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tag:blogger.com,1999:blog-83366437195371444952017-05-25T17:03:50.743-07:00Off and On: The Alaska Parkinson's RagPeter Dunlap-Shohlhttps://firstname.lastname@example.com:blogger.com,1999:blog-8336643719537144495.post-88068642126624380892017-05-08T15:19:00.000-07:002017-05-10T11:01:35.439-07:00Important update! Bonus Support Group Meeting This Thursday: The Carbidopa/Levodopa Gel PumpDon't forget, there is a BONUS meeting of the support group this Thursday at 3:30. The meeting scheduled for this Thursday, a presentation on the Duopa carbidopa/levodopa gel and pump delivery system is now to be held in the Marriott Hotel in downtown Anchorage, 820 W. 7th Ave. on the second floor in the Skagway Valdez room. To find the meeting, take the elevator to the second floor make a right, then another right and the door to the room should be in front of you. The time remains the same, 3:30 Thursday the 11th of May. Speakers include a patient who uses the gel and pump, a nurse who works with such patients and a doctor who oversees the administration of the therapy. The program is to last an hour, and there will be time for questions. This meeting is sponsored by Abbvie, the makers of the therapy.Peter Dunlap-Shohlhttps://email@example.com:blogger.com,1999:blog-8336643719537144495.post-27845009006270770702017-04-26T12:42:00.000-07:002017-04-26T12:52:25.456-07:00May Parkinason's Forecast for Anchorage and EnvironsIn other news there will be a *SPECIAL MEETING* of the support group for those interested in learning more about the new Levodopa gel pump. The program is described by the sponsor this way "The Duopa Patient Partner Program is an educational program developed to provide patients and their caregivers an opportunity to hear from a Duopa Nurse and a Duopa patient. The nurse will provide an educational overview of Duopa while the Patient Partner will share their personal story regarding their experiences with Duopa. A Patient Partner is a volunteer who has agreed to share their story with others affected by Advanced Parkinson's disease."

This special meeting is scheduled for our usual meeting place on the fifth floor of the Pioneer Home at the usual time, 3:30, on an UNUSUAL DAY, Thursday, May 11. We will also have our regular meeting scheduled for May 20, because you just can't meet about Parkinson's Disease too often! I believe the agenda for that meeting will be a speaker on adaptive devices, but I have been wrong about that before :~{Peter Dunlap-Shohlhttps://firstname.lastname@example.com:blogger.com,1999:blog-8336643719537144495.post-78737407208028556922017-04-13T14:21:00.001-07:002017-04-13T14:21:08.459-07:00April Meeting agenda: Hospice and End-of-Life ConcernsHello friends, We don't expect this Saturday's meeting to be canceled by snow (looks nervously skyward.) So you are all urged to attend the support group. We will have a presentation from Autumn Pudge of Frontier Home, Health and Hospice, who will speak on "Hospice Services/philosophy, end-of-life, and future planning, etc. I'll bring along any useful handouts/material/information, and answer any questions-or at least suggest a direction for finding any specifics or answers I may not have."

I hope to see you there as I do not relish the idea of facing this alone!

3:30 the 5th floor, West Lounge of the Pioneer Home,

Until then, I remain your humble servant,

Peter
Peter Dunlap-Shohlhttps://firstname.lastname@example.com:blogger.com,1999:blog-8336643719537144495.post-70909651498425556002017-04-11T18:08:00.000-07:002017-04-13T13:48:41.274-07:00Shakey-speare: Parkinson's Awareness Month Meets Poetry MonthLong-time friends of this blog (both of them) are all too aware that April is both Parkinson's Disease Awareness Month and Poetry Month. I like to celebrate this cosmic coincidence by mashing up two things that go together like Brussels sprouts and ice cream, namely, PD and Poetry. How? Easy! By penning, or, more accurately, keyboarding, a Pd poem. Still with me? Good. Here goes...

"I've never seen a Parkie Cow..." No that won't do... "A parkinsonian lad, name of Tucker, was one crazy, tough little ... " no, better not go there... "Roses are red, Parkinson's shakey, when I'm dyskinetic, my movement is snakey..." no, no!..

OK, I think I got it...

