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Dear Sr. Meyer: Hope this one finds you in good espirit. I'm a 56 yr old male misdiagnosed with Familiar Tremor in Nov. of 2000. In March of 2005 I was officially diagnosed with P.D. after a couple of PET Scans done in North Shore Hospital, NY. I've been practicing Transcendental Meditation twice daily for more than 30 yrs, this helps me in more ways than just the physical... I take Azilect 1 mg/daily, been taking it for 2 1/2 yrs, prior to this I was taking Selegiline for 1 yr. I also have been taking Requip 3 mg x 3/daily for the last 7 months. Requip/Ropinirole makes me feel, among other things, nauseated. I take 2 tbs of organic Red Wheat Bran for constipation soaked in a glass of water the night before and washed before taking it in my morning cereal. I walk about 2-3 x wk, drink at least 8 glasses of water p/day, do some yoga daily, bike 2 x wk and Bow Flex 2 x wk. I was introduced to MaxGXL about 5 months ago, even though my doctor does not believe this supplement does anything, everyone around me tells me the contrary. Friends who had not seen or talked to me since last Christmas confirm what I feel and have experienced so far. I have regained the strength of my voice, I am more focused, my memory has improved a great deal, I don't have to search for words endlessly when talking, I sleep much better, I don't wake up at night to go to the bathroom and my dreams are vivid; why or what are the mechanics to all of the above, I don't know, but it works just like that. I felt the effects in about 3 wks after I started on it. This is a supplement that has been granted a 'Compositional Patent' because of the results obtained by its developer Robert H. Keller, MD, an Oncologist, Hematologist, Immunologist with a 23 pages long resume. According to the info I have been able to gather, this supplement increases the Glutathione (GSH) levels in the cells by up to 292%, causing them to increase their levels of energy (ATP) and thus, their ability to quench more and more Free Radicals and many other benefits; (www.maxgxl.com/133282) I suggest learning all you can about Glutathione and MaxGXL, if you think it is for you, order some and try it, it's made a big difference in my situation, I hope it does even more for others. Below a couple of links I found on 2 independant MDs talking about Glutathione and its benefits. http://www.youtube.com/watch?v=fDkkzILyZwM Glutathione treatment for PD http://www.youtube.com/watch?v=Eh2PYQBICWs Gen info on GSH Best wishes, Ernesto Divo, Miami, FL On Mon, Apr 13, 2009 at 9:35 PM, Charles Meyer <[log in to unmask]> wrote: > Jim and List, > > *I am a 64 year old psychiatrist. who has been off and on this list for > most of the approximately 15 years of its existence. I had been diagnosed > with PD in 1989 and retired from practice in 1997. I also participated, > in the double blind fetal transplant study done around 1997. I have > Bilateral DBS STN stimulators and am wheelchair bound at this time. > > I would like to comment on Jim Slattery's excellent summary on his > experience of psychiatric aspects of PD. I will comment on the issues he > brings up one by one > * > > J/im Slattery wrote:/ > >> /Here is my personal view of apparent personality disorders in PD, from >> my 25 years of having PD, and 10 years of intensive research. I am not a >> doctor of medicine and anything I say here is my personal opinion only. >> >> 1. I prefer to use the term "parkinsonism" to avoid needless petty >> argument as to whether or not a particular group of symptoms is "true >> IPD" (idiopathic Parkinson's Disease). If it looks like a duck, walks >> like a duck and quacks like a duck, it probably is a duck, though not >> necessarily an Anas platyrhynchos. Strange when you think about it, since >> "idiopathic" means "arising from an unknown cause". However, PD is >> quicker, so lets stick to that./ >> > > > *Comment: The reason that physicians use the term Idiopathic PD is to >> differentiate it from other causes of parkinsonism. There are several >> parkinsons-like diseases which start out looking like IPD. Most of these >> have a much worse prognosis than PD. Also PD symptoms can be caused by >> certain medications which can be reversed by by stopping the meds. For the >> physician it is important to differentiate between these causes of PD in >> order to properly inform the patient as well as to develop an effective >> treatment plan. * >> > > * >> */2. If you look up the drugs used to treat PD and/or its side-effects, >> you will find they many of them are "psychotropic" (affecting the mind or >> mood or other mental processes). For example selegeline metabolises in >> the body to meth-amphetamine, hard to explain if you get pulled over for >> a traffic bust!/* >> * >> > > *Comment: Psychotropic meds are used in treatment of depressed or > otherwise psychiatrically affected PD patients. Selegiline is an MAOI > which is used primaily in treatment of PD and generally is not used in > psychiatry > * > >> >> > > /3. One of the most often quoted side-effects is "depression" > (chemically induced in this case, although it often rides on top of > depression arising out of the circumstances of the PWP and family). > / > > > *Comment: This is very true and important to recognize to minimize the > symptoms and the impairment in general functioning this condition causes!! > BTW. The depreesion not a side effect of the medication but is from the PD > itself. > > * > >> /* * >> / >> >> /4. Most PWPs have the so called Parkinson's "facies" (a facial >> appearance / >> /typical of a particular disorder). A psychologist or psychiatrist >> might say / >> /they have a "flat aspect", often attributing it to depression, >> whereas it is / >> /brought about by lack of muscle tone as a direct consequence of PD./ >> >> >> > *Comment: The parkinsons facies and flat affect often mimics depression > ans it becomes difficult to tell them apart even for the experienced > clinician. .