Winter 2019 Parkinson's Post!

Parkinson’s Post to educate, inspire and empower individuals affected by Parkinson’s Winter 2019 Parkinson’s Post! Julie Pavelka, MS, APRN-NP Memory and Movement Disorders | Department of Neurological Sciences | Nebraska Medicine [email protected] Welcome to the Winter 2019 edition of Parkinson’s Post and first edition of 2019! Parkinson’s Post will be published four Inside this issue times (March, June, September, • Carbohydrates December) in 2019 to coincide • Impulse Control with the seasons! Disorders The Movement Disorder Team has been • Home Modifications planning our upcoming symposium, for Safety Parkinson’s Disease in 2019: A Conference for Patients, Family, and Caregivers that is • Parkinson Disease Monday, October 14, 2019 from 8 a.m. to 3:30 and Driving p.m. at the Embassy Suites and Conference Center, La Vista, Neb. The Symposium offers an • Upcoming Events excellent opportunity for all individuals affected by Parkinson’s to network with Parkinson • Caregiver Strategies Disease Experts; vendors representing treatments, products, and services specific to • Nebraska State Parkinson Disease; and others who understand Registry for PD the daily struggles, battles, and triumphs that Brian Grant patients, families, and caregivers endure daily. The curriculum includes sessions presented • The Mind & Brain by our Movement Disorder Team including Today, Brian continues to inspire as a speaker, Health Labs our Physicians, Therapy Department (Physical, philanthropist, and a patient who insists on Occupational, and Speech) and Nutritionist. thriving with Parkinson’s disease. His mission is • Skate-A-Thon Our Keynote Speaker for our Symposium is to help people become their best, even when Brian Grant who was an NBA idol, known for it seems impossible. Brian started his career • Reliable Resources tenacious rebounding and a fearless attitude at Xavier University where he was Player of on the court. During his 12-year career, he the Year twice for the Midwestern Collegiate played for five teams and became a strong Conference. He was drafted in the first round, contributor to his surrounding communities. eighth overall, in the 1994 NBA draft by the cont. pg. 2 January / February 2019 cont. from pg. 1 Sacramento Kings. His career continued with believe that his athletic body couldn’t push that unite us as people, regardless of age or the Portland Trail Blazers, Miami Heat, Los through the pain or get better with time. background. Brian is also on the Trail Blazers Angeles Lakers, and Phoenix Suns. During He was scared and humbled, yet fiercely Alumni Ambassador Corp and he loves to this time, Brian also served underprivileged determined to be as healthy as possible. fish, surf, and enjoy the mountains in Oregon. youth and sick families in his community. This motivation launched the Brian Grant Brian learned from his coaches that you can’t His contributions earned him the J.Walter Foundation, for those with Parkinson’s who always control the ball, but you can control Kennedy Citizenship Award. want to lead active and fulfilling lives. your effort. As a father of eight, he wants to In 2006, Brian retired from professional Since then, Brian has become a sought show his kids that quality of life takes sweat basketball. Only two years later, he was after keynote speaker. Companies and and determination, but the results are always diagnosed with young-onset Parkinson’s organizations nationwide are drawn to his worth it. disease at age 36. It was hard for him to authenticity and captivated by his stories Registration for the symposium will begin August 1 and will be completed on-line – registration process details will be in the next Parkinson’s Post published in June. There also are Sponsorship, Vendor, and Donor opportunities for the symposium available – contact Julie Pavelka for further details at [email protected]. Fuel #1: Carbohydrates Jenna Paseka, MS, RD, LMNT Nutrition Therapist | Neurological Sciences Department | Nebraska Medicine This article is the first of a three part series to higher in fiber and can help keep blood highlight the main macronutrients in our diets. sugar levels steady. Whole grains such as The foods and some beverages we eat and barley, brown rice, buckwheat, bulgur, millet, drink consist of carbohydrates, fat and protein. oatmeal, popcorn, quinoa, whole wheat Each macronutrient plays an important role in crackers, whole wheat flour and whole wheat supplying energy for our bodies. pasta are complex carbohydrates. Other complex carbohydrates include vegetables, Carbohydrates make up the largest portion beans, lentils and sweet potatoes. of calories in most diets and are our main energy source. The Dietary Reference People with Parkinson’s disease can benefit Intakes and 2015-2020 Dietary