Peter Dunlap-Shohlhttps://email@example.com:blogger.com,1999:blog-8336643719537144495.post-75934226747015602392017-03-16T15:05:00.000-07:002017-03-16T15:07:07.561-07:00March 18th Support Group Meeting, Preventing falls
We're going to meet the heck out of this week's meeting. You ask "What's on the agenda, Pete? Or is this going to be another of your last-minute improvisations, like the time you led a two-hour discussion of the topic 'Pachyderms and Parkinson's, a tragedy not waiting to happen'"?

Well, glad you asked. We will have a roughly 30 minute presentation on falls and their prevention. This is a topic of critical interest, as falls can lead to drastic impairment and even death from complications for people with Parkinson's. So you have a simple choice: Come to the meeting or face a journey into the great beyond.

No pressure.

See you there, the usual time and place, 3:30 Saturday (the 18th) in the upper reaches of the Anchorage Pioneer Home, the 5th floor West lounge.

Best,
PetePeter Dunlap-Shohlhttps://email@example.com:blogger.com,1999:blog-8336643719537144495.post-57034774157216826792017-02-28T17:00:00.000-08:002017-05-25T17:01:29.850-07:00Tired of Coping? Tips for Those Who Want to Make Their PD WorseWe smarty-pants bloggers are quick to nag with ways to make your life with Parkinson's Disease better. We constantly scan the horizon for the latest about what you can do to enhance your quality of life, despite the fact that a progressive, disabling and incurable disease has you in its coils, slowly but surely squeezing the breath out of you. It's not easy, but you can learn to deal with this unhappy fact in a way that is meaningful, effective and dignified.

But trying to cope well to make your life better is not the only way to respond to Parkinson's Disease. Some people seem intent on finding ways to make their condition tougher on themselves, their family and friends. In the interest of fairness it's time to give these people some advice, too. So, without further ado, allow me to present pro tips on making your PD even worse.

• Tip one, wallow in denial. This used to be good advice for everyone with Parkinson's Disease. After all, in the earlier days of PD treatment (a time period covering the dim early origins of our species up until almost the present day,) there wasn't a damn thing we knew of that would change the course of the disease. Back then it was all about managing decline. So denial was a luxury you could afford. But now we know early intervention in the form of exercise and introduction of medicines that control symptoms lessens the grade of your downward path. Your symptoms will remain milder for longer if you practice early intervention. Denial negates the sense of urgency to intervene, so it is clearly the way to go if you want to make your PD worse.

• Tip two, avoid exercise at all costs There are countless good reasons to avoid exercise if you wish to worsen Parkinson's Disease. Exercise can have dramatic impact on the severity your symptoms, reducing them up to 35% in some well-documented instances. Exercise is relatively cheap, and can take whatever form you find the most enjoyable, (or the least miserable.) Symptomatic improvement, including tremor reduction and improved balance has been shown in a wide range of activities, everything from boxing through gardening. It can't be any clearer, if you want your case of Parkinson's to be truly excruciating, take the elevator, not the stairs to worse health.

Tip three: Poor adherence to pill dosage and schedule We who have Parkinson's have a number of medications, some quite powerful, for relieving our symptoms. Precisely compounded under strict laboratory protocols, they deliver a carefully measured dose of relief to soothe our whacked-out nervous systems. These exquisitely calibrated amounts are customized to our individual stage and severity of disease. Dosages are then married to a schedule worked out between the patient's experience of their effects and the doctor's knowledge of the medications efficacy, interactions with other medications, and side effects. The end result is an ongoing routine like a well-oiled bicycle chain meshing in rhythm with a sprocket to drive the entire enterprise smoothly forward. Or not.

With surprisingly little effort you can wreak havoc on this delicate balance. Take too high a dosage or take the medicine too often, and you will become a wriggling mass of uncontrolled jiggling. Take too little, and you will grind to a halt, your stride will shorten, and you will increase your danger of falling. This can be done without any conscious effort at all by merely forgetting to take a scheduled dose.

I could go on, but these should be enough to do serious damage, good luck with that.Peter Dunlap-Shohlhttps://email@example.com:blogger.com,1999:blog-8336643719537144495.post-73724862177692775202017-01-26T16:02:00.000-08:002017-01-26T16:02:59.363-08:00Getting My JAMAs On, Journal of the American Medical Association has Kind Words for Comic About PDIt seems that there has been a gap in my role of relentless self-promoter. At the tail end of December, 20016, The Journal of the American Medical Association praised the heck out of my now-a-year-old graphic-novel-style memoir of coping with Parkinson's Disease, "My Degeneration". And somehow it never got mentioned in this authoritative blog. We here at Off&On Media Enterprises are just sick about this oversight and assure you, loyal reader, that steps have been taken, measures put in place, and the guilty tracked down and summarily dealt with. Our apologies to you, your ancestors, and of course my ancestors.

