelchair in the park, take a walk around the block or a short stroll in your backyard, the benefit of nature is priceless.
Author: Monique Giroux, MD
Copyright 2013 Northwest Parkinson's Foundation Wellness Center
Pausing Parkinson's: Movement may help slow disease
Copied from The Northwest Parkinson’s Foundation Weekly News Update
Symposium will discuss exercise, stress reduction
Candace Chase
Daily Inter Lake.com - Joe Jackson, brother of famed basketball coach Phil Jackson, grew up in an active family. He remains active even now, as he lives with Parkinson’s disease, a chronic and progressive movement disorder.
“My physicians say it’s going very slow; I’m lucky that way,” said Jackson, 70. “I try to exercise frequently. The one thing that’s correlated with slowing it down is exercise.”
Jackson, a clinical psychologist and former Flathead Valley resident, kicks off “Moving Together with Parkinson’s” at a two-day event that starts Friday at 9 a.m. at the Red Lion Hotel Kalispell. It continues Saturday with another full slate of speakers selected to educate, encourage and inspire patients, caregivers and medical providers.
Lois Wagner, one of the organizers, said Parkinson’s statistics remain unclear due to the difficulty of diagnosis. The disease includes many manifestations, including tremors, slowness of movement, rigidity, impaired balance and coordination.
The cause remains unknown but involves the malfunction and death of vital nerve cells in the brain. Symptoms range from mild to severe, with onset usually after age 60 — although some younger people, such as actor Michael J. Fox, also develop Parkinson’s.
“In our support group, we have the full range of ages and abilities and disabilities and the effects of the illness,” Wagner said. “We have people in wheelchairs, and we have people who have just come from work.”
Wagner, a nurse whose father had the disease, organized a Parkinson’s support group with her friend Inga Myers, a Parkinson’s patient. The group meets at The Summit at 3 p.m. on the second Wednesday of each month.
The upcoming symposium represents the first large gathering of experts initiated here by this support group. The group worked in partnership with the American Parkinson’s Disease Association and The Summit.
The symposium will feature Dr. Susie Ro, a neurologist movement specialist, as well as specialists in daily living problems, physical therapy, art and music therapy, massage and more.
Beginning at 9 a.m. Friday, Jackson will open the symposium with a three-hour session on mindfulness-based stress reduction. He developed his stress-reduction program based on meditative techniques for mindfulness popularized by Jon Kabat-Zinn.
“Because most stress comes from worry about the future or worry about the past, we need to learn to live in the moment,” he said.
Now a resident of Charlottesville, Va., Jackson taught stress reduction in Virginia for about eight years, including working with the University of Virginia football team. A former valley resident, he and his wife still maintain a summer home in Rollins.
Jackson has a history in this area that began with his family’s cabin on the Middle Fork of the Flathead River near Hungry Horse.
“It was a stable part of my childhood,” he said.
Jackson earned a doctorate psychology from the University of Texas and has extensive clinical practice as well as university teaching experience. His children were born in the Flathead Valley, where he practiced for 10 years.
He was diagnosed about three years ago with a form of Parkinson’s that does not involve noticeable tremors. He said people might notice that he has stiffness or rigidity.
“It’s one of those diseases — as everyone who has had it knows — that starts years before it’s diagnosed,” he said.
“Little things started to change. Like I thought I had more saliva than I thought I should. My writing was starting to get cramped, and my voice was starting to get a little hoarse. I had no objective reasons for that.”
Like many patients, Jackson researched his symptoms on the Internet and found they correlated to Parkinson’s. His general practitioner confirmed the diagnosis.
Although his disease has progressed very slowly, he monitors changes while continuing the active lifestyle that has always defined his life.
“My brother is Phil Jackson, so we’re a sports family. Sports was just part of our life, so I was active and still am,” he said.
“I’m a little stiffer than I used to be, but I’m not sure if that’s age or Parkinson’s.”
Jackson points out that it’s called a dis-ease, which speaks to the discomfort inflicted on the patient as well as the family. He found mindfulness techniques helped with the stress of dealing with a chronic disease like Parkinson’s.
“Maybe it slows down Parkinson’s a little,” he said. “I felt like if people had some techniques and methods, at least they could use those to ease the stress. This is the first class I’ve taught for Parkinson’s patients.”
Jackson teaches body scanning, yoga poses and meditative focusing on the breath. These techniques train people to focus more effectively in the present moment and stay there.
“They’re going to get a three-hour program where they get a chance to experience coaching and being mindful under different conditions,” he said. “If they want to continue it, we’ll give them resources to do that.”
Meditation and mindfulness practice have given Jackson an inner serenity, although he said he still occasionally feels self-consciousness fumbling for his wallet in front of a long line at the grocery store.
