PARKINSON'S DISEASE
The Way Forward!

Background & Summary

Parkinson's Disease - What is it?

This degenerative neurological disorder, which strikes the young as well as the elderly, is prevalent internationally. Symptoms include tremor, slowness of movement, rigidity and loss of balance. Many eminent personalities, including Mohamed Ali and Michael J Fox, suffer from it.

Who does the book address?

Patients and Carers - practical strategies with explanations and a positive approach

Doctors, Neurologists, Surgeons and Anaesthetists - provides academically referenced texts for the optimum management of Parkinson's disease.

Healthcare Professionals - Academically referenced texts provide a scientific basis for recommendations by nutritionists and dieticians, sexual therapists, psychologists, physiotherapists, exercise specialists, osteopaths, hand and foot specialists, speech therapists, acupuncturists, stress management therapists and nurses.

Chapter Details

1. Diagnosis and Monitoring

Methods of diagnosis and monitoring of Parkinson's disease are presented including Rating Scales and Cerebral - Imaging, describing the latest techniques. As diagnosis is sometimes difficult, this information is invaluable.

2. Drugs

The information presented is extremely helpful. Incorrect dosage causes distressing side effects. Recommendations for drug use and the interaction of drugs with nutrients are presented in sections for the medical professional as well as patients and carers. Some information may help to reduce dyskinesia.

3. The Assessment Diary

This is designed as an invaluable tool to help assess how often to take drugs and to analyse which lifestyle factors may need adjustment.

4. Surgery and Anaesthesia

A unique multi-disciplinary team approach to neuro-surgery by a neuro surgeon, anaesthetist, neurologist, specialist nurse and neuro-psychiatric psychologist. Very informative for patients and health professionals. There is also a chapter on special aspects in general anaesthesia for people with Parkinson's disease as well as the problems of detoxification.

5. Reducing Dyskinesia

Invaluable information to reduce this upsetting side effect of uncontrolled movements.

6. L-dopa and Other Drug-Nutrient Interactions

The following aspects, with helpful strategies, are addressed in the drug management and nutritional support programs of patients. Movement disorder can sometimes be reduced by manipulation of drugs and protein. Suitable for all health professionals as well as patients and carers.

• The medication L-dopa ('Sinemet' and 'Madopar') interacts with protein.
  The book details specific foods which affect absorption of L-dopa and gives subsitutes.
• Vitamin B6 needs decarboxylase inhibitors with L-dopa
• Foods containing high levels of tyramine interact with monoamine oxidase inhibitor drugs
• Aspartame and MSG are excito-toxins
• Recipes compatible with L-dopa absorption and also for general use.

7. Free Radicals

Free Radicals are implicated in degenerative diseases including Parkinson's disease. The book explains this and offers strategies to quench free oxidizing radicals and enhance immune system function. Suitable for patients and carers as well as health professionals.

8. Dentistry

Dental mercury is discussed in relation to Parkinson's disease. Chelation protocols are described for those who need to have mercury fillings removed for medical reasons but caution expressed for people with Parkinson's disease. Removal may not be suitable in all cases. For patients, carers as well as dentists and health professionals.

9. Sexuality

This important problem is brilliantly dealt with, offering helpful strategies including the emotional approach, physical adaptations, pharmaceutical treatment and general health optimisation. There are sections for the medical profession as well as for patients and partners.

10. Pregnancy

More young people are developing Parkinson's disease. This chapter describes pre-conceptual care, cellular nutritional deficiencies and drug implications. For patients (men and women) as well as doctors and nutritionists/dieticians.

11. Nursing

Describes the special role of Parkinson's Disease Nurse Specialists in the emotional support and practical care of patients and carers.

12. Biochemical Tests

The Parkinson's patient deserves to function as best as he or she is able. As such, it is important to know as much as possible about his or her cellular status in order to responsibly design a drug or nutritional support program based on each patient's biochemical individuality.

The importance of assessing the nutritional and general health status of patients on a cellular level is explained. Patients with PD often present with nutritional deficiencies which, if not recognised and addressed, may possibly compromise general health, cellular integrity, the manufacture of cellular energy or the efficacy of the immune system. References, with significant nutritional deficiencies found, are presented. Pharmaceutical treatment may also affect cellular status and this may need monitoring and support.