Is there anything I can do to make it up to you? Probably not. But to assure you of my future good intentions, allow me to post a link to this article in Parkinson's Life Magazine about the JAMA article. And if you want to see the JAMA story, why, it's right here. Again, my apologies. It won't happen again.Peter Dunlap-Shohlhttps://email@example.com:blogger.com,1999:blog-8336643719537144495.post-68768669849278313262017-01-06T17:28:00.000-08:002017-01-10T19:55:45.802-08:00"Parkie", an Improper Noun? Parkie. It's a word that slides easily off the tongue , then catches in the craw. Some of us use it freely. Others loathe it. Why?

A fellow PD patient recently made the case against "parkie" in a post on Facebook. Her argument was that the term trivializes PD. Here is how it was put in the post: "I can not think of one other illness, disease or condition that is referred to by a cute nickname. Parkinson's is not a club I wanted to join. I was abducted into it."

Can we think of another disease that gets similar treatment? "Leukies" for leukemia victims? "Leppies" for those with leprosy? "Lupies" for those with Lupus? "Crohnies" for people with Crohn's?

And yet, "parkies" is used regularly in the community of those with the disease. I have always felt a bit wary of the term, though I used it in the company of allies from the PD world. Looking at the list above, I wonder what came over me. My cronies must have thought I was loopy. I can't imagine calling someone with leprosy a "Leppie", there is an air of condescension about it, an unearned intimacy.

But there is a bit of confusion here. The objection above is to referring to an "illness, disease or condition... by a cute nickname." "Parkie" does not refer to the disease, it refers to a person with the disease. And here, context matters. Used between two people with Parkinson's disease "parkie" is a diminutive that functions a little like the word "namasaste", only instead of the spark within me recognizing the spark within you, it's the pain in me that recognizes the pain within you, my fellow person with Parkinson's. What could be more ruefully human than that?

This also explains why it falls so wrong on the ear when used by someone who doesn't have the disease, or who isn't an active caregiver. Such a person hasn't earned the right to the intimacy of the diminutive, so for them to use it does indeed trivialize PD.

But, parkie-to-parkie, I am glad to have people around to share the misery. PD forces us to give up so much."Parkie" is the rare case where we get to do something nobody else can.Peter Dunlap-Shohlhttps://email@example.com:blogger.com,1999:blog-8336643719537144495.post-38423578105578280842016-10-20T14:41:00.003-07:002016-11-04T14:00:09.367-07:00Optimism and entanglement, My Changing view of Parkinson's Disease

Parkinson's Disease is considered rare. But most of us carry a vague mental picture of it, or more precisely, its effects. This picture centers on the brain and usually includes uncontrollable shaking, drooling, gait impairment and weakness. What's more these effects are progressive, disabling and incurable. Aside from this, the other thing people know about Parkinson's is it's a disease of the elderly.

That was roughly the mental picture I had when I was handed my diagnosis in 2002. Bang went the illusion that youth was a bulwark against PD. I was 43, much "too young:" to have Parkinson's. This rude shock was just one of many changes to the picture I have of PD 14 years after diagnosis.

First, yes, Parkinson's is a brain disease, but it is more than a malfunction in the tiny part of your brain where the dopamine that tells muscles how to move is made. We now know it also affects the motor cortex and the prefrontal cortex, where it has effects beyond movement problems. This never-tiring disease also involves the body beyond the brain, afflicting those who have it with constipation, loss of sense of smell, and sleep disturbance a decade before the appearance of motor problems most commonly associated with the disorder.

Which brings up a whole class of symptoms that were, for the most part, downplayed. These are non-motor symptoms. There is a raft of them, but perhaps the most significant are depression and cognitive decline. Can I get an oy vey?

On top of these underappreciated non-motor symptoms is a boatload of motor complications that add to the many miseries of Parkinson's. Miseries of which I was blissfully unaware. Suffice it to say that PD not only fucks you up, it fucks you up in great detail. Like a jagged coastline, the closer you look at it, the more of it there seems to be. Oy. Vey.