* > > /5. Most PWPs have, at one time or another (often on and off throughout >> the day), "anarthria", a partial or total loss of articulate speech, >> directly arising from loss of muscle tone in the organs of speech. >> Paradoxically, the PWP often thinks they are speaking in a reasonable >> tone and volume./ >> >> > > C*omment: I believe that dysarthria - difficulty in articulation that is > due to the dysfunction of the muscles which are used to form words and > dysphonia occur widely in PD- including me- and create a significant > handicap. Lee Silverman Voice training can minimize yhese symptoms- > especially the dysphonia (or aphonia) which are related to the vocal > chords themselves. Also a symptom I have which is troublesome is word > finding difficulty and loss of fluof ency of .* > >> >> 6/. The above two symptomspeechs can give rise to a feeling that >> the PWP is / >> /"disinterested" or "uncaring" about family or personal matters, >> whereas they / >> /themselves may think they are acting perfectly normally. Children >> especially / >> /are prone to believe that "Gran doesn't love us anymore."/ >> >> >> > (*Comment: I agree but also can be signs of loss of executive function > (Explanation to follo*w). > > /7. Again checking the manufacturer's own data, a combination of >> symptoms from medication may give the appearance of dementia, or even >> Alzheimer's Disease. If this is suspected, a doctor may recommend a "drug >> holiday" where, under strict professional supervision, the PWP is taken >> off all medication, and they are re-instituted one at a time in small >> increasing doses. This is known as drug "titration". This process can be >> very dangerous if mishandled, and should only be undertaken by a doctor >> skilled in the process./ >> >> > > *Comment: Alzheimer's Disease is an irreversible (to date) dementing > illness where the patient suffers significant loss of brain cells. while > delirium is an acute problem and may mimic Alzheimers . Toxic delerium > can be secondary to either one or a combination of prescription - > including PD-(or non-prescription) drugs. It can for instance occur post > surgery from presumed metabolic causes. This has happened to several > friends one with PD and one without. . The PD patient was given > antipsychotic meds and had her PD meds adjusted while the other had his > pneumonia treated. Both resolved completely after several days of bizarre > behavior requiring restraints. > * > *I agree with the necessity of having a skilled person- who knows PD and > psychiatry both- involved with titration of PD meds* > > /8. The difference between dementia or Alzheimer's from natural causes, >> and that chemical induced, is that the former is irreversible, where, >> with care and skill, the later usually disappears when the causative >> agent is removed/. >> >> > > Comment: See above > >> >> /9. Common or garden variety constipation can be very detrimental >> in PD, / >> /rendering some medication partially or totally ineffective. For >> example / >> /l-dopa, the principal ingredient of dopamine-replacement >> medication, has a / >> /half-life of 30-45 mins. It is induced into the blood stream by >> absorbtion / >> /from the small intestine, so any delay amounting to more than >> about 22 mins / >> /between swallowing and absorption may render that dose useless. >> Without / >> /going into too much detail, PD affects "motility" (movement of >> food through / >> /the digestive system), the muscle tone of the rectum walls, the >> anorectal / >> /flap, and the anal sphincter. If constipation persists, the PWP >> can become / >> /seriously un/dermedicated. >> >> >> > *Comment: It can be dangerous as well as uncomfotable. It can cause rupture > of the gut if it goes untreated. I take Miralax which seems to be > effective.* > > /10. PWPs seem loath to drink sufficient fluids during the day. Chronic >> dehydration can have deleterious effects on the chemical processes within >> the brain. >> / >> >> > > *comment: Agreed* > > /11. PWPs can descend into a mental "fugue", a dream-like state of >> altered consciousness that may last for hours or even days unless the PWP >> is forced out of it. This might involve definite eye-contact and physical >> intervention. >> >> / >> > /C*omment. This often occurs with "freezing" or going "off" and > can usually be resolved with levo-dop*/*a or an agonist, I am not > familliar though with the type that you mention. > * > > *12. Dopamine, the substance in short supply in PD, is a member of *the >> "catecholamine" chain of neuro-transmitters which contains, among others, >> adrenaline, of which dopamine is a precursor, so any excessive stress can >> severly deplete the supply of dopamine. The details of these processes >> are too complex to go into here. >> >> > > *Comment: Agreed* > >> >> /So, all in all, the business of balancing the salutary effects of >> medication >> against the deleterious side-effects, coupled with the symptoms of >> the >> disease, is no easy process, and it is useful to have some >> knowledge of the >> complexities, whether medical practicioner or carer./ >> >> >> > *Comment: Agreed and I certainly believe that it is necessary to have a > Movement Disorders Specialisst with whom you are comfortable to treat your > PD . > > Also the type of mental deterioration that is common in those of us who > have been diagnosed the longest is loss of executive function specifically > deficits in planning and inhibitory control . Working memory deficits are > often noted. This accounts for my difficulty with flow of speech. . > Longterm memory unlike in Alzheimer's Dementia, remains relatively intact . > > > Jim , Thanks for your sharing your personal experience and research . . > * > > * > Chsrles T. Meye MD > Middleton WI* > > ---------------------------------------------------------------------- > To sign-off Parkinsn send a message to: mailto: > [log in to unmask] > In the body of the message put: signoff parkinsn > ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn