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Wednesday 30 May 2018

My cognitive impairment

Why do I stumble over words when speaking, especially when asked a question. I know the answer and I start to speak when suddenly my mind goes blank. Why? Because I am mildly cognitively impaired.

Whoa! Hold on there. Does that mean (whisper)....you are losing your mind?

Probably not but, but let's break it down.

What does "Cognitive" mean

According to a paper written by Jennifer G. Goldman cognition is a general term that refers to the mental abilities that we use to process information and apply knowledge. In the study of cognition, academics talk about "cognitive domains" which reflect different types of cognitive processes and describes each process. They are

  1. Attention and working memory
  2. executive function
  3. memory
  4. Language
  5. Visuospatial function

You can, and should read the article. The only ability I am interested in is number 4. language.

Doctor Goldman says this:

Language abilities include naming objects, generating words, comprehension, and verbal concepts. The most common language problem in Parkinson’s Disease is finding the “right” words. People with Parkinson’s Disease also tend to speak less overall (in addition to softer voice) and use simpler speech. This can be an area of frustration for both the patient and caregiver because verbal communication is such an important part of human behavior.

She describes me to a "T"

What to do? What to do?

Personally, I just keep quiet and when forced to talk, I allow myself to stumble and sound stupid but I usually get my opinion heard.

So am I going to hell?

When my father sank into the depths of Alzheimer's, he described his descent as "I am going to hell!", I don't think that will be my destination. I call "dibs" on Dr. Goldman's thoughts on cognitive changes in PD:

Cognitive symptoms in Parkinson’s Disease are common, though not every person experiences them. In some people with PD, the cognitive changes are mild. In others, however, cognitive deficits may become more severe and impact daily functioning.

....Cognitive deficits that are mild and do not impair one’s ability to carry out activities of daily living have been termed “mild cognitive impairment.” Studies estimate that mild cognitive impairment occurs in about 20-50% of patients with PD. We now recognize that mild cognitive changes may be present at the time of Parkinson’s Disease diagnosis or even early in the course of PD. They may or may not be noticeable to the person. They may or may not affect work or activities, depending on the demands of specific tasks and work situations.

I call "Double Dibs" on the descriptive words of the second paragraph. If I am impaired at all, it is very mild. My impairment does not affect my daily activities, except for not joining in conversations around me, but who cares? I was never really social at any time in my life. I like my own company and PD is just what the doctor ordered to explain my anti-social behavior. As for being mildly cognitively impaired, as long as I can write, I think I will sit back and enjoy the lack of stress and comfort in being slightly off course.

Click here to find out if a cow is in the early stages of mild cognitive impairment.

Monday 28 May 2018

Success is no accident

Tim Hague

I just finished Tim Hague's book, "Perseverance, the seven skills you need to survive, thrive, and accomplish more than you ever imagined" It was a good read and I recommend it to everybody, but especially to PWP.

Reggie Leach

Tim's book made me think of a quote I had hanging on the wall of my classroom when I taught Grade 9 Math. It comes straight from the mouth of Reggie Leach (for readers outside of North America, Reggie was a famous hockey player). He said:

"Success isn't the result of spontaneous combustion.
You have to set yourself on fire."

Good advice for PWP when deciding whether or not to exercise with an eye to slowing the progression of the "disease".

What is your IQ?

To add to Tim's definitions of "perseverance", I have always thought that there is a direct relationship between intelligence and IQ. Perseverance is definitely a quality of the highly intelligent.

What is all the fuss?

The morals gleaned from today's little gems are, or should be:

  • Read Tim's book. It is highly informative and a pleasure to read.
  • Reggie was a great hockey player who was not known for little plums of wisdom, but he hit the nail on the head this time. So everyone, but particularly PWP, should turn off the TV, get off the couch and go boldly into the future, walkng or running or yada, yada....some form of exercise.
  • Get smart, get fit and when you tire of exercising and want to quit, keep on keeping on and the fear of failure will disappear.

In other words, persevere.

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Sunday 27 May 2018

What's a little pain between frenemies?

I am having trouble keeping up this blog and may take a month's hiatus unless something exceptional happens; even then I may be consumed with alien fragments of my life. But, for now, let's stick with the progress of my PD as to pain.

Rolling over in bed is impossible. Sleeping in one position is an assault on my back. I hate pain!

Getting out of bed is a comedy of errors. I am restricted by the pain and like a bad gymnast, I go through all manner of contortions before success. I try to sit up on the side of the bed and inevitably I fall back into the bed 3 or 4 times before I can stabilize myself. Every motion hurts. When I have achieved a sitting position, it will take me another 2 or 3 attempts to stand. At this time, I can eventually win the battle, but it makes me think I should be laughing at the spectacle. Treating this dilemma with humor chases away the "why me" burden.

Speaking! What can I say? Not much I fear. I can think of what I need to say and I am able to write down those thoughts without a problem but when I open my mouth to speak, my brain stops and I am speechless. I come up blank and I fumble for words or I just shut down immediately with my audience waiting and trying to find the word for me. This is classified as mild cognitive impairment and my mind treats this as mental pain.