“But I’m not focused on what will happen in two years or what will happen in three years,” he said. “It’s helped me not be too nervous. I meditate daily, and I do stretching exercises to stay focused.”
Along with Jackson’s stress reduction session, the Friday symposium features Ro speaking on “Moving with Parkinson’s” at 1:30 p.m. and Lydia Skoog, ADPA coordinator, at 3:30 p.m. presenting “Living with Parkinson’s: The Daily Issues.”
University of Montana assistant professor Laurie Slovarp, a specialist in language and speech pathology, starts the Saturday session at 9 a.m. with “Coping with Speech and Swallowing Problems.”
Physical therapist Julie Bless speaks at 10:15 a.m. on “Bringing Motion to Life,” followed at 11:30 a.m. with massage therapist Lacie Angel presenting neuromuscular massage techniques.
The afternoon sessions are:
n 1:30 p.m. — Natalie Norrell, counselor and art therapist.
n 1:30 p.m. (concurrent with the above) — Care Partners Session facilitated by Wagner and Skoog.
n 3:15 p.m. — Jenna Justice, music therapist.
n 4 p.m. — Marisa Roth, dance instructor and owner/director of Northwest Ballet Co.
Wagner prefers that people pre-register by calling Skoog at (800) 233-9040, although they may register each morning between 8:30 and 9 a.m. A donation of $20 is requested for the American Parkinson’s Disease Association.
http://www.dailyinterlake.com/news/local_montana/article_35db337a-8c3b-11e1-95e0-0019bb2963f4.html
More about Stress
By John Pepper
Is your life stressful?
If you answered, yes; have you done anything about it?
What can you do about it?
My name is John Pepper. I was diagnosed with Parkinson’s disease in 1992.
Get hold of a copy of my book, ‘Reverse Parkinson’s Disease’, and learn, not only what I did to get rid of ‘Harmful Stress’, but what type of stress is harmful and what isn’t.
Not all stress is harmful! The brain needs certain levels of ‘stress’, in order to survive, but it does not need harmful stress.
What constitutes harmful stress?
How do you go about getting rid of harmful stress?
Why do you need some forms of stress?
How do you know the difference between the two forms of stress?
Read my exciting book and take the necessary steps to start reversing, or maybe only slowing down the inevitable progression of Parkinson’s disease
Can anybody do it?
NO!
Why NOT?
If you were recently diagnosed with Parkinson’s disease and you are prepared to invest a certain amount of time and effort into changing your life style, then YES, you do stand a good chance of at least slowing down the progression of your Parkinson’s disease, if not actually reversing it, as I have.
If you were diagnosed quite long ago, then you still stand a chance to at least slow down the progression of your Parkinson’s disease
If you were diagnosed long ago and you find difficulty in moving, then you would be ill-advised to even consider going this route. However! There is no harm in trying, if you are determined to give it your best effort!
But if you only go at it half-heartedly, you will stand very little chance of changing the course of your Parkinson’s disease and will land up very disappointed and disillusioned.
Why would you not give it your best effort?
My experience, over the past ten years, has been that there are many patients who think they are unable to change their levels of stress, especially where the stress is caused by family members.
My book explains that there is nothing different between dealing with family members, than there is dealing with other people. The results of not taking this action will be the same for both groups. If you don’t get rid of your stress levels, your Parkinson’s disease will definitely get worse, quicker than it will if you do get rid of it.
You have to ask yourself, “If you continue to get worse, will it help that family member, more than if you were not to get worse?
It obviously, cannot benefit anyone, if you continue to get worse, especially if you stand a chance of getting better, if you don’t have that stress!
What is needed here is tough love. Even though it may not appear to be possible for the family member to find a solution to the problem – he/she would stand a better chance, if you were forcing her/him to do so! There is an old saying, “Where needs must, the devil drives”. You would be amazed how people find answers to problems, when they are forced to do so.
When you are no longer able to help him/her, or maybe also not any longer able to help yourself, that family member will then have no option but to find a solution to the problem - only then, there would be even more People with a problem!
Maybe, that family member just needs that push to find a solution to the problem. If he/she has no other alternative but to go out and find that solution, then he/she will go about it in a much more aggressive way.
There are, of course, Parkinson’s disease patients, who would rather go down the drain, together with that family member, regardless of the consequences, rather than taking the bull by the horns, while there is still time to find that solution.
There are other types of stress, which are self-imposed; such as wanting to keep a promise, which was made, before you knew about your inability to handle the stress it has caused you. Again! Ask yourself, “If anybody stands to gain from you continuing to keep your promise?” You are not responsible for your Parkinson’s disease condition, and it is your duty to do everything you can to solve that problem.
