At 03:56 AM 2/7/97 -0500, you wrote:
>Good morning everyone,
>Since November I've notice that after a small effort physically,
>like ruuning after the dog for 30 seconds or getting up somes stairs, I
>really, but now really am short of breath. I pumping air like I never
>did in my life. Just 2 years ago when I was playing hockey, I never were
>looking for my breath like this. (I still play hockey but now, with
>really old men!)
>
> Is it PD or just out of shape? I'm 39 years old (almost 40, my
>God that must be It!) and was diagnosed 5 years  ago.
> Denis
>
>39/5

Hello Denis,

I started paying attention to this phenomena when I realized that I ran out=
 of
breath with the smallest physical exertion when I was OFF and there was=20
rigidity in my trunk (chest, sides and back). My breathing becomes short and=
=20
shallow -- like hyperventilation.  With concentration I can 'force' myself=
 to=20
take deeper and fuller breaths.=20

I just remembered a post from Alan Bonander discussing hyperventilation:=20
" I remembered a trick taught as a child for hyperventilation.  Just breath
into of a paper bag.  This would reduce the oxygen slowly and bring
hyperventilation=20
under control.  I said to myself, why not try it -- nothing else was working
and the
dyskinesia and gasping was getting worse.

As soon as I started to breath into the paper bag my symptoms started to
subside.  It took about a minute of this breathing  to reduce the gasping
problem and reduce the dyskinesia to near zero.  This was a fantastic
feeling.  In all the years I have had PD never have I heard of
hyperventilation being a side benefit.  Yesterday, Dr. Robin Fross, a
consulting neurologist to Kaiser Parmanente in the Bay Area, spoke to the
Young-Onset support group.  On one of her slides on anxiety was Dyskinetic
Hyperventilation.  It feeds on anxiety and the wrong medication.

I am telling this story so that others might benefit from my experience.  =
 We
do know that anxiety can heighten dyskinesia and hyperventilation.  A simple
solution for me was the old hyperventilation trick learned many years ago --
breathing into a paper bag.  It sure worked for me. The cost was one I could
afford also."(Sun, 16 Jun 1996 ).

The over-all decrease in pulmonary function in PD has also been cited in
studies.
So, we can have a problem that originates from many single and combination
sources.
It is VERY important that a thorough physical exam is conducted and your
general health
is evaluated.  A daily aerobic exercise schedule and meditation will help to
keep you
in condition.=20

>From my files:
Chorea of the diaphragm?
This response submitted by a neurologist on 6/4/96.
Author's Email:
Your mother may be experiencing Sinemet-induced chorea of the diaphragm. The
diaphragm, like any voluntary muscle, can acquire a random-appearing
overactivity (i.e., chorea) as a side effect of any dopamine-stimulating
medication. This inability to voluntarily control the main breathing muscle
produces the sensation of shortness of breath. This can occur at the peak of
the action of the Sinemet ("high-dopa chorea") or as the level of the drug
is falling or rising just before or after a dose ("low-dopa
chorea"). In either case, the solution may be to space the Sinemet doses
closer together or to add another medication such as Eldepryl, Parlodel,
Permax or Symmetrel while reducing the size of each Sinemet dose.
=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=
=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D
Obstructive and restrictive pulmonary dysfunction increases disability in
Parkinson disease.
Author:     Sabat=E9 M, Rodr=EDguez M, M=E9ndez E, Enr=EDquez E, Gonz=E1lez=
 I
Address:     Department of Physiology, Faculty of Medicine, University of La
Laguna, Tenerife, Canary Islands, Spain. Source:  Arch Phys Med Rehabil, 77:
1, 1996 Jan, 29-34 Abstract
        OBJECTIVE: The purpose of this study was to determine in Parkinson disease
the impact of pulmonary dysfunction on daily living activities (DLA).
PATIENTS: Extrapyramidal motor impairment, pulmonary dysfunction, and DLA
disabilities were studied in 58 Parkinson patients consecutively enrolled in
a rehabilitation service at a university hospital.
MAIN OUTCOME MEASURES: Extrapyramidal motor impairments were assessed by the
Unified Parkinson's Disease Rating Scale (UPDRS) and the DLA disabilities by
the UPDRS, Hoehn-Yahr, and Schwab-England scales. The pulmonary dysfunctions
were assessed by spirometry with flow-volume loops, body plethysmography
with lung volumes computation, and maximal inspiratory and expiratory static
mouth pressures
RESULTS: Parkinson patients showed important modifications of pulmonary
function with a decrease in forced vital capacity, forced expiratory volume
in the first minute, and arterial PO2, and an increase in residual volume
and total airway resistance (RAW). In addition, they showed a high incidence
of airway ventilatory obstructions and restrictive dysfunction. The impact
of lung disease on daily living activities in Parkinson disease patients was
higher in subjects with restrictive pulmonary dysfunctions (SchwabEngland
test and turning in bed and adjusting bedclothes, walking, falling, and
freezing when walking items  of UPDRS) and airway obstructions (handling
utensils, dressing and hygiene items of UPDRS). CONCLUSIONS: Airway
obstructions or restrictive pulmonary dysfunctions present a high prevalence
in Parkinson disease, contributing as a main factor for DLA dysfunctions.
The evaluation and rehabilitation of respiratory disturbances should be
systematically included in the management of these patients.
Language of Publication
        English
Unique Identifier
        96143267





Margaret Tuchman (55yrs, Dx 1980)- NJ-08540
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