Challenging Times

‘Acceptance doesn’t mean resignation; it means understanding that something is what it is and that there’s got to be a way through it.‘

Michael J Fox

I read about people ‘battling’ and ‘fighting’ Parkinson’s and I understand and respect the sentiment. The terminology alone, however, exhausts me. I don’t wish to spend my days battling and fighting. I’ve chosen not to go to war with Parkinson’s and not to do battle with it, instead I’m learning to accept its presence, listen to its demands and to navigate my way through the challenges it presents, one step at a time.

I find when talking with other people about our respective experiences of living with Parkinson’s, we don’t need lots of words or explanations, we have a connection, a bond, brought about by our shared experiences, a shared understanding and a shared uncertainty about our futures. We rarely struggle to find words to describe our experiences to each other in a way we might struggle to explain Parkinson’s to someone who isn’t living with the condition. The nature of Parkinson’s with its unpredictable, diverse and at times bizarre range of symptoms can make it hard to explain and hard to understand.

Recently, a friend sent me a link to The Waterboy’s Song ‘Strange Boat’. ‘Strange’, he said, was perhaps the best description of life with Parkinson’s. I could relate to this immediately on so many levels and started to think about some of the ways in which Parkinson’s is ‘strange’.

Strange

‘Strange’ indeed!

Prior to diagnosis, I started to notice that smiling had begun to require a lot of effort. Over time, this has become more and more noticeable. Smiling is no longer a spontaneous occurrence. There is a time lapse from my wanting to smile until my facial muscles respond. To compound matters, when my facial muscles do respond, they do so in a slow, sluggish, half-hearted way. The end result can sometime resemble a grimace more than a smile. This lack of facial emotion or facial masking is a well documented symptom of Parkinson’s.

‘Parkinson’s Mask’ (Hypomimia)

‘A symptom of Parkinson’s that limits the accurate expression of emotion in the face due to a decrease in the speed and coordination with which the facial musculature is activated’ 

This inability of my face to accurately convey emotion has an impact on many of my social interactions. For example, if I am out walking and meet a friend I haven’t expected to see. Pre Parkinson’s, my response would have been to break into a broad smile and clearly and confidently, say what a pleasant surprise. There could be little doubt that my friend would know that I was genuinely pleased to see them and my intention was to stop and chat.

Now, after five years of living with Parkinson’s, if I am out walking and meet a friend I haven’t expected to see, my response is very different. By the time I realise I am approaching someone I know and my slightly wonky brain has sent a request to my face to smile, some time has already passed. My slow and stiff facial muscles take their time to respond in their limited capacity, and so, I often miss the opportunity to greet my friend with a warm smile, or indeed any smile at all. At this stage, my slightly wonky brain hasn’t even begun to think about the need to speak! My friend would have no idea whether I was pleased to see them or not and whether my intention was to stop and chat or walk on by.

Initially, I thought that I might compensate for the absence of a smile, by using the tone and volume of my voice to communicate some positive emotion and interest. However, one step ahead, Parkinson’s has changed my once clear, confident and intonated voice, to a much quieter, slower, monotone. I sound as uninterested as I look! I can therefore no longer rely on my voice to communicate my emotions accurately either.

I fear these factors combined can make me appear stand offish, aloof, miserable or downright rude. To add insult to injury, if my medication is wearing off, my ability to string a fluent, coherent sentence together can evade me and I stumble to find the right words or forget what I am saying mid-sentence.

I confess that on occasions, when I’m not at my best, I have pretended not to notice a friend and to try pass them by without acknowledging them. If unsuccessful at this, then, once I have acknowledged them, I have pretended that I am in a hurry and can’t stop to chat. This is so out of character for me but frustration and embarrassment have conspired to change my behaviour. At times like these it feels preferable to do this than to have to try to explain or excuse my monotonous, expressionless, rambling attempts at conversation!

Wearing a mask like, expressionless face can impact on any relationship, even with those who know me best. When one of my son’s could no longer tell if I was teasing him or not, we started to use a hand signal. This hand signal told him what my face no longer could. I’m having fun with you, I’m teasing you, I want you to join in and laugh with me.

Worse than an expressionless face is one that looks cross or angry when at rest. My family noticed this first and when I mentioned it to a friend, she enlightened me that this is commonly known as a ‘Resting Bitch Face’. It is not unique to Parkinson’s but is not the look I want to portray either!

‘Resting Bitch Face’

‘An unkind, annoyed or serious expression that someone has on their face when relaxed, without intending to’ Cambridge (Dictionary)

My ‘Resting Bitch Face’
(In my head, I too was laughing at the joke!)

There are many hidden challenges to living with Parkinson’s that I wouldn’t expect other people to have any knowledge of. I certainly didn’t before I was diagnosed. I love a challenge and as with most things, they are much more fun and much more likely to be successful when others are involved. So sharing my experience with others and raising a little awareness feels like a positive step in the right direction.

In a recent blog ‘The Elephant in the Room’, I commented on the fact that when we are out together, people often ask my husband how I am, rather than ask me. A very astute observation by my husband was that ‘I don’t mind being asked about you, but I am not always sure I say what you would want me to’.

We’ve been together nearly 30 years. No-one knows me better, so surely he has some idea about what I would want him to say?

