Spring 2019 Parkinson's Post!
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Parkinson’s Post to educate, inspire and empower individuals affected by Parkinson’s Spring 2019 Parkinson’s Post! Julie Pavelka, MS, APRN-NP Movement Disorders | Department of Neurological Sciences | Nebraska Medicine [email protected] Welcome to the Spring 2019 edition of Parkinson’s Post! The Movement Disorder Team continues attitude on the court. During his 12-year career, planning our upcoming Symposium, he played for five teams and became a strong Parkinson’s Disease in 2019: A Conference contributor to his surrounding communities. Inside this issue for Patients, Family, and Caregivers that Today, Brian continues to inspire as a speaker, • Walk with Confidence is Monday, October 14, 2019 from 8 a.m. – philanthropist, and a patient who insists on 3:30 p.m. at Embassy Suites and Conference thriving with Parkinson’s disease. His mission is • Parkinson Disease Center, La Vista, NE. The Symposium offers an to help people become their best, even when and Swallowing excellent opportunity for all individuals affected it seems impossible. Brian started his career by Parkinson’s to network with Parkinson at Xavier University where he was Player of • Fuel #2: Protein Disease Experts; vendors representing the Year twice for the Midwestern Collegiate • Your Voice: How treatments, products, and services specific to Conference. He was drafted in the first round, Parkinson’s Disease Parkinson Disease; and others who understand eighth overall, in the 1994 NBA draft by the the daily struggles, battles, and triumphs that Sacramento Kings. His career continued Can Affect It patients, families, and caregivers endure daily. • Exercise Your Mind – The curriculum includes sessions presented How Physical Activity by our Movement Disorder Team including our Physicians, Therapy Department (Physical, Can Improve Brain Occupational, and Speech) and Nutritionist. Function and Mood Registration for the Symposium will begin • Occupational August 5, 2019 and we will be emailing Therapist Tips on How and mailing Registration Forms – it is to Use Your Pets/ essential to submit your registration in a timely manner as there will again be a Animals for Therapy space limitation to this very popular event. • Using Wearable There also are Sponsorship, Vendor, and Devices to Monitor Donor opportunities for the Symposium available – contact me for further details. Tremor As detailed in the previous Parkinson’s Post, • Gait in PD our Keynote Speaker for the Symposium is • Upcoming Events Brian Grant who was an NBA idol, known for his tenacious rebounding and a fearless Brian Grant • Reliable Resources cont. pg. 2 Spring 2019 cont. from pg. 1 with the Portland Trail Blazers, Miami through the pain or get better with time. background. Brian is also on the Trail Blazers Heat, Los Angeles Lakers, and Phoenix He was scared and humbled, yet fiercely Alumni Ambassador Corp and he loves to Suns. During this time, Brian also served determined to be as healthy as possible. fish, surf, and enjoy the mountains in Oregon. underprivileged youth and sick families in his This motivation launched the Brian Grant Brian learned from his coaches that you community. His contributions earned him Foundation, for those with Parkinson’s who can’t always control the ball, but you can the J.Walter Kennedy Citizenship Award. want to lead active and fulfilling lives. control your effort. As a father of eight, In 2006, Brian retired from professional Since then, Brian has become a sought he wants to show his kids that quality basketball. Only two years later, he was after keynote speaker. Companies and of life takes sweat and determination, diagnosed with young-onset Parkinson’s organizations nationwide are drawn to his but the results are always worth it. disease at age 36. It was hard for him to authenticity and captivated by his stories believe that his athletic body couldn’t push that unite us as people, regardless of age or Walk with Confidence Jennifer McKune, PT Physical Therapist | Nebraska Medicine Walking is the primary means of locomotion for most people and often an activity that we take for granted. It is something we have done most of our lives. Walking is a wonderful method of exercise and can improve strength, endurance, and overall health. But what happens when walking is affected due to symptoms associated with Parkinson’s disease? Some individuals experience reduced arm swing and poor posture. Others have shortened step length and limitations with stride. Often, an individual develops a “running” type of gait (a person’s manner of walking) that leads to unsafe mobility and increased risk of falls. It may become difficult to transition over different types of flooring, to walk through a balance and walking to reduce risk of falls. 