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Nutrients and Parkinson’s
Posted: Sun Apr 08, 2007 4:56 am Post subject: Q: Nutrition and PD
How to balance/compromise between the Nutrition and PD treatment as it can cause a Patient developing weight loss and under-nutrition? How to optimize/manage nutrition with PD patient? What are the sideeffect the PD medication on patients that PD are at increased risk for malnutrition? PD is a complicated disease, that affect each person differently,but there are needs for nutrition to sustain the body and stay healthy. Kindly advise. TEO KIM HOE
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Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Mon Apr 09, 2007 11:51 am Post subject:
Dear Teo, These are very good questions, because many people with PD become malnourished. Here are some of the possible causes – - nausea - loss of the senses of smell and taste - loss of appetite — sometimes due to medications — sometimes due to depression - loss of manual dexterity - eating very slowly, unable to finish meals; often because chewing and swallowing becomes tiring - fear of choking - difficulty swallowing To optimize nutrition, it’s first important to determine whether any of the above conditions occur. If so, then the approach must depend upon managing that condition. For instance, if depression is the cause, then the first approach will be to manage the depression. If due to inability to manage eating utensils, then the first approach will be to locate plates, cups, and utensils that are designed for those with limited dexterity; and to provide “finger foods” as often as possible. Thus, it is important to consult a dietitian, for personal help. The dietitian will assess the reason for the poor nutrition and design an eating plan that overcomes the limitations. For extra calories, add nourishing between-meal snacks, of about 100-200 calories. These should be low in protein — fresh fruit or juice; a fruit smoothie made with soy or rice milk, vegetables, rice cakes or bread with a little mayonnaise or a teaspoon of peanut butter, salads. Generally, it’s a good idea to begin slowly, adding only 200-400 calories a day and increasing gradually, so as not to stress the system._________________Best regards, Kathrynne Holden, MS, RD
words by Dr.Kathrynne Holden
Dear Teo,
It is a sad story, indeed. Some denial initially is understandable, also seeking a second, or even third opinion from other doctors. At some point, though, the most helpful and positive action is to begin self-education with regard to PD; to understand its nature, and how best to manage it and stay healthy and productive. I know of many people who continue to pursue their hobbies — playing golf, running marathons, quilting, painting — because they keep a positive attitude and are very proactive with regard to their health. I hope you will always remain a good example for us all, and for your family as well. Best regards, Kathrynne Holden, MS, RD>>> -
words by Dr.Kathrynne Holden
Dear Teo,
You’re right, there is very little information or research on the problems caused by breathing difficulties in PD.
I believe that in some cases dystonia (abnormal contraction of the muscles) of chest muscles can lead to abnormal breathing.
But I have seen little to no research on breathing problems or their causes.However, there have been a number of studies of the many benefits of exercise for those with PD, and exercise affects breathing. Tai chi, walking, stretching, and other forms of exercise have all been shown to make great improvements in health; and I am certain that in part this is due to improved breathing.Thank you for bringing this to our attention, it’s a very important point.Best regards,Kathrynne Holden, MS, RD–
PD and Medication
Some PD patients do not acknowlege that they are PD after they are diagnosed by Movement Disorder specialists.
They do not take the PD medications as there are some sideffects.
They do not want to learn how to manage the diseases to slowdown from its progression.
As PD symptoms aggravates every 3 to 5 years it is too late for them to be normal
Exercise
Post subject: Exercises and Movement
PD is a muscles movement disorders.
It is a chronic neurological illness i.e. not going away”
PD patients are different from what we define them self as “patient” i.e only during acute, self-limited illness or injury that temporarily impact their lives as an inconvenience or comfort.
The major functions of muscles are to produce movements of the body, to maintain the position of the body against the force of gravity,to produce movements of structures inside the body, and to alter pressures or tensions of structures in the body.
The symptoms of muscles disorders are as follows:
1. Bradykinesia i.e. slowness of movement
2. Resting tremor i.e shaking,either one or both side
3. Rigidity i.e. marked stiffness 4.Decreased arm wing on one or both side 5. Problems with walking and balance i.e. freezing being unable to initiate a step forward 6. Small, cramped handwriting
7. Masked face i.e. reduced facial expression 8. Low voice i.e not clear Therefore PD patients have to choose an exercises that gets their muscles moving i.e stretching, in order to overcome the muscles stiffness, rigidity and slow movement.A physiotherapy, doctor or personnel trainer may be consulted as how to start on an exercise routine. When doing these exercises patients should not experience an pain.
What are the type of exercises suitable for PD patient?
Who do you prefer to start an exercise routine a personnel trainer or physiotherapy? What are the different between both of them?
Who is more helpful for PD slowdown progression?
Teo Kim HoeBack to top
Dr. OkunJoined: 19 Jan 2007Posts: 0Location: University of FloridaPosted: Tue Apr 10, 2007 9:32 am Post subject:
We believe stretching and exercise is important however we do not have any studies to recommend regimens. I would say that aerobic exercise (walking, jogging) with stretching and light weights are best. 1/2-1 hour a day and you should break a sweat and increase your heart rate. Also, eat healthy.
Michael S. Okun, M.D
PNF(proprioceptive neuromuscular facilitation)
Posted: Thu Apr 12, 2007 7:11 pm
Post subject: PNF (proprioceptive neuromuscular facilitation]
There are exercises that the PD patients may do their own to maintain flexibility.
Although it depends on each limitation and capabilities’
Can you recommend what are the simple exercises for the PD patients should not experience any pain and done it slowly and in a controlled manner?
It is to help them to improve their mobility, stability and flexibility and relieve their muscles/limb stiffness, difficulty for swallowing, breathing, communication,walking and sitting posture.
What are about some parts of PNF stretching exercises?