Make the most of every opportunity you have, to improve your Parkinson’s disease condition, you owe it to yourself and your family.
Put everything into perspective! Nobody can gain from you letting your condition get worse.
If you try everything I am recommending, to the best of your ability, and FAIL, nobody is going to hold it against you! They will admire you for trying, and your care-giver will be thankful for everything you did!
If you don’t believe anything I tell you in my book, that is your choice! If your doctor does not believe what I have written in the book, then that is his choice! Just because there has only ever been one person, who has managed to reverse his Parkinson’s disease, does not mean that others cannot follow.
If it is possible to reverse Parkinson’s disease, as I claim it is, there has to be a FIRST, so that others can follow.
NONE OF MY RECOMMENDATIONS CAN BE HARMFUL TO YOU, PROVIDING YOU DON’T HAVE SOME OTHER CONDITION, WHICH PREVENTS YOU FROM DOING WHAT I RECOMMEND.
YOU OWE IT TO YOURSELF, AND YOUR FAMILY, TO GIVE IT YOUR BEST SHOT!
What have you got to lose?
Look at my Website - www.reverseparkinsons.net to order. MY BOOK
Is Work Stressful?
by John Pepper
In 1970, my wife Shirley, and I started a new business, printing computer stationery. This business grew very quickly, along with the growth of computers, and in 1987, this company went public, on the Johannesburg Stock Exchange.
The problems we encountered in this growing company, soon became too much for us to handle. I am an entrepreneur, and have no formal training in management procedures, or the desire to manage others. I first appointed a new Managing director, in 1982, to run this fast-growing company, on a daily basis.
The company continued to grow, after it went public. Soon afterwards, I found that the company was not sticking to its tried and tested culture, and I appointed a new Managing Director. This improved the company’s performance, but it did not bring the culture back into line.
In 1974, while all these problems were developing, I did something very unusual. I started to write a suite of computer programmes, which would run this burgeoning company from the time the orders came in, to the time the client received his account. It also ran everything else, except the final accounts.
I found it impossible to train other computer programmers to take this workload off my shoulders. I landed up running the business during the daytime and writing programmes during the night. This became too much for me to handle, when I got down to sleeping for only three hours a night.
I set up another company, to take over the writing of these programmes, and also to broaden the market for these programmes, to include all different types of printing. However, I was never able to find anyone capable of writing those programmes, for the production and estimating functions.
I soon realised that it would be easier to find a professional manager, to run the printing company, than it was to find someone who was able to write computer programmes and, at the same time, solve the problems of how to quote any type of printing job. I appeared to be the only one able to do this work.
In 1992, when I was first diagnosed, I decided to take that final step. I resigned from my position as the CEO of a this large printing company. I also closed down the software company, which I had founded in 1976. Both of these changes had made an enormous difference to the high levels of stress, under which I had been working.
The company was soon taken over by some large conglomerate and my late wife’s and my own involvement in it, have long since been forgotten. Was it all worth it? Yes. I proved to myself that I was as capable as anybody else of creating something good.
In answer to my own question at the beginning of this article, NO! Work is not stressful, unless you allow it to get you down!
Quick relief from stress
Contributed by Beatrice Rabkin. Bsc. Nutritional Medicine; Dip Pharmacy
You may not be able to change your life but you CAN change your response!
These “tension tamers” turn off the alarm response and turn on the relaxation response:
Breathe from your Belly:
Sit in a comfortable position, take a few deep breaths by expanding the belly. Releasing physical tension and increasing oxygen intake. As you breath say to yourself SOFT BELLY – and as you say it, feel your stomach soften. Try to picture yourself in somewhere beautiful and peaceful – e.g. picture the crashing of waves on the beach.
Take a short walk:
Change your scenery, change your perspective – indoors or outdoors. Get the blood circulating and “blow off” steam.
Spring into Action:
A short burst of exercise (run up the stairs, push ups or abdominal crunches or simple stretching) This delivers increased oxygen to the brain and distracts from stress and gives a fresh perspective.
Listen to Music:
Soft music helps relax tense muscles – upbeat music lifts your mood and keeps you energised.
Dance or Sing
Start moving to your favourite tunes – bursting into song or a silly dance can transport you into a stress-free zone.
Take a Mental break:
Steal a few minutes of peace to gaze out your window or visualise yourself in your favourite place (in the garden or on the beach) or being with your favourite people. This renews the spirit and breaks the stress.
Laugh:
Maintain a sense of humour – download a laugh track, read cartoons and jokes or watch a comedy. There is often comedy on at the Baxter or other theatres.
Write in your Journal:
This clarifies your thoughts and feelings for increased self knowledge. Helps to refocus and get perspective, allows you to reflect and may help you cope better next time.
