Thursday, May 31, 2007

Nutrients,exercises, antioxidants and medication 2

: Wed May 30, 2007 9:53 am Post subject: Nutrients, Exercises, Antioxidants and medication 2

Dear Doctor,

Thank you for your excellent reply.

However I still believe when you exercise more you need more nutrients to protect yourself from oxidative stress whether you are athletics or not.

Because of increasing energy production in the cell (from some medicine, exercise or stress, etc ) will increase free radicals production as well, this is the natural biological process in the body.

But regular exercising will increase endogenous antioxidant enzyme that enhance antioxidant mechanism in the overall. The aging process, antioxidant level and oxidative stress are dynamic process which we have to monitor every 6 months or every year at least i.e blood test on your nutrient level.

I understand most PD patients have deficiencies or decreasing of antioxidants, frolic acid and Vitamin B 12 or 6 and these deficiencies occur in old adult too. To improve your nutrient level in natural and safe way mean you have more fruits, vegetables and fish ( source of Co enzyme Q 10.)

Kindly advise.

Best regards

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Kathrynne Holden, MS,
Posted: Wed May 30, 2007 10:05 am

Dear Teo,

Yes, it’s very true that exercise, medications, and in fact even metabolizing the food we eat, results in the production of free radicals.

However, a healthy human body is very well adapted to combat these free radicals by producing its own metabolic pathways and enzymes to quench the free radicals.

The key, first and foremost, is a high-quality diet that supports the production of such enzymes – as you say, fruits, vegetables, and fish are excellent.

Having said that, however, this can change with age, disease conditions such as PD, and many types of medications. That is why CoQ10 and creatine are being studied, to see if they can help alleviate PD.

It’s also good to remember that long-time use of levodopa can result in higher levels of homocysteine in the blood, and if this happens, supplements of B vitamins are needed.

Best regards, Kathrynne Holden, MS, RD
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Tuesday, May 29, 2007

Hormone replacement THerapy and PD

Posted: Sun May 27, 2007 4:52 pm Post subject:Hormone Replacement Therapy

Dear Doctor, I have read that Hormone Replacement Therapy may have protective effects vis a vis PD. I do realize HRT carries risks but risks aside have you seen evidence that it is protective against this disease or that it can *possibly* slow the progress of the disease? Thanks so much!
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Dr. FernandezJoined: 20 Jan 2007Posts: 90
Posted: Sun May 27, 2007 9:03 pm Post subject:

We have looked at the effects of both estrogen and testosterone in PD.

I must admit that I think the evidence for both is weak.

There are several studies (including one that I wrote) showing that patients on estrogen may have had a slower motor and cognitive decline.

But these are all epidemiological studies, not prospective clinical trials on estrogen. And the results of the studies have not been uniform.

On the other hand, Dr. Okun has reported the beneficial effects of testosterone but this are small and open-label studies. When he did the double-masked, placebo-controlled trial, this benefit was not different from placebo.

Thus, in my opinion, we have no solid proof, one way or another that estrogen or testosterone treats PD symptoms and that its side effects need to be seriously considered before starting either drug.

Hubert H. Fernandez
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Monday, May 28, 2007

Parkinson's fitness delays the disease

News: Parkinson's Fitness Plan Delays The Disease

Kathrynne Holden, MS, RD
Posted: Mon May 28, 2007 8:24 am

Dear Friends, the following may be of interest

Parkinson's Patients are discovering first-hand that daily exercise has a positive effect on the course of Parkinson's Disease, minimizing symptoms and delaying the effects of the disease. David Zid, an ACE, APG certified trainer, has collaborated with orthopedic surgeon Thomas H. Mallory, M.D., who is afflicted with Parkinson's Disease, in the development of a Parkinson's-specific fitness program designed to proactively minimize tremors and improve flexibility, stability, balance and strength. The noticeable physical and mental improvement of program participants led Zid to share the fitness agenda in his newly released book, Delay the Disease - Exercise and Parkinson's Disease (70 pp, $19.95) Emerging scientific evidence confirms that exercise lessens neurological deterioration that contributes to Parkinson's progression. Exercise, combined with appropriate medication, has an overwhelmingly positive effect on the course of this disease. As Assistant Professor of Neurology and Director of the Movement Disorder Division of The Ohio State University Medical Center, Karen Thomas, D.O. specializes in the treatment of Parkinson's Disease. "The development of this exercise program has been invaluable to my patients. I stress the multi-factorial approach to Parkinson's Disease and emphasize that staying active and exercising daily absolutely must go hand-in-hand with medicine treatment. This program allows a guided approach that focuses on the specific exercise needs of persons with Parkinson's Disease," states Dr. Thomas. Parkinson's patients participating in Zid's fitness program notice improvement in walking, dressing and maintaining balance. According to a program participant, "This exercise program gives me the feeling that I am taking control of my illness. My arm swing is returning and my walking speed has increased. I no longer shuffle. I can sit and stand with ease. I am more independent. But most importantly, my mental outlook is better." Author Zid states "My biggest joy is when a participant in my Parkinson's exercise program approaches me to say 'Thank you, David; I thought today was a bad day, but now that I have exercised, I am so much better.'" Zid wants more people to experience that improvement. His advice to readers: "Keep moving. Stay positive." The user-friendly book outlines a daily and weekly exercise agenda for every patient at any stage of the disease and clearly labels level of difficulty options. Exercises are divided into categories (wake up call, walking and balance, cardiovascular, strength, facial and vocal, night-time stretching); and movements are clearly demonstrated in full-color photographs. A companion DVD is available. Parkinson's Disease remains a mystery of medical science. For reason's unknown, certain brain cells stop producing a substance called Dopamine, which affects an individual's movement, strength and balance. There is currently no cure, though stem cell research offers future promise. A portion of the proceeds from the sale of Delay the Disease will be used to support the research, development and treatment of Parkinson's Disease. The book is available for purchase at select bookstores and online at Author David Zid, a graduate of The Ohio State University, has been a professional fitness instructor and certified trainer in Columbus, Ohio since 1997. He is owner and president of Columbus Health Works, a personal training company. David developed a special interest in training older adults, and finds inspiration in his clients with Parkinson's Disease.
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Nutrients and Exercises

Sun May 27, 2007 5:06 am Post subject: Q: Nutrients and exercises

Dear Doctor,

Is it related that the nutrients be added if you do more execises as it might affect the level of antioxidants in the blood? Jumex has long been neuron-protective property.

However, it also increases cellular energy production that has had bad potential effects.

The enhanced cellular function increases free radicals and aggravate stress.

It may be necessary to periodically re-adjust the nutrients.

Is Jumex related with the nutrients?

Kindly advise.


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Kathrynne Holden, MS, RD
Posted: Mon May 28, 2007 7:54 am

Dear Teo,

In the case of exercises, generally only athletes need to be concerned about additional nutrients.
Humans evolved to hunt, run, gather food, and otherwise engage in physical labor, and meet their nutrient needs with their normal daily diet.

