With Thanksgiving, November is the beginning of our great food season. Whatever holidays we celebrate, we all enjoy the plethora of food that fills or tables and then our stomachs. So before we pull out the holiday decorations, we turned our attention to the issue of Nutrition.

We were very lucky to have, as our guest speaker for November, Bailey Vernon, MPH, CHES, patient educator from the Movement Disorder Program at Johns Hopkins University. For an hour and a half, she presented us with useful information and answered questions we had. Nutrition is not a topic we have covered yet in the group.
Everyone diagnosed with Parkinson’s Disease would do well to assemble a team of specialists.It’s recommended that we have a Physical Therapist who we see on an annual basis ( a doctor referral is needed). The physical therapist can establish a baseline and catch problems as they develop and deal with them.
Many Parkinson’s patients find that their voices get really soft and are hard to hear when they speak. It is suggested that we have on our team a Speech Therapist. While many of us thought that we would go to a speech therapist when we notice our voice quality changing, Bailey says it’s never too early to. have a screening visit.   A speech therapist can monitor to notice changes but ask can give us exercises to keep our voices strong.
The Movement Disorders Neurologist examines you on a periodic basis and monitors your progress and your medications. As Parkinson’s Disease is a progressive, chronic disease, it is important to have a doctor tracking your changes.
Although it wasn’t specifically mentioned, it is good to have a physician who can be your central contact on your team. Perhaps it could be, like mine, your Primary Care Physician. I have all my medical records sent to her so she can follow what’s been done.

Besides your team of medical specialists, people with Parkinson’s Disease need to have an exercise plan. Exercise is the number one most important think that we can do for ourselves. Whether it’s dance, boxing, tai chi, running or walking, it’s good as long as you actually do it.

Nutrition – Ten Tips

Bailey started her talk on nutrition by listing ten nutrition tips for living well with Parkinson’s. She credited it to Kathrynne Holden, MS, RD, published on the www.parkinson.org website.

 1)  Vitamins D3 and B12 levels are usually low in people with Parkinson’s Disease. Supplements help.
2)  Flax Seed is very high in fiber; it helps control blood sugar and keeps the stool soft.
3)  Ginger helps with the nausea that some medications cause.
4)  Tumeric has been evaluated for benefit to people with Parkinson’s.

5)  Berries and cherries are great sources of antioxidants.
6)  Honey is a way to fill your cravings for sweets and still get some nutritional value.
7) Beans are rich in protein , fiber and B vitamins.

8)  Fish are a form of complete protein. Fatty fish like salmon, sardines, herring, anchovies and halibut are especially beneficial, containing omega-3 fatty acids which protect against dementia and depression.
9)  Tea, especially black, green, white and oolong teas contain “polyphenols”, and people who drink more tea seem to be diagnosed less with Parkinson’s and Alzheimer’s. Studies to demonstrate the connection are underway.
10)  Nuts are rich in vitamin E, which seems to protect against the development of Parkinson’s. But they’re also high in fiber, which is reason enough to put them in your diet.I wonder if we could make a salad or stew containing all of the above.

Constipation

Is your face turning red just at seeing the title? Did your head pop up to look around at who may see what you are reading? Did you just slam your iPad cover shut? Well, come on, folks, you know it’s an issue for a lot of people with Parkinson’s. In fact, Bailey stated that 60% of Parkies have constipation issues. One nurse practitioner that Bailey heard speak said that she wants her Parkinson’s patients to have a daily bowel movement. If this is an issue for you, do you know steps to take to improve your situation?

Bailey laid out a series of steps to help “relieve” the problem:

Step 1 – Diet and Fluid Intake

Eat meals at the same time each day.
Make sure you include fruits, vegetables and whole grains/cereals daily. In bread products, strive for whole grain wheat with 100 calories and 3 grams of fiber.
Drink more fluid, try for 6-8 glasses of non-alcoholic and decaffeinated beverages. (Try WATER).
Warm liquids in the morning.
Try to set a regular time for bowel moments.
Exercise. If you move, your bowels will follow in time.

Step 2 – Bulk Formers

Bulk formers include bran or products like Metamucil or Fibercon. You can use it daily; it’s not habit-forming.
Its even more important to drink a lot of liquids with bulk formers; other wise, they could make the situation worse.
Be patient. Use of these products could take up to 2-3 months to correct the situation.
Exercise. If you move, your bowels will follow. (Intentional repetition)

Step 3 – Stool Softeners

As you work through these steps, you may need a stool softener. These products aren’t habit- forming and don’t require a prescription.
Use the product daily.
Begin with one a day. Increase to one each morning and one each evening if needed.
Exercise. If you move, your bowels will follow in time.

Step 4 – Laxatives and Suppositories
and
Step 5 – Enemas

These are the next steps you could or would take if you are still having issues with your bowels. You can read more about these at this link:

Sinamet and Protein

There’s a lot of questions about the timing of protein consumption and taking your Sinamet. I had heard that the problem was with animal protein but not other kinds. Bailey explained that animal protein is a complete protein. When consumed, it is broken down to amino acids and taken to the blood /brain barrier causing your meds to compete, meaning they may not be absorbed. She said that this is a problem that most patients don’t experience, at least in the early years of their diagnosis. A show of hands showed that less than half of the attendees experienced this issue. She also said that eggs and cheese may not be problematic.

Bailey suggests taking the pill 45 minutes – an hour before eating. She also suggests eating smaller meals throughout the day,

Weight-Loss, DBS and Acid Reflux

Losing weight is problematic for people with Parkinson’s Disease. Dyskinesias are one reason. All that movement burns calories. Its one reason that doctors recommend Deep Brain Stimulation (DBS). Another symptom of Parkinson’s, depression, can also lead to weight loss. Weight loss is reason for concern because it increases the chance of falls, which can lead to bone fractures.

Another DBS note: DBS can result in a softening of the patient’s voice. This is something speech therapists can’t really help.

Acid reflux is more common in people with PD. There are treatments available.

Thanks so much to Bailey Vernon for taking the time to drive down and spend her time educating us on these important topics.
December’s program will be all about Quigong. Details later.