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Carmen Moller

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Sydney DBS Visit Patients in Noumea

Sydney DBS doctors, Neurosurgeon Dr Raymond Cook, Neurologist Dr Paul Silberstein and Neuropsychiatrist Dr Linton Meagher recently returned from their annual trip to Noumea, New Caledonia. During this visit, they assess patients for Deep Brain Stimulation as well as follow up with local patients who travelled to Sydney to undergo DBS at North Shore Private Hospital.

These DBS patients are at different stages in their follow up and by continuing to see these patients with the local team of professionals, ensures strong efficacy and a low complication rate for these patients. DBS helps many patients to achieve substantial improvements in neurologic symptoms including tremor, stiffness, slowness of movement and walking difficulty.

Dr Cook, Dr Silberstein and Dr Meagher also run a Parkinson’s Disease and Movement Disorder clinic where they work with local Neurologists to review patients. Dr Cook, Dr Silberstein and Dr Meagher have been making this trip annually since 2013. The doctors are pictured at the newly opened Medipole Hospital.

 

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Sydney DBS Blog: Dealing with a Parkinson’s Disease Diagnosis


Dealing with a diagnosis of Parkinson’s Disease
A new diagnosis of Parkinson’s Disease can lead to a range of emotions such as shock, confusion, anxiety, worry or even a strange sense of calm. 

There are many ways of coping with a Parkinson’s disease diagnosis and there is no correct way to respond. Some suggestions to aid the process include:

Seek information from a trusted source when it is most suitable
Knowledge and understanding of Parkinson’s disease and its progression may help to clarify concerns. While some aspects of Parkinson’s disease are predictable, many are not and it is impossible to learn or understand everything immediately. Seeking out information is something to be explored at a pace suitable to each individual. 

When gathering information, PD NSW www.parkinsonsnsw.org.au and the Shake It Up Australia Foundation www.shakeitup.org.au are useful Australia based starting points. The Michael J Fox Foundation for Parkinson’s Research www.michaeljfox.org is a well-recognised international resource. Many countries have established patient support organisations with local information available through web and social media-based internet resources.

Consider support:
Support services and resources are available to provide assistance and strategies for dealing with a diagnosis of Parkinson’s disease and to learn and prepare for what may occur at different stages of the condition. 

Here are some patient support organisations in Australia. Many countries have their own support resources which can be accessed locally or online.

There is no “right” or “best” time to discuss a diagnosis with family and friends. Some people choose to discuss a new diagnosis immediately, whereas others delay discussion in order to allow time to process the diagnosis. Taking time to think through emotions and reactions can ultimately help to manage communication about PD in the optimum way for each individual.

Aim to maintain a healthy active lifestyle
Managing and maintaining a healthy lifestyle is helpful for both physical and emotional well-being

Aim to:
Eat a healthy diet

Exercise regularly – see our blog on PD and exercise here

Ensure sufficient rest

Reduce consumption of unhealthy foods 

Reduce alcohol consumption

Quit smoking

Aim to maintain a healthy mindset
Mindfulness based meditation techniques can be useful to help focus on the present rather than on concerns for the future. Many mindfulness-based apps are available for smartphone download. These can be used in isolation or accompany support and treatment from a counsellor, psychologist, GP or Psychiatrist.  

Planning for the future:
It can be helpful to consider planning for the future. For some people, this can provide a sense of control and lead to greater positivity. A health professional can provide assistance with developing a short-term plan and/or a longer-term plan. 

It’s important to bear in mind that most patients with Parkinson’s disease are able to achieve good quality of life over many years from the time of diagnosis.  There is a wide range of existing medical and non-medical therapies that provide significant benefit to people living with PD, and the research pipeline is looking promising for even better therapies in the future.

Contact us
Sydney DBS Facebook Twitter

Integrated Neurology www.integratedneurology.com.au

Sydney North Neurosurgery www.snns.com.au

References

The information provided in this article is of a general nature only and is not treatment advice. Recommendations regarding therapy can only be made on a case by case basis, discussed between a patient and their treating doctor(s).

The information in this article was current at 16 October 2018.

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Sydney DBS Blog: Parkinson’s Disease and Exercise

Here’s a look at the benefits of regular exercise if you have Parkinson’s Disease.


 Exercise is a key component for a healthy lifestyle, and it’s important for people of all ages – even those who are aging.

While exercise helps to keep you fit, healthy and active, it also supports brain health.

Exercise can offer both short and long-term benefits for many people with Parkinson’s Disease.

