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Parkinson's Disease

Living With Parkinson's Disease

Monday, April 23, 2012 - 14:55

Contributing Author: Guy Slowik FRCS

People with mild Parkinson's disease who take medication often regain a relatively ordinary activity level. The following suggestions may be useful:

General advice

Good nutrition

Managing stress

Traveling

General Advice

  • Continue regular daily activities. This is important to help maintain mobility. In the early stages of PD, such normal movement should be maintained to the fullest extent possible. Do all you can to remain mobile and active.
  • Lead as normal a life as possible; don't restrict activities you're able to do.
  • A regular exercise program that involves some stretching and weight bearing (short of becoming exhausted) is beneficial because, as motor function becomes more impaired, an exercise program or physical therapy may help maintain or reestablish physical conditioning.
  • Walking is excellent, and a 30-minute walk each day can be a realistic goal. Start with a 10-minute walk and build it up in 5-minute increments over the course of several days, according to your tolerance. You should walk when you feel your best and not put it off while you complete household chores, etc. In inclement weather, walk around the house with the radio or CD player on.
  • It is never too early to seek the advice of rehabilitation specialists for help determining a realistic exercise level, or if you have difficulty with activities of daily living (getting in and out of the tub). It also is helpful if you have problems with balance and safety, difficulties with speech, or for fatigue and stress management. The physical therapist, occupational therapist, and speech language pathologist can each help you maintain function and independence.
  • If balance is a problem, adaptive training and use of quad-canes or straight canes, and other mechanical aids, can help maintain independence.

Because constipation can result from the PD, or from drugs used to treat the illness , or from inactivity, you should consume adequate food and a high-fiber diet. Dietary supplements such as psyllium or stool softeners can help regulate bowel movements as well.

Need To Know:

Constipation

It is important to embark on a program of prevention rather than crisis management.

  • Increase daily fluid intake, especially in hot weather. Families and caregivers may need to reinforce this. At least six cups of liquid should be drunk daily.
  • Older people may not be able to tolerate large amounts of raw fruit and vegetables, but can usually manage dried fruits, hot prune juice, canned fruits, and soft cooked vegetables, all of which may help to relieve constipation.
  • Introducing bran or high-fiber cereal into the diet is important, but they should be started slowly and in small amounts. Large amounts can cause stomach cramps and excess gas, particularly in people who cannot exercise. Bran should therefore be taken with caution and be accompanied by an increase in fluid intake.
  • Regular exercise is also important.
  • Stool softeners, bulk laxatives, and bowel stimulants are the main categories of laxatives available over-the-counter. Any of these may be used if a simple change in diet is not effective.

Good Nutrition

Good nutrition will help you maintain your best level of health if you have PD. A professional dietitian/nutritionist is your best source of reliable nutrition information.

  • There is no specific diet for people with PD. Recommended daily allowances of the various food groups can be obtained from a dietitian or from your local health unit.
  • Sometimes your symptoms can interfere with your eating well. If you are experiencing problems with appetite, chewing or swallowing, weight loss, or constipation, a consultation with a registered dietitian/nutritionist could be very helpful.

For people with difficulty chewing and swallowing:

  • Smaller frequent meals may be easier to manage than three full-sized meals a day.
  • Food should be hotter or colder than the inside temperature of the mouth.
  • Avoid crumbly fibrous food if swallowing is difficult.
  • Eat in a quiet and relaxed atmosphere in a high backed chair.

Sucking on ice for a few minutes before eating may make swallowing easier (it may also help speech). Iced sodas also promote swallowing. The icy bubbles on the back of the throat help to trigger the swallowing reflex. Sour or acid food may be easier to swallow.

  • Put a few ice cubes in a blender with a small amount water or juice and blend until the ice is in small fragments. Have some of this chipped ice available throughout the day
  • Add some liquid to food in your mouth to assist swallowing.

Managing Stress

Try to avoid unnecessary stress in your life:

  • Leading a healthy life, eating regularly, sleeping regularly, and exercising will help keep you fit both mentally and physically.
  • Many people continue to work although this can be a problem for those who face the public every day, particularly for those who need to speak in a large space (classroom) or are required to supervise in some situations. The executive with a personal secretary to provide protection from the public will find it easier than a schoolteacher.

All symptoms of PD get worse under stress. Therefore, talk to your physician and your employer about managing stress and/or early retirement or reduced working hours if necessary (and possible). Since most people need to continue working for financial reasons, talk to your doctor about regulating your treatment so that it works best while you are on the job - particularly if you work shifts or work either very short or long days. This information will help the doctor to plan the best dosing schedule.

Traveling

Having PD does not mean you need to stay at home. Many people with PD travel frequently, and long distances, very successfully. You just need to plan a journey more carefully.

  • Rest the day before and after you travel, particularly if time changes are involved.
  • Take advantage of any service offered at airports, railroad stations, cruise ship terminals, etc. that allow you to board or exit in advance.
  • Don't walk miles at airports if there is a moving walkway, motorized cart, or wheelchair service. Save your energy.
  • If you are traveling by car, stop frequently for some exercise, and don't travel as many miles in a day as you once did. Don't travel for long periods in very hot weather.
  • Always keep all your medication in their original bottles in your hand baggage. Checked-in baggage may be lost or delayed. Customs officials are suspicious of odd containers containing several unnamed pills.

Parkinson's Disease