Meditation practice isn’t about trying to throw ourselves away and become something better. It’s about befriending who we are already.
Pema Chodron, Num
Meditation
Mindfulness meditation is the practice of paying attention to the present moment, an object, or a thought. The main aim of this type of meditation is to increase awareness and let go of distractions. Such a meditation technique can greatly help in symptom management (reduction of tremors and rigidity, while improving balance, and coordination) in people with Parkinson’s. It also helps reduce stress and anxiety, in addition to improving cognitive functions like attention and memory. Overall, it improves the quality of life with emotional and mental well-being.
How to practice meditation?
It is a simple practice where one can practise it at their convenience. Here are some steps to follow:
1. Find a quiet place to sit and choose a comfortable posture like sitting on a chair or the ground with your back straight.
2. After getting comfortable, close your eyes and concentrate on your breathing, a thought or a mantra.
3. If your mind starts to wander, try to bring back the attention by concentrating on your breath or counting the number of breaths. You can also use guided meditation audio to follow instructors to maintain attention.
4. Start by doing this for 5-10 minutes and can then increase the time of practice.
Practice meditation regularly to bring positive results.
Here are some resources you can follow to meditate:
Constipation affects more than 50% of people affected with Parkinson’s. It is one of the precursors or early signs of Parkinson’s. If bowels are not cleared daily, other PD symptoms like fatigue, inability to move and frequency of falls tend to aggravate.
In our conversation with Sandhya Manian, Nutritionist, we learned of a few good practices that can be followed to manage constipation. not just by people with PD, but also by the general population.
Here are some quick food and lifestyle changes that can help you manage constipation:
FOOD SUGGESTIONS
Consume warm water (200ml to 300ml) on an empty stomach first thing in the morning.
Soak 3-5 black seeded raisins at night and have them with warm water on an empty stomach in the morning.
Other options for an empty stomach are 1 teaspoon soaked badam pisin or one spoon of chia seeds soaked for 30 mins.
Avoid having caffeine (tea/coffee) first thing in the morning.
Have fruit (especially banana) or salad as a snack but not immediately after or as a part of a big meal.
Avoid processed food like biscuits for snacks.
Hydrate all through the day.
Include healthy fats in all your meals – ghee, garnishing with coconut scraps.
Consume fibrous food throughout the day – 4-5 cups of vegetables.
Consume moisture-rich food, especially at dinnertime. For instance, replace dry food like dosa with idli and chapati with Kichadi.
A warm glass of milk at night can be a good laxative.
LIFESTYLE CHANGES
Take an oil bath at least 3-times a week.
Perform stress-relieving activities like yoga, meditation, and walking.
Move your body throughout the day. Do not be seated for long hours.
Good sleep hygiene. Wake up at least 30 mins before sunrise and go to bed by 10 pm.
Squatting position for passing stools. Buy a poop stool that can be placed on the western toilet closet.
NOTE: If constipation is high despite following most, or all of the above suggestions, please take a laxative (allopathy or ayurveda) every day.
Each person who gets diagnosed with Parkinson’s experiences the disorder differently. Parkinson’s comes with a baggage of symptoms that vary from tremors, sleeping disorders, stiffness, and swallowing problems to vivid dreams and hallucinations. There are several underlying conditions that alter the progression of the disease. For example, the food we consume and our overall gut health influences brain function and how people cope with Parkinson’s.
Parkinson’s also has an effect on the person’s vision. To learn more about this, we spoke to Dr. Elfride Sanjana, an ophthalmologist. She discusses a series of effects and underlying conditions that influence or indicate a progression of the disorder.
Common conditions in people with Parkinson’s
Here are some of the common vision-related symptoms that people with Parkinson’s may experience:
Visual hallucination
When a person sees an object without it actually being present, it is known as a visual hallucination. It occurs due to dopamine agonists and can be extremely disturbing to the person. People with Parkinson’s may experience visual hallucinations due to medication or due to the worsening of the disorder.
Visuospatial orientation
Visuospatial orientation refers to our ability to walk in a room of people, furniture or other things without bumping into them. People with Parkinson’s may have a weakened visuospatial orientation due to the low levels of dopamine in their eyes.
