Moving Forward

The Parkinson’s and Movement Disorders Team is fortunate to include registered dietitian Sarah Zangerle, RD, CD. Sarah wrote the following article and wanted us to share it on our blog. Thanks, Sarah!

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Winter has hit Wisconsin hard! The cold weather is accompanied by shorter days and minimal sunlight. Try to imagine back to those warm sunny days in June, July and August. The sunlight felt so good against our skin. Even better, the sun brought something else important to our body …vitamin D.

Since vitamin D is found in very limited quantities in the diet, the major source of vitamin D for the human body is exposure to sunlight. Exposure to UVB rays on the arms and face help us to make vitamin D. The reason why “the sunshine vitamin” has been getting so much attention lately is due to a pandemic of vitamin D deficiency across the world.

Here in Wisconsin, we are unable to make sufficient vitamin D during the fall and winter months from sunlight alone. Given our northern latitude on planet Earth, some believe that Wisconsin-ites aren’t able to make enough vitamin D from the sun during the summer months either, especially for some elderly or handicapped individuals who spend limited amounts of time outside.

What good is Vitamin D anyway?

Vitamin D performs a variety of functions in the body. Vitamin D is crucial for the formation and maintenance of bones and teeth. It is most commonly known for aiding in the absorption of calcium and phosphorus into the bone. Vitamin D deficiency is associated with increased risk for osteoporosis and has been linked to many other diseases, including increased risk of breast and colorectal cancer. Deficiency has also been linked to increased risk of developing heart disease and autoimmune disorders such as multiple sclerosis. Vitamin D receptors are also found in the brain which could link deficiency to neurodegenerative disorders including Parkinson’s disease. In a recent study, individuals with PD were found to have higher prevalence of vitamin D insufficiency compared with other healthy adults.

How much do I need a day?

During summer months, 10 to 15 minutes of sun exposure during peak sun hours (10:00 am to 2:00 pm) on arms and face provides sufficient UVB rays to make adequate vitamin D. The recommended adequate intake is 400 IU per day for adults aged 51-70 years and 600 IU for adults 71 years or older.

Where can I get it from?

Food sources are not very rich in vitamin D, but provide some supplemental intake. Milk has about 100 IU in 1 cup, canned salmon has 360 IU in 3 oz, canned tuna in oil contains 200 IU per 3 oz serving, and eggs contain 20 IU in each yolk.

What about supplements?

Most multivitamins contain between 50-400 IU per capsule; however this may not be enough to meet nutrition needs. We are still waiting for new recommendations to come out this year (2010) on how much vitamin D we need to maintain sufficient levels. During winter months a supplement of 1000-2000 IU per day with a meal should be adequate to maintain normal levels. If you are concerned, consider requesting to have your vitamin D level checked by your primary care doctor. Be prepared to take a higher dose supplement if you are deficient.

Since posting the post below on the Six Word Memoir, our patients have contributed a few more:

Other symptoms:

The facade is not the fellow.

Strength and encouragement:

My face lies. Ask for truth.

Fear and questioning:

I am not who I was.

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The following is feedback received for this blog: Enjoyed all the six word sentences, thanks everyone. - Richard Secklin

Have you heard of the six word memoir? Once asked to write a full story in six words, legend has it that novelist Ernest Hemingway responded: "For Sale: baby shoes, never worn." That certainly tells a whole, painful story.

In this spirit of simple yet profound brevity, the online magazine Smith asked readers to write the story of their own lives in a single sentence. The result is Not Quite What I Was Planning, a collection of six-word memoirs by famous and not-so-famous writers, artists and musicians. Their stories are sometimes sad, often funny — and always concise.

We thought it might be interesting to ask our patients to write a six word description of life with Parkinson’s. Here are some terrific entries.

On tremor:

Now I shake. It’s still me.

Was originally just a pinkie tremor.

Great cooks improvise. Shake ... can't whisk.

Other symptoms:

Frozen not cold. Come on feet.

Question. Wait, wait, wait, wait. Answer.

Bradykenisia, hypomimia, orthostatis. Come on, doc!

locking finger ... doctors, tests ... answer, questions

Scuffle, stumble, fumble, but never grumble.

When I fall, I fall hard.

Here’s a series that might be saying that Dairy Queen can cure a broken heart:

You Don’t Die From Parkinson’s Disease ....

A Broken Heart Can Kill You ....

Help! Call 911 … Or Dairy Queen!

Some understandable fear and questioning:

married, mom, 35, PD ... what's next?

It's me, frightened and stuck inside.

Some strength and encouragement:

My name is Kathy, not Parkinson's

Still me. Have hope. Keep moving.

life changes, keep moving, live now

move for those that can not

Parkinson's is the enemy. Let's fight!

We’d love to hear your six words on Parkinson’s. Respond by clicking on the feedback button below or send them to our Parkinson’s and Movement Disorders Program Coordinator, Vicki Conte at vconte@mcw.edu.

Post written by Dr. Serena Hung

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“Life is full of special moments. And the key is to be present when they happen. These are the little victories, that when added up, signify a life well-lived. When you face a challenge like Parkinson’s disease, where so much of your capability is slowly stripped way, it is even more imperative to acknowledge — and to celebrate — these moments.”

- Davis Phinney

I started my new year enjoying some special moments in Costa Rica with my husband, exploring nature and enjoying the sun, the sea and the rain forest. I reminded myself that I don’t have to keep my nose so closely to the grindstone all the time. I want my life to reflect a certain well-roundedness that can’t be achieved by only identifying myself as a neurologist. My goal is to have this “life well-lived” that Davis Phinney speaks of.

I want to encourage all of you to think about what a life well-lived means to you and how are you going to achieve it. For one of my Parkinson’s patients, Gottfried Georgi, 71, a life well-lived means working 40 hours a week as a volunteer at Racine United’s HS Automotive Program. Check out his story at the Racine Journal Times.

Oscar Wile said, “I don’t say we ought to misbehave, but we should look as though we could.” It’s that “twinkle in the eye” spirit that I see in my patient Paula Moore. Her husband, Jim, doesn’t think she’s ever “misbehaved,” but she has that open and honest and inviting look that puts people at ease and makes them want to be with her. Paula attends the Parkinson’s support group at Small Stones on the third Tuesday of each month and she always leaves the meeting with a new friend — or two. At over 80, with a variety of health concerns, Paula could be grumpy and closed off. Instead, she wears bright colors, smiles constantly, asks about people’s children and grandchildren, and encourages, encourages, encourages others to find those small victories of which Davis Phinney speaks.

I am very proud of my patient, Sr. Ann Bisek. She was initially devastated by the diagnosis of Parkinson’s disease. It took her the better part of a year to adjust and to regain her confidence. In the process, she has discovered new things about herself — like she can dance. Sr. Ann attends the Young Onset support group every month. She also attends Moving and Grooving: the Parkinson’s Dance Class and she dances faithfully, every week. Sr. Ann might not agree with Henri Matisse about original sin but she definitely agrees about the joy in dancing!

“Ever since there have been men, man has given ‘himself’ over to too little joy. That alone, my brothers, is our orginal sin ... I should believe only in a god who understands how to dance.”

- Henri Matisse