Living Well With Parkinsons
While medication and DBS surgery are the most effective treatments for PD, individuals often choose to delay these treatments because of their adverse side effects. Until a therapy is developed that can halt the progression of PD, there is a significant need for strategies that provide symptom relief without causing negative side effects.
Diet, Exercise, and Stress Reduction
Findings from several studies suggest that exercise has the potential to provide relief from certain PD symptoms. Anecdotally, people with Parkinsons disease who exercise typically do better. However, many questions remain. Among them is whether exercise provides a conditioning effect by strengthening muscles and improving flexibility or whether it has a direct effect on the brain.
In an NINDS-funded trial comparing the benefits of tai chi, resistance training, and stretching, tai chi was found to reduce balance impairments in people with mild-to-moderate PD. People in the tai chi group also experienced significantly fewer falls and greater improvements in their functional capacity.
Technologies that Improve Quality of Life
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Manage Swallowing Problems With Parkinsons
You can do many things to manage swallowing problems associated with Parkinsons. As the Parkinsons Foundation notes, the first step to treating dysphagia is telling your neurologist about the problem. They can refer you to a specialist, known as a speech-language pathologist , for treatment.
The SLP will begin by asking you about the swallowing difficulties youve been experiencing. They will evaluate your symptoms and medical history. In most cases, they will order a video X-ray or an endoscopy to see how your swallowing muscles are functioning as you eat and drink.
After identifying the cause of your swallowing problems, the SLP will recommend one or more approaches to help you start swallowing and drinking as normally as possible. Some interventions may work for some people but not for others. You may have to try several before you find one that improves your swallowing.
Foods That Are Hard To Chew
Another Parkinsons symptom is difficulty chewing and swallowing. In fact, its estimated that 80% of people with this condition experience difficulty swallowing as the disease progresses .
Choosing foods that are easy to chew and swallow may be important, as may working with a speech language therapist.
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Cbd Side Effects And Risks
In most studies, CBD is tolerated well. It rarely causes side effects, and the ones that do happen tend to be mild. They include tiredness, changes in appetite, and diarrhea or nausea.
However, CBD can interact with prescription and over-the-counter medications. Talk to your doctor before taking CBD, especially if youre on medications that contain a grapefruit warning. CBD and grapefruit have a similar effect on certain enzymes related to drug metabolism.
Communication Strategies For Optimal Success
In this 1-hour webinar speech language pathologist Angela Roberts reviews the changes in speech, facial expressions, cognition, voice and hearing caused by PD that can interfere with communication and meaningful connection with others. These changes impact the social, emotional, physical and practical aspects of living with PD. Communication strategies for optimizing successful conversation are shared. Registration is required, but it is free.
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Swallowing Exercises Can Be Very Helpful To Improve Your Swallowing
After a formal swallow assessment, swallowing therapy sessions can be designed for you, involving exercises tailored to the specific parts of your mouth and throat that are causing the swallowing problem. Sessions may involve practicing compensatory swallowing strategies with various types of foods in order to maximize safety and efficiency while swallowing.
During swallow therapy, recommendations may include:
- Best feeding techniques
- Exercises to strengthen oral and throat muscles
- Compensatory techniques to assist in safe swallowing
- Oral and mouth care techniques
- Appropriate food selection and ways to modify food texture
- Safe positioning strategies
- Patient/family education
Managing Swallowing Changes In Psp Cbd And Msa
In this one hour and fifteen-minute webinar speech language pathologist Julie Hicks has just one slide specific to PSP, CBD, and MSA. The rest of her presentation provides general information about working with a SLP, what swallowing evaluation looks like, and what treatment might involve. In the question-and-answer time Julie talks about when to see an SLP, the use of feeding tubes, practical tips families can use to help people slow down and control impulsivity while eating, and how to find an SLP with experience treating those with parkinsonism disorders.
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Building Stronger Caregiving Partnerships Through Better Communication
In this one-hour talk, the speaker explains that diminished communication significantly impacts the social, emotional and physical burdens of caregiving. The fourth speaker at the Parkinsons Foundation Caregiver Summit, Angela Roberts, PhD, explains how changes in speech, cognition and hearing due to Parkinsons disease affects communication. She then offers specific strategies for optimizing communication.
Mitochondria Microbiota And Marijuana
The microbiome also plays an important role in the health of our mitochondria, which are present in every cell in the brain and body . Mitochondria function not only as the cells power plant they also are involved in regulating cell repair and cell death. Dysfunction of the mitochondria, resulting in high levels of oxidative stress, is intrinsic to PD neurodegeneration. Microbes produce inflammatory chemicals in the gut that seep into the bloodstream and damage mitochondria, contributing to disease pathogenesis not only in PD but many neurological and metabolic disorders, including obesity, type-2 diabetes, and Alzheimers.
The evidence that gut dysbiosis can foster the development of PD raises the possibility that those with the disease could benefit by manipulating their intestinal bacteria and improving their microbiome. Enhancing ones diet with fermented foods and probiotic supplements may improve gut health and relieve constipation, while also reducing anxiety, depression and memory problems that afflict PD patients.