In general, my perception has moved from terribly oversimplified to a realization that PD is fiendishly complex. Yet I am now far more optimistic than I was 14 years ago about the prospects for PD patients to live fulfilling, meaningful and dignified lives.

What is my basis for this outlook? Do I have some inside information on a cure around the corner? I do not. Nobody knows when the longed-for cure will finally make its appearance. I doubt it will be in the next few years, As I wrote above, PD is terribly complex. The cure hasn't been found yet because it's hard to cure. The likelihood that a simple fix, let alone a complex one, will be found in time for me, now two years shy of 60 years old, seems small.

But consider: I've lived the last 14 years, not without loss, but with fundamental quality of life largely intact. There are unquestionably things I have given up. I rarely drive anymore. I have found myself looking over at the last minute and avoiding disaster too many times to be confident behind the wheel. I would dearly love to be unchained from the pill routine that I must maintain to approximate normal. And don't ask about my ability to play guitar and sing.

So, despair, right? No. After 14 years, a bit of brain surgery, a devotion to exercise, and a simplification of life following the loss of my wonderful but stressful job, my experience leads me to believe with a bit of luck, some discipline and maybe a bit more luck, a person using the information and interventions we now have available can live a life that is full and rewarding. I know this is possible, because I live it. Maybe not full in the way you expected. But, to quote John Lennon, "Life is what happens while you are making other plans."Peter Dunlap-Shohlhttps://email@example.com:blogger.com,1999:blog-8336643719537144495.post-55466202318110805672016-10-18T17:45:00.001-07:002016-10-18T17:45:51.470-07:00ENDPAIN Interview: The Weirdness of Parkinson's Disease

The formidable Julia O'Malley interviewed me for the Los Angeles based media site Endpain. The interview came out almost too well. Elegant design, superb photos, and penetrating questions from Julia make my replies seem almost coherent, and thoughtful. You may judge for yourself here.Peter Dunlap-Shohlhttps://email@example.com:blogger.com,1999:blog-8336643719537144495.post-52062514376995052912016-10-04T15:24:00.000-07:002016-10-04T15:24:25.744-07:00Anchorage Parkinson's Support Group Member Attends Her Own Celebration of LifeIn one of the neatest tricks since Tom Sawyer attended his own burial service, Sheri Hadley, who is a member of our support group, went to her own celebration of life. The celebration took the form of a bittersweet and raucous Old-Time Fiddle jam. It was attended by musicians from across the state.

Sheri has a Parkinson's-like illness. The disease, Progressive Supranuclear Palsy is one of a small number of disorders similar to, but more virulent than "garden-variety" Parkinson's Disease. Among these other illnesses frequently mistaken for Parkinson's are Dementia with Lewy Bodies, and Multiple-System Atrophy. These diseases tend to progress more quickly than PD, and are resistant to the treatments that normally make possible a decent quality of life, at least for awhile, in normal Parkinson's.

Faced with the bleak outlook, Sheri did not retreat into denial. Instead she made a memory for herself and for her large circle of friends that will be a comfort to all who took part. The memory I will take with me is of a woman brave enough to not let imminent death rob her life of joy. Bravo, Sheri!

You can read more in Michelle Theriault-Boots story in The Alaska Dispatch News.Peter Dunlap-Shohlhttps://email@example.com:blogger.com,1999:blog-8336643719537144495.post-63938485282279451072016-09-12T21:54:00.000-07:002016-09-14T09:43:37.651-07:00Hillary's "Parkinson's Diagnosis" a Second Opinion I wasn't going to get into the dogfight over the supposed "diagnosis" of Hillary Clinton as a sufferer of Parkinson's Disease. Why not? Because neither I nor anyone who is not a trained neurologist and hasn't performed a rigorous examination of the patient, is qualified to render a credible opinion. This didn't stop Florida anesthesiologist Ted Noel.

Dr. Noel posted a video to YouTube outlining his shoddy case for a PD diagnosis of Mrs. Clinton. This is where I got dragged into the matter. Noel quotes a post I wrote for the Northwest Parkinson's Disease Foundation as evidence for his opinion. (the quote appears at 3:22.) As noted above, I do not have the expertise to diagnose Parkinson's. But I didn't spend a quarter century newspapering without learning what bullshit looks like, and have no problem diagnosing that here.