Athletes, however, have a much higher activity level than normal, and may need extra nutrients.

Water is an exception. This most vital of all nutrients is easily lost by all humans and needs to be constantly replenished.

In the case of people with PD, there is an additional factor.

PD is stressful and stress produces free radicals, and thus cellular damage.

While there is no evidence that dietary nutrients can have an effect upon the area of the brain affected by PD, diet most certainly affects the health otherwise.

Here, the first line of defense is a nourishing diet.

Foods contain an array and balance of phytochemicals, flavonoids, vitamins and minerals that cannot be duplicated in pills and other supplements. Vegetables, fruits, nuts and seeds, whole grains, cooked legumes, and fish should be the backbone and mainstay of the daily diet.

A multivitamin supplement is a good addition, but does not take the place of foods.

An annual physical examination with lab tests will determine whether there is a need for other supplements, and this certainly can be the case as we age – vitamin B12, for example, is less well absorbed.

Jumex (selegeline) and in fact all PD medications can have undesirable side effects that increase various kinds of stress, and here again, a wholesome diet, plus exercise, is the best way to combat these effects.

You are doing exactly the right things in following a good exercise program and eating healthful food.

Best regards, Kathrynne Holden, MS, RD
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Nutrients, exercises, antioxidants and Jumex medication

Sun May 27, 2007 7:26 pm Post subject: Q: Nutrients, Exercises, Antioxidants and Jumex medication

Dear Doctor,

I wish to add the following in my earlier email to you.

The nutrients level with you depend on 3 factors:

1. The amounts of nutrient that you are taking from food and supplements.

2. Ability of intestinal absorption.

3.The body utilization that depend on your physical activity. If you do exercise more, you will need more nutrients that might affect the level of antioxidants.

Jumex is a long term neuron-protective property.

However Jumex increase cellular energy increase free radicals and aggravate oxidative stress.

It may be necessary to periodically re-adjust the supplements. Kindly elaborate briefly the above.


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Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location:
Posted: Mon May 28, 2007 7:55 am Post subject:

Very good points, Teo.

Please see my last message for an elaboration._________________

Best regards, Kathrynne Holden, MS, RD --

Sunday, May 27, 2007

Message by Mr. Boon Kok Ching

Dear Mr. Teo,

Congratulate you for the success in conquering Parkinson disease by Yoga exercise. However, if you did master Chinese Qi Kong or Buddhist Jhana, before the age of 50, you could have avoided this disease, which is not terminal.

Yours sincerely,
Boon Kok Ching.

Saturday, May 26, 2007

Yoga (chinese version





瑜伽教练难速成 急于求成造成伤害


Friday, May 25, 2007

What are the role of caregivers?

What are the roles of caregivers?

The are many roles of caregivers in the management of PD. The most important roles are as follow ;

a) To provide the assistance needed for patients to carry out their daily activities

Patients often have difficulties in carrying out their daily activities such as bathing, eating meals, walking, dressing up, etc. I remember a PD patient who has a wife who suffered from Alzheimer’s disease. Despite having the ability to walk round the house and even driving car, she had a severe memory loss that affected her own daily activities. Whenever she had to go shopping, her husband always had to follow her on a wheelchair so that she would not get lost at the shopping center. Thus, both husband and wife seemed to complement each other. One had difficulty walking while the other had difficulty remembering whatever she did. Despite this, his wife managed to help out in his daily activities. This case illustrated that even a sick housewife can play an important role as the caregiver of a PD patient.

b) To provide the moral support

It has been reported that 20-40% of PD patients are depressed. I personally believe that the actual percentage is much higher than this figure, because depression is often unrecognized. Depression is the most common psychiatric disorder in PD. In addition to medications (antidepressant), the moral support of caregivers is useful in alleviating depression.

I know an elderly patient who became depressed when her husband passed away. To make the situation worse, her children sent her to an old folk’s home. She lost hope of life and became bed-ridden. This illustrates the importance of having a supportive and loving family in the management of PD.

c) To supervise patients’ medications

Caregivers can be very helpful in certain situations - patients cannot reach out to their medications due to difficulty walking, patients have too many different drugs that they forget which and when to take. Caregivers also can help to monitor the medication of patients – some patients who have great difficulty walking may “overmedicate” themselves, leading to side effects such as hallucination and confusion.

d) To help patients in the “rehabilitation” process

Rehabilitation is a process whereby doctors and other health personnel help patients to recover their physical, mental, social and occupational function. It is a very slow process that can only work if the patients have very supportive caregivers. In fact, the rehabilitation program will certainly be unsuccessful if the caregivers do not actively participate.

One example is the role of caregivers in the maintenance of physical mobility of patients. I remember a PD patient who had difficulty in walking due to slowness of leg movement. She also had a tendency to fall backwards whenever she tried to stand or walk. She had a very good maid who always stood behind her when she walked. What the maid did was remarkable – she “pushed” the patient’s leg forward each time the patient took a step forward. By standing behind the patient, the maid also prevented the patient from falling backward. As a result, the patient could walk round her house for daily evening walk. The patient would not have been able to do this without a good caregiver.

What if all the children are busy working and patient has no spouse?

It is advisable to hire a maid by contacting the relevant agency. If a maid is properly trained, she can carry out all the instructions given by the doctor. She can be taught to serve medications at the right time. She can also accompany the patient whenever there is any need to move round the house, such as morning walk. This can boost the confidence of patients so that they can move around without fear of falling down. In fact, I have encountered some maids who have done an excellent job in taking care of PD patients.

What about sending patients to nursing or old folk’s home? I personally do not agree with this idea, except in certain situations that are mentioned in the following section. Patients always love to stay at home with their children. Moreover, hiring a maid only costs about $600-700.00 per month while sending patients to nursing or old folk’s home usually costs about $1300-1500.00 per month.

How can caregivers cope with their stress?

Caregivers are actually ”patients” because they are subjected to physical and mental stress. Whenever I see my PD patients during the follow-up, I also try to probe whether the caregivers are “worn out”. When I discover any caregiver who has difficulty coping with PD patients, I suggest the following ways to overcome the problem :

a) Allocate some time for entertainment and sports program

Caregivers should spent a few hours per week on any recreational and sports activities so that they can relax. This can help in reducing stress and anxiety.

b) Taking a “break”

Caregivers should give themselves a period of complete rest so that they can recover from the physical and mental stress of taking care of patients. There are many ways to get a “break”. If the patient has several children, he / she can stay with each child on a “rotation” basis. If there is nobody else to take care of patients, one can send the patient to nursing or old folk’s home. This is known as the “respite” care. This is morally not wrong as it is only a temporary measure that allows the caregiver to have adequate rest. There is no point taking care of the patient when the caregiver is already very tired or stressed up.