Cannabis therapeutics may also help to manage PD symptoms and slow the progression of the disease. Acclaimed neurologist Sir William Gowers was the first to mention cannabis as a treatment for tremors in 1888. In his Manual of Diseases of the Nervous System, Grower noted that oral consumption of an Indian hemp extract quieted tremors temporarily, and after a year of chronic use the patients tremors nearly ceased.
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Directions For Future Research
- 1.investigate the optimal time in the disease to initiate intervention for swallowing and to explore the impact of the natural evolution of dysphagia in patients with PD
- 2.evaluate the efficacy and adverse effects of compensatory treatment on clinical endpoints such are nutrition, hydration, respiratory complication, hospital readmission, QOL and mortality in patients with PD and dysphagia
- 3.compare the efficacy and complications of different swallowing treatments and to evaluate their effect on the progression of dysphagia in PD
- 4.evaluate the impact of nutritional intervention for dysphagia in patients with PD, including the impact of PEG placement on nutrition, respiratory complication, QOL and mortality.
Excessive Saliva And Drooling In Parkinsons
Saliva is needed for the first stages of digestion, including chewing and swallowing. This watery substance contains enzymes that start to digest our food.
Many people with Parkinsons experience poor saliva control, which may result in excessive saliva and drooling, or alternatively, in a dry mouth and other eating problems.
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How Do I Know If I Have A Speech Or Voice Problem
- My voice makes it difficult for people to hear me.
- People have difficulty understanding me in a noisy room.
- My voice issues limit my personal and social life.
- I feel left out of conversations because of my voice.
- I cannot participate in telephone calls because of my voice.
- My voice problem causes me to lose income.
- I have to strain to project my voice.
- My voice clarity is unpredictable.
- My voice problem upsets me.
- My voice makes me feel handicapped.
- People ask, “What’s wrong with your voice?”
Problems With Tongue Muscles
Parkinsons can also cause problems in the tongue muscles. The tongue is important in swallowing. We use it to move food around and push it to the back of the mouth to trigger the swallowing reflexes. Parkinsons can also impair the reflexes that protect our windpipe from food and drink. A problem coordinating breathing and swallowing may make this problem worse.
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The Risks Associated With Difficulty Swallowing
Many risks are associated with swallowing problems. Unintended weight loss is common, as having problems swallowing may make a person less inclined to eat. Long-term dysphagia can also deprive a person of nutrients, leading to malnutrition.
Aspiration pneumonia is another potential problem. When swallowing is difficult, people can end up inhaling liquid, food particles, or saliva in their lungs. Since the lungs cannot get rid of these substances easily, an infection can develop. Sometimes, these infections can lead to significant illnesses like aspiration pneumonia.
Risks Associated With Dysphagia
Many people can find dysphagia embarrassing or frustrating. Difficulty swallowing can impact your quality of life, but it can also have serious effects.2
Dysphagia can cause malnutrition or dehydration. It can also cause aspiration, the medical term for food going down the wrong pipe. Aspiration can lead to aspiration pneumonia, which is the leading cause of death for people with PD. This is a type of lung infection that occurs when food, saliva, liquids, or vomit is breathed into the lungs or airways leading into the lungs, instead of being swallowed.1
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Progression And Management Of Dysphagia In Pd
Unlike stroke, dysphagia in PRD degenerates with disease progression. Although their swallowing dysfunction is assessed by using VFSS or FEES, rehabilitation is required for determining PD patients’ quality of life. A transdisciplinary approach, including physicians, nurses, physical therapists, speech pathologists, and nutritionists, is required for long-term management.
Two specific questionnaires have been developed to detect dysphagia in PD: the swallowing disturbance questionnaire and the Munich Dysphagia test-Parkinson’s disease . The SDQ containing 15 questions is more basic and an easier screening test for asking about specific symptoms with dysphagia and their frequencies. The MDT-PD can detect the beginning of oropharyngeal symptoms and the risk of laryngeal penetration or aspiration. It consists of 26 items divided into 4 categories: difficulty in swallowing food and liquids, difficulty in swallowing independent of food intake, further swallowing-specific and associated problems, swallowing-specific health questions.
Foods High In Saturated Fat
Although the specific role of saturated fat in Parkinsons is still being studied, research suggests that a high dietary fat intake may increase your risk of this disease .
Generally speaking, diets high in saturated fat have been linked to chronic conditions like heart disease. As such, you may wish to keep these foods in moderation (
- some baked and fried foods
Conversely, a very small study notes that the keto diet which is high in fat is beneficial for some people with Parkinsons. However, a low fat diet also showed benefits. Overall, more research is needed .
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Treating Eating And Swallowing Difficulties
If you or someone you care for is experiencing difficulties with eating, swallowing or saliva control, the first step is to consult your doctor, who may refer you on to an SLT / SLP.
Your doctor may be able to adjust the timing and dose of medicines so that these are working well at mealtimes and so swallowing problems are better managed when eating. However, for some patients, medications do not affect the swallowing function.
Your doctor may also adjust your medications, or may prescribe new ones to reduce production of saliva. Some Parkinsons medicines, including levodopa, improve muscle movement and may help to reduce drooling. However, some medications, such as clozapine, which is prescribed for mental health problems, can actually increase saliva production.
