GOODBYES AND HELLOS

It's easy to start, harder to stop. Most people begin forming habits without thinking about it. What's a habit but a groove worn into your mind and body, conscious and unconscious? (Merriam-Webster says : a behavior pattern acquired by frequent repetition or physiologic exposure that shows itself in regularity or increased facility of performance b : an acquired mode of behavior that has become nearly or completely involuntary, as in 'I got up early from force of habit').
Goals guide habits most fundamentally by providing the initial outcome-oriented impetus for response repetition. In this sense, habits often are a vestige of past goal pursuit. Parkinson’s Disease (PD) appears to primarily affect the posterior putamen of the basal ganglia. This region is known to affect control of habitual behavior. Thus, PD patients, no longer able to rely on the vestiges of goal-directed behavior found in habits, need to focus on goal-directed behavior. A motor control example might be the learned habit of tying your shoes. PD has negatively affected the normal function of habit that allowed you to tie your shoes without thinking, by setting the goal of mindfully tying your shoes; you have recaptured the ability to tie your shoe. It is a goal-directed behavior now, and no longer relies on the habit mechanism.
It also implies to me that goals must be routinely adjusted to ensure the brain does not rely on habits for control of day-to-day activity. While this analysis originates in the examination of motor symptoms, might it not apply also to non-motor symptoms such as depression, loss of emotional control, cognitive deficiency, and more? Further, can the brain use goal-directed behavior to reassert control of those activities governed by habit? What is mindfulness if it is not goal-directed behavior? It is reasserting conscious control. How is that different from conscious pursuit of a goal, large or small? There is no indication of deficit in formation of goals in PD or the capacity for mindfulness, so once the habit of formulating and reformulating goals, then applying mindful attention to carrying them out is established, the process can allow for a productive and fully functioning life. So, with this motivation in mind, I will focus on developing a goal-directed approach, using higher goals and sub goals, and developing a higher level of mindfulness needed to act mindfully in pursuit of these goals. So today, I choose eleven habits to which I will say goodbye. Habits of:
TWENTY ELEVEN GOODBYES
Sitting in the same chair,
Walking to work the same way.
Eating meals quickly.
Eating left-handed.
Overeating
Evening sweet or salty snacks.

TWENTY TWELVE HELLOS
Practice of meditation daily,
Tracking mindful actions each day on calendar dedicated to that use.
Mindfully performing daily exercises.
Regularly learning new exercises.
Initiating conversations.
Smiling
Kissing my wife

Well, it's a work in progress, but so am I.

Talking Loud and Moving Big

It's actually a therapy aimed at PD. It seems that we reach a point where there is no longer any unconscious movement, only what we decide to do. As this trend takes hold two things happen--our ordinary movements become weaker, especially when we are doing them unconsciously. Smiles become small, speech grows soft, handwriting shrinks.

Then our ability to multi-task disappears. If you aren't focusing on an act or movement, it just sort of tails off altogether--you drop what you were holding while you opened the door, or you fell as you were reaching for something because you didn't move your feet in that direction, too.

But you can reverse all that by learning to "talk loud and move big." So, if those around you are noticing the "stone-face" most of the time, and asking you to stop mumbling and you can't read what you write any more, this may be for you. It's called LSVT-BIG, and it has been proven to make significant inroads in movement, speech and more. You need to find a therapist certified in LSVT-BIG and the process takes four weeks to learn (not sure how much time per week, but what else do you have to do?).

Another approach has been developed by John Argue, whose background is in theater, Tai Chi and yoga. The obvious fit with theater is projection of your voice, larger movements and graceful movement. John has a book and video supplementary materials to teach his approach. It means learning to act consciously, learning the art of movement--graceful, mindful and complete (body awareness, conscious effort, mono-tasking).

My only trouble is that reading about these things seems to lead me to seeing the progression of symptoms in myself. Was it denial--that I really was just ignoring what was happening? Or is this the power of suggestion, like the hypochondriac who develops every condition they read about? In either case, the point of it is a specialized kind of exercise I can try to a greater or lesser extent depending upon the extent of my symptoms or similarities to the developments I described. Exercise--face it--is what I need. So, buying the book, finding the therapist, or a personal trainer is going to help, no matter where Iam in a progression. Whether I am imagining your symptoms, denying them or just plain experiencing them.

A River In Egypt

I started this little blog when I was first diagnosed, figuring I would write in it from time to time, chronicling the things I learned, the positives and the negatives, and so on. I think I expected I'd need an outlet. Funny thing is, I hardly ever returned. It's been a year and a half and I have not, until this last couple of weeks, given it another thought. Denial has been working pretty effectively. I took up yoga (after a fashion, mind you). As my yoga teacher puts it, never compare your pose with others'. You focus on your own effort and enjoy your own progress. Works for me, I could not possibly bend as much as the younger, thinner, shorter people in my classes have, but I feel stronger and have modestly better posture and balance. No deterioration in those two areas.

I started a special diet 2 months ago to lose weight and reduce the sudden craving for sweets that had helped me add another 10 lbs. I did not need. Good news is I have dropped more than 20 lbs. and I don't eat candy by the bagfuls. Bad news is I am probably feeling the effect of impulse-control disorders (ICD's) associated with dopamine agonists, which most of us PD people take. ICD's that affect as many as 20%of dopamine agonist users fall into 4 groups--compulsive eating, sexual urges, gambling and shopping. Good news is I am not gambling or shoppping to excess as yet. ;>)

I ordered an ergonomic keyboard today. Typing has become a struggle, especially when I try turning my wrists laterally to hold them parallel above the keys. My number of mishits was rising dramatically (is "mishits" a word, it looks a little vulgar there on the screen? It's meant to be a contraction of "missed" and "hits"... oh, well). It became hard to ignore as I spend more time at the keyboard. I am thinking I will need to look up my nephew's favorite voice transcriber--the name escapes me--he is a doctoral candidate at U of M and teaches as a graduate assistant. He doesn't type anything, to hear him tell it, he speaks it all into his computer and it is magically transcribed (I looked it up--it's Dragon Naturally Speaking).

The keyboard was my second concession to my difficulties with digits this week. Earlier in the week, I sought permission from opposing counsel and an arbitrator to digitally record a hearing because my tremors happen to concentrate in my left hand (I write left-handed). Using the voice recorder, I don't have to try keeping up with note-taking.

So, denial is officially off the table for me. I am just beginning to accept a few limitations. so, I'm back. i will likely have a word or two to say here again.