Simon Lewis spoke on sleep disturbance, which I experience from time to time. There is daytime sleepiness and then the night problems of not falling asleep easily, lack of REM sleep which affects memory, then the vivid or disturbing dreams in which PD sufferers often lash out and act out their dreams, sometimes hurting themselves or their bed partners. Have yet to experience that one!
His hints for poor sleep include the usual avoidance of caffeine after 4pm, don't think alcohol will make you sleepy, no hot baths (pity), don't eat too late (its 9 pm and we have just got in from a late meal at a Vietnamese restaurant - steamed chicken and the most deliciously fragrant broth with glass noodles and green herbs and veges. Naps should be no longer than half an hour. If all else fails it is better to get up and relax in a dim environment before having another attempt at nodding off.
The obsessive compulsive disorders were the topic of the second session by Antonio Stratella. They are often triggered by the dopamine agonists which I am not on. However excessive computer use and shopping are two addictions that were mentioned that I can identify with. Those who know me know how much I like my iPad and the propensity I have for op shopping. At least things don't cost too much at the op shop and I often take things back a wee while later albeit to another op shop to save face. It is a vicious circle - too much dopamine leads to ICDs, not enough leads to anxiety, panic attacks and depression.
If the prospect of that was not bad enough the next talk by Jennifer Goldman on cognitive impairment and dementia was slightly worse. PWP are susceptible to slower thinking, executive dysfunction , short term memory loss, visual and spatial acuity loss and language problems. Other things like illness, sleep problems, hearing and vision problems, head trauma and medications all make life harder for the PD sufferer too, she said.
There are strategies for overcoming these serious complications - things like exercise and rest periods. Make lists, label things. Keep track of the calendar and current events. Have a social life. Use pill dispensers , look at home safety and declining driving .
Strategies for speech and swallowing by Debbie Phyland emphasised the positive too, outlining things you can do to overcome quiet, monotone, breathy or husky voices. Singing is good for one's voice . Try karaoke , a choir or sing on your own. Think loud. With others is more fun of course.
Swallowing difficulties affect 80% of PWP . We spend a lot of time chewing and preparing food for swallowing with delayed swallow initiation leading to reduced raising of the larynx resulting in food going down the wrong way or pooling in the throat, rather unpleasant, as I know from experience. Avoid dry and sticky foods, she said, and have more water. Cueing could help too - say to yourself chew, stop, hold your breath, swallow. Worth a try, I would think.
Then there was a session by Daniel Weintraub on anxiety and depression which is common among PWP at any stage or age. It can cause sleep disturbance, weight loss, slow one down, cause fatigue and difficulty in concentration.
The last session of the day was presented by Lynn Rochester on the benefits and types of exercise.
Structured repetitive exercise as well as physiotherapy intervention and aerobics and tai chi all have their good points and outcomes, reducing motor sympton severity in the case of strength training and improving balance in the case of tai chi so that there are not as many falls. There is emerging evidence it is good for your cognitive function. If none of that appeals there is always dance, even computer games were mentioned but not the sedentary type of ones. All in all an active lifestyle is called for. Exercise little and often, and don't make it too easy! It is good for your brain too.
And that was the end of day 2, leaving one day of sightseeing on the Monday before leaving sunny Sydney and returning to Auckland.
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