Anticholinergic medications may help to reduce the amount of saliva you produce but are not suitable for everyone. For more information see Managing medication.
Botulinum toxin can be injected into the salivary glands to reduce saliva production. This treatment will not work for everyone and injections may need to be repeated every three to six months. However, for some patients, Botox injections are not recommended and may be dangerous.
In severe cases when other treatments are not effective, radiotherapy to the salivary glands can restrict saliva production. In extreme cases the salivary glands can be surgically removed as a last resort.
Training And Coaching Of Trial Therapists
Before the start of the trial, participating speech therapists follow a 2-day training in which they are informed about the study procedures and the PERSPECTIVE intervention protocol, including delivering online treatment. During the study period, speech therapists will be coached online by one of two experts to ensure that every patient receives optimal speech therapy. These experts have been responsible for the education of speech therapists in ParkinsonNet and the development of the voice trainer. Coaching of speech therapists takes place in a group video call with the coach, speech therapist, and patient during three online treatment sessions , in which the coach provides live feedback to the speech therapist.
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How To Manage Difficulty Swallowing In Parkinsons
Parkinsons disease can cause a person to have difficulty chewing and swallowing. This can have many effects on their health and quality of life. They can develop dry mouth, dehydration, or malnutrition. They can also aspirate food, liquid, or saliva into their windpipe, which can be frightening. As one MyParkinsonsTeam member shared, I recently started choking on my own spit, and for the first time ever, I got really scared because I couldnt get any air.
Difficulty swallowing can be a challenging symptom of Parkinsons. The good news is that it can be treated. Heres what you need to know about this symptom, including why it happens and how it can be managed.
How Could Cbd Oil Help With Parkinsons
While doctors havent been using CBD oil for Parkinsons disease long-term, and research into the benefits of CBD for this condition only began a few decades ago, current findings are very exciting. Studies suggest that CBD may have some positive effects on certain symptoms of Parkinsons disease, especially when it comes to anxiety, depression, and sleep difficulties.
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Why You Might Experience Speech Impairment And Difficulty Swallowing With Parkinsons Disease
Parkinsons disease affects the muscles and nerves that control speech. This condition affects your throat, larynx, facial muscle movement, respiratory muscles, tongue, lips, as well as the brain part that controls speech processing and hearing. Just like the manner in which the PD affects the mobility of other parts of your body, it affects the way you speak.
Besides producing the voice, PD may also lead to a masked or frozen face, making it hard to communicate the emotions, which goes along with what you are expressing.
This could lead to some of your friends or family misinterpreting it as aloofness or lack of interest. In other cases, you may struggle to find the right words or speak very slowly. On the other hand, this condition may also lead to individuals speeding up their speech, making it sound like stuttering.
Parkinsons disease can also affect your ability to eat and drink safely. Dysphagia or difficulty swallowing is a common symptom of Parkinsons Disease. Difficulty swallowing solid textures, choking during meal times, coughing when eating and drinking are also signs of difficulty swallowing. Swallowing problems are serious as they may pose choking risks and put you at risk of aspiration pneumonia. It is important to see a medical professional if you or your loved ones are experiencing difficulty swallowing.
Exercises For Restoring Health Breathing
There are various suggested types of exercise which can help gradually shift the equilibrium point of CO2 intolerance back to healthy states. However, all of these emphasize nose breathing over mouth breathing , and diaphragmatic breathing over chest breathing. This represents an immediate roadblock for people with PD, for whom mouth breathing is likely to have become so ingrained that it feels like the nose is permanently stuffed up, and who have diaphragms which are so frozen that it cannot voluntarily be flexed. However, it is possible to open the nose in the majority cases through some simple exercises. Robert Litman in the above video demonstrates this, and below is another video of Patrick McKeown on the topic. See also my article on how I restored nose breathing with the help of a red light anti-allergy device. It is also possible to restore access to diaphragmatic breathing, as I covered in another article, which explains how I used Block Therapy to achieve this.
Once nasal and diaphragmatic breathing is made possible there are a few different types of breathing exercises one try for restoring CO2 tolerance to more normal levels. It is important to note that these exercises are not necessarily targeted at immediate regulation of the Nervous System, unlike breathing methods designed for in-the-moment relaxation or mobilization, but are aimed at long term retraining of breathing patterns in order to restore healthy oxygenation levels to the brain and muscles.
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Studies Show Cbd Is Effective For Parkinsons Disease
The findings below suggest that CBD may promote several vital processes relevant to the prevention and treatment of Parkinsons Disease, such as:
- Antioxidant protection of neurons
- Psychosis treatment
- Overall quality of life improvements.
As mentioned, the endocannabinoid system is active in the area of the brain affected by Parkinsons Disease, but CBD also interacts with outside receptors to address PD symptoms.
For example, University of Louisville researchers discovered that CBD acts as an inverse agonist at GPR 6 receptors , which have been associated with dopamine reduction.
Through these mechanisms and others, CBD is showing promise as a viable treatment for PD symptoms.
Heres what the research has to say.