People with Parkinson’s can often experience non-motor symptoms such as anxiety. This can have severe effects like chronic fatigue, sleeplessness, affecting work and relationships to the extent that they may avoid social engagements. Anxiety also causes fear, worry or nervousness. These fears are typically not based on reality, for instance on perceived judgements and imagined criticism.
Causes of anxiety
The causes are not entirely clear, however many people with Parkinson’s have been found to have low levels of these nutrients (such as iron, vitamin D, and vitamin B6) which are related to anxiety. Hence fixing these deficiencies can take care of most of the issue.
How do you know if you have nutrient deficiencies?
In consultation with your doctor, test your blood for levels of iron. If levels are very low, the doctor may prescribe supplements or even injections, to bring your blood levels back to normal.
Follow the chart for vegetables and fruits rich in Vitamin D and Vitamin B6.
Parkinson’s Disorder is different for everyone. How it affects one’s ability to work depends on their type, stage and severity of the symptoms and the kind of work they do. Some people with PD can work more years after their diagnosis. Some people who find that their symptoms make work difficult and hence transfer to a different, more manageable job or work part-time. Others are unable to continue in their jobs after a year. The issue intensifies specially of a person is affected at a young age (Young Onset of Parkinson’s Disorder – YOPD).
For instance, one of our members is YOPD and faces difficulty in working as a mechanic due to tremors.
Regarding PD and work, a few things one considers are –
Should I tell my employer that I have PD? If so, when?
Are there ways to lengthen my ability to work despite my PD?
When I reach this point, what are my options for disability payments?
A few tips that can help –
Talk to a counselor
Share your concerns and issues with close family and friends who can help you think through
Take help of occupational therapists who can help with specific expertise in work rehabilitation.
Consider asking for PD specific accommodations that can help mitigate the effects of motor or non-motor symptoms on your employment (include flexible work hours, telecommuting, scheduled naps, designated breaks, close parking space, adjustments to work space, changes in the location of workspace, adjustments to keyboard and mouse).
If PD worsens and if accommodations are not enough to sustain employment, as an option of final resort, you may consider utilizing disability benefits which can help you with a few financial needs.
I am Ford Ebenezer and was diagnosed with Parkinson’s Disorder in 2008 at the age of 33 yrs. The diagnosis was a huge shock to me, since I had not heard of the disorder before and I questioned what will become of my life.
However, I am managing my daily activities with medicine support and a lot of self motivation. I am now live in Chennai and have lived with PD for 10 yrs. As a management professional I have a business in catering and oil distribution.
Every day I brisk walk for at least an hour, although walking in the morning is difficult without taking my PD medication. I am able to drive both, a two wheeler and car. I also play cricket, Badminton and I keep myself occupied. I hope that God will do a miracle in my life to get rid of this weakness.
I want to encourage people affected by PD to never give up in your life. Be confident and face this world boldly in all aspects. We should overcome this weakness by doing Yoga, Physiotherapy, Cycling, Swimming, Dancing and brisk walking. I understand that age is a constraint but do exercise which supports your body. I wish you all a happy living.
Here is a Heroic wife (with holding name) who have shared about her beloved husband’s PD journey .
When my husband joined “The Central Bureau of Mines” at Nagpur in December 1962 he was just 20 years old .The bureau of mines was then conducting an exploratory mining projects as a part of an integrated prospecting process for minerals. Moving from IBOM to Geological Survey of India and then to Mineral Exploration corporation he finally returned to GSI from where he retired in 2005.
The accommodation would be tents during mining. Each camp was a mini – India as a staff were from different parts of the country . There were encounters with man eating tigress, leopards, bears, and mostly snakes. Once I was there in the bathroom and there was a 2 feet long snake on the opening latch. Somehow I managed to open the door swiftly and came out when once I lifted a pressure cooker from the ground. There was a snake coiling around the vessel.
Just after retirement he went to an orthopedist for treating his knee pain. When he told the doctor that he was unable to wear his dress or dress up. The doctor immediately recommended him to a neurologist who diagnosed him Parkinson’s Disorder.
He was put on to lot of medicines and nerve vitamins . So far the past 14 years my husband is battling with Parkinson .He has internal tremors ,trunk twist ,difficulty in speaking , freezing etc.
We did nor realize it earlier, however it looks like the use of carbide lamps and pollution in the mines might have caused “Parkinson’s disease” in the later years.
My husband and I continue to manage this debilitating disorder with the help of our loving daughter and our extended family.
Having small, shuffling steps are one of the signs of neurodegenerative Parkinson’s Disorder (PD). Also this condition, which is known as Parkinsonian gait, is caused by changes in posture, slow movement and also freezing.
“Gait is our manner or pattern of walking” when we walk our body is normally upright, neither leaning forwards nor backwards, with an even stride and arms swinging at the sides we will have good balance.
Parkinsonian gait is a distinctive, less steady walk. The person who has Parkinsonian gait feels, their feet dragging on the ground; freezing – feeling feet are stuck to the floor. This affects balance and increase the risk of falling.
Our members have most of these issues.
To overcome Freezing
Change direction: if you can’t move forward, try stepping sideways and then go forward.