Sometimes, I do admit the patient to hospital for this purpose, especially when the patient is a government servant (thus exempted from paying the hospital fees). However, there is a limitation because there is usually shortage of beds in the hospital.

c) Support group

Currently, there is no official support group for PD caregivers in Malaysia. However, the Malaysian PD Association does play an indirect role in providing support for caregivers. The monthly meeting of MPDA enables caregivers to come together and share their experiences in taking care of PD patients.

In conclusion, caregivers play a pivotal role in the management of PD. As PD is a long term illness, the physical and mental stress experienced by caregivers deserve attention.

Thursday, May 24, 2007

Daily exercise 30 mins

HI !




i need to know what to tell the trainer to educate me in the use of (MACHINE WISE)
thanks a bunch !


Joined: 22 Jan 2


Dear JM,

A combination of stretching, weightlifting, and cardiovascular exercises is ideal.

Exactly which and how much will depend upon your own abilities, and for this I would ask your doctor to refer you to a qualified physical therapist.

The PT can assess your strength and abilities and help you design the best possible program for your individual needs.
Best regards,
Kathrynne Holden, MS, R

Monday, May 21, 2007

Parkinson's disease introduction


靜止時顫抖(resting tremor) 





姿勢保持反射障礙(postural instability)











米高˙福克斯(Michael J. Fox,好萊塢影星)

Sunday, May 20, 2007

Parkinson Surgeries



马来西亚帕金森症协会(Malaysian Parkinson's Disease Association)现任会长赵汝光医生(Dr Chew Nee Kong)举出目前3种帕金森症开脑外科手术:


(2)割除某一个脑部器官 (Lesioning Procedures)

(3)深切脑部刺激手术(Deep Brain Stimulation)
脑神经外科亨德逊医生(Dr. Jaimie Hen-derson)在受访时说:“做深切脑部刺激疗法,能控制帕金森病情的恶化,给病人带来希望,促进病人发挥他的脑部潜能。”






Saturday, May 19, 2007

Parkinson's disease introduction (chinese version)


Stalevo治柏金森氏症 推薦給朋友 列印
updated:2007-05-02 21:42:37



(吉隆坡訊)柏金森氏症(Parkinson’s Disease,PD)是一種慢性腦部退化性疾病,主要是腦內的多巴胺(dopamine)不足,引起行動障礙問題。傳統藥物左旋多巴(levodopa)能刺激多巴胺神經,以製造更多的多巴胺來控制病情。目前,一種綜合左旋多巴及體內兩種抑制劑的新藥物Stalevo,證實能增加腦內的多巴胺,延長左旋多巴在腦內的滯留時間,發揮達6個小時的藥效,并抑制乙醯膽素的分泌。一如傳統藥物,過量服用此藥會引起妄想症及暴躁等副作用。






















很多人會把柏金森氏症及阿茲默海氏症(Alzheimer’s Disease)混為一談,把它們歸納為同等類的老人痴呆症。馬來西亞柏金森氏症協會主席劉麗香解釋,柏金森氏症病患會比較聰明,但是動作遲緩,阿茲默海氏症病患則剛好相反。






多巴胺是一種腦內分泌物質, 可影響一個人的情緒。科學家卡爾森( Arvid Carlsson)因為發現多巴胺在腦內扮演信息傳遞者的角色,而在2000年獲得諾貝爾醫學獎。多巴胺主要負責大腦的情慾及感覺,能傳遞興奮及開心的信息。大家常說,戀愛能讓人快樂,它的秘訣在於能激發大腦產生大量的多巴胺。此外,吸煙和吸毒都可以增加多巴胺的分泌,使上癮者感到開心及興奮。


科學家證實,通過恢復腦內多巴胺的水平,有助於控制柏金森氏症。 (光明日報‧2007.05.02)

Friday, May 18, 2007

Parkinsion's and Alzheimer's disease (Chinese version)










老 年 痴 呆 症

老 年 痴 呆 症 是 一 種 腦 細 胞 退 化 疾 病 , 有 別 於 正 常 的 衰 老 過 程 , 患 者 的 腦 功 能 會 逐 漸 衰 退 , 而 變 得 日 益 健 忘 , 智 力 退 化 , 性 格 也 會 有 所 改 變 。

老 年 痴 呆 症 的 成 因

導 致 老 年 痴 呆 症 的 原 因 很 多 , 但 主 要 可 分 為 三 大 類 :

阿 爾 茲 海 默 氏 痴 呆 症 是 最 普 遍 的 類 別 , 此 退 化 性 疾 病 的 原 因 未 明 , 現 時 並 未 有 有 效 的 治 療 方 法 可 以 阻 止 患 者 的 衰 退 , 而 患 者 的 衰 退 程 度 是 漸 進 式 , 所 以 早 期 患 者 較 難 被 察 覺 。

多 發 梗 塞 痴 呆 症 是 因 一 連 串 的 腦 中 風 而 引 起 , 通 常 是 由 於 多 條 幼 細 血 管 損 壞 , 令 腦 部 血 液 供 應 不 足 , 引 致 腦 功 能 下 降 , 患 者 衰 退 的 速 度 是 梯 級 式 的 。

其 他 導 致 老 年 痴 呆 症 的 成 因 包 括 情 緒 抑 鬱 、 營 養 不 良 、 甲 狀 腺 分 泌 失 調 、 藥 物 中 毒 、 酗 酒 等 , 此 類 痴 呆 症 是 可 以 透 過 藥 物 幫 助 減 輕 其 病 情 和 可 以 痊 癒 的 。
老 年 痴 呆 症 的 病 徵

早 期 病 徵

患 者 會 喪 失 近 期 記 憶 , 當 病 情 惡 化 時 , 一 些 較 遠 期 的 記 憶 亦 會 喪 失 。

思 考 、 計 算 及 接 受 新 事 物 會 出 現 困 難 。

對 時 間 及 方 向 感 覺 混 亂 , 不 清 楚 今 天 是 何 年 、 何 月 、 何 日 及 何 地 。

日 常  居 生 活 技 能 受 到 影 響 。

判 斷 力 減 低 。

性 格 改 變 。

缺 乏 主 動 性 。

中 期 階 段

失 去 認 知 能 力 , 如 學 習 、 判 斷 及 思 考 能 力 。

情 緒 不 穩 定 , 容 易 生 氣 及 激 動 。

日 常 起 居 生 活 需 要 家 人 協 助 。

日 夜 顛 倒 , 影 響 家 人 睡 眠 時 間 。

後 期 階 段

完 全 失 去 認 知 能 力 。

完 全 喪 失 自 我 照 顧 能 力 , 如 吃 飯 、 洗 澡 。

忽 視 個 人  生 甚 至 大 小 便 失 禁 。

日 漸 消 瘦 , 走 路 不 穩 或 甚 至  床 不 起 。
治 療 方 法

阿 爾 茲 海 默 氏 痴 呆 症 及 多 發 梗 塞 痴 呆 症 都 是 退 化 的 病 症 , 暫 時 未 有 根 治 方 法 , 但 最 好 能 及 早 察 覺 病 徵 , 並 請 教 醫 生 作 出 深 入 診 斷 及 評 估 。 現 時 有 一 些 新 藥 物 是 可 以 對 阿 爾 茲 海 默 氏 痴 呆 症 患 者 有 減 慢 退 化 的 療 效 。 若 果 患 的 是 不 能 痊 癒 的 痴 呆 症 , 家 人 亦 可 以 及 早 學 習 照 顧 患 者 的 技 巧 及 尋 求 適 當 的 協 助 。