So, I got to thinking, maybe just occasionally, he doesn’t listen to me, maybe he doesn’t ever listen to me! Maybe I don’t tell him or maybe I don’t explain myself very well. Maybe Parkinson’s is just difficult for anyone not living with it to truly understand. Maybe it’s inevitable that his version will be different than mine as he’s seeing it from a different perspective. Maybe as a doctor he finds it all too easy to slip into a medical role discussing my symptoms with friends as though he were at work discussing a patient with colleagues.

Any of these might explain the difference in our respective responses and I suspect there may be an element of truth in each of them. However, another, more likely explanation is the complex and variable nature of Parkinson’s, means that symptoms differ day to day. No two days are ever the same and even if they were, how I feel about them changes day to day. Some days I want to talk about it, some days I don’t. Some days I give into my symptoms and take it easy and some days, I carry on regardless. Some days I can laugh at myself, other days I get frustrated. Some days I have boundless energy, some days I have hardly any. Some days I can manage after three hours sleep, some days I can’t keep my eyes open. There is no way of predicting, no way of knowing. This is part of the challenge of living with Parkinson’s and undoubtedly part of the challenge of living with me.

So, to be fair, no matter how hard he might try, my husband really does find himself in an impossible situation. If Parkinson’s is so unpredictable that I never know how I will feel or what I would say, he certainly hasn’t got any hope of getting it right!

‘Before you judge a man, walk a mile in his shoes’

For many years, a gentleman would walk past our house each day. He occasionally looked up but rarely smiled, waved or spoke. After a while I concluded, despite his relative young age, that he was a ‘grumpy old man’.

One day he stopped by our gate and asked me, rather abruptly, to cut back a branch from a tree in our garden that was overhanging the pavement. He looked unfriendly, stern even, he never smiled and our conversation was short. I cut back the offending branch later the same day. The gentleman continued to walk past our house each day, never smiling or speaking and rarely acknowledging me. As before, I would smile and wave and think of him as a ‘grumpy old man’.

Over the next few years the gentleman walked past our house less and less frequently and more and more slowly until eventually I didn’t see him walking past at all.

I saw him some time later and spoke to him and his wife. I had been diagnosed with Parkinson’s for a couple of years by this time. I remarked that I hadn’t seen him walk past for a long time. When he tried to reply, his speech was so poor that I couldn’t understand him. His wife explained that his Parkinson’s had progressed so much in recent years and after many falls, he rarely ventured out of his home.

In an instant I realised my assumptions about the ‘grumpy old man’ were entirely wrong. The ‘grumpy old man’ was fighting a battle every day to maintain his independence. His walk down our street was fraught with difficulties requiring all of his attention to navigate them safely. He was challenged by his poor balance, stiffness and uneven gait. The overhanging tree branch was just one more unnecessary obstacle to navigate.

His expressionless face was not that of a ‘grumpy old man’ but one where Parkinson’s had stolen his ability to smile. His lack of a wave was because he could not maintain his balance if he were to look up and raise his arm. He didn’t speak as he passed by because he was concentrating so hard on simply staying upright. His daily walks past our house were part of his exercise regime, aimed at keeping him mobile for as long as he could, until Parkinson’s made that impossible too.

The many challenges that people with Parkinson’s face every day when undertaking the simplest of tasks are often not visible to others. I hope by raising a little awareness of the nature of these challenges that I and others might avoid being labelled a ‘grumpy old man’!

‘Before you judge a man, walk a mile in his shoes’

I’ve been pondering………

Parkinson’s can sometimes feel like the elephant in the room.

Sometimes after meeting a friend, I realise that we have discussed life, the kids, the universe, my friend’s health, the health of our respective ageing parents but not my health. I sometimes wonder if I don’t make it easy for people to ask about my health or if the significance Parkinson’s as a progressive, degenerative condition makes it too uncomfortable for some people to acknowledge.

During my pondering, I wondered if some of the other reasons people might not ask me are:

1. In case I have forgotten that I have Parkinson’s and the question might be an unwelcome reminder.

2. In case I might actually tell it how it is and that could take some time!

3. In case I break down and cry and that would just be plain awkward.

4. That I look well, it is easy to assume that all is well.

5. Because they have forgotten I have Parkinson’s or underestimate the significance of it.

6. Because they have asked my husband instead.

7. Because they may feel too embarrassed or awkward to ask.

8. Because they would rather not know.

9. Because they feel it is not the right time or place.

10. Because there are many more fun things to talk about!

I rarely talk about Parkinson’s unless asked. There are indeed many other more fun things to talk about but Parkinson’s is life changing. It is with me every second of every day and so, whether I like it or not, it has a major impact on my life.

I have lots of friends who ask regularly and I’m touched by their concern. Whether people ask or not, many show their concern, friendship and compassion in other ways. I completely respect that people may choose not to ask but I would urge people not to refrain from asking out of concern for any of the reasons above.

If the shoe were on the other foot, I might be concerned about any or all of the reasons above and avoid the question too. Indeed, I have done at times in the past. But now the shoe is on my foot, I would urge you, if you are interested, to simply ask me. There is rarely a bad time, you won’t be reminding me of something I’ve forgotten, I won’t dissolve into tears, I will try to keep it succinct and we can then move onto more fun topics! I don’t need you to ask every time we see each other but it need not be the elephant in the room either!

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In the five years since my diagnosis of Parkinson’s I have learned a number of new skills to help me manage an ever changing range of symptoms associated with the condition. These new skills include:

Yoga

Boxing

Cycling

Mindfulness

Playing Bridge