Exercise helps to manage Parkinson’s Disease symptoms
Research into the physical benefits of exercise for people living with Parkinson’s Disease has demonstrated clear benefits. For example, one study suggested that people with Parkinson’s Disease who exercised regularly for 2.5 hours a week had a smaller decline in mobility over a two-year period.

Research has also suggested that exercise can improve specific motor (physical) symptoms in people who have Parkinson’s disease such as:

  • gait
  • balance
  • tremor
  • flexibility
  • grip strength
  • motor coordination

Exercise may also help to prevent falls in people with Parkinson’s Disease which can also help to avoid complications and prevent further injury.

Different types of exercises can benefit people with Parkinson’s Disease at different stages.

Exercise can help promote a balanced mood
 As well as improving physical symptoms, exercise helps to support improved cognition and fatigue.

Exercise can also help to promote a good mood, making you feel happier and more positive in general.

Exercise strategies for people living with Parkinson’s Disease
 A good exercise program should include a combination of flexibility (stretching) exercises, aerobic activity and resistance training or strengthening exercises.

Before you start an exercise program, though, speak to your doctor about the most suitable exercises. You may need a tailored plan or more specific advice about exercise and there may be other considerations relating to your general health or fitness.

Aim to find an exercise you can commit to regularly – one that you enjoy and can build on. Working out with a partner or friend can help to motivate you and make exercise more enjoyable.

Some exercises which may be beneficial for people with Parkinson’s Disease include:

  • Treadmill training
  • Bike riding
  • Tai Chi
  • Yoga
  • Pilates
  • Dancing
  • Weight training
  • Stretching and movement

Physiotherapists and exercise physiologists are health professionals that can develop a tailored, individualised exercise program.

Organisations that can help
 The following organisations provide exercise therapy for Parkinson’s Disease:

Some Sydney hospital-based exercise programs include:

Contact us
Sydney DBS: Twitter Facebook

Integrated Neurology www.integratedneurology.com.au

Sydney North Neurosurgery www.snns.com.au

References
Parkinson’s Foundation: Exercise
http://www.parkinson.org/Understanding-Parkinsons/Treatment/Exercise

Parkinson’s Foundation: Neuroprotective benefits of exercise
http://www.parkinson.org/Understanding-Parkinsons/Treatment/Exercise/Neuroprotective-Benefits-of-Exercise

 
The information provided in this article is of a general nature only and is not treatment advice. Recommendations regarding therapy can only be made on a case by case basis, discussed between a patient and their treating doctor(s).

The information in this article was current at 20 June 2018.

 

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First in a series of Blogs from Sydney DBS: What is Parkinson’s Disease?

Sydney DBS will publish a series of Parkinson’s disease related blogs over the coming months. We will provide readers with expert information on a condition which affects an estimated 80,000 Australians. In this blog, commonly asked questions about PD are discussed such as ‘What causes PD?’, ‘What are the symptoms of PD?’ and ‘How is PD diagnosed?’. Next blog, Parkinson’s Disease and Exercise.

What is Parkinson’s Disease?
Parkinson’s Disease (PD) is a neurological disease that causes a variety of typical changes of human movement.

People with Parkinson’s disease may also experience changes in mood, behaviour, sleep, speech, swallowing, bladder and bowel function.  

Late in the disease, PD can be associated with cognitive change.

What causes PD?
Scientists still aren’t sure what causes PD, but emerging research suggests a combination of genetic and environmental factors may play a role in the development of the disease. 

How does PD develop?
The pathologic changes of PD first begin in the nerves of the intestines and nose. 

Current medical evidence suggests that these changes might make their way up into the brain by transport through the nerves that arise from the brain to the gut and the nose.  

The changes in the brain of patients with PD appear first at the lower end of the brain (brainstem) and make their way over years to decades to the outer surface of the brain (cortex).

What are the symptoms of PD?
PD can cause movement-related (motor) symptoms as well as symptoms unrelated to movement (non-motor).

Common motor symptoms of PD include:

  • Shaking of the hands, arms, legs, jaw and face – also known as tremor
  • Stiffness of the limbs or trunk
  • Slowness of movement
  • Gait or balance problems

These symptoms develop when a midbrain structure, called the Substantia Nigra, becomes affected by the condition.

The Substantia Nigra is responsible for the majority of the brain’s production of a chemical called dopamine.  

Dopamine is an important modulator of the processes in the brain that control co-ordination and movement.  

When the cells of the Substantia Nigra are affected by PD, they begin to degenerate and die.

When dopamine production becomes critically depleted, the physical symptoms of PD develop.

The non-motor symptoms of PD can include:

  • Loss of sense of smell and constipation – this is thought to occur as a result of the changes that first develop in the nerves of the nose and gut
  • Mood, behaviour and sleep disturbances – likely caused by the reduction in dopamine production and changes in other brainstem structures

Non-motor symptoms may develop before the motor symptoms of PD. 

PD is a progressive disease, meaning it develops slowly – usually over a number of years – and gets worse over time. In many cases, symptoms begin on one side of the body and spread to the other side over time. 

While the disease itself isn’t fatal, complications can be serious. 

How common is PD?
PD is the second most common degenerative neurological disease in Australia after dementia, affecting an estimated 70,000 Australians. 

Every day, 32 Australians are diagnosed with PD. Around 20% of people diagnosed with PD are aged under 50 years, and 10% will be diagnosed before age 40.

How is PD diagnosed?
Usually, people with PD will develop a noticeable symptom, such as a tremor, which will prompt them to visit their doctor and obtain a referral to a neurologist (a specialist trained in diseases of the brain and central nervous system) for further evaluation.

A neurologist will perform a thorough medical history and investigation to assess whether the symptoms are caused by PD or another neurological condition. 

PD is diagnosed with both medical history and physical examination. A neurologist may test for other conditions that may be similar to PD or causing symptoms. Common tests include blood tests and MRI (Magnetic Resonance Imaging).

There is currently no specific laboratory test to diagnose PD.

How is PD treated?
While there’s no cure for PD, there are good-quality treatment options available to help people with PD to reduce the severity of their symptoms and live a fulfilling life.

Medical management of both motor and non-motor symptoms is critical to achieving optimal treatment outcomes.

People who are in the early stages of PD are usually prescribed medication and exercise to help manage their symptoms. These strategies can be very helpful in improving PD symptoms and may establish good control of symptoms for years and sometimes more than a decade.

Over time however, the benefit from medication can become gradually more inconsistent. In this instance, a second level of therapies such as Deep Brain Stimulation (DBS) can reduce the severity of symptoms and support a better quality of life.

PD affects everyone differently, regardless of their age or health status. Some people with PD can stay fit and active for a long time, while others may find their symptoms more debilitating over a shorter time course.

What should I do if I suspect I have PD?
If you or someone you know is displaying several of the common symptoms of PD, make an appointment with your GP who can examine you and refer you to a specialist neurologist if necessary.

Our commitment
We are committed to treating PD symptoms in aid of a better quality of life for both patients and their support networks. 

We work with Parkinson’s NSW and Shake It Up Foundation (partnered with internationally based, Michael J Fox Foundation) to drive awareness about treatments, ongoing research, living with PD and Device Assisted Therapies including Deep Brain Stimulation.

We are actively involved in training Neurologists, Neurosurgeons and specialist PD nurses in PD management.

Contact us
Sydney DBS: Twitter Facebook

Integrated Neurology: www.integratedneurology.com.au

Sydney North Neurosurgery www.snns.com.au

References

The information provided in this article is of a general nature only and is not treatment advice. Recommendations regarding therapy can only be made on a case by case basis, discussed between a patient and their treating doctor(s).

The information in this article was current at 3 July 2018.

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Dr Paul Silberstein Visits DBS Colleagues in New York

Neurologist Dr Paul Silberstein has just returned from New York, USA, where he visited and shared experience with DBS colleagues at Columbia University and New York University Hospitals.

Dr Silberstein also attended Cornell University where he viewed Exablate, the MRI guided High Intensity Focussed Ultrasound (MgFUS or HIFU) device.

HIFU is a technique whereby a targetted lesion is made to the brain using an external focussed ultrasound beam. In essential tremor, HIFU is used to interrupt brain tremor circuitry. HIFU is already approved for essential tremor in the USA and is under evaluation in Parkinson’s disease (PD) and dystonia, where it may have a future role in the management of patients where symptoms predominantly affect one side of the body.

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PD Warrior Seeking Volunteers with PD to assist with Professional Training Program

PD Warrior are hosting an instructor course for health professionals on 24 June 2018 in St Leonards, Sydney, and are seeking volunteers with Parkinson’s disease to assist them for demonstration purposes.

To thank their volunteers, PD Warrior are offering afternoon tea, a copy of The New Parkinson’s Treatment book, an assessment and treatment with an instructor in training, use of their exercise circuit and a taste of PD Warrior! They will also be operating another course on 16 September 2018. If you’d like more information, please contact admin@pdwarrior.com.