給 患 者 家 屬 的 建 議

當 你 懷 疑 家 人 患 上 老 年 痴 呆 症 時 , 你 應 立 即 :

請 醫 生 作 徹 底 診 斷 。

參 加 老 年 痴 呆 症 家 屬 小 組 , 彼 此 分 享 經 驗 , 減 低 因 照 顧 患 者 而 帶 來 的 焦 慮 與 壓 力 。

善 用 社 會 服 務 資 源 , 如 老 人 日 間 護 理 中 心 , 老 人 暫 託 服 務 等 。

向 親 友 及 鄰 居 解 釋 患 者 所 患 的 疾 病 , 增 加 他 們 的 了 解 , 接 納 及 支 持 。

留 意 家 居 環 境 避 免 發 生 意 外 。

為 患 者 安 排 一 個 固 定 的 起 居 作 息 時 間 表 , 減 輕 患 者 的 混 亂 感 覺 。

為 患 者 配 帶 刻 有 姓 名 及 電 話 的 手 鐲 及 在 家 中 備 有 患 者 近 照 , 若 患 者 迷 路 , 家 人 也 易 於 尋 找 。
預 防

阿 爾 茲 海 默 氏 痴 呆 症 到 現 時 為 止 並 未 有 預 防 方 法 , 但 多 發 梗 塞 痴 呆 症 的 病 源 是 由 於 血 管 疾 病 所 引 起 的 , 所 以 培 養 良 好 的 生 活 習 慣 , 如 不 吸 煙 、 不 酗 酒 、 注 重 均 衡 飲 食 、 經 常 運 動 、 保 持 心 境 開 朗 、 控 制 高 血 壓 及 糖 尿 病 等 , 均 可 減 低 患 血 管 疾 病 , 從 而 減 低 老 年 痴 呆 症 病 發 的 機 會 。


Monday, May 14, 2007

Medication and exercises

Fri Mar 23, 2007 6:24 pm Post subject: medications and exercises


I was diagnosed as PD in the year of Sept 2005 and taking Sinemet 25/100 one tablet at morning, afternoon and evening and one Jumet 5 mg at morning and afternoon only.

I did very well in my gym classes at gym centre 2 -3 hours per day from Mon to Friday as I did not feel tired and exhausted. I took part body pump, combat, cardio, spinning, Yoga and Pilate when there were available in the gym.

After 2 years in the gym exercises i.e 2005 to 2006 I started tired and exhausted at the beginning of the year 2007 after my first hour of gym exercise.

Is it my PD movement disorders help me to continue the exercises for 2 to 3 hours that I do not feel tired and exhausted?

Is it am I able to overcome/improve of my movement disorders during the gym that I feel tired and exhausted i.e muscles are more flexibility, mobility and strength after 2 years of medication?

Is it my medication wearing off and requires more doses or alternative?

Is it my exercise cell help me to be able to spend 2 - 3 hours in the gym without feeling tired and exhausted during my first two years Pd's life?

Teo Kim Hoe

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Dr. Okun

Joined: 19 Jan 2007
Posts: 251
Location: University of Florida
Posted: Sat Mar 24, 2007 6:23 pm Post subject:


Exercise is currently under investigation for putative neuroprotective effects in PD. We have always felt exercise is like a dug and stretching is very important. Exercise leads to changes in the chemicals in the PD brain that may be important symptomatically.

Why have you had a decline? It is unclear, but I would suggest having your medications optimized. It may be a combination of problems including medications and PD progression. Exercise may have helped you from the very start of your disease and I would keep it up.
Michael S. Okun, M.D.

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Posted: Mon Mar 26, 2007 7:59 pm Post subject: medication and exercises


I don't understand in your email why exercises had a decline i.e changes in the chemicals in the PD brain that may be important symptomatically? Would you kindly elaborate?

Is that my exercise for a long times wearing off the effectiveness of Sinemet as exercise helps me from the very start of my disease? Any remedial to slowdown the PD besides exercises and medicines as exercise is still investigation of the effectiveness for putative neuroprotective effects in PD?

Teo Kim Hoe

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Posted: Tue Mar 27, 2007 2:28 am Post subject: medication and exercises 4


After I have consulted with my doctor I increased one dose extra of Sinemet 25/100 before my bed time i.e. 4 doses of Sinemet per day: one in the morning, one in the afternoon, one in the evening and one before bed times i.e 4 hours in between.

I feel much better and look more fresh i.e no hackles,no mask face, looking tired and exhausted after the exercises. I walk firmly and confidence.

I agree it is the time for me to increase the intake of Sinemet. I still do not understand why the exercise leads to changes in the chemicals in the PD brain is so fast i.e 1 1/2 years only?

Exercise and medication may have helped me for the very start of my disease but why it is wearing off 1 1/2 years and the Sinemet be increased? Why it had a decline? Is it I spend 2-3 hours on exercises daily and dried up the chemical in the PD brain? Would you tell me what are the possibilities lead to above changes? Would you tell me what are the combination of problems i.e PD progression and medication? Is it exercise?

Teo Kim Hoe

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Dr. Okun

Joined: 19 Jan 2007
Posts: 251
Location: University of Florida
Posted: Tue Mar 27, 2007 6:38 am Post subject:


We do not honestly know the specific answers to your questions.

PD is a progressive neurodegenerative disease. Presumably up regulation of some chemicals early in the course when more cells are preserved would likely have more benefit. I do not honestly think exercise can stave off PD, but there is a notion it can positively influence the course. I would therefore adjust medications and continue daily exercising if you can.
Michael S. Okun, M.D.

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Posted: Tue Mar 27, 2007 8:47 am Post subject: medications and exercises


Thank you for your explanation of the PD as there is no treatment of the disease but there is a way to slowdown progression i.e medication and exercises. The doctor has to monitor, adjust and optimize the effectiveness of medications.

Teo Kim Hoe

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Posted: Tue Mar 27, 2007 7:45 pm Post subject:


PD is a progressive neurodegenerative disease.

It is also a chronic disease, possibility an aging disease.

There are possibilities to slowdown the progression i.e exercises and medications. Medications have to be monitored and optimized for its effectiveness to slowdown the progression from time to time by doctor.

Stretching is important and helpful for your body i.e flexibility, mobility and strength.