Thanks
Teo Kim Hoe
Post subject:A good stretching and exercise routine is a great idea in PD where exercise is like a drug. It is not known if one is better than another—yet to be studied._
Michael S. Okun, M.D.
Exercise and Movement
Mon Apr 09, 2007 10:33 am Post subject: Exercises and Movement
PD is a muscles movement disorders.
It is a chronic neurological illness i.e. not going away” .
PD patients are different from what we define themself as “patient” i.e only during acute, self-limited illness or injury that temporarily impact their lives as an inconvenience or comfort.
The major functions of muscles are to produce movements of the body, to maintain the position of the body against the force of gravity,to produce movements of structures inside the body, and to alter pressures or tensions of structures in the body.
The symptoms of muscles disorders are as follows:
1. Bradykinesia i.e. slowness of movement 2. Resting tremor i.e shaking,either one or both side 3. Rigidity i.e. marked stiffness 4.Decreased arm wing on one or both side 5. Problems with walking and balance i.e. freezing being unable to initiate a step forward 6. Small, cramped handwriting 7. Masked face ie. reduced facial expression 8. Low voice i.e not clear
Therefore PD patients have to choose an exercises that gets their muscles moving i.e stretching, in order to overcome the muscles stiffness, rigidity and slow movement.A physiotherapy, doctor or personnel trainer may be consulted as how to start on an exercise routine. When doing these exercises patients should not experience an pain.
What are the type of exercises suitable for PD patient? Who do you prefer to start an exercise routine a personnel trainer or physiotherapy? What are the different between both of them? Who is more helpful for PD slowdown progression?
Teo Kim Hoe
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Tue Apr 10, 2007 9:32 am Post subject:
We believe stretching and exercise is important however we do not have any studies to recommend regimens. I would say that aerobic exercise (walking, jogging) with stretching and light weights are best. 1/2-1 hour a day and you should break a sweat and increase your heart rate. Also, eat healthy._________________
Michael S. Okun, M.D.
Constipation and Parkinson’s
Here is a copy of what we give our patients when they are constipated:
Definition Constipation is an alteration in stool frequency, consistency, and/or passage of stool.
The normal pattern of bowel movements can and will vary by 1 to 3 days.
A stool-voiding pattern of every day or every other day is encouraged.
II. Causes A. Change in diet or activity B. Medical reasons: cancer, pregnancy, hemorrhoids, neurological disorder, muscular disorders, intestinal inflammation
C. Medications: narcotics, sedatives, antacids, antispasmodics, iron supplements III. Treatment Management A. Fluids - Drink at least 6 to 8 – 8 ounce glasses of fluids per day. This is all inclusive (everything you drink like water, tea, coffee, juice, colas, etc.), but water is best, and we encourage you to drink primarily water. Bladder patients should reduce fluid intake after the evening meal. B. Activity - Exercise and increased activity will assist in establishing regular bowel patterns. C. Diet - Include fiber-rich foods: bran, whole-grain breads – oat, rye, fruits, vegetables (leave peel on), whole-grain cereals, oatmeal, pasta, nuts, popcorn, and brown rice. Daily recommended fiber intake: 20 – 30 grams Natural Recipe Miller’s (unprocessed wheat) Bran* 1 cup Applesauce ½ cup Prune Juice ¼ cup Mix these ingredients together and refrigerate. Replace the mixture each week. Take 1 – 2 Tablespoons daily for one week for desired results. If needed, you may increase dose by 1 Tablespoon each week. Stool frequency and gas may increase the first few weeks but will usually adjust after one month. *Miller’s Bran is unprocessed wheat bran. This can be purchased at most large grocery stores (Cub Foods, Kroger, Ingles, etc.) and is sold with either the hot cereals or flours and baking goods. The most commonly found brand name is Hodgson Mill and comes in a brown 14 oz. box. Miller’s Bran can also be purchased in bulk at health food stores. You can also sprinkle bran on food to supplement your fiber intake. D. Bowel Clean Out The bowel clean out should be done before starting on the bowel program that is outlined for you by your physician. This should be done on a day when you will be at home all day to minimize the risk of accidentally soiling your clothes. The bowel clean out is a two-part procedure. In the morning take 2 oz. Milk of Magnesia and follow that with a hot drink. This could be hot coffee, hot tea, or even hot broth. This helps to stimulate the bowel and enhance the effects of the Milk of Magnesia. That evening, after dinner, give yourself a Fleets enema. This helps to make sure the rectum is empty. You should be able to rest through the night without worry or discomfort. This procedure can be repeated the next day if needed. E. Medications 1. Bulk producing: Metamucil, Fibercom, or Citrucel. Mix 1 -2 Tablespoons in juice or water and take by mouth 1 to 2 times daily. - Adds consistency or bulk to the stool and facilitates water retention in stool. - Must take adequate fluids by mouth to avoid causing constipation. 2. Stool Softeners: Colace. Soften stool by facilitating the admixture of fat and water (detergent activity). Do not use with mineral oil. Take 1 tablet by mouth 1 to 2 times daily. 3. Combinations: Pericolace. Mild stool softener and laxative combined. Take 1 by mouth 1 to 2 times daily. 4. Irritant/Stimulant: Products containing Senna. Laxative with direct action on the intestinal mucosa and the nervous plexus of the bowel. 5. Suppositories: Glycerin, Dulcolax. Inserted rectally every other day or when needed. Stimulates rectum and assists with evacuation. I hope this helps!_________________Hubert H. Fernandez
Parkinson’s progress with times
Thank you for your explanation of the PD as there is no treatment of the disease but there is a way to slowdown progression i.e medication and exercises. The doctor has to monitor, adjust and optimize the effectiveness of medications.
Teo Kim Hoe