Dr. Anil Venkitachalam, Consultant Neurologist and Movement Disorder Specialist, Nanavati Super Speciality Hospital writes that the treatment of Parkinson’s, as opposed to a traditional viewpoint, extends beyond medication.
Parkinson’s as a chronic ailment is ubiquitous with more than 10 million people worldwide living with it. Yet, there are treatment options to manage the symptoms. As a movement disorder that progresses slowly, the symptoms of Parkinson’s worsen only gradually, calling for a difference in its treatment. However, the understanding of the disorder has traditionally been very controlled and restricted. The treatment of patients with Parkinson’s extends beyond pharmacology to include non-pharmacological elements. Curbing Parkinson’s entails tending to the disease holistically.
Mumbai-based Nanavati Super Speciality Hospital launched a virtual holistic care programme – ‘Parkinson’s Support Group’ to guide patients with Parkinson’s on tips for their holistic care. Amidst the low availability of medical care during the COVID-19 pandemic, the programme offered comprehensive, individualised and holistic support that addressed a patient’s clinical, physical, diet prudence and not to forget emotional needs.
As a disease that is caused by failure in the functioning of nerve cells, the preliminary and the most common symptoms of Parkinson’s include a loss of motor functions. Such symptoms may include tremors in hands, arms, jaw, legs and even the head, stiffness in limbs, slowing of movements (sometimes even complete loss) and imbalanced or unsteady walk. As they progress, these symptoms get coupled with more non-motor aspects that encompass mental and behavioural changes. Since motor functions are more palpable and distinct, they have traditionally been catered to pre-eminently. The majority of cases are treated with medications based on individual plans of treatment. Even so, it becomes imperative to focus on the day-to-day management of the disease, which requires not just medical intervention but also nonmedical changes.
Parkinson’s disease’s non-motor aspects are characterized by depression and anxiety, sleep problems, fatigue, memory difficulties and emotional imbalances. These factors, as much as motor symptoms, should be diagnosed as and when they become visible to begin a treatment plan that is holistically beneficial for the patient living with the disease. Lifestyle changes become the necessity of the moment in the treatment plan.
Diet and physical activity – While there’s no stringent set of restrictions on what patients with Parkinson’s can eat, a healthy and nutritious diet can aid in maintaining good overall health, which in turn makes it smoother to focus on domains that need attention in the treatment. However, patients with Parkinson’s should ideally regulate their calorie consumption and choose a diet which is low in fats, sodium and sugar. A healthy distance from alcoholic beverages would be beneficial in the long run, even if/when alcohol consumption is not strictly shunned.
A healthy diet coupled with an exercise regime can be helpful in maintaining a healthy weight; this can reduce chances of high blood pressure and diabetes.
Therapy for maintaining mental health – The mature stages of Parkinson’s are characterized by anxiety, depression and a number of emotional variations. To deal with them, visiting a psychologist (sometimes even a psychiatrist) becomes a pressing priority. Since both anxiety and depression are more than temporary bouts, these feelings can hamper day-to-day living of the patients and hence, require being addressed and redressed.
Physiotherapy– The most noticeable signs and symptoms of Parkinson’s disease are linked with movement. Since the condition is predominantly characterized by tremors, stiffness in limbs and movement imbalances which are disabling aspects of the disease, physiotherapy becomes a non-negotiable aspect of the non-pharmacological treatment of patients living with Parkinson’s. Physiotherapy can address the issues of mobility, balance, physical capacity and posture, thereby lending greater autonomy to the patients over their day-to-day movement. It can be helpful in relieving muscle tension and stiffness in joints. Physiotherapists can use exercise to not just increase the levels of independence of the patient but also improve their overall quality of life.
Speech and swallowing therapy -People with Parkinson’s may start finding it difficult to speak, chew, eat and swallow. This is because just as muscles responsible for movement in other parts of the body start getting affected, so do muscles in the face, mouth and throat. As the symptoms worsen, these difficulties become more prominent. Since clear speech becomes a problem for the patients, communicating expressions and emotions also becomes burdensome. Speech can be affected in different ways for different patients – some patients might speak in a low voice and blandly while others might mumble or speak rapidly, leading to stuttering or stammering. Speech therapy, thus, becomes necessary for patients to ensure that their social interactions are not gravely hampered.
Dysphagia (or swallowing difficulty) can cause dehydration and malnutrition and affect the quality of life of patients with Parkinson’s. Swallowing therapy is required to ensure that these patients consume appropriate food and drinks so as to be safe and healthy.
Sleep therapy–Parkinson’s is marked by struggling to get quality sleep as well. In fact, many a time, sleep problems are also early indicators of developing Parkinson’s. Sleep disturbances impact alertness and can lead to insomnia and drowsiness during daytime. Sleep therapy includes a combination of healthy sleep habits such as sticking to bedtime schedules, going to bed whilst doing calming activities and amidst a comfortable environment, avoiding long naps at odd hours, reducing screen exposure right before bedtime and engaging in regular exercise. These measures deviate from the traditional treatment of sleep disorders that includes taking sleep-inducing pills and are proven to be effective in catering to patients with Parkinson’s.
Battling with urological problems – Bladder dysfunctions are a common occurrence in patients with Parkinson’s. Many diagnosed with the disease also experience urinary tract issues. Control of bladder functions becomes a bigger problem during the later stages of the ailment, unlike bowel dysfunction. People might experience an irresistible urge to urinate frequently or might face trouble delaying urination once the need arises. Urinary tract problems can be looked into by visiting a urologist who might suggest some lifestyle changes.
The treatment of Parkinson’s, as opposed to a traditional viewpoint, extends beyond medication. There’s an overwhelming need to look at the ailment as a disease that, even though is not curable, requires deviation from a traditional narrow approach. Concentrating on the non-pharmacological aspects of the ailment becomes as crucial as treating the ailment medically. It is only when we look at the disease holistically that we can improve the quality of life of the patients living with it.