Teo Kim Hoe

Sunday, May 13, 2007

Nutrition and PD

Q: Nutrition and PD

Posted: Sun Apr 08, 2007 4:56 am Post subject: Nutrition and PD -----------------------------------------------------------------

How to balance/compromise between the Nutrition and PD treatment as it can cause a Patient developing weight loss and under-nutrition?

How to optimize/manage nutrition with PD patient?

What are the sideeffect the PD medication on patients that PD are at increased risk for malnutrition?

PD is a complicated disease, that affect each person differently,but there are needs for nutrition to sustain the body and stay healthy. Kindly advise.


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Joined: 22 Jan 2007
Posts: 94
Posted: Mon Apr 09, 2007 11:51 am Post subject:


Dear Teo,
These are very good questions, because many people with PD become malnourished. Here are some of the possible causes –

- nausea
- loss of the senses of smell and taste
- loss of appetite
-- sometimes due to medications
-- sometimes due to depression
- loss of manual dexterity
- eating very slowly, unable to finish meals; often because chewing and swallowing becomes tiring
- fear of choking
- difficulty swallowing

To optimize nutrition, it’s first important to determine whether any of the above conditions occur. If so, then the approach must depend upon managing that condition. For instance, if depression is the cause, then the first approach will be to manage the depression. If due to inability to manage eating utensils, then the first approach will be to locate plates, cups, and utensils that are designed for those with limited dexterity; and to provide “finger foods” as often as possible. Thus, it is important to consult a dietitian, for personal help. The dietitian will assess the reason for the poor nutrition and design an eating plan that overcomes the limitations.

For extra calories, add nourishing between-meal snacks, of about 100-200 calories. These should be low in protein -- fresh fruit or juice; a fruit smoothie made with soy or rice milk, vegetables, rice cakes or bread with a little mayonnaise or a teaspoon of peanut butter, salads. Generally, it’s a good idea to begin slowly, adding only 200-400 calories a day and increasing gradually, so as not to stress the system.
Best regards,
Kathrynne Holden, MS, RD

Wednesday, May 9, 2007

Discussion Corner : Why me?

Posted: Mon May 07, 2007 6:01 am Post subject: "Why me ? "


Hi Doctors

I received my very unwelcome PD diagosis about 2 years ago aged 63. Dispite my best efforts and given that 99.97% of the world's population do not have PD, I still suffer badly from the "why me" effect.

I appreciate that there are no magic pills to take the feeling away but what do you tell your patients who find the diagosis hard to cope with ?

As always, many thanks for the time you devote to this forum.


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Dr. Okun

Joined: 19 Jan 2007
Posts: 251
Location: University of Florida
Posted: Mon May 07, 2007 10:03 am Post subject:


First I tell them to see and be seen by a specialist as PD has many medication and surgical options. With proper management your issues for longevity and quality of life may be related more to your general health than PD but this is difficult to predict. It is a good time to have PD with lots of research and lots of available trials to enroll in. A lot of people worldwide are getting PD and a lot more will get it as we become more successful at making people live forever (or at least longer).

Strong spirit, daily exercise/stretching, and dtermination to face each challenge as they come will result in success. Enjoy your life and choose a specialist to get you on the right regimen and to do your worrying for you so you can live your life.
Michael S. Okun, M.D.

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Posted: Tue May 08, 2007 6:20 am Post subject:


Dr. Okun,

Many thanks for your encouraging words which have placed things in perspective for me.

Grateful appreciation for this wonderful forum.


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Dr. Okun

Joined: 19 Jan 2007
Posts: 251
Location: University of Florida
Posted: Tue May 08, 2007 7:40 am Post subject:


Please feel free to keep writing as you have questions.
Michael S. Okun, M.D.

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Coffee beverage and PD (Chinese version)















Constipation and PD (Chinese version)

许昌日报 (2001-08-22)







Alzheimer's disease (Chinese Version)

當家裡的雙親或老人家出現健忘的現象時,我們通常會認為這只是年老的正常現象,並不是很大的問題,但我們卻忽略了老人家可能已患上老人失智症(老人痴呆症)。在老人本身和家人的疏忽之下,老人失智症未能及時就醫,導致原本的輕微症狀變得更為嚴重,從健忘變成反應遲鈍,最終產生行為上的問題,為家人帶來許多不便,這時,藥物已難以發揮控制病情的作用了。因此,為了協助公眾鑑定親人是否是老人失智症患者,馬大醫療中心提供一條專線,讓公眾通過電話咨詢。健忘是初期症狀老年精神病學專家艾斯特指出,老年失智症的症狀可以從行為和精神方面來看,而健忘是老年失智症的最初期症狀。她說,其實,每一位年長的人都會面對記憶力衰退的問題,這是很普通的現象,但是,如果這問題沒有加以處理,其可能會影響老年人的日常作業。她說,最普通的健忘例子是忘了鎖匙的位置,忘了錢收在哪裡,而可能會誣賴家人不問自取。有些老人更忘記回家的路,而發生迷路的事件。“這些都是很初期的症狀,但是這階段的病人,有95%的患者並沒有尋求治療。病情中等的患者則有75%沒有看醫生,以致大多數患者都是在病情嚴重時才正視他們面對的問題。”她表示,在沒有及時尋求治療之下,患者會出現反應能力減緩的問題,以致很多事情都做不好,例如煮菜時把食物調得太咸或太甜。有些老人的駕駛技術退步,造成危險。會有幻覺產生恐懼她說,到嚴重的地步時,患者會有行為上的問題。他們的疑心很重,時常懷疑人家偷他的東西,而且患者會有幻覺,例如他們會看到一些災難或禍害就要發生,而內心產生恐懼。“患者這時也會一直聽到有人在跟他說話,而會神經兮兮。這時候,患者的心裡嚴重缺乏安全感,因而極度依賴家人。他們會如影隨形地跟著家人,不敢獨身處在一個地方,若沒有獲得家人的諒解,此舉肯定會引來家人的反感。”她說,通常在這時候,患者的家人才發現病情的嚴重性,才把患者帶到醫院接受治療,卻已經太遲了。因為所有的藥物都是在症狀的初期才能夠發揮效果。馬大提供專線服務艾斯特披露,因此,為了加強公眾對老年失智症的醒覺,馬大醫療中心舉辦了一項計劃,稱為“預防及提早治療老年失智症”。她說,這是我國第一次舉辦的活動,該計劃提供一條專線,讓公眾通過電話,回答一些簡單的問題,電腦就會計算結果,讓公眾知道親人是否有患上老年失智症的可能。“公眾利用這專線時可選擇國文、英文或華文,在完成測驗後,該專線將提供全國6個記憶診所(Clinic Memory)的聯絡電話,讓公眾預約以進行血液檢驗、體檢、記憶測驗等,再接受治療。”針對治療,艾斯特指出,目前有3種藥物對抑制老年失智症的症狀有所幫助,但都是應該初期時接受治療,否則效果也不會很好。老年失智症病因逾百種艾斯特指出,造成老年失智症的成因有超過100種,最普遍的是“阿耳茨海默氏失智”(Alzheimer's dementia),共有60%患者是因為這個原因患上老年失智症。她說,另一個主要原因是中風,約有20至25%患者因為中風而患病。另外有少過10%的患者是因為柏金遜而患病的。“那些導致中風的主因,如中年高血壓、高膽固醇、糖尿病等,都會引發患上老年失智症的可能。”須維持良好生活習慣她說,因此,要預防老年失智症,維持良好的生活習慣是很重要的,如多做一些運動,並且定時進行體檢,以瞭解自己的健康狀況。“在老年失智症的患者當中,只有1至2人的病情能夠受到控制。”她表示,年齡的增長其實是患上老年失智症的因素,60或65歲以上的老人,患病的機會比較高,而55歲以上的老人有30至35%患病的機會。她說,而且,老年失智症的女性患者會比男性患者多,這並不是因為她們的腦部健康較差,而是因為女性的壽命比較長,所以看來比較多女性患上此症。老年失智症後果嚴重患上老年失智症的老人通常在2至20年後離開人間,因為如果沒有獲得治療,患者的健康狀況會很快地走下坡,且難以照料。艾斯特指出,特別是嚴重的病情,是須要家人的特別照料,因為病人連簡單的動作都做不到。她說,因此,為了避免產生不愉快的事件,在患病初期,患者應該趁自己的意識尚清晰時做好遺囑,讓自己屬意的人選繼承產業,否則會引發家庭糾紛。與樂齡人口增長有關艾斯特指出,老人失智症日益普遍,與樂齡人口的增長有密切關係。特別是在現代人少生孩子的情況下,我們的樂齡人口就越來越多。她說,目前我國年齡超過60歲的人口已有6.4%,平均每年增長0.1%,到了2020年,我國的樂齡人口將會更多。“到時,患上老年失智症的人會越來越多,我們必須有所準備來面對這問題。”她說,因此,我們應該鼓勵年輕夫婦多生育,以平衡樂齡、青年和小孩的人口。年輕人健忘非患失智症其實,年齡50歲以下的人士並不會患上老年失智症,他們通常是因為生活壓力而健忘,他們要做的東西太多,以致時間管理方面達不到效率。他們都有能力去解決這些問題,所以並不是患上失智症。艾斯特表示,那些年齡超過50歲的人若發現有健忘的現象,就要加以留意,並尋求治療。馬大醫療中心預防及提早治療老年失智症專線號碼:03-79535628 (星洲日報/醫藥寶庫‧報導:黃素芬‧2004/03/01)

