Post written by Dr. Karen Blindauer
The "Moving Forward" bloggers at the symposium: Dr. Serena Hung, me (Dr. Blindauer) and Dr. Bradley Hiner
I have been asked by a number of people with Parkinson's diseare (PD) or their family members to write about our second annual Parkinson’s Symposium and touch on the highlights of the day. It is with great delight that I reflect on a very successful and informative educational event. More than 350 people were in attendance on a not-so-pleasant, rainy Saturday.
|Dr. Safwan Jaradeh, chairman of Neurology at the Medical College of Wisconsin, and Christopher Sheridan, RN, PD program manager, kicked off the program with a warm welcome and introductions and an overview of the day's events.
Vicki Conte, coordinator for the Parkinson's and Movement Disorders program, was her usual encouraging self.
They keynote speaker was Dr. Walter Rocca, professor of Epidemiology and Neurology at the Mayo Clinic College of Medicine. Dr. Rocca’s talk was entitled “Environmental Risk Factors and Genetics of Parkinson’s Disease.” He gave a fantastic and very clear summary of what is known today about these issues in PD. He described risk factors for PD including advancing age, male gender, positive family history, prior severe head trauma, exposure to certain environmental toxins, and inheritance of certain genes. It was reassuring to learn that genetic forms of PD are rare and that having a positive family history of PD does not mean one is destined to develop PD.
The average person has a lifetime risk of developing PD of about 1 to 2 percent. With a positive family history, that risk goes up to about 4 percent, which is higher, but clearly still a small risk. Since the population is aging and everyone is living longer, the prevalence of PD will increase. This is an effect of the population having more older folks around and not a sign of a PD epidemic. He did point out that there are many different causes for PD in each individual patient and many more causes in the population at large. That is why it has been so difficult to find the cause of PD in order to find a cure. He noted there is no definite proof of any vitamins or medications preventing PD, but that exercise has been shown to be beneficial in PD. There may be some reduced risk of PD in smokers and coffee drinkers, but the cause and effect relationship here is not clear. He therefore recommended that if someone does smoke they should stop because of all the negative health effects, and that someone should not start smoking because they have PD.
The next speaker was Dr. Mark Rusch, psychologist for the Parkinson’s and Movement Disorders Program at Froedtert & The Medical College of Wisconsin. He gave a very clear and comprehensive review of cognitive and emotional changes in PD. He discussed depression, anxiety, apathy, fatigue, sleep disorders, and cognitive impairment including problems such as dementia. He reviewed how these conditions manifest in PD and how these conditions can be treated. It is very helpful for all to learn that PD goes beyond the tremor and movement disorder. Addressing these non-motor symptoms improves the overall well-being and quality of life for people with PD.
|After these in-depth and informative lectures, we were treated with an entertaining introduction to the Parkinson’s Disease Dance Project. Dance instructors Tom Thoreson and Susanne Carter led their class of students in a fun and energizing dance to the music “Singing in the Rain.” The students are people with PD who are improving their mobility, flexibility, and balance through dance. It was clear that they were having a lot of fun while working hard. I was able to join in as an audience participant, and have to say, dance is a fun way to exercise.
Susanne Carter leads the group in movement and stretching exercises.
After the lunch break we reconvened with an excellent overview of the rehab resources that are available at Froedtert & The Medical College. Physical therapist Jessica Doine, occupational therapist Bill Reinhard, and speech therapist Laurie Dulitz all clearly defined the role of therapies in improving function, safety, and quality of life in PD. They reviewed the goals in therapy for early and later stages of PD and taught us about the Move BIG and Think LOUD strategies to improve mobility and communication. We are truly grateful to have such talented and enthusiastic therapists on our comprehensive PD team.
We had the opportunity to meet our registered dietician, Sarah Zangerle, who explained dietary needs specific to people with PD.
Our patients with PD also have the benefit of complimentary services in the community to continue on with improving the balance, strength, mobility, and voice after the therapies have been completed. Bonnie Jean Barczak, music therapy director at the Wisconsin Conservatory of Music, reviewed the merits of exercising the voice through song to improve volume and articulation in PD. Pat Culotti, Tai Chi instructor, reviewed the role of her program in helping people with PD. She demonstrated a few basic exercise moves, with audience participation. The stretching and movement really felt good. JT Mathwig, PT, discussed the benefits of PD Treadmill Exercise Class, which has been getting great reviews from our patient population. Dee Schwaiger gave additional information about the PD Dance Project, which is rapidly growing in attendance.
Last but not least, my team, the Parkinson’s and Movement Disorders neurologists, gave presentations on a smorgasbord of PD topics in just over an hour. What a feat!
Dr. Serena Hung discussed some of the hottest topics in PD research and reviewed how to find good information on the Web.
Dr. Hiner gave a good review of the Braak staging system in PD that shows how changes occur in the nervous system outside the dopamine pathways. This explains why some of the non-motor symptoms like constipation, sleep problems, anxiety, depression and cognitive impairment occur in PD. He then reviewed the recent scientific publication showing the superior benefits of DBS over the best medication adjustments in the treatment of PD symptoms. He also shared a video from a patient who had successfully undergone the DBS, showing the dramatic change in his PD symptom control from before to after the procedure.
I reviewed the changing philosophy in the field of neurology on when to start medication in early PD, what medication to start first, and the pros and cons of these options. I also discussed the “levodopa phobia” phenomenon and how it can negatively impact patients who are afraid to take levodopa when they need it.
All in all it was a great day. The speakers were excellent, the information presented was outstanding, the audience participation and questions were delightful and insightful. I felt energized and excited about my mission to help people with PD and their families. As we all departed, the sun broke through the clouds in a sort of symbolic way, indicating the day had been successful, enlightening and uplifting. Symposium participants get involved .