Acceptance

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.

Words of Wisdom

In his role as Marty McFly, in the 1985 hit movie ‘Back to the Future’, Michael J. Fox travelled between the past and the future. Diagnosed with Parkinson’s, in 1991, at the age of 29. I feel it is reasonable to assume therefore that he is something of an expert, on the past, the future and living with Parkinson’s. If further evidence of his expertise were needed, this quote is widely attributed to him. Such words of wisdom only serve to reinforce my view.

‘Don’t spend a lot of time imagining the worst-case scenario. It rarely goes down as you imagine it will, and if by some fluke it does, you will have lived it twice.’

Michael J. Fox

This summer saw the 5th anniversary of my diagnosis with Parkinson’s. It is a day I would choose to forget but the date and time is inked in my memory. I’m never quite sure whether to ‘celebrate’, curl up in bed for the day feeling sorry for myself or just try to carry on as though it were any other day. This year, I tried to carry on as though it were any other day but found myself reflecting more than usual.

I thought back to a glorious sunny day a couple of weeks after diagnosis. I drove my eldest son to Bath to look around the University. He was excited, as he should be, about the future, and was full of enthusiasm and energy. It should have been a joyful day for both of us. However, my overriding memory was one of feeling distraught at the thought that when the time came for him to leave home, I might not be able to drive him to his university of choice or to help him move his belongings into his new accommodation as he started out on a new chapter of his life. I remember my thoughts spiralling out of control. ‘If I couldn’t do this for him, then I certainly couldn’t do any of this for my other sons, what else might I not be able to do……….’ My enjoyment of that day was marred by such thoughts.

In the weeks after diagnosis, I was riddled with anxiety about my future and how things might be. None of us (except perhaps Marty McFly) know what the future holds but worrying about it can certainly get in the way of enjoying the present. The anxiety associated with diagnosis was overwhelming. I seemed to lose any control of my emotional on/off switch. I started to catastrophise and found I was very good at it!

I instinctively knew that I needed to do something to look after my mental health. Time is a great healer and I am lucky to have the support of family and friends too. I knew however, that in addition to this, I needed to learn some strategies that would help me at the time and in the future. Since then, I have worked hard at developing a range of coping strategies, mainly mindfulness based. I attended a series of mindfulness courses and immersed myself in the associated home practice. It wasn’t easy and has required a dedication and determination. I have invested time and energy in learning these new skills and as with exercise, practising them daily reaps huge rewards. As a result, I have been able to regain some control and anxiety is no longer the problem it once was.

I have since made a number of trips to the University of Bath, helped my eldest son move into and out of various accommodations and thoroughly enjoyed doing so. I have done the same for my middle son, now in his third year at the University of Exeter and I have no doubt I will do the same for my youngest son when he leaves home in the next couple of years.

Our mental health is just as important as our physical health and we need to respect it and nurture it in the same way we do our physical health. Those of us living with Parkinson’s often look to those further into their journey for inspiration, advice and guidance. I found each of these in the words of Michael J. Fox which only confirms to me that it was indeed reasonable to assume that he is something of an expert, on the past, the future and living with Parkinson’s!

Strange

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 that everyone with Parkinson’s has different symptoms and different rates of progression.

Strange that some days I can write a few lines and other days, I can’t hold a pen properly.

Strange having a face that doesn’t accurately express my emotions.

Strange that whatever time I go to bed and however tired I am, I wake at 3.00am and rarely get back to sleep.

Strange that many people think Parkinson’s is an old person’s disease and that I’m too young to have it.

Strange that my symptoms are so much worse when I’m cold, tired, stressed or under time pressure.

Strange that the loss of one neurotransmitter (dopamine) can be responsible for such a wide range of symptoms.

Strange that Parkinson’s is classed as a movement disorder, when movement is only one of a whole diverse range of symptoms.

Strange that one side of my brain and therefore one side of my body is affected more than the other.

Strange that my jaw moves involuntarily, even when I’m not talking!

‘Strange’ indeed!

Let’s Face It!

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.

Who Knows?

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!

Easy Like Sunday Morning

Exercise is never an option for someone living with Parkinson’s. It has been shown time and time again to ease a wide range of symptoms, improve mood and it is thought to slow progression of the disease down. It is the single biggest thing we can do to help ourselves. If a neurologist told me there was a pill which could do all of these things, then I’d do whatever it takes to get hold of this ‘wonder drug’.

Even with this knowledge, there are times when I might prefer to curl up on the sofa rather than get up and go. I rarely let my desire for the latter win but despite the rewards, it not always easy to maintain the motivation, day after day, month after month.

As well as developing a love of cycling, I’m lucky to have a large group of friends to cycle with. Exercising with others makes it fun, sociable and so much easier to do. Inevitably, I go further and faster when I’m out with others.

The same is true of the gym where I share a personal training session with a friend who also has Parkinson’s. Again this makes it more fun and we inevitably spend some time afterwards checking in with each other. Making that commitment to exercise with someone else means I’m much more likely to maintain that commitment to avoid letting anyone else down.

Sunday mornings have become a favourite fixture in my diary. Amongst our friends, there is a small, well established group who cycle every Sunday morning. When training for our Raid Alpine change we were invited to join them and since then, Sunday mornings have, whatever the weather, become physically challenging, socially rewarding and our knowledge of the best cake and coffee stops in Gloucestershire and beyond has become second to none.

Thank you to these wonderful friends for making it ‘Easy like Sunday Morning’.

Walk a mile…….

‘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’

The Elephant in the Room

I’ve been pondering………

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

Image Source: rawpixel.com

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!

Image Source: rawpixel.com

Lessons Learned

I’ve learned that, understandably, many people can’t imagine what living with Parkinson’s is like, so this is my attempt at welcoming you to my world…..

I’ve had to learn to create lists for everything (sometimes multiple lists for the same thing) and yet discover it is still possible to forget things!

I’ve learned not to carry a glass of wine in my right hand if I want to keep any for drinking but my left hand manages fine!

I’ve learned that I have to reapply for my driving licence every three years and I can never assume it will be renewed.

I’ve learned to be patient, that many things take longer to do but I get there in the end!

I’ve learned the hard way that chopping vegetables can be a dangerous pastime for someone with Parkinson’s!

I’ve learned that I can only do one thing at a time and that multi tasking is a thing of the past.

I’ve learned to avoid buying shoes with laces or it can take me all day to tie them!

I’ve learned to survive on three hours sleep (and cat naps during the day)!

I’ve learned that every day (sometime every hour) is different. I never (thankfully) have all of the 40+ symptoms all of the time but I always have some of the symptoms all of the time. There appears to be no way of predicting which will occur, when. It’s a guessing game. The unpredictability adds another level of complexity to living with Parkinson’s.

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What’s New?

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

To combat the stiffness, rigidity and reduced range of movements.

Boxing

To improve my balance, co-ordination, response time and speed of movement.

Cycling

To improve my balance, cardiovascular fitness and my brain! There is evidence that cycling can help improve symptoms and may delay disease progression.

Mindfulness

Anxiety and depression are very common symptoms of Parkinson’s so I’ve learned and practice some of the basics of mindfulness to try to keep one step ahead.

‘You can’t stop the waves but you can learn to surf’ Jon Kabat Zinn

Playing Bridge

Learning a new skill is thought to be helpful in combatting cognitive problems associated with Parkinson’s such as problems with memory, concentration, inability to multi task, problems with decision making, thinking and planning. Learning to play Bridge was my new skill last year. I’m still learning this year and probably next year too!