Colour vision contrast sensitivity
When you walk from a bright room into a dim one or vice versa, your pupils adjust almost automatically to make it easy for you to see. However, reduced dopamine levels in people with Parkinson’s makes it difficult for them to adjust in a new lighting.
Blepharospasm
The eye lid can remain closed for an extended period of time if Parkinson’s reaches a critical level. Patients may require an injection of Botulinum toxin or artificial tear drops to treat this condition.
Blepharitis
Blepharitis is dandruff-like scales on the eyelashes. To reduce the symptoms mix 2-3 drops of baby shampoo with lukewarm water and use earbuds to lightly scrub the eyelashes at night with eyes closed. Accompany this with artificial tear drops, for at least a month to effectively reduce the discomfort. Visit an ophthalmologist in cases of redness, pain or irritation.
Gaze palsy
Gaze palsy causes the eye to remain fixed in one direction and the blink rate to slow down. This can be caused by PD, and is accompanied by tear evaporation, dryness, and reflex tearing. Furthermore, age can weaken the muscles that pump tears, resulting in increased tearing.
Why do people with Parkinson’s find it hard to read?
Blurring vision makes it difficult for people with Parkinson’s to read. However, there are several other underlying conditions that may contribute to this problem:
Dry eyes
The ocular surface can be affected by a decrease in dopamine levels in the eyes, resulting in a decrease in blink rate. This can lead to an increase in evaporation of the tear film, reduced tear secretion, burning sensations, and the sensation of dust in the eyes.
Colour vision and contrast sensitivity
Colour vision is the ability to differentiate between different shades and hues of colour. However, with Parkinson’s, if an object has low contrast in comparison to its background, it can be difficult to spot. This issue is known as contrast sensitivity and can even make reading difficult. Fortunately, Neuro physicians can help by adjusting the PD prescription.
Convergence insufficiency
Due to a dopamine deficiency, the eye muscles don’t work together, leading to convergence insufficiency. People with PD find it hard to fix and focus on a particular point. One method to tackle this is to take short breaks instead of reading continuously. closing one eye and reading, or using separate glasses for reading and distance.
Loss in saccadic movement
Saccadic slowing down causes difficulty when shifting the focus from one part of the visual field to another. While adjustments to PD prescriptions may provide some relief, it can be difficult to achieve a complete cure.
How to manage vision-related conditions?
Here are some ways that may help bring relief to people with Parkinson’s experiencing vision-related issues:
Alter PD prescription
Vision-related issues may rise due to PD medication. Work with your neurophysician to understand its effects and alter the medication. An ophthalmologist cannot change the medication prescribed by a neurophysician.
Check for Glaucoma
Glaucoma is a condition that leads to an imbalance in eye pressure. The condition is not caused due to PD. It is vital to communicate this condition to your neurophysican as anti-cholinergic drugs cannot be prescribed to Glaucoma patients. Sharing your full medical history will help determine the best course of medication.
Other underlying conditions
Not all vision-related issues rise due to Parkinson’s. Some patients may have issues like cataract, diabetes, hypertension or ARMD (Age Related Muscular Degeneration). A vision problem rises over several weeks or months. It is vital to regularly get your eyes checked and take the necessary course of action.
Day-to-day changes
Avoid dusty environments or use glasses if such environments are unavoidable. Artificial tear drops can be effective in comforting the eyes and must be accompanied with wet hygiene. Avoid making changes to your house settings as adjusting to new environments may be difficult. Lastly, use separate spectacles for reading and distance.
Death cleaning is a method of organizing and decluttering your home or your space before your die. It aims to lessen the burden on your loved ones after your unfortunate demise. The practice, also known as Swedish Death Cleaning, is making decisions about what you keep and what you let go.
Our member, Mr. Raman addresses death cleaning and says –
Death Cleaning…..
தமிழில் இதை இறப்பிற்கு முன்பான சுத்தம் எனக் கொள்ளலாமா?
இதை முதலில் ஆங்கிலத்தில் எழுதியவர், ஒரு ஓய்வு பெற்ற இந்திய ராணுவ ஜெனரல் ஆவார். இவருடைய கருத்து மிகவும் ஏற்புடையதாக இருப்பதால், அதை தமிழாக்கம் செய்து மற்றவர்கள் நன்மைக்காக கொடுக்கப் பட்டிருக்கிறது.
