April - Parkinson's Awareness Month

 Part I of III,

How can I address the topic of 'Parkinson's Awareness' this year?

I decided to talk about where I am in terms of my ability to process information, what upsets me, and how my physical side is faring.  So this is the first of a three-part article to inform readers of this blog about the disease that an estimated one million people live with in this country, ten million worldwide.  Plus there are 60,000 people diagnosed each year. 

Processing Information:

During the last six-month visit, my Neurologist suggested I have an adaptive driving evaluation.  So I made an appointment with Spalding Rehabilitation Hospital, in Aurora. 

There were two parts over a two-week period to the process.  Part one includes a series of tests including identifying a building at varying distances as it relates to other structures, identify muted numbers within a multi-colored space, and identify various other shapes and images.

Next, I was given a laminated page with images showing 12 different road signs.  I was to study them for one minute, then return the page and recall as many of the signs as I could.  Next was a device called the brake reaction simulator.  I was to place my right foot on a throttle type pedal while waiting for a green light to turn red.  When the light changed, the device measured my reaction time to go from the throttle to the brake.

In addition, this part of the evaluation had a sizeable Q & A phase where I was placed at a monitor and used a mouse to click through a series of timed exercises.  The focus here was to identify shapes, numbers, and colors from memory.  Plus a part where I was given specific instructions, then timed for an answer.

Result:

• Brake reaction score was 9% faster than the norm.  The evaluation specialist told me, "Mr. Alleman, you have a reaction time similar to that of a high school kid."  OK, I'll take that.

• Recall identification of road signs;  Recalled 12 of 12 correctly.  On a roll.

Next, I was taken to a large room where an electronic wall-mounted panel displayed blinking LED's in a random sequence and at varying speed.  My instructions were to hit the blinking LED when it appeared on the 6' X 5' board.  I was told there would be a continuous series of blinking LED's.  I was to attempt to hit as many as possible when I noticed them and before the LED went out.  Credit would be given for a quick hit to kill the light and partial credit given to a late hit but no credit given if I missed hitting the correcxt LED or if I did not see an LED light up.

Result:

•  Score of 108 out of 120 LED's correctly hit. There were 5 late and 7 missed responses.

As I walked to my vehicle after that first part of the evaluation, I felt I had done well despite my apprehension when I arrived and the uneasy feeling I had when the process first began.  The person administering the evaluation did a good job of insuring I was comfortable and repeatedly told me it was going well.

Part two was where the rubber literally hit the road.  I would be driving a 10-year-old sedan with an automatic transmission.  This baby had more extra devices attached to the dashboard, instrument panel, and steering wheel than there are crackers in a box of Ritz.

It took 10 minutes for the evaluator to explain what each device was, how it was to be used if required.  The last thing I was told before putting the key in the ignition, "You will notice that I too have a brake pedal on my side of the vehicle, just in case."  Well, that certainy put me at ease...NOT!

The one thing that did concern me was the automatic transmission.  My entire driving life-50 years-, I have driven a manual transmission vehicle.  The last 12, a 5-speed 4WD pickup.  I told the evaluator to disregard if my left foot went for a clutch or a shifter on the floor that was not there.  Neither happened.

The experience turned out to be a good one.  After I understood the features the vehicle had, I was able to strike up a conversation with the evaluator while demonstrating safe driving habits throughout city streets and on I 225.

Back in the parking lot, I was to park in the same space as the one I backed out of.  As I turned off the ignition, the evaluator said, "OK, Mr. Alleman, I saw no safety violations, no lack of focus, and you answered all my questions correctly.  Then she asked a question to test my general awareness of my surroundings while driving. "How many 7-11 stores did we pass?"  My answer, 3.  The correct answer was 4 but no demerits for it.  I had demonstrated good focus and concentration while on the road sufficient to her satisfaction.

With that, the evaluation was over.  How did I do?  I was somewhat confident based on the bits of feedback my evaluators had given after both phases that I had done well.  I had to wait until I received the full written evaluation in the mail.  When it arrived, over three weeks later, I anxiously opened the package and began reading the text.

Result:

The patient demonstrated safe defensive driving techniques, followed rules of the road, and demonstrated good decision making.  Memory appeared in tact and never needed instructions repeated.  Used good judgement consistently.  The recommendation is to return to independent driving.  That's it!!!

So for now, I am happy to be able drive when and where I want.

In terms of my ability to process information in the course of my daily routine, there have been noticeable changes over the past year.  

• Most obvious is the slowing of movement or bradykinesia.  The pace of normal walking has slowed.
• In bed, moving from one side to my back, then the other side goes in a slow deliberate sequence. 
• I tend to be less likely to engage in detailed conversation.
• At times a word I know and want to use is not able to be verbalized.
• While reading, I am aware that I must work harder at concentrating.
• Preparing for instructing a class on a topic I have had a passion for many years...hiking, I write everything out before the presentation.
• My attention span is reduced...TV, radio
• At rest, my feet continue to move
• While standing in line at a bank, or sporting event, I find myself shifting my weight from side to side
• Routine tasks, i.e. folding wash, dressing takes more time.
• Brushing teeth first thing does not happen unless I am totally on meds.

 

Daily exercise is critical.

What am I doing today to fight off the bradykinesia?

• Reading...I read a 300 page murder mystery novel in two days this week.
• Walking a treadmill five days a week for 40 minutes at 3 mph.
• Have something to do or some place to go every day.
• Remain in touch-long distance-with family and friends through hand-written letters.
• Volunteer two days a week.
• Hike/snowshoe one day a week.
• Write this blog, using all ten fingers on the keyboard.
• Enjoy my hobby, back country photography.
• Meet with close friends for lunch, or coffee regularly.
• Maintain the checkbook/pay the bills.
• Maintain a challenging 10 to 15 item annual "Life List."
• Added zipper pull extensions to coats and trousers to avoid delays.
• Carry a list of important phone numbers on my person
• Still wear button down collared shirts...to force fingers to work

A healthy diet is a no-brainer.

What do I see ahead for me...next 1 to 3 years?

• Reduced amount of physical exercise.
• Difficulty when dressing.
• Difficulty when bathing.
• Cut back amount of driving.
• Rely on some public transportation.
• Difficulty to maintain good posture.
• Difficulty to maintain balance.
• Added reduction of fluid motion.
• Difficulty in communicating with others.
• Difficulty eating.

We have no choice of the cards we are dealt in life.  We do, however, have a choice of how we play the cards we have, and make the most of every day for as long as we can. 

Part two of this three part article will be posted soon.  So check back.  If you or someone you know might benefit from this article, send me your feedback.  Use the comment box at the end of every posting to respond to that topic.

It's All About The Journey!