13. Nutritional Management

Helpful recommendations are presented for those on L-dopa medication and those who are not. For patients as well as, carers, doctors, nutritionists / dieticians, and biochemists.

• Nutritional supplementation (oral and intravenous protocols) for nutritional deficiencies found in Parkinson's disease patients
• Bowel function (recommendations for constipation, which can be a great problem in PD)
• Liver detoxification problems in PD, explanation and cautionary recommendations
• Drug-nutrient interactions (L-dopa and protein, vitamin B6 and decarboxylase inhibitors, tyramine-rich foods and monoamine oxidase inhibitor drugs)
• Excitotoxins MSG and aspartame - implications and recommendations
• Weight control
• Blood sugar balance
• Energy production (a problem in PD)
• Nutritional content of foods
• Recipes - delicious, simple and nutritious recipes are presented which are compatible with the absorption of L-dopa as well as for general use.

14. Muscle Function and Circulation

The book presents exercises by a physiotherapist and remedial exercise specialist. There are also strategies to increase circulation. Hydrotherapy is also recommended.

15. Remedial Exercise

The book presents exercises (mobilising, toning and stretching) by a remedial exercise specialist. For patients, carers and movement therapists.

16. Hands

Hand flexibility in Parkinson's disease is optimised by unique exercises for hands and general posture which influences hand movement. They are designed by a physiotherapist, doctor and pianist and are suitable for patients generally. They are also for those who wish to move more flexibly and easily on a computer keyboard or musical instrument. Well illustrated and described for patients as well as movement therapists.

17. Feet

A podiatric surgeon describes helpful exercise and surgery for Parkinson's disease patients. For patients as well as podiatrists and movement therapists.

18. Physiotherapy

Practical physical strategies are presented to enhance movement difficulties including 'freezing' (becoming rooted to the spot) and getting up from sitting. For patients, carers and movement therapists.

19. Osteopathy

Presentation of the importance and scope of musculoskeletal assessment and treatment because tremor, dyskinesia and rigidity can cause restrictive problems. Treatment can indirectly influence vascular and neural elements and may help relieve stiffness and rigidity.

20. Speech Therapy

Excellent strategies are presented for prevention of problems and maintaining communication possible at all stages. There is invaluable information about psychological and practical aspects. For patients, family, carers and healthcare professionals.

21. Stress Control and Depression

Autogenic training is presented for deep mind/body relaxation. This strategy helps control movement disturbance which can be exacerbated by stress in Parkinson's disease patients. Also very useful for carers and health professionals who may lead stressful lives. Depression is also discussed.

22. Patients Self-esteem

This vital chapter offers some strategies for patients to help them retain some measure of self-esteem in the face of a debilitating illness.

23. Older People - Special Features in Parkinsonism

Advice on multi-disciplinary management and recommendations for complications as a result of drug therapy. For doctors as well as patients and carers.

24. Carers' Needs

Carers have always been "unsung heroes" who can easily loose their sense of individuality whilst "sacrificing all" to their charges. This chapter presents essential, important strategies to deal with carers' vital and ongoing needs and gives them a sense of self-worth. The views of a carer and carers' organization are also presented. Contact organizations for carers are listed.

25. Patient and Carer Viewpoints

A Patient and Carer write their views about how wonderfully supported they have felt by the multi-disciplinary approach which they have experienced.

26. EDTA Chelation Therapy

This intravenous therapy helps to clear the arteries of plaque if patients are suffering from atherosclerosis. Parkinson's disease patients with this condition, which can compromise blood flow to the brain, might benefit from this technique. For doctors as well as patients and carers.

27. Traditional Chinese Medicine

Research from academic medical departments in the USA and Austria is presented acknowledging the usefulness of acupuncture in enhancing blood flow in the brain and in the control of some symptoms in Parkinson's disease patients. Interesting to patients, carers and health professionals.

28. Electro-Magnetic Fields

Application of electro magnetic fields to Parkinson's disease patients has resulted in control of some symptoms. Academic references are presented. Interesting to patients and the medical profession.

29. Useful Addresses