டெத் கிளீனிங் என்பது. ….
நாமெல்லாம் அறுபது வயதை அடைந்து விட்டால், சிறிது சிறிதாகவும், தொடர்ச்சியாகவும் ஒரு பண் பட்ட விதத்தில், நம்மைச் சுற்றி நாம் கடந்த 60 வருடங்களில் சேகரித்த உலகாயுத பொருட்கள், மனதில் உள்ள பல கெட்ட படிமங்கள் ஆகியவற்றை சுத்தம் செய்து (வெளியேற்ற) ஆரம்பிக்க வேண்டும்.
முதலில் நாம் சேகரித்து வைத்துள்ள தேவையற்ற துணிகள், பொருட்கள், பல இடங்களில் நாம் வாங்கிய கலைப் பொருட்கள், ஞாபகார்த்த சின்னங்கள்,
அதாவது நாம் பணி புரிந்த இடங்களில் நமக்கு கொடுத்த பரிசுப் பொருட்கள், நாமே விரும்பி வாங்கிய பொருட்கள், நமக்கு பரிசாக கிடைத்த பொருட்கள், அலங்கார பொருட்கள், இன்னும் பிற விஷயங்கள் ஆகியவற்றை அவை உபயோகமானதா என ஆராய்ந்து, சிறிது சிறிதாக அவைகளை வெளியேற்ற வேண்டும்.
நாம், உண்மையில் வயதாகி விட்டால் இந்த உலகத்தில் நமக்கு இடமில்லை என்பதை உணர வேண்டும்.
நம்முடைய குடும்பத்தாருக்கு நம்மை கவனிக்க நேரம் இல்லை.
ஏனெனில் அவர்களுக்கு கவனிக்க வேண்டிய பல விஷயங்கள், அவர்களுடைய சொந்த குடும்பம் ஆகியவை உள்ளன.
நம்முடைய இறப்பிற்குப் பின் நாம் ஏன் மற்றவர்களுக்கு இந்த சுத்தம் செய்யும் வேலைகளை மிச்சம் வைக்க வேண்டும்?
நாம் நல்ல உடல் நிலையுடனும், மன நிலையுடனும் இருக்கும் பொழுதே, நம்மிடம் இருக்கும் பொருட்களை/ சொத்துக்களை, நன்கு சிந்தித்து அதற்கு ஏற்ப பயனாளர்களை தேர்ந்தெடுத்து, அதனால் அவர்கள் பயனடைகிறார்களா என்பதை ஆராய்ந்து, அவர்களுக்கு அதைக் கொடுத்து விட வேண்டும்.
அவர்கள் சொந்தங்கள் ஆக இருக்கலாம், மற்றவர்கள் ஆகவும் இருக்கலாம்.
நம்மிடம் இருக்கும் பொருட்களை எடுத்து பகிர்ந்தளிக்கும் பொழுது, தீர்க்கமாகவும் மன சஞ்சலம் இல்லாமலும், அதைச் செய்ய வேண்டும்.
அப்படி பகிர்ந்தளிக்கும் பொழுது, மன அழுத்தத்திற்கு உள்ளாவதோ, உணர்வு பூர்வமாக மன சஞ்சலம் அடைவதோ, அதீத உணர்ச்சி அடைவதோ கூடாது.
கொடுக்க நினைத்தால், கொடுத்து விட வேண்டும்.
இதை இப்பொழுதே ஒவ்வொரு வாரமும், சிறிது சிறிதாக செய்ய ஆரம்பியுங்கள்.
ஒவ்வொரு வருட முடிவிலும் ஏதாவது பெரிதாக செய்யுங்கள்.
புதிது புதிதாக தேவையற்ற பொருட்கள் வாங்குவதை நிறுத்துங்கள்.
உங்களிடம் பணம் இருக்கிறது என்பதற்காக வாங்கிக் கொண்டே இருக்காதீர்கள்.
உங்களிடம் இருக்கும் பணத்தை பத்திரப் படுத்தி வையுங்கள்.