Guidelines from carbohydrate intake. Carbohydrates can recommendations are to consume between help alleviate some of the side effects from 45-65% of calories from carbohydrates. medications like carbidopa-levodopa. Taking Carbohydrates supply energy to the brain, the medication with a carbohydrate such Stay tuned to future cells, tissues and organs. as fruit, crackers or toast can help manage the side effects while still allowing the issues of the Parkinson There are two different types of medication to be effective. carbohydrates – simple and complex Post to learn about the carbohydrates. Simple carbohydrates include As a general rule of thumb, choose less other macronutrients, sugars found naturally in foods and sugars processed carbohydrate sources to maximize protein and fat! added to foods. They break down quickly the fuel you can provide your body. Reading in the body to be used as energy. Simple nutrition facts labels can also help guide carbohydrates are found naturally in fruits your choices. Look for foods with a higher and milk, and also added into foods such as fiber content and ingredients that use the fruit canned in syrup, baked goods, candy, term “whole,” such as “whole wheat flour” soda and sweetened yogurts. Complex as the first ingredient in bread. Avoid foods carbohydrates are starches and take longer that have “sugar” as one of the first three for the body to digest. These are typically ingredients. Parkinson’s Post | 2 Impulse Control Disorders Sarah M. Szymkowicz, PhD Clinical Neuropsychology Fellow | University of Nebraska Medical Center Impulse control disorders (ICDs) occur in spending and binge-eating behaviors are symptoms to the treatment team if the PD 14-60% of Parkinson’s disease (PD) patients more common in women. patient does not want to reveal that these and are characterized by impulsive and behaviors are problematic. ICDs are related to the dopamine compulsive behaviors. Impulsive behaviors replacement therapy used to treat the If ICDs are suspected, working with your refer to actions that a person cannot resist motor symptoms of PD, particularly with Movement Disorders specialist to lower doing, with the behaviors providing an dopamine agonists. Because individuals with dopaminergic medications is the first step. immediate feeling of pleasure or reward. PD have long-term exposure to dopamine This can be challenging, as these medications Compulsive behaviors consist of an intense replacement therapies, it is thought that are needed to treat the motor symptoms urge to carry out an action repetitively and in some individuals develop hypersensitivity, of PD. Stopping medications all together is a very particular manner. The failure to resist which may cause a person to “overreact” to not advised, though stopping or reducing engaging in these behaviors rises to the level the medications. One common overreaction the dose of the suspected medication that of a disorder when it causes distress, impairs is dyskinesia, while another example of how is causing the ICD symptoms often helps. functional abilities, and / or reduces quality of the body overreacts to dopamine medication If ICDs are occurring in you or a loved one, life. ICDs can be time-consuming and often is ICDs. speak with your Movement Disorders go unrecognized, only becoming obvious specialist before making any medication once they have wreaked havoc on the lives of Not every PD patient undergoing dopamine changes yourself. patients and their families. replacement therapy will develop ICDs. There appears to be specific clinical factors that Behavioral management of symptoms is Examples of ICDs include gambling, may increase risk. These include younger also important, as it can help to reduce the excessing spending, sexual behaviors age of PD onset, male gender, prior history of consequences of such behaviors. Taking (e.g., hypersexuality, paraphilias), and binge depression or substance abuse, family history away credit and bank cards, limiting bank eating, as well as less severe behaviors of pathological gambling, novelty seeking account access, restricting internet access, such as punding (i.e., stereotyped, repetitive, personality, REM sleep behavior disorder, and 12-step gambling programs are examples purposeless behaviors), hobbyism, aimless and higher rate of dyskinesia. of behavioral techniques that may be helpful wandering, and hoarding. For some people, in minimizing ICDs. A referral for cognitive- ICDs may be mild and / or just a minor ICDs often start when dopaminergic behavioral therapy is another option to help annoyance (e.g., increased focus on eating medications are increased or when a second reverse unwanted thoughts and behavioral sweets with a 10 lb. weight gain). For others,

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