Just to make certain I am not comfortable, the gods have cursed me with additional grief in the form of pain in my left shoulder and bicep and that verdammt pain is limiting my participation in boxing! Those boxing workouts are an enjoyable way to get exercise. Gone today. I now spend time on the treadmill and stationary bike. This morning I walked about a mile with my Nordic poles for support. Big deal! These solitary workouts are a drag.

Even though my arm will hurt, I have made up my mind. It is my intention to go back to boxing tomorrow. I have a need to be among some other members of the tribe. There I don't feel embarrassed if I limit my speaking and I won't (can't) do any hooks. I won't be pain-free, but at least I will be taking charge.

Leonard Cohen once said that a pessimist "waits for the rain, while I am already soaked". That's me! So, however pessimistic this entry might sound, I remain at peace with my prognosis and still exercise daily. I will slow down PD's rate of advancement. Exercise can do that. Boxing can do that. Forget the pain. If I slow PD down, even a smidgen, people in white coats might find a cure within my lifetime.

One can only dream and hope.

Maybe I won't take that hiatus.

Wednesday 16 May 2018

Handwriting is the shackle of the mind. (Plato)

Now, I am not real sure what Plato meant by this but then, I am never sure about anything any philosopher said or says.

I will just cheat and say, "The title says it all."

This entry will be about micrographia:

Micrographia is an acquired disorder that features abnormally small, cramped handwriting or the progression to progressively smaller handwriting. It is commonly associated with Parkinson's.

A change in handwriting is one of the first signs of PD, among others.

Let's take stock of our symptoms. These are the common motor symptoms. I will deal with each one as it affects my life but you must realize I have been very lucky. After 8 years of dealing with PD, I am relatively symptom-free thanks to the goddess, Fortuna, and medication. The early signs (or "omens" if you will) of parkinson's and my experience with each are:

  1. The onset of tremors. Not always present but are viewed as a sure sign of PD. My experience was with a tremor in my right hand. It made an appearance following a few hard workouts and eventually caused me to seek medical advice.
  2. Bradykinesia - a slowing of movement that affects all PWP. It can lead to problems with walking and standing. YUP, got that too. I move at glacial speed.
  3. Rigidity or stiffness in the arms and legs. Not sure about this but I think I have missed it, except when I get out of bed, which can be a riveting drama.
  4. Instability when standing. Loss of balance. I have some minor issues. Nothing serious.....yet!
  5. Mask-like expression (hypomimia) Remember Ali? His expression never changed. I have avoided this little joy; although, early on, my wife did comment on a rigid expression.
  6. Parkinsonian gait common to those with PD. It is walking stooped over and can be accompanied by festination (uncontrolled walking). I have festinated 3 times. It is not fun!!
  7. Difficulties with speech, word finding, an unusually soft voice or slurring of your words. I sound like a moron when I speak.
  8. Trouble with handwriting. You start a handwritten note with decent writing and gradually, as you continue, your hand starts to tighten and your handwriting begins to get cramped and smaller. The worst thing is, you can't control the PD penmanship.

    'Nuff said.

Sorry, I got carried away. This post is supposed to highlight my handwriting which was once clear and flowing but is now...well, see for yourself (scroll down). The first jpg is a note I wrote in 1996 to my teenaged daughter's teacher. The second jpg is a replication of that note written by me today. See the difference? Need I say any more? I think not.

I believe I am beginning to understand Plato's musing but I am afraid to make it public.

Friday 4 May 2018

And miles to go before I sleep

Cognition: that which allows me to think, sleep, learn, forget. You know, all those things I enjoy and rely on. The one thing it doesn't allow me is the ability to predict the future accurately. I think I am smart, not exceptionally so, but smart enough to be able to hear those distant drums, the rhythm of PD calling out "I've got you! Yes I do!" over and over again. I can ignore them now but I guess that one day they will lead me into the darkness of Parkinson's. But what if we could predict the future? What if we could change that future? What if we could predict PD and find a cure for our dark shadow? We could silence those drums forever.

I admit to having little knowledge concerning advancements in the treatment of, or the slowing down of, or the curing of, our dark nemesis (and by "little", I mean "none") but lately, I have been reading research articles about scientists using certain MRI techniques during the prodromal phase of the condition, to predict who might become a victim of PD. The lexicons of the articles include words such as "prodromal", so have a dictionary handy and read the abstracts anyway. Start with this "article"". Medical articles are not easy to read containing, as they are wont to do, medicalese that keeps us from figuring out what's going on.

I GET SO CONFUSED

However, I take away from the confusion that researchers believe they can (or will be able to) predict the future.

That may help the undiagnosed, but how does that help us PLWP? I hear you ask.

Beats me! But those scientists seem excited, so I think it must be a beneficial advancement. I believe it to be another step in the progress of finding a cure or a slow down At the very least, we know there are people out there working on banishing PD and that can't come soon enough for me.

How's that for Cognition!