ஆனால் அதற்கான உயிலை எழுதி வையுங்கள்.
ஆனால். …
உங்களுடைய கடந்த கால நினைவுகளை போற்றிப் பாதுகாத்து வையுங்கள்.
அது உங்களுடன் கடைசி வரை, பல கால கட்டங்களில் பயணம் செய்யும்.
நாம் நம்முடைய கடந்த 60 வருட வாழ் நாளில் யாரையேனும் தெரிந்தோ தெரியாமலோ துன்புறுத்தி இருந்தாலோ, அதாவது மனதளவிலோ அல்லது உடலளவிலோ. … அவர்களிடம் மன்னிப்பு கேளுங்கள்.
நமக்கு உதவி செய்பவர்கள்/ செய்தவர்கள் அனைவருக்கும் நன்றி சொல்வோம்.
நாம் யாரின் மீதும் காழ்ப் புணர்ச்சி கொண்டிருந்தால், அவற்றை சுத்தம் செய்து துடைத்தெறிந்து விட்டு, நம்முடைய மனதை தூய்மையாக வைத்திருந்தால், எந்த துர் கர்மாக்களும் இல்லாமல் இறப்பை எதிர் நோக்குவோம்.
நல்ல மனதையும் நல்ல எண்ணங்களையும் மட்டுமே நாம் கொண்டு செல்வோம்.
அது நம்முடைய மரபணுவில் ஒரு நல்ல அழிக்க இயலா அச்சை உருவாக்கும்.
Naturopathy is a system of alternative medicine that treats diseases without using drugs. It relies on techniques like controlling diet, exercising and identifying the root cause of a disease rather than treating symptoms.
The approach to naturopathy differs in every country. For example, in India, it focuses on a holistic diet-based approach with herbs, massage and physical therapy while in the USA it is an amalgamation of homoeopathy, botanical medicine, clinical medicine and Chinese medicines. To learn more about this, we spoke to Dr. Mansi Vira, a naturopathy doctor practising in the USA:
Treating pain and burning sensation
Pain and burning sensations are common symptoms of Parkinson’s. Engage in physical therapies to cope with them. Dr Vira also suggests that these symptoms could result from a lack of magnesium in the body. There are various forms of magnesium, making it vital to identify the appropriate form, and consume medicines that help replenish magnesium levels in the body. She also suggests that our body gives us clues when lacking certain nutrients. For example, a craving for dark chocolate may indicate a magnesium deficiency.
Heavy metal concentration
Heavy metals are said to damage the nervous system. In today’s world, heavy metals can be found in everything from perfume to the food we consume. An increasing concentration of heavy metals in the body may cause gut issues that correlate to brain conditions. Dr Vira says that constipation or diarrhoea may be indicators of one’s inability to think clearly. She recommends a ProTox toxicity prediction test to assess the levels of heavy metals in the body. She also suggests being more mindful of the food we eat and its source to limit the number of heavy metals that enter our bodies.
Naturopathy medicines and treatments are individualised. However, there are several methods that one can adopt to detox, maintain a healthy lifestyle and cope with symptoms of neurodegenerative disorders like Parkinson’s. Here are a few suggestions from Dr Vira:
Decrease consumption of processed food
Reduce consumption of dairy and gluten
Restrict protein intake to improve the efficacy of medicines
Adopt anti-inflammatory foods such as celery, turmeric or ginger in the diet
Take an IGT or IGA test to check for food sensitivity and the implications it has on your body
Consume plenty of water and balance electrolytes in the body
Dr Vira suggests that it is vital to make detox a long-term plan and a lifestyle choice to reap its benefits and lead a healthier life.
Change begins with small steps, and simple dietary modifications can help people with Parkinson’s cope with their symptoms and lead a better life.
You can watch the entire conversation with Dr. Mansi Vira here:
Mr. Ramu (name changed) had a lightness about him and was cheerful at our regular yoga therapy program. While we assumed it was our yoga asana and pranayama practise that added the bounce, it was, however, a visit from his grandkids that cheered him up. Spending time with grandchildren had a significant impact on not just Mr. Ramu’s mental health but also on his physical well being.