Tuesday, May 8, 2007

Are there different type's of PD?

Are there different type's of PD ?

Discussion Corner Forum Index -> Ask The Doctor
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Posted: Sat Apr 21, 2007 7:22 am Post subject: Are there different type's of PD ?

Are there different type's of PD ? Are some worse then others ? Thank you !
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Sat Apr 21, 2007 1:26 pm Post subject:

Yes, we believe PD has many subtypes and some may even be genetic. We have identified many genes such as Parkin, LRRK2, DJ1, and PINK1. We also have noticed that PD with resting tremor may have a different prognosis (better) than PD without it. Finally there are several parkinsonian syndromes which seem to respond less well to PD medication (PSP, MSA, CBD, etc.)_________________Michael S. Okun, M.D.
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Posted: Sat Apr 21, 2007 2:14 pm Post subject: resting tremor

Waht does resting tremor mean ? Thank you .
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Sat Apr 21, 2007 4:04 pm Post subject:

A resting tremor is a tremor well, basically at rest (when not performing action). It is the most common tremor associated with PD. There are other types of tremors when one holds a posture or performs an action._________________Michael S. Okun, M.D.
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Posted: Sat Apr 21, 2007 5:22 pm Post subject: Are they different type's of PD?

Dear Dr. Okun, In view to your article as above I am quite interested to find out from you what are the type's of PD associated with Genetic? My family have three PD patients and am sure they are all interested to find out from you i.e. many genes such as Parkin, LRRK2, DJ1, and PINK1. As they are in medical terms and difficulties for us to understand and be pleased that you give brief. What are the types of PD are not well responded with the PD medication? Lord bless Thanks TEO KIM HOE
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Posted: Sun Apr 22, 2007 10:00 am Post subject: tremors

Thank you .
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Sun Apr 22, 2007 4:45 pm Post subject:

Dear Teo, I rarely say this, but you are asking lots and lots of general questions and I would really like to be sure you are not diverting attention from others who have important questions to ask about themselves and about others. You will find an update on genetics I placed with a recent abstract. Thanks for your enthusiasm._________________Michael S. Okun, M.D.
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Q:Exercise and Movement

Q: Exercise and Movement

Exercises for PD patients are important, though it is not the treatment. It leads the patients stay healthy, keeping muscle strong,flexibility and maintaining balance and movement mobility. Regular exercises keep the body weight,pumping your heart and a good sleep. It is good to relieve your tremor,muscles stiffness because of PD disease and upright your stoop posture. Teo Kim Hoe

Q: Lifestyle of PD and the family

Posted: Tue Apr 10, 2007 3:10 am Post subject: Q: Lifestlye of PD and the family

As PD is not a going on disease the nature of PD disease and the rate of progression, varies differently from one to other. They have to learn how to overcome difficulties i.e. lifestyle that it takes longer or concentration to accomplish a task once considered automatic. There are emotional, psychological, financial, family relationsip and social life for them to learn how to cope up. "Why me" anxiety, fear, helplessness and loss of control if are not managable made worsen by PD disease.These are normal reactions amongst the PD patients. In this connection kindly advise how and what shall they have to manage and overcome the difficulties i.e. emotional, spiritually financially, family and relationships and social life? How and what the caregivers can help? Teo Kim Hoe
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Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location:
Posted: Wed Apr 11, 2007 5:13 pm Post subject:

Dear Teo,

You make excellent points. The role of the caregiver can be demanding, and in some instances, can even take a toll on his or her health. As I am not an expert in this area, however, I will refer you to two very valuable forums, especially for caregivers of people with PD. Your questions will receive answers from people who speak from experience. 1) Right here in the NPF Discussion Corner: Caregivers Forum A place where caregivers of people with Parkinson disease can converse and address their unique concerns. Posts in this forum are NOT anonymous. Caregivers Forum A place where caregivers of people with Parkinson disease can converse and address their unique concerns. Posts in this forum are NOT anonymous. 2) CARE CARE - for CareGivers of People with Parkinson's To read archives: To join: regards, Kathrynne Holden, MS, RD -- For a Parkinson Tip of the Day visit:

Some good news?

daevyd said...

Some good news?