Dr. Noel starts the video well enough, pointing out his lack of familiarity with Clinton's medical history and present condition by admitting that he is not her personal physician. Given that, he could not "claim that what I have to tell you is a conclusive diagnosis." He was right enough about that, and should have quit there. Instead he goes on to cherry-pick symptoms to make his case, contradict biology on Parkinson's side effects and speculates about what he is clearly ignorant of.

Below is a list of symptoms of Parkinson's disease. As you can see, it's quite long. There are plenty of symptoms if you want to cherry-pick among them to support your thesis. What's more, Parkinson's patients usually present some but not all of these symptoms. An example of how slippery PD is to pin down: some PD patients do not even have the hallmark symptom of tremor. Can you begin to see how complicated and difficult it is to diagnose this disease? I've read of studies that showed a third of diagnoses made by neurologists without specialized movement disorder training are mistaken.

There are no studies of how well anesthesiologists like Dr. Noel do at diagnosing PD, because it's so obviously a bad idea.

Here is the edited list of symptoms from the Parkinson's Disease Foundation's Web site.

Resting Tremor: In the early stages of the disease, about 70 percent of people experience a slight tremor in the hand or foot on one side of the body, or less commonly in the jaw or face.

Bradykinesia: means "slow movement." A defining feature of Parkinson's, bradykinesia also describes a general reduction of spontaneous movement, which can give the appearance of abnormal stillness and a decrease in facial expression. The reduction in movement and the limited range of movement caused by bradykinesia can affect a person's speech, which may become quieter and less distinct as Parkinson's progresses.

Rigidity: causes stiffness and inflexibility of the limbs, neck and trunk.

Postural Instability: One of the most important signs of Parkinson's, a tendency to be unstable when standing upright.

Freezing: Freezing of gait is an important sign of PD that is not explained by rigidity or bradykinesia . People who experience freezing will normally hesitate before stepping forward. They feel as if their feet are glued to the floor. For reasons unknown, freezing rarely happens on stairs.

Micrographia: This term is the name for a shrinkage in handwriting that progresses the more a person with Parkinson's writes. This occurs as a result of bradykinesia, which causes difficulty with repetitive actions.

Mask-like Expression: This term means a person's face may appear less expressive than usual.

Unwanted Accelerations: Some people with Parkinson's experience movements that are too quick. These unwanted accelerations are especially troublesome in speech and movement. People with excessively fast speech, tachyphemia, produce a rapid stammering that is hard to understand. Those who experience festination, an uncontrollable acceleration in gait, may be at increased risk for falls.

Other symptoms

Stooped posture, a tendency to lean forward
Dystonia
Impaired fine motor dexterity and motor coordination
Impaired gross motor coordination
Poverty of movement (decreased arm swing)
Akathesia: agitation
Speech problems, such as softness of voice or slurred speech caused by lack of muscle control
Difficulty swallowing
Sexual dysfunction
Cramping
Drooling and excess saliva resulting from reduced swallowing movements
Sleep disturbances
Constipation
Bladder problems
Sexual problems
Excessive saliva
Weight loss or gain
Vision and dental problems
Fatigue and loss of energy
Depression
Fear and anxiety
Skin problems
Cognitive issues, such as memory difficulties, slowed thinking, confusion and in some cases, dementia
Medication side effects, such as impulsive behaviors
Let's look at Dr. Noel's analysis of Clinton's symptoms. His claim that she suffers a parkinsonian head tremor is underwhelming. The tape he cites as evidence of head tremor (at 5:47 of the video) is more rationally explained as body language that says "Go on, I'm listening." It bears little resemblance to a PD tremor, it's way too slow. A pd tremor occurs at five times per second, according to Johns Hopkins Medical school.

Likewise his treatment of "freezing" episodes rings false. He focuses on an incident where Clinton trips on a staircase, (5:15 in his video) saying this is an example of a Parkinson's "brain freeze."* In fact, most of us who have PD notice stairs are mysteriously easy to climb. Before my brain surgery I often would make painfully slow progress across an open expanse of flooring, punctuated by periods during which I would come to a complete halt only to bound up the stairs when I finally reached them. As the Parkinson's Disease Foundation notes "For reasons unknown, freezing rarely happens on stairs."

You can judge for yourself Dr. Noel's wacky analysis of Mrs. Clinton's "hand posture". (6:51) Clinton is behaving quite normally in the tape he cites as evidence of brain dysfunction. The only posturing here is Dr. Noel pretending to know what he's talking about.

One thing that is known by everyone with PD but not Dr. Noel is that freezing and dyskinesia don't happen at the same time. You freeze when you are low on dopamine. You have dyskinesia, excessive uncontrollable motion, when you have too much dopamine on board for your brain to handle. Dr Noel explains head movements by Clinton that he finds odd (around 8:56) as dyskinesia set off by a freeze. But how can a person suffer from too much dopamine and too little at the same time? It's never happened to me.

The nonsense flows through the rest of the tape. Dr. Noel flies by the seat of his pants through unfamiliar territory, dispensing misinformation. For instance, he says Clinton's use of the term short-circuit is odd. "The term short-circuit is not in slang usage." he claims.

Short-circuit there.

His gibberish and speculation leave no room for credibility.

One thing is clear to me after reviewing this sorry mess. I wouldn't let this guy treat my dog, let alone my Parkinson's Disease. **

*Incidentally in 14 years with diagnosed PD, I can't remember anyone refer to freezing episodes as a "brain freeze" Everyone knows that term describes an ice cream headache.

**Further debunking of this matter can be found at this link to Snopes. Peter Dunlap-Shohlhttps://firstname.lastname@example.com:blogger.com,1999:blog-8336643719537144495.post-68978605719886637812016-09-03T15:07:00.001-07:002016-09-03T15:07:54.680-07:00What's Up in Anchorage in the Parkinson's Department for the Month of September
Hello friends, it's time for our monthly round-up of the panoply o' Parkinson's events plodding toward you in September, like some rough beast out of a William Butler Yeats poem. What do the portents portend? Let's cast the Runes aloft and see...

Monday the 12th at 1:00, LIVE from SPOKANE it's the return of the Telehealth Conference! These live, interactive teleconferences about different PD topics bring in the experts to enlighten we Parkspeople about various aspects of coping and caring. The topic this month is Acupuncture and the benefits to those affected by pain and chronic conditions, as well as who acupuncture works for, and a demonstration. To find the Anchorage area venue for this live and interactive hour-long session, head to the Piper Street side of the Providence Hospital mega-plex, go to the second floor, walk down the lonnnnnnnng hall that stretches South from the cafe and look for room 2401 pretty much at the end of the hall on your right.

Also this month, the Yoga for Parkinson's group will continue to meet Tuesdays at 1:30 at The Alaska Dance theater studios, 550 E 33rd Ave, West of the Moose's Tooth. Gentle Yoga for PD people who wish to work on their flexibility and balance, led by our very own Rocky Plotnick or our very own Susan Wong.

Then we have our usual meeting the 17th of September at 3:30 at the Anchorage Pioneer Home. I will be traveling, and so will miss it. As someone pointed out at our last meeting, this provides an excellent opportunity for everyone to get together to plot a coup and topple me from power as president-pro-temp-apparently-for-life of the support group. If that doesn't interest you, I believe we will have a new member there who is anxious to brainstorm about ways to make sure the unique needs of Parkinson's patients can be better served in hospitals.

Finally, a question. Is anyone from the group planning to attend World Parkinson's Conference in Portland? If so, please email me.Peter Dunlap-Shohlhttps://email@example.com:blogger.com,1999:blog-8336643719537144495.post-90651808312996014722016-08-21T17:39:00.000-07:002016-08-22T11:27:49.841-07:00Support Group Hijacking, Just Whom Is Your Group Supporting?
Can your well-meaning support group get hijacked by other interests? This question came up recently after I announced to our group that we would be having a talk on a new form of the front-line medication for Parkinson's, Levodopa/carbidopa. The talk was to be given by a representative of the maker of the medication. A member of the group, who had worked in the pharmaceutical industry, objected. "Isn't the direct marketing of medications to patients bad ethical practice?"

Yikes!

There was an unspoken question or two beneath the spoken inquiry. "Pete, are you shilling for Big Pharma now? Or are you merely their patsy?" To be fair, I'm not sure that these unspoken questions were dangling in the mind of the group member who spoke, but they rang loud and clear to me as implications of the first question. Had I unintentionally allowed a company to use our time for their own purposes? I holed up at home and thought about it. Here are my conclusions.

First, on direct marketing (DM). Can DM cause problems even if no deceptive practices are involved? The answer is yes, it can create pressure on doctors and pharmacists to dispense medication that might not be medically necessary. The result: wasteful spending and the potential exposure of the patient to unpleasant side effects of the medication.

But this potential harm must be balanced by the patient's need for information, a need arising from our expanded role in our own treatment. We are now expected to be more involved in and assertive about our care. This is especially true of Parkinson's patients without access to a movement disorders specialist. It's hard for the general neurologist to be current in every aspect of a disease and its treatment. A case in point: local neurologists unaware of the benefits, or even the existence of LSVT Big therapy, a powerful tool for symptom management.

It falls to the patient to be an advocate for new therapies or procedures. Understanding these new options, or just discovering them, can be the outcome of talks sponsored by the people who dispense them. Knowledge empowers the patient, which most of us agree is good.

This leads us to the question of the role of the support group. A primary benefit of the group is the exchange of information about dealing with PD. With that in mind, if I am going to make a mistake in regulating the flow of information, I am going to make it in favor of too much information, not too little. If the result is more pressure on doctors to prescribe a certain therapy, then doctors will have to resist that pressure where the outcome would result in harm to the patient. Patients have a duty as well, to understand as best they can the particulars of their medical situation, and the arguments the doctor makes concerning treatment.

Most patients grasp that a representative of a company likely has the interests of the company close at heart, and can factor that into their perception of the presentation. And there will always be those pitching snake oil that have to be weeded out. But "too much information" is rarely the problem in dealing with Parkinson's Disease.

I would be interested in hearing from other support groups if they have had discussions of this issue, and what conclusions they came to. Comments welcome. Peter Dunlap-Shohlhttps://firstname.lastname@example.com:blogger.com,1999:blog-8336643719537144495.post-56025465844286592442016-08-03T14:46:00.000-07:002016-08-03T14:47:31.624-07:00Anchorage Area Parkinson's Activities For August
Time for a gaze into the mystical, magical, all-seeing, all-knowing orb, the Parkinson's eight ball, for a glimpse of the immediate future. The first thing I see is... there will be no teleconference again this month. The buzz on that is the teleconference will resume in September. So your next Monday is free time!

 We will have a special, bonus meeting on THURSDAY, August 18 at 5:30 in the afternoon, in our usual haunt, the Pioneer Home fifth floor West lounge. This meeting will be an informational presentation by Kendall Cook of Abbvie on their pump-administered Levodopa gel infusion. If you're asking yourself "What the heck is pump-administered Levodopa gel infusion?" you are the perfect candidate to attend this informational presentation, and get knowed up on this therapy, which just recently was approved by the FDA. The session, with question and answer period, should last about an hour.

You'll want to rest up Friday so as to be ready for our regular meeting the following Saturday, August 20, when we will have a pair of therapists in to talk about the Lee Silverman Big and Loud physical therapy program. Based on the concepts that guide Lee Silverman Voice Therapy, Silverman Big and Loud has been shown to substantially improve symptoms in patients with PD.

That's it for August, be well, and well-medicated,
PeterPeter Dunlap-Shohlhttps://firstname.lastname@example.com:blogger.com,1999:blog-8336643719537144495.post-71572881257086326652016-07-27T15:59:00.000-07:002016-07-27T18:18:57.476-07:00Cartoonist Richard Thompson Dies of Parkinson's Disease

One of Thompson's best-known drawings

Proof came today that rare talent, personal graciousness, hard work, high standards, and an extraordinary sense of humor are no shield against Parkinson's Disease. Cartoonist Richard Thompson died this morning. Richard struck me as a genuinely humble man, both aware of his great gifts and unimpressed by them. He cut his own brilliant path. It was marked with restless artistry that was held together by his enormous talent, great charm and intelligence, and driven by his uncompromising high standards.

I used to keep one of his drawings, a caricature of the late North Carolina Senator Jesse Helms, up above my drawing board at work. Not as an incentive to equal or surpass it. That was clearly out of the question. I put it there to inspire me to do the best work I could do, to remind myself that creativity matters, and mainly because it was a beautiful and devastating drawing that was a joy to look at.

Richard varied the look of his work with a love of experimentation few could match.