While medications and supportive care (yoga, physiotherapy) help an affected person with PD, it is usually children, and most often grandkids, who end up adding to the quality of life!
The relationship between a grandchild and their grandparent is unique. Both are at a stage where they share an innocence and curiosity that fuels their relationship. Their questions, activities, and conversations can be very stimulating to a grandparent affected by PD.
A study sponsored by the National Parkinson Foundation reported that 61% of Parkinson’s patients surveyed reported experiencing depression. Research also suggests that those who felt emotionally close to their grandchild noted fewer symptoms of depression. We have had grandchildren accompany our members during their dance, speech or yoga sessions. With most meetings moving to an online format, the younger generation is indispensable in terms of tech support.
Have a look at Karthik and how his daily routine is incomplete without assisting his grandfather:
When the future generation is sensitized to caring for someone with a neurodegenerative disorder like PD, we can be hopeful for a compassionate community in the years to come.
Engaging with children in conversations, physical and cognitive activities may help relieve patients with PD.
For many, being present for their loved ones is a core value. Caregiving is a strenuous long-term process of assisting a loved one, hoping to ease their pain and make them comfortable. While caring for a loved one is invaluable, research has shown that caregiving has all the features of a chronic stress experience. It creates physical and psychological strain over time, primarily because it is usually a long-term experience with unpredictable developments.
What kind of stress does caregiving cause?
Caregiving is exceedingly demanding and causes physical and mental strain. Over prolonged periods, it may also take a toll on the caregiver’s health. Here are some indicators of the effects one might experience from caregiving:
Feeling irritated and exhausted
Feeling guilty for spending time on leisure activities
Unable to sleep
Neglect your own needs and requirements
Unable to relax and be in the moment
Feeling helpless and dispirited
Frequent headaches, body pain and other physical ailments
Gaining or losing weight
How to cope with caregiver stress
While the role of a caregiver will never be stress-free, there are several steps you can take to cope with the stress. Here are a few tips to help you get started:
Educate yourself about the disease
The lack of knowledge to deal with a patient suffering from a chronic disease or disability causes stress. When you learn about the condition or disability, it will become easier to support your loved one. There are several support groups and online resources you can explore to empower yourself.
Exercise regularly
Caregiving can be physically very exhausting. You need to build strength and stamina to cope with it through regular physical exercise. It also helps you stay healthy to ensure you can continue to serve your loved ones.
Take time for yourself
Caregiving may seem like a full-time job, but you must be able to take some time off for yourself. It is easy to feel guilty for doing so, but it is necessary to avoid burnout. Small leisure activities help you relax and rejuvenate yourself.
Accept the situation
Accepting a situation will help bring clarity of thought and help you think about the next steps. Avoid asking questions like, ‘Why did this happen to us?’, as it will only bog you down. Acknowledge that despite the burden and complete change in your lifestyle, caregiving is unavoidable – this can help you cope with the situation.
Manage the situation
When questions like ‘why me’ arise, the first step is to acknowledge it and not negate the feeling. To work through such emotions would be to approach a qualified psychologist and have a conversation around it. For many of our members, psychologists have included family members to facilitate structured conversations to help them deal with the challenges of PD and its caregiving.
Celebrate the little victories
Caregiving is a long journey, but celebrating the small victories along the way can help you stay motivated. Pat yourself on the back for every situation you handled well, be it with the patient or otherwise.
Seek support
Asking for help does not make you weak but prepares you for the future. Ask for help from your family, friends or even a support group to cope with the stress. It is essential to accept support. Caregiving requires will and external support that can help ease the process.
Both Diabetes and PD conditions are a result of progressive loss of hormone production. While Parkinson’s disorder is an inflammatory, progressive condition in the brain that occurs due to the loss of dopamine-producing cells, diabetes results from the loss of insulin production and beta cells in the pancreas. For Parkinson’s disorder, age is considered one of the most significant risk factors, while genetics account for up to 20% of the risk.
Theoretically, diabetes is suspected to be a precursor to Parkinson’s disorder. There is evidence that diabetes is a risk factor for developing Parkinson’s disorder, but there is no evidence that optimal diabetes control reduces the risk of Parkinson’s disorder.
