DEAR DR. ROACH: Please discuss the benefit of exercise for treatment of Parkinson’s disease. I am a 78-year-old woman who was diagnosed with PD in March and given a prescription for carbidopa/levodopa. A second opinion in June confirmed the diagnosis, but I am reluctant to start taking the meds. I work out on a recumbent cross-training stair climber for 50 minutes, plus other machines, three days a week. I do aqua aerobics on alternate days. Is this voluntary exercise beneficial as a treatment for PD?
I have a limited hand tremor and an occasional buzzing sensation in my torso, which feels like a tuning fork. There is no rigidity or fixed stare. My handwriting is normal. I am perplexed by the lack of symptoms while at rest — or is the worst yet to come? — D.D.
ANSWER: Parkinson’s disease is a disease of motor and other brain function that is progressive. Generalized slowness of movement happens in almost all people. While tremor, rigidity and balance troubles are common, they are not universal.
The progression of Parkinson’s disease is highly variable among those affected. In general, people diagnosed at a younger age may have a more rapidly progressive course. Some people have no significant disability for many years after diagnosis.
As far as exercise goes, any exercise that promotes good balance, flexibility and strength is helpful. Aqua aerobics are particularly recommended. Since you are doing well with your Parkinson’s so far and are getting very good amounts and types of exercise on your own, I don’t see a need for you to do additional exercises with a physical therapist. (As a general rule, I am a big believer in physical exercise, especially when supervised by a therapist, for many conditions, including Parkinson’s). One good study showed tai chi to be especially helpful for balance in Parkinson’s patients.
DEAR DR. ROACH: My question is whether you can get too much fiber. I have been taking a medication that had side effects of constipation for five months. I would have a fiber protein bar for breakfast and then fiber cereal mid-morning, then a normal diet. I even tried adding five to seven prunes a day. I still had constipation. When I went on vacation I was worried about a change in routine — no fiber bar and no fiber cereal, just a “normal” diet. The constipation went away and function was returned to normal. What’s up with that? — M.M.H.
ANSWER: The body certainly is complex and doesn’t respond the way it is supposed to according to textbooks. With what you were taking, I would have expected to see an effect.
That being said, fiber should be increased slowly; too much fiber, too quickly can cause bloating and gas. Also, fiber requires plenty of water.
Most episodes of constipation will go away by themselves with a “normal” diet — my guess is that’s what happened while you were on vacation. But stress can cause constipation, and good vacations are great stress relievers.