 When Richard was diagnosed with PD, his friend Chris Sparks formed Team Cul de Sac, the cartoonist's project against Parkinson's Disease. Chris had the idea of publishing a book of tribute drawings by other cartoonists in honor of Richard's daily comic strip, Cul de Sac. Richard, with typical generosity, invited the other artists to play with his characters, transforming them with their different styles, and imagining their own interpretations. The project made news when the reclusive Bill Watterson, one of Thompson's many cartoonist admirers, contributed a small oil of Petey, one of the main characters in the comic. It was the first artwork the public had seen from the Calvin and Hobbes creator since his retirement of his beloved strip many years before.

Watterson was not alone, he was joined by the likes of Pat Oliphant, Lynn Johnston, Jim Davis, and others, both well-known and obscure. Including the drawing below, I'm proud to say. The book, and an auction of the artwork brought in thousands of dollars for the Michael J. Fox Foundation. Since its founding, Team Cul de Sac has raised over $200,000 dollars toward ending Parkinson's Disease.

Richard and I met once, and spent an afternoon talking about the things we had in common, a shared love of British master cartoonist Ronald Searle, a shared burden of Parkinson's Disease. I left his house thinking our paths would cross again, that he would be helped by brain surgery and have years of drawing ahead of him yet. Parkinson's had other plans. Richard, once a most prolific artist, seemed cut off from his muse by Parkinson's disease. The hoped-for benefits of the surgery didn't take. Despite admirable support from family and friends, his decline became steep and irreversible. He died at 58 years old.

Parkinson's Disease was cruel to him, and cruel to those that loved him or admired his work. I was wrong about his chances with PD, but I am sure of this: His reckless line will remain a thing of beauty with few peers. Peter Dunlap-Shohlhttps://email@example.com:blogger.com,1999:blog-8336643719537144495.post-2865903618003361992016-07-13T14:48:00.002-07:002016-07-13T14:48:28.967-07:00Parkison's Activities for the Anchorage Area in July, Latest Shocking Report
It's high Summer, and no relief from 70 degree weather in sight! This means you can ride your bike, walk or run to the next meeting of the Anchorage Parkinson's Disease Support Group this Saturday, July16 at 3:30. Why would you want to do that? Because I'm announcing the APDSG Move it Or Else (MORE) challenge. As it becomes ever more obvious that exercise is critical to dealing as effectively as possible with PD, I'm looking for ways to create incentives to keep us moving. Incentives, that is, beyond the already established incentives, as enumerated here by the National Parkinson's Foundation:

Symptom management.  Research has shown that exercise can improve gait, balance, tremor, flexibility, grip strength and motor coordination. Exercise such as treadmill training and biking have all been shown to benefit, as has tai chi and yoga (although more studies are needed).

Possibly slowing disease progression.  There is a strong consensus among physicians and physical therapists that improved mobility decreases the risk of falls and some other complications of Parkinson's. They agree that practicing movement — physical therapy, occupational therapy, and participating in an exercise program—improves mobility. By avoiding complications, you can avoid some of the things that can make PD worse. Beyond this, we know that people who exercise vigorously, for example by doing things like running or riding a bicycle, have fewer changes in their brains caused by aging. Studies in animals suggest that Parkinson's disease is also improved by exercise. Many neurologists in the NPF Center of Excellence network recommend intense exercise to their patients and also to people who are worried about getting PD because of a family connection. One neurologist told us that he tells people with a relative who has PD to exercise 300 minutes a week, with at least half of it devoted to intense running or bike riding. One Parkinson's Outcomes Project study has proven that people with PD who vigorously exercise for 2.5 hours per week show a slowed decline in quality of life, and the sooner they begin vigorous workouts after diagnosis, the better,

 Wow, Pete! That's amazing! Where can I learn more? Right here,

Or, how about here
?...

This, too

I could go on, but you get my drift. So what is MORE? MORE is the acronym for Move it Or Else. The idea is simple, because I don't do complex with much elan these days. Here it is: based on the well-founded premise that any type of exercise you do is better for coping with your PD than no exercise, we will pass out forms on which you can list the amount of time spent exercising in minutes, and the type of exercise you did. Any form of exercise will count the same, Biking will be worth the same as walking. Pole vaulting will count the same as bowling, the idea is to spend time moving. Whomever among our support group participants completes, compiles and notes on their form the most minutes of exercise between the July meeting and the annual holiday potluