‘Best medication is physical therapy, lots of antioxidants, good sleep, and good meditation’
By MYLENE C. ORILLO
One of the things that affect most patients with a medical condition is depression. But Liwanag Caldito doesn’t allow depression to rule her life, instead it motivated her to go out, be with people, and encourage them to live life despite their illnesses.
Liwanag, 66 years old, has been living with Parkinson’s disease for 14 years now. Last year, she was recognized as PWD Filipino of the Year during the 2015 Apolinario Mabini Awards held in Malacanang for “pursuing a career as special education (Sped) teacher battling Parkinson’s disease.”
“In spite of my disability, I was able to go out and help other people. I work with the deaf, I help interpret for them. I also help build schools through the Congress, put up a building for special education. They saw this and they awarded me last September,” she narrated.
In 2002, Liwanag suffered a stroke, damaging her basal ganglia. The basal ganglia are associated with a variety of functions including: Control of voluntary motor movements, procedural learning, routine behaviors or “habits” such as bruxism, eye movements, cognition, and emotion. From then on, she would experience twitching and involuntary kicking movements.
She went to see a doctor who told her she’s having seizures, was given one kind of medicine, but it’s not helping her at all. She went to see another doctor, who after running some tests, revealed that she’s suffering from Parkinson’s disease.
“I was given medicines and I started getting better, attending forums to learn more, because it is in learning that you’ll be able to help yourself,” said Liwanag.
Unlike other patients who suffered depression, Liwanag maintained a happy disposition with the support of her husband and children.
“I believe that when something happens to you, there’s a purpose to it. I meet people. I talk to them how I am able to do this. I crochet. I made this blouse (showing the blouse she was wearing). I make things to make me feel good. I bake, I cook, and I set up a non-government organization.”
For Liwanag, everyone can be an awardee like her. “Just go out and be with people.”
Transcranial magnetic stimulation
Over the decades, better, safer, and more effective technology is being discovered to stimulate the brain and help PD patients, like the transcranial magnetic stimulation (TMS).
TMS is an indirect and non-invasive tool that uses strong magnetic field outside the skull to stimulate the brain and change its the response. It has been around since 1900s after Michael Faraday discovered the fundamental principles of electromagnetic induction while attempting to stimulate nerves and the brain.
The first successful TMS was performed in 1985. It was approved as treatment for medication resistant depression in 2002 and was approved by Food and Drug Authority as treatment initially for depression in 2008 after undergoing very rigorous testing.
TMS centers are all over the US, Europe, and Japan for its safe and effectivity geared toward treating depression, tinnitus, among many others, and it produces long-lasting effects for at least three months after the effect.
Repetitive TMS (r-TMS), meanwhile, are magnetic pulses administered in a rapid succession. It only induces electrical currents in localized regions of the brain we want to stimulate. A patient can have up to 500, 1,000 to 2,000 repetitive TMS in a day.
“In stimulation, frequency is very important. If we stimulate the brain, at less than one second, which is slow, you turn the brain off. If you do it faster, more than five seconds, you turn the brain on,” said Dr. Ludwig F. Damian, a neurologist during the Parkinson’s disease symposium.
Typically, one treatment of TMS happens every day from Monday to Friday for 30-40 minutes a day; except Saturday and Sunday.
TMS has very good studies for depression and other psychiatric disorders such as acute mania, bipolar disorders, panic hallucinations, obsessions, catanonia, post-traumatic stress disorder, or drug craving.
“In Japan, it has a TMS center with 30 machines side by side, which only shows how they frequently use the machines. In Indonesia, it has 80 TMS clinics all over the country,” shared Dr. Damian.
TMS started from psychiatric depression, to other neurologic diseases such as dystonia, tics, stuttering, tinnitus, spasticity, or epilepsy, Alzheimer’s disease, and now it helps improve memory recall.
It does not, however, cure PD. It only helps on top of your medicine as an add-on to improve motor symptoms. It is an outpatient procedure. Magnetic fields do not hurt, this process is not painful; no use of anesthesia.
“Before the biggest worry was if you over stimulate the brain, you get a seizure. When they first introduced TMS, they had few reports of seizures. But for a while now, there has been no more seizures because we know if we don’t go above a certain number, we don’t get a seizure,” said Dr. Damian, adding that further research and investigations are ongoing.
The New England Journal of Medicine reported that tai chi may improve balance and prevent falls among people with Parkinson’s disease. The study, involving 195 men and women recruited by a team from the Oregon Research Institute, had mild to moderate Parkinson’s disease.
The participants were randomly assigned to twice-weekly session of either tai chi, stretching, or strength-building exercises. After six months, those who did tai chi were stronger and had much better balance those the other two groups. It was four times better than those in the stretching group and two times better than those in the resistance-training group.
The tai chi group also had significantly fewer falls, slow rates of decline in overall motor control. It was safe, with little risk of Parkinson’s disease patients coming to harm.
During the Parkinson’s disease symposium recently, Edwin Decenteceo, a retired teacher and a tai chi practitioner for more than 30 years, demonstrated how to perform tai chi, but reminded the patients to be careful on self-studying as data found online about Parkinson’s is inaccurate and incomplete.
“When you do tai chi, you need a teacher and it has to be at least 20 minutes for the chi to circulate. Any Chinese arts or martial arts that you do, do it for 20-minute long or more,” said Edwin, who also takes Buddhism classes and is a clinical psychologist in New York.
Also discussed during the symposium are the new developments regarding glutathione and how to increase gluta in body.
Glutathione is the most powerful component of our body’s antioxidant defense system. It serves as an antioxidants (body’s premiere neutralizer of all types of free radicals), immune system enhancer (protects and regulates immune cells), and detoxifer (one of the primary ways the body eliminates toxic environmental chemicals).
It is a potent antioxidant that is capable of penetrating the central nervous system (brain). However, glutathione depletes due to stress, alcoholism, sleep deprivation, pollution, illnesses, smoking, strenuous exercise, sun exposure, radiation, and poor diet.
Apparently, intracellular glutathione levels are diminishing by 10 to 15 per decade starting at the age of 20 and more than 75 diseases/disorders are associated with low glutathione levels such as cardiovascular, cancer, diabetes, infectious diseases, dermatological, ob-gynecological, ophthalmic, pulmonary, rheumatic disorders, neurodegenerative disorders, immunological disorders, and kidney failure/dialysis.
The challenge now with commercial glutathione is majority of the scientific and medical communities regard commercial glutathione as an ineffective method to increase intracellular glutathione levels.
The gastrointestinal tract contains enzymes that destroy orally ingested glutathione long before it reaches the cells and absorbed in the body. Even if glutathione could reach the cell, the molecule is too big and heavy to pass through the cell membrane.
Patients are advised to be wary of different glutathione therapies being offered in the market today. New treatments are already available that can be readily absorbed by the cells, which will allow the body to manufacture and increase glutathione levels inside the cell.
While these new treatments and updates are good news for PD patients, nothing beats taking good care of oneself.
“Best medication is physical therapy, lots of antioxidants, good sleep, and good meditation,” concluded Dr. Virgilio Gerald H. Evidente, Movement Disorders Center of Arizona in Scottsdale, Arizona and Medical Director of Parkinson’s Support Group of the Philippines Foundation.
Vital Signs Issue 84 Vol. 4, February 1-29 2016