Carry a laser pointer in your pocket; when you freeze – shine the laser in front of your foot and step on the light – this cue can help you re-start.
Visualize an object on the ground in front of you and try to step over it.
Wear a metronome on your belt or carry a small one in your pocket – turn it on and the external beat can help you re-start.
Try humming a song and time your re-start with the beat of the music.
Count “1-2-3-go” and then step forward.
Weight shift side to side to help initiate taking a step.
March in place a few times and then step forward
To maintain balance
Keep at least one hand free at all times; try using a backpack or fanny pack to hold things rather than carrying them in your hands. Never carry objects in both hands when walking as this interferes with balance.
Attempt to swing both arms from front to back while walking. This may require a conscious effort if PD has diminished your movement.
Consciously lift your feet off of the ground when walking. Shuffling and dragging your feet may cause you to lose your balance.
Do one thing at a time! Don’t try to walk and accomplish another task.
Do not wear rubber or gripping soled shoes, they may “catch” on the floor and cause tripping.
Move slowly when changing positions.
Use deliberate, concentrated movements and if needed, use a grab bar or walking aid.
Count 15 seconds between each movement. For example, when rising from a seated position, wait 15 seconds after standing to begin walking.
If balance is a continuous problem, you may want to consider a walking aid such as a cane, walking stick, or walker.
Once you’ve mastered walking with help, you may be ready to try it on your own again!
Occupational therapy is the one profession that helps people across the lifespan to do the things they want and need to do through the therapeutic use of daily activities (occupations). Occupational therapy practitioners enable people of all ages to live life to its fullest by helping them promote health, and prevent—or live better with—injury, illness, or disability.
Occupational Therapy for Parkinson’s Disorder (PD)
Occupational therapy is used to help people with PD to continue with their daily tasks as the disorder progresses.
How can an occupational therapist help?
In PD, occupational therapist’s primary objective is to enable patients to participate in the activities of everyday life by working with them to improve their ability to engage in tasks they want to, need to, or are expected to do.
The areas where the Occupational therapist provides treatment in PD are in,
Mobility: Here the therapists help people with PD to concentrate on their walking and standing. Occupational therapists also teach patients how to change direction without abrupt turns to optimize stability. They may also check for the need of walking aids and home modifications.
Prevention of falls: The therapists aims to reduce the risk of falls in PD patients. Also they recommend people with PD to pay full attention and to concentrate on walking and using alternative equipment when carrying items, such as diagonal shoulder bags, body belts, or trolleys.
Fatigue management: People with PD find that they become tired more quickly, which may be due to the effort of staying upright and inefficient movement strategies. occupational therapists can review routines and help prioritize tasks, restructure activities according to energy levels, and introduce regular resting periods, including good sleep.
Sit-to-stand transfers: Sit-to-stand transfers from chairs, toilets are difficult for people with PD. OT can provide appropriate strategies like equipments to aid transfers including chair risers, riser recliner armchairs, and level-access showers instead of a bath.
Bed mobility: Therapists teach movement methods for turning over in bed, adjusting a position, and getting out of bed.
Domestic skills: Meal preparations, housework, and shopping may be affected due to loss of coordination and balance, and a reduced ability to multitask. Small items of equipment may be introduced to help promote domestic skills, such as non-slip latex for easier jar opening, lever taps to reduce effort when using taps, and a wire mesh to help drain pans or vegetables. Extra assistance for housework such as ironing, maintenance tasks, and management of paperwork may be required.
Eating and drinking: Therapists can recommend good sitting posture, adequate lighting, and ways to have fewer distractions while eating and drinking. Occupational therapists also assess if modified eating and drinking equipment are required to minimize difficulties.
Handwriting: People with PD tend to have micrographia, or handwriting where letters are smaller and sloping toward page corners instead of straight across. Visual or auditory cues as well as sitting comfortably and in an upright position at a table with good lighting may help with handwriting.
Constipation is common in Parkinson’s disease. It refers to bowel movements that are infrequent or hard to pass.
What Causes Constipation in People With PD?
In some people affected by PD, constipation may occur due to the improper functioning of the autonomic nervous system – which is responsible for regulating smooth muscle activity. If this system is not working properly, the intestinal tract may operate slowly, causing constipation.
For those taking Artane (Trihexyphenidyl) which helps to treat and prevent the muscular conditions and Cogentin (Benztropine) treats tremors in Parkinson’s disease. These medication can cause constipation as its side effects.
How Can You Avoid Getting Constipated?
1. Drink 1½ to 2 litres of water and other fluids a day. (Note: Milk can cause constipation in some people).
2. Liquids that contain caffeine, such as coffee and soft drinks, seem to have a dehydrating effect and may need to be avoided until your bowel habits return to normal.
3. Move your bowels when you feel the urge.
How Is Constipation Treated?
1. Drink two to four extra glasses of water a day.
2. Try warm liquids, especially in the morning.
3. There is an ayurvedic tablet called ‘Kayam’. You can intake one tablet at night which has no side effects.
4. Yoga asanas are also proven to reduce the intensity of constipation