Diary food linked with Parkinson's Disease in Men

Dairy food linked with Parkinson's disease in men By Amy Norton - Apr 20, 2007 Reuters

- A new study has confirmed a relationship between consuming large amounts of dairy products and an increase in the rate of Parkinson's disease in men, but the reason for this relationship remains a puzzle.

Researchers found that among more than 130,000 U.S. adults followed for 9 years, those who ate the largest amount of dairy foods had an increased risk of developing Parkinson's disease, a disorder in which movement-regulating cells in the brain die or become impaired.

There was a clear pattern seen among men, whose Parkinson's risk increased in tandem with consumption of diary, particularly milk. The results were more ambiguous among women, however.
The findings, which appear in the American Journal of Epidemiology, echo those of earlier studies that found a link between dairy consumption and Parkinson's in men, but not women.

For now, it's not clear what effect, if any, dairy foods might have on women's risk of the disease. Nor is it known why there is a relationship seen in men, lead study author Dr. Honglei Chen, a researcher at the National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, told Reuters Health.
Larger studies are needed to find out which dairy products might be responsible, and why, according to Chen.

The findings are based on detailed dietary and lifestyle information collected from 57,689 men and 73,175 women who took part in a cancer prevention study. Over 9 years, 250 men and 138 women were diagnosed with Parkinson's disease.

Men with the highest levels of dairy consumption were 60 percent more likely to develop the disease than those who consumed the least amounts of dairy, the study found. Men in the highest-intake group consumed an average of 815 grams of dairy per day, which is roughly equivalent to three to four glasses of milk; those in the lowest-intake group consumed 78 grams of dairy per day, on average.
Milk, rather than dairy products like yogurt and cheese, explained most of the association, according to Chen's team.

This study and previous ones indicate that calcium, vitamin D and fat are not responsible for the link between dairy foods and Parkinson's disease. One theory is that pesticides or other nerve-damaging toxins present in milk could contribute to Parkinson's disease over time. However, dairy foods would likely be only a small part of most people's exposure to these chemicals, according to Chen.

Furthermore, pesticide residues may also be present in other foods, but no other foods were related to Parkinson's disease risk in this study, the researcher noted.

For now, Chen said there is no reason to shun dairy because of the potential relationship to Parkinson's disease. "Given some of the potential health benefits of dairy foods, people can still enjoy their moderate amounts."

However, the researcher added, since the dairy-Parkinson's link has now been seen consistently in different studies, further research is needed to understand why.
SOURCE: American Journal of Epidemiology, May 1, 2007.

Forium: Do you agree/ not agree?

Do you agree / not agree ?

Discussion Corner Forum Index -> Open Forum
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teokimhoeJoined: 03 Mar 2007Posts: 9Location: Malaysia
Posted: Sat Apr 14, 2007 5:19 am Post subject: Do you agree / not agree ?

Do you agree some doctors kill or made worsen sick person?

The reasons are as follows:

Wrongly or inaccurately diagnosed the sick person?

Wrongly medicines prescription made worsen sick person? Richard
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Sunday, May 6, 2007

Alzheimer's disease: Exercise

Alzheimer's Disease: Exercise

Exercise is important for those with Alzheimer’s Disease.

Physical activity should be continued for as long as possible.

This will help prevent muscle weakness and health complications associated with inactivity.

Exercise also promotes a normal day-and-night routine and may help to improve mood. Repetitive exercises -- such as walking, indoor bicycling, and activities such as folding laundry -- may decrease anxiety in people with Alzheimer's disease because they don't have to make decisions about the activity or remember what to do next.

While exercise does not stop Alzheimer's disease from progressing, patients do receive the emotional satisfaction of feeling they have accomplished something.

You should check with your doctor before beginning any exercise program. Your doctor may make recommendations about:

The types of exercise best suited to you and those to avoid.

How hard you should be working out.

How long you should work out.

Referrals to other professionals, such as a physical therapist, who can help you create your own personal exercise program.

The type of exercise that works best for you depends on your symptoms, fitness level, and overall health. The final precaution, when you get the OK to begin exercising, is to go slowly.

Tips For Exercise

Always warm up before beginning your exercise routine, and cool down at the end.
If you plan to work out for 30 minutes, start with 10-minute sessions and work your way up.
Try water exercise, such as aqua aerobics. These exercises are often easier on the joints and require less balance.
Work out in a safe environment; avoid slippery floors, poor lighting, throw rugs, and other potential dangers.
If you have difficulty maintaining your balance, exercise within reach of a grab bar or rail. If you have trouble standing or getting up, try to exercise on the bed rather than on the floor or an exercise mat.
If at any time you feel sick or you begin to hurt, STOP the activity.
Most of all, select a hobby or activity you enjoy and stick with it.
Some suggestions include: Gardening, walking, swimming, water aerobics, yoga, and Tai Chi.
Reviewed by the doctors at the The Cleveland Clinic Neuroscience Center.

Saturday, May 5, 2007

Well Done Teo" by Dr.Hansa Chavalithamrong

Dear Mr. Kim Hoo Teo,

Please find the following message replied to you by Dr. Hansa.

Dear Mr. Hoe,I believe that what you did and what you wrote are excellent, keep onwith the good work. Sincerely yours,

Hansa Chavalithamrong.M.D.
Posted by Hero Teo at 7:41 AM

Well Done Teo" by reader

Your latest input person, Teo Kim Hoe, is absolutely on the money =>>> regarding>>> things, simple things, that can greatly help the Parkinson's sufferer.>>>>>>
His points about Tai Chi, Yoga Meditation and especially the deep =>>> breathing>>> ones are more than brilliant.
They are absolutely truths.>>>>>> How wonderful for you, in your typically subtle manner, to quietly =>>> "post">>> his inputs and let the readers carry it all forward. =20>>>>>>
The ones who are "pro-active" in their care, will latch on to these bits >>> =>>> and>>> pieces, and fill in the rest.>>>>>>
Those who are looking to be spoon fed solutions, will sit and evaluate. >>> =>>>>>>>>>
This all, by the way, fits into my Theory about oxygen depravation as a >>> =>>> root>>> cause of PD. And I have already been able to ferret out a number of>>> alternative protocols/regimens which - to varying degrees and varying>>> speeds, combat our conditions.>>>>>>
As always, God Bless,>>>>>>>>> Terry>>>>>> --- End Message --->>> *****************************************************>>> You are currently subscribed to dietitian as:>>> To unsubscribe send
Posted by

Am I Hero?