Take a Power Nap:
Mid-day sleep gives you more patience, better reaction time, increased learning, more efficiency and better health. Just 5 minutes relax and close your eyes.
Smell the roses:
Have roses, lavender or rosemary in your home and work, eg. a pot of lavender in a sunny spot.
Sexually alive with Parkinson’s Disease – A new perspective on sexuality
1. A new perspective on sexuality: An ongoing journey
We are born sexual beings and we die sexual beings. What keeps on changing throughout our lives, is how we speak, express, enjoy, hate, develop, stunt, grow, and adapt our sexuality throughout our lives.
Nelson has said about sexuality:
“We are being called and given permission to become body words of love.”(1)
This statement fills me with hope: It helps me to realise that in spite of the worst possible scenario, our bodies and our being can still be vehicles of love, closeness, tenderness and passion. We can choose to adapt and change our journey although we are different.
I have been privileged to experience this with my husband in our marriage of 31 years, his journey with Parkinson’s disease, and even more, sitting with patients who had to go through:
A spinal cord injury and adjust to new ways of caressing because of his paraplegia;
A stroke that robbed the ability to walk and talk but touching with one hand remained as well as the ability to relax when the healthy side of the body was caressed;
The woman with the second mastectomy whose husband had to nurse her wound and his own anxieties and after her death, give himself permission to enjoy a new relationship after years;
the patient who struggled with ED after his radical prostatectomy and hormone treatment and decided not to take medication for ED, because their relationship has stabilised on a limited level of intimacy after her chemotherapy; for him adapting in their sexual relationship was accepting that he could still be healthy, exercise and masturbate when needed.
Others with extra-marital affairs, sexual abuse, MND, amputation, grief, depression, bipolar mood disorder, Premature ejaculation, ED, Vaginismus, Lack of desire, Anorgasmia. Everyone of these patients made their individual decisions to adapt/ not, to use medication and counselling/ or not in moving on in their lives.
In moving on, we need to remind ourselves of some basic facts:
Our biggest sex organ
Our biggest sex organ is our skin. Laura Berman reminds us:
”The right touch can be as intimate and erotic as sex itself”(2)
But to allow our erotic minds to stay alive, we need to get our most important sex organ, our brain, on our sides.
Our most important sex organ is our brain:
Parkinson’s disease is the result of Substantia Nigra Cells that stopped producing Dopamine, leading to the motor and non-motor symptoms. But the rest of the brain is still working and can help one to adjust.
Understanding and discussing the illness, accepting it and and it’s effect on sexuality, is part of accepting and moving on. It leaves one with more choices, especially if normal functioning, sexual responses and differences between men and women as well as the effect of ageing on sexual responses are taken into consideration.
2.Sexual functioning
Sexual functioning depends on the neurological, vascular and endocrine systems allowing sufficient blood supply to and from genital organs, a balanced hormonal system and a healthy emotional state. Sexual functioning is influenced by psychosocial factors, family and religious background, the sexual partner and individual factors such as self-concept and self-esteem. Sexuality can be changed by aging, life experiences (e.g. abuse) and various illnesses and their treatments.(3) (Verschuren, et al,2010)
Sexual response
Sexual response has identifiable stages – desire, arousal, climax, and resolution which are accompanied by bodily changes.
Desire occurs when we see, smell, hear or experience emotions that trigger sexual energy and sexual potential is awakened.(4)Loving sex
During sexual arousal the heart rate quickens, cheeks flush and pupils dilate.
A woman’s nipples become erect and blood flow to the genitals increase. In the woman the vagina becomes moist (vaginal lubrication), the clitoris ( which is 10-12 cm in length) fill with blood. The speed of response by the clitoris depends on whether it is stimulated directly by touch, fingers, mouth or erect penis or indirectly by touching of other erogenous zones.
Because of its position, the clitoris is not stimulated directly during intercourse, so movements of the penis on its own are often insufficient to excite the clitoris to orgasm. Additional touch by fingers or mouth (masturbation by the partner or self) may be necessary to reach orgasm.
As sexual excitement increases the vagina lengthens and distends and the colour of the vulva change from pink to dark purple. During orgasm the vagina and uterus contracts 3-15 contractions at 0.8 second intervals. Women may have multiple orgasms or experience arousal without achieving an orgasm. After orgasm, the body relaxes and the vagina and clitoris return to normal, resolution.(4)Magic of sex
A man’s response to sex starts in the brain when he is aroused by something real or imagined. (predominantly visual stimulation or conditioned experiences).