5. When walking through a doorway, look doorway, to walk in crowds, to turn around It might be necessary to trial different gait beyond the threshold and focus on to change directions, to go up and down aides to improve safety with walking and an object you are moving toward. stairs, and even to initiate gait. When this increase independence. Learning specific 6. Place colored tape on the threshold happens, we realize just how challenging gait strengthening exercises for your core and of various doorways to serve can be. There are strategies and techniques legs can also help with gait and balance. as a cue for stepping over it. that can help with gait difficulties. Utilizing Other techniques that you can begin 7. Take wide steps when turning and internal cues and external cues can be helpful. using right away might include: avoid pivoting. Try using rhythmic Internal cues consist of self-talk to tell 1. Avoid rushing to get somewhere. movement and counting or say “right, yourself to step big or step long, to stand left, right, left” to aide in turning. 2. Keep floors clear of clutter and tall, to take a step with the right leg, then the rearrange furniture to create open 8. To begin walking or re-start when left leg, to step wider, and to shift weight. spaces/pathways within your home. freezing occurs–stop, take a deep breath, External cues may consist of visual or shift your weight, visualize stepping over 3. Use night lights to illuminate the auditory stimuli such as tape on the floor, a an object, and tell yourself to step big. bedroom, hallways, and the bathroom. laser light, a metronome, music, or counting. So walk with confidence and keep moving! Working with a physical therapist is beneficial 4. Let others get on/off elevators or to learn and practice various gait strategies. enter a room before you so you do The PT can teach techniques to work on not feel pressure to move quickly. Parkinson’s Post | 2 Parkinson Disease and Voice/Swallowing Jayme Dowdall, MD Otolaryngologist | Assistant Professor | Department of Otolaryngology – Head and Neck Surgery | University of Nebraska Medical Center What is new with voice and Why do I need a scope before Any new surgical techniques swallowing? I do Lee Silverman Voice for voice and swallowing? I very much enjoyed the session for the Therapy? Vocal fold augmentation can be performed Parkinson’s Support Group in May “A Hard in the office or the operating room. This is Lee Silverman Voice Therapy is very effective Pill to Swallow: What’s New for Swallowing performed for glottic insufficiency which for Parkinson’s hypophonia. The diagnosis for Patients with PD.” It was such a vibrant there is too much air escape between the of Parkinson’s hypophonia is made by and interactive experience with many key vocal folds. We inject a filler agent in the listening to the voice, a patient history and an questions from patients and family members vocal folds to add bulk to the vocal folds. In examination of the voice box (larynx). Patients which I’ll try to address with this post. Parkinson’s, this has been shown to help with have other diagnoses for their voice troubles voicing and has also shown some benefit in such as cancer in the voice box and blood swallowing (Howell, 2019, Dashtipour, 2018; What do you have here at blisters (hemorrhagic polyps) that will not be Sinclair, 2013). UNMC/Nebraska Medicine treated, or made worse, by Lee Silverman that is different from my ENT Voice Therapy. Why do we advocate for at another hospital? What simple things can I do singing? Last year, I very enthusiastically joined an for my voice and swallowing? There are now multiple studies that show that incredible laryngology program started by individual and group singing for patients with The appropriate amount of moisture for the Dr. Chris Bingcang in 2013. This is a unique Parkinson’s can have a number of benefits. mucous membranes is critical for swallowing practice model with the only two fellowship Benefits of singing include improvements in and for voicing. It’s very much like Goldilocks trained Laryngologists in the state of voice, breathing, swallowing, gait and mood and the Three Bears – hard for the body to Nebraska. Our entire practice is focused on (Tamplin, 2019, Han 2018, Stegemöller, 2017, get it “just right.” voice, airway and swallowing so we are able 2018). These benefits can be seen in person to stay up to date on these topics. We enjoy Swallowing is like a water slide. If you or via telehealth (Stegemöller, 2019). collaborating closely with the movement swallow pills on a dry throat they are most disorders neurology group here. Together, likely to stick in the many nooks and crannies we have a full range of medical and surgical of your throat. Simple tricks like sitting down voice, airway and swallowing services for when swallowing pills and drinking a few sips patients. We very much enjoy collaborative of water prior to taking your pills to wet the practice with speech language pathologists in throat can be helpful.