How to handle Diabetes and PD?
All of us know that diabetes can be controlled by following a healthy diet, losing weight, managing blood sugar and blood pressure, exercising regularly, and avoiding smoking. However, when the two are present in the system, it is essential to be more careful and be wary of the following indicators.
Accidental falls – PD increases chances of fall, and diabetes reduces bone strength
Impulse control – Both PD and Diabetes lead to impulsive behavior (gambling and shopping)
Mental Health – Feeling of depression is common for both. Seek counseling and talk to family
Parivarthan conducted a detailed session on Diabetes and PD with Dr. Usha Sriram.
This quote perfectly summarises the positive attitude of Mr.Ramesh(68) and his wife, Mrs. Kasturi(53).
In 2016, their lives started to change when Mrs. Kasturi was diagnosed with PD in June, and Mr. Ramesh was informed of his PD diagnosis in December the same year.
Both of them were relatively young at the time of diagnosis. Mrs. Kasturi and Mr. Ramesh, were informed by their doctor that Mrs. Kasturi might have genetically inherited her condition from her father, but the cause for Mr. Ramesh was unknown. Nevertheless, with no former knowledge about PD, they accepted the situation and prepared themselves for the unknown. This diagnosis radically altered the lives they built.
Mr. Ramesh (a retired bank manager) and Mrs. Kasturi (an LIC employee and post office agent) share an unbridled love for travel. For years they have, as a family,extensively travelled across the country. They continue to do so despite PD (temporarily paused due to Covid-19!). Settling in Madurai post-retirement, the couple have built a life for themselves and continue to remain independent with their children living in the USA, London, and Chennai.
Early into PD, both realised it is important to pay attention to their physical health, hence they have immersed themselves in yoga, physiotherapy, and exercise. They disconnect from electronic devices an hour before bed to sleep better. Even when watching TV, they avoid dramatic action / thriller movies to maintain mental and physical health.
Recently, they have started to share their love for food and cooking through their website yummysourashtra.com and have also started a YouTube channel. They have written a recipe book together which is available on Amazon! They are now working on a Tamizh version. Mr. Ramesh also loves to read Hindu religious works like Ramayana and Mahabharata. Both of them feel that keeping the mind sharp and keeping oneself productively engaged has helped them cope with PD. Support of their children, friends and extended family has been an immense help for the couple. A full and enriched life, despite PD.
Mr. Sundar (name changed) does not feel fresh upon waking up in the morning. He falls asleep as he watches television, or when he is reading a book or newspaper. He tires easily and does not have much energy even for routine activities. Mr. Sundar is afflicted with fatigue – a common non-motor symptom in Parkinson’s Disorder (PD). It can happen at any point during the disorder, irrespective of whether movement symptoms are mild or severe. The actual cause for chronic fatigue is still unknown. It is, however, believed that it could result from muscles getting tired due to motor symptoms such as tremors and stiffness. While fatigue is not sleepiness, a person who experiences fatigue could feel exhausted despite being well-rested. Some of the manifestations of fatigue are —
Mental fatigue — mental tiredness that can affect concentration
Before considering help from a doctor or changing medication, performing a complete medical check-up can help rule out non-Parkinson causes. Reasons such as anemia can also make a person fatigued. Once the fatigue is classified, the next step in easing the fatigue associated with PD is to identify the causes of tiredness, such as sleep issues, depression, or wearing off of medications.
Tips to combat fatigue
A few lifestyle changes to handle fatigue better –
Regular exercise can help one feel energized.
A brisk walk in the morning and mild yoga stretches at the end of the day.
Sleep is essential to fight fatigue.
Avoid long naps during the day, aim for 10-30 minute‘power’ naps. This will not disrupt the sleep cycle at night.
Avoid distractions such as TV in the bedroom as they can disturb sleep schedule.
Stress and fatigue are related. Check to see if there are specific stress-triggering factors.
Meditate or practise mindfulness to minimize stress and tension.
Eat fibre-rich food (e.g. guava, papaya, pears, chickpeas, chia seeds). It will help reduce constipation and keep energy levels up.
Parivarthan for Parkinson's 