Posted: Wed Mar 28, 2007 11:34 am Post subject:Teo you are my hero!!68 years young and working out in the gym for"only" one hour--I'm feeling really embarrassed at 63 years old and hardly ever make t to the gym at all!!
Posted by Hero Teo at 3:53 AM

Well Done Teo"

Well Done Teo"

Kathrynne,I was about to "register" for your new Forum, when I decided to go back =andread the only other Reader Input that you posted today. It was the oneabout another Reader's dilemma regarding her husband's balance.The =VERYWISE answer was from David P, of course. =20I also have noticed that stopping and slowly trying to figure out how tobalance my body has given me much better confidence in how to navigate myself during these past few days, wherein the weather has been =slightlyhorrendous with snow storms, ice build--ups, and what have you. Talk =about stressful pushing of my body's capabilities! This is after thirteen =yearsof suffering with PD!Please note, that I had three plus wonderful, postsurgical years in the Spheramine Protocol Clinical Trial (Being Patient =No.1 in the Stage 2 Trial.)The benefits are either wearing off or I amoverloading my system with stress. So, I have begun backsliding a bit =andam now having the intermittent freezing again.Also a bit of imbalanceagain.=20I find that David P.'s suggestions are very wise.Also I believe that =Teo'speriodic suggestions have great wisdom in them!His are ="observational,"his having PD himself.Like me, he only offers his experiences of what seems to work for him.=20David P. has taken me on as a friend /patient of sorts.He is one of =themost non-aligned thinkers I have had the luck to run in to. Like Teo, =PatW., and a few others whom I have had the good fortune to meet thru yourDigest, my life
has been greatly benefited! That is why I end my =missivesto you with "God Bless." I am not a religious fanatic, but I do know =how tosee the hand of Godliness in everybody's vectoring around you, dearKathrynne.So, thanks for the "Forum." I am, like a wobbly Don Quixote, riding off =tosee how to utilize your new base for informational thoughts that may, noWILL, help other sufferers climb back up out of this hell hole we arewallowing in. It is not an ILLNESS. It is a condition that could bereversible. Like the Pritikin Promise gave hope and remedy to those whosuffered severe angina, there is a solution to our condition.I am more firmly convinced than ever that the root cause of our c condition isPeripheral Arterial Disease, like with leg cramps. But what it does to =us,with our particular DNA weakness/vulnerability is that the resulting =oxygendepravation starves our neuron cells.Therefore, no dopamine. All stem =celladvances will only provide a temporary fix. It is blending the infusion =ofthe stem cells, PLUS a reworking of daily regimen that will keep our =motorsin good condition. (Note, even if Glenn's amazing IV drip of umbilical =cordfluids gives him amazing relief of symptoms, it will ultimately play =out,without a supplemental repair of the toxins that originally triggered =hisPD.The Pritikin Promise only worked/works for the followers whoworked/work the program religiously.As a society, we have a lot of reorganizing to do re: our daily livinghabits vs. choosing new habits that are more beneficially supportive of =ourwell being.It is certainly a wonderful time to be alive!=20God Bless, Kathrynne, and Teo, et al...See you on the Forum!Terry[Terry George Hoffman]=20 --- End Message ---
Posted by Hero Teo at 6:10 AM

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Anonymous said...
I am impressed. You look pretty normal and flexible. Doesn't look like a PD patient from the pictures.Best wishes,Emanuel Deschaux
April 9, 2007 8:47 AM
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daevyd said...
Great site. Keep up the good work.
April 18, 2007 2:38 AM
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Friday, May 4, 2007

Forum: How do you do if you are an early PD patient?

teokimhoeJoined: 03 Mar 2007Posts: 9Location: Malaysia
Posted: Thu Apr 12, 2007 3:11 am Post subject: How do you do if you are an early PD patient?

Posted: Sun Apr 08, 2007 10:21 am Post subject: Q: What is the behaviours of early PD Patient? --------------------------------------------------------------------------------

The behaviours of early PD patient as follows: When do I tell others, and what do I say? Whether to tell " is a question posed by many people in the early stage of PD disease.

1. Is it jeopardize my job? Don't let other people feel sorry for me and for my children?

2. Keep it yourself as secret and privacy and once it reveals you feel sorry as you cannot take it back.

3. I feel relieve as I tell out and I could get some support.

4. It is hard to keep it secret as PD is not a' going away "disease and the tension of hiding it.

5. It helps more people to aware the diseases and encourage more support group i.e fund raising for the fund and learn to manage the disease and feel you are not alone.

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wolfJoined: 08 Apr 2007Posts: 50
Posted: Thu Apr 12, 2007 7:54 am Post subject:

Hello, I noticed you come from Malaysia, To answer your questions I would need to know the customs and culture of your society. Only you can judge whether to open up or not. Here in America it is good to tell people of our PD, but not to overwhelm them or cry our troubles. There is always a balance between what is appropriate to tell and what to keep to yourself, and this is depending on the culture. Peace Jack
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Wednesday, May 2, 2007

Forum: Five behaviours or 5 stages of Grieving ?

Forum: Five behaviours or 5 stages of Grieving ?

Discussion Corner Forum Index -> Open Forum
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teokimhoeJoined: 03 Mar 2007Posts: 9Location: Malaysia
Posted: Fri Apr 13, 2007 4:01 am Post subject: New Patient has five behaviours?

Do you agree the new patient has five behaviours? 1. Total self denail 2. Angry 3 Bargain 4 Grief (inflicted pain) 5. Accept Teo Kim Hoe
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IngeJoined: 01 Mar 2007Posts: 28Location: San Diego
Posted: Sun Apr 29, 2007 7:34 am Post subject:

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amlor2Joined: 04 Mar 2007Posts: 67Location: Arizona
Posted: Sun Apr 29, 2007 4:06 pm Post subject: A Considered Response

Hi Teo, What you have listed are the 5 stages of Grieving......... 1- Denial 2- Anger 3- Bargaining 4- Depression 5-Acceptance_________________Warm Regards from Arizona, Ralph :-)
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What are the 4 stages of PD?

Wed Apr 04, 2007 6:18 pm Post subject: 4 stages

What are the 4 stages of Parkinson's Disease?
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slumpyJoined: 07 Mar 2007Posts: 5Location: Ridgecrest, CA
Posted: Wed Apr 04, 2007 7:37 pm Post subject: Stages

Thelma, There are actually 5 stages and they're listed right here on the NPF website under "About Parkinson's Disease" -> UPDATES.

Here they are:

1. Stage One 1. Signs and symptoms on one side only

2. Symptoms mild

3. Symptoms inconvenient but not disabling

4. Usually presents with tremor of one limb

5. Friends have noticed changes in posture, locomotion and facial expression

2. Stage Two 1. Symptoms are bilateral

2. Minimal disability

3. Posture and gait affected

3. Stage Three

1. Significant slowing of body movements

2. Early impairment of equilibrium on walking or standing 3. Generalized dysfunction that is moderately severe

4. Stage Four

1. Severe symptoms

2. Can still walk to a limited extent

3. Rigidity and bradykinesia

4. No longer able to live alone

5. Tremor may be less than earlier stages

5. Stage Five

1. Galactic stage

2. Invalidism complete

3. Cannot stand or walk

4. Requires constant nursing care This rating system has been largely supplanted by the Unified Parkinson's Disease Rating Scale, which is much more complicated_________________Slumpy
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