The penis becomes erect and internal and external body changes occur. A “sex flush” that may appear over his abdomen, chest, neck and face, nipple swelling and increased heart rate, breathing rate and blood pressure. A feeling of “inevitability” is experienced two to three seconds before ejaculation and a drop of fluid may form at the urethral opening of the penis prior to ejaculation.(secretions from Cowper’s gland)
Orgasm occurs with simultaneous muscle contractions and rhythmic contractions of the penis and ejaculation. Orgasm and ejaculation are two separate processes and may, or may not occur at the same time. One can occur without the other.
During resolution , the penis becomes flaccid following intercourse and the man will not get another erection for some while.
3. Ageing and sexuality
The majority of older people still find sex thrilling and energy –giving; neither heir desires or capabilities vanish. Sex may wane a little in frequency and vigour, but not in sweetness and satisfaction.(4)
In both sexes, the sexual impulse declines with age but the general pattern differs in men and women. A man’s sex drive reaches a peak in late teens and thereafter gradually diminishes. A woman’s sexual feeling reaches a maximum much later in adult life, is sustained on a plateau of responsiveness which tends to decline in her late 60s. Much research support the existence of a strong sexual urge in 70- and 80-year old women and men.(4)
Goodwill, caring, thoughtfulness, a desire to comfort and shared intimacy keep long term relationships alive and mutual respect and affection help couples to remain close.(4)
Sex and the older man
Until about the age of 50, men’s sexual responses stay stable. This is due to the testosterone levels remaining consistent through to his midlife.
Changing in sexual activity need open honest discussion to maintain a loving relationship.
· Desire levels drop according to testosterone levels
· Arousal changes – erections become more unreliable, erectile dysfunction more common; 40% chance of ED over the age of 40, 50% if over 50. ( MMAS; Feldman et al)
· Orgasms are less intense and frequent.
· Orgasms are prolonged.
· Orgasms may happen without ejaculation
· He may need days rather than hours before he is ready for intercourse. The resolution phase prolongs (5)
Coping with the changes, may need more active involvement from the partner. Changing the emphasis of sexual activity to longer and stronger foreplay, more tactile stimulation including caressing, rubbing, cuddling and the use of different sexual positions. The partner becoming more active as initiator.
Erectile dysfunction may be the indicator of other health issues, especially endothelial dysfunction, causing cardiovascular disease. Medical evaluation to rule out underlying cardiovascular disease, DM, Testosterone deficiency or a neurological disease is crucial.(5 )
Sex and the older woman
Studies show that women have a more stable sex drive than men. Women over sixty-five continue to seek out, and respond to, erotic encounters, have erotic dreams, and continue to be capable of orgasms, even multiple ones. (5)
She can however expect the following sexual- response changes:
· Decreased desire
· Arousal takes longer because vaginal blood flow and genital engorgement are reduced; vaginal lubrication is delayed and reduced in quantity.
· Reaching an orgasm takes longer due to a decrease in vaso-congestion of the clitoris and vagina, as well as decreased sensitivity.
· Decrease of breast and nipple erection.
· Orgasmic capacity is retained- even multiple orgasms are still possible.
· The number and intensity of vaginal contractions is reduced.(5)
The availability of a partner and the opportunity for regular sexual activity are the most important factors influencing sexual behaviour. Masturbation is instrumental in keeping alive an older woman’s sexuality and sexual identity, and it will keep her physiological responses in good working order (especially during widowhood).(4)
Managing changed sexual response may need more use of fantasy, openness about the kind of sexual touches that turns on and using additional lubrication or vaginal hormonal cream to prevent painful penetration and using hormonal replacement.
Use leisure time for leisurely sex, give more attention to foreplay and introduce something new like oral sex, sex toys, masturbation, new positions to increase arousal and desire.(5)
A satisfying relationship is crucial to enhance sexual responses.
4. Sexual dysfunction
Sexual dysfunction is not uncommon in the general population. It is linked to risk factors such as age, smoking, DM, CVD, other chronic diseases, menopause and ageing in the
male. It is multifactorial in chronic, neurological disease.
Sexual dysfunction in Parkinson’s Disease
Sexual dysfunction is common in PD and associated with depression and relationship dissatisfaction.
Women: 75% difficulties with arousal &orgasm
50% low sexual desire
Men: 70% erectile difficulties
40% premature ejaculation
40% delayed orgasm (6)
In the general population without health problems, estimates of sexual problems vary from 10-52% of men and 25-63% of women.(7)
5. Sexual function is interfered with by typical PD symptoms
1. Muscle rigidity, bradykinesia and clumsiness in fine motor control affect the ability to undress, touch and caress and indirectly the willingness to initiate. The slowness of movement , tremor or rigidity may interfere with practicalities of lovemaking.
Undressing your partner with PD can become a necessary but also playful part of foreplay.
A hot bath or shower before lovemaking, may lessen muscle stiffness and tiredness.
Changing roles: the woman becoming the more active initiator if the man has PD
The man spending more time to make his female partner with PD feel safe before caressing and touching.”Studies suggest that feeling safe may be the most important factor in determining whether or not a woman reaches orgasm.”(2)
2. Sexual functioning may be worse in late evenings, especially with daytime scheduling of medication.
Rescheduling night time lovemaking to mornings could overcome this problem.
If you do feel sexual attraction, even if it is at a bad time for medication, follow your desire. Additional lubrication, or extra stimulation with a vibrator may surprise both of you.
3. PD medication can lower sexual desire or can enhance desire.
It is more often the associated depression, fatigue associated with PD or relationship strain that cause a lack of libido.
Increase in desire may occur with levodopa and deep brain stimulation.
4. Tremor , dyskinesias can be enhanced during sexual arousal.
Accepting this as a compliment rather than a “put off” may bring some humour and a change in attitude.
Switching your side of the bed, may enable touching and caressing with “the better side”.
Use positions that will lessen the strain on stiff muscles (side by side)
5. Hypersalivation and sweating
Has never been a turn on!!! Shower/ brush your teeth/ suck a sweet.
6. The mask–like face may reduce the appeal for the partner. Subjectively it influence the self–image of the partner in a negative way.
Deliberately practise open eye kissing, smiling while you caress.
Try to look into your partner’s eyes while you have an orgasm.
7. Men can have problems getting and keeping an erection.
Causes: lack of dopamine/ anti-depressants/performance anxiety/ other physical causes.
8. Treatment of ED:
Sildenafil 85% efficacy in PD patients with depression
Tadalafil & Vardenafil are also effective.
It enhance the response to sexual stimulation. The partner remains crucial.
Sildenafil should be taken 1 hour before intended sexual activity.
Often the larger dose needs to be used.
A longer time of onset is needed because of slowed gastrointestinal mobility.
It can be used once / twice per week.
9. Contra –indications for PDE5I
Nitrates
Retinitis pigmentosa
History of priapism (prolonged erection)
Hypotension
Coronary artery disease
10. Non-responders to oral treatment
Intrapenile injections of Alprostadil
Taught under medical supervision
Vacuum-device : rarely adopted by elderly
Difficulty placing / removing bands, bruises
11. Ejaculation problems with PD
Rapid ejaculation: SSRI like Sertraline/ Paroxetine
Rapid ejaculation linked to ED: Sildenafil may help both
Delayed ejaculation: ejaculation is a reflex
Increased stimulation with a vibrator
Share this information with the partner
Decrease marital tension , embarrassment
12. Women may experience vaginal dryness
Use additional lubrication to prevent pain with penetration.
Give more caressing/ foreplay.
Use a vibrator for clitoral stimulation to ensure an orgasm.
13. Women may struggle with urinary urgency and incontinence
Empty the bladder before lovemaking
14. PD symptoms worsen at night / sleeping apart reduces opportunities for spontaneous sex
Talk frankly and openly about sexual needs. Communication is the best remedy for all relationship problems.
Consider outercourse if intercourse is not an option.
15. Depression and the use of anti-depressants in PD are common.
Both are associated with higher frequency of Sexual dysfunction.
PDE5I are recommended for arousal problems( ED or lack of lubrication)
16. High prevalence of Testosterone deficiency in elderly PD patients
20-25% of males over 60 years
Depression, fatigue, decreased libido, ED, decreased work performance
Respond to testosterone treatment.
Motor and non-motor symptoms of PD improved with daily transdermal T-patch.
17. Hypersexuality in PD
Rare side-effect of Dopamine agonists, Levodopa, Deep brain stimulation.
Discuss adjustment of dosage / medication with your neurologist.
18. Issues for the person who has PD
Besides the effect of the condition and the medications, sexual problems may develop because of a negative body image, reduced self-esteem, depression and grief, anger and stress.
Open communication and understanding are
Stress - Stress Management
Is your life stressful?
If you answered, yes; have you done anything about it?
What can you do about it?
My name is John Pepper. I was diagnosed with Parkinson’s disease in 1992.
Get hold of a copy of my book, ‘Reverse Parkinson’s Disease’, and learn, not only what I did to get rid of ‘Harmful Stress’, but what type of stress is harmful and what isn’t.
Not all stress is harmful! The brain needs certain levels of ‘stress’, in order to survive, but it does not need harmful stress.
What constitutes harmful stress?
How do you go about getting rid of harmful stress?
Why do you need some forms of stress?
How do you know the difference between the two forms of stress?
In my exciting book I will take you through the necessary steps to deal with certain types of harmful stress and start reversing, or slowing down the inevitable progression of Parkinson’s disease.
Can anybody do it?
NO!
Why NOT?
If you were recently diagnosed with Parkinson’s disease and you are prepared to invest a certain amount of time and effort into changing your life style, then YES, you do stand a good chance of at least slowing down the progression of your Parkinson’s disease, if not actually reversing it, as I have.
If you were diagnosed quite long ago, then you still stand a chance to at least slow down the progression of your Parkinson’s disease
If you were diagnosed long ago and you find difficulty in moving, then you would be ill-advised to even consider going this route. However! There is no harm in trying, if you are determined to give it your full effort!
But if you only go at it half-heartedly, you will stand very little chance of changing the course of your Parkinson’s disease.
Why would you not give it your best effort?
My experience, over the past ten years, has been that there are many patients who think they are unable to change their levels of stress, especially where the stress is caused by family members.
My book explains that there is nothing different between dealing with family members, than there is dealing with other people. The results of not taking this action will be the same for both groups. If you don’t get rid of your stress levels, your Parkinson’s disease will definitely get worse, quicker than it will if you do get rid of it.
You have to ask yourself, “If you continue to get worse, will it help that family member, more than if you were not to get worse?
It obviously, cannot benefit anyone, if you continue to get worse, especially if you stand a chance of getting better, if you don’t have that stress!
What is needed here is tough love. Even though it may not appear to be possible for the family member to find a solution to the problem – he/she would stand a better chance, if you were forcing her/him to do so! There is an old saying, “Where needs must, the devil drives”. You would be amazed how people find answers to problems, when they are forced to do so.
When you are no longer able to help him/her, or maybe also not any longer able to help yourself, that family member will then have no option but to find a solution to the problem - only then, there would be one more person with a very serious problem!
Maybe, that family member just needs that push to find a solution to the problem. If he/she has no other alternative but to go out and find that solution, then he/she will go about it in a much more aggressive and determined way.
There are, of course, Parkinson’s disease patients, who would rather go down the drain, together with that family member, regardless of the consequences, rather than taking the bull by the horns, while there is still time to find that solution.
There are other types of stress, which are self-imposed; such as wanting to keep a promise, which was made, before you knew about your inability to handle the stress it has caused you. Again! Ask yourself, “If anybody stands to gain from you continuing to keep your promise?” You are not responsible for your Parkinson’s disease condition, and it is your duty to do everything you can to solve that problem.
Make the most of every opportunity you have, to improve your Parkinson’s disease condition, you owe it to yourself and your family.
Put everything into perspective! Nobody can gain from you letting your condition get worse.
If you try everything I am recommending, to the best of your ability, and FAIL, nobody is going to hold it against you! They will admire you for trying, and your care-giver will be thankful for everything you did!
If you don’t believe anything I tell you in my book, that is your choice! If your doctor does not believe what I have written in the book, then that is his choice! Just because there has only ever been one person, who has managed to reverse his Parkinson’s disease, does not mean that others cannot follow. There has to be a first time for everything!
If it is possible to reverse Parkinson’s disease, as I claim it is, there has to be a FIRST, so that others can follow.
NONE OF MY RECOMMENDATIONS CAN BE HARMFUL TO YOU, PROVIDING YOU DON’T HAVE SOME OTHER CONDITION, WHICH PREVENTS YOU FROM DOING WHAT I RECOMMEND.
YOU OWE IT TO YOURSELF, AND YOUR FAMILY, TO GIVE IT YOUR BEST SHOT!
What have you got to lose?
Lifestyle Changes
Dear Reader,
William here, I want to tell you John Pepper's story as he related it to me. John's story is a story of passion and excitement that I want to share with everyone, especially those that suffer from Parkinson's disease.
In 2002, John wrote his first book – “There IS LIFE After Parkinson’s Disease” - but doctors complained that the title claimed that his Parkinson's disease was now in the past, and he was therefore cured, even though he says he is not cured – so he changed the name of the second edition to - “There IS LIFE After Being Diagnosed With Parkinson’s Disease”.
In his book, he claimed that:
“Nobody would ever know he still has Parkinson’s Disease”.
To put this claim to the test, John consulted another eminent neurologist, who said that:
“You do not have Parkinson’s Disease. There is no cure for Parkinson's disease, therefore you never had Parkinson's disease”
This neurologist did not carry out a proper clinical test on John. He mainly based his opinion on John’s outward appearance, which certainly did not look as if he had ever had Parkinson's disease. But, as he states quite clearly in his book, he still has many of the symptoms of Parkinson's disease, but because he has been able to overcome most of the movement problems, he is now able to live a perfectly normal life, providing he maintains his new life style regimen.
After selling 700 books, without any advertising, other than by word of mouth, he decided to change the name of his book to – “Reverse Parkinson’s Disease” – because of the success his story has had with patients, who have read his book and taken the bold steps he has recommended, in order to change their life style.
Why not find out what those lifestyle changes are?
All of John’s recommendations are common-sense solutions to general health problems, and cannot do any harm to anyone, unless their doctors have advised them not to do any meaningful exercise.
If John’s recommendations are all common sense, then why don’t more doctors recommend that Parkinson's disease patients take his advice?
That is a good question!
Do any of John’s recommendations get used for the treatment of other health problems?
Yes! They do!
Speech Therapists use some of these solutions and Cardiologists use others, to treat people with heart problems! Business people use other solutions to improve their business skills!
Why don’t Neurologists routinely recommend these solutions to
their Parkinson's disease patients?
The only answer John can come up with, as a layman, is that only a Parkinson's disease patient knows what he/she is capable of doing.
Parkinson's disease is a movement disorder, and part of his regimen involves strenuous exercise, and who would think that that would be a possible solution?
What type of strenuous exercise is John recommending?
You will have to read his book to find out how he came to the conclusion that walking was the single best exercise to do for Pd. He also does other exercises for strengthening his core muscles, but the answer to this question has to be put into a routine that most Parkinson's disease patients will be able to follow, without injuring themselves.
John has been there! He knows what is possible for a dedicated
‘Couch Potato’ like him to do!
John also knows that unless the Neurologist insists on his patient carrying out these life style changes, or the patient knows for certain that other patients have successfully done it, then the patient will never commit to this routine. It is much easier to take pills and accept what the future has to offer!
Why does John not claim to be cured?
Because he is not cured! If he stops his routine, due to other health problems, of which he has several, then his Parkinson's disease starts to deteriorate again. If ever he stops exercising, or whenever he got clever and stopped taking his medication, during those ten years after being diagnosed, then his condition got appreciably worse.
Why does John no longer take
any Parkinson's disease medication?
John’s Parkinson's disease is at the stage where medication is no longer needed, providing that he continues with his new lifestyle regimen.
Thank you for reading this story,
William Ainslie (John's Personal Trainer)
Parkinson's Insights – My Story Part 1
There is no doubt that, contrary to established thinking, the progression of Parkinson’s disease, can be reversed. Although it has not been done by very many people, the fact remains that I've done it, and many others have followed, and will continue to follow.
My name is John Pepper and I have successfully reversed my Parkinson’s disease, to the point where I no longer need to take any Parkinson’s disease medication, since 2003, and nobody would ever know that I still have Parkinson’s disease.
How did I do this?
My case was quite unique, for the three following reasons:
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My neurologist had prescribed a monotherapy of a unique type of Parkinson’s disease medication, which was the only medication that the manufacturers claimed - as a result of conducting extensive double-blind scientific studies on a wide range of patients – could possibly slow down or even reverse the progression of this condition. I know of nobody else, who has only been prescribed this type of medication and nothing else.
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I was in the habit of doing regular energetic exercise, for over twenty years, before I was first diagnosed with Parkinson’s disease. I was therefore bodily very fit, which was not a unique occurrence amongst newly diagnosed patients, but it was, and is, not the norm; especially as it was accompanied by reason number one. I have continued to do rigorous exercise, since I was diagnosed, which is not common amongst Parkinson's patients at all.
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I gave up my high-powered job, three months after I was diagnosed. I was aware that my job had become very stressful to me and I would have done anything at that stage to help me cope with the Pd. I also stopped singing in the church choir. It was not just the services that ate into my time it was all the rehearsals and the travelling to get there and back that was the problem. I wanted to simplify my life. I also left my Rotary club, which was not a burden, but I did not want to be amember who did nothing active in the club. Stress is one of the major triggers for many health issues. It affects many of my symptoms.
The combination of a Monotherapy of a special type of medication, regular energetic exercise and the management of stress, all urned out to be the crucial changes I had made in my lifestyle that have reversed the progression of my Pd, and they made my circumstances unique.
In addition to these three unusual circumstances, I made the following changes to my life style, during the next eight years, after diagnosis:
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I decided to change my type of exercise.
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I learned how to control my movements by focusing my full attention on controlling each movement!
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I examined and changed my whole attitude.
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After having given up my job, and having experienced the huge improvement in my health, I came to the realization that ‘Stress’ had played a major roll in the progression of my Parkinson’s disease.
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Many people ask me about diet. I have found only one food item that must not be eaten by Parkinson’s disease sufferers and several other interesting substances that should be avoided.
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Two years after my diagnosis, I realized that I had to learn to manage my sleeping problems.
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The last change I made to my lifestyle was to start doing regular brain exercises.
I hope you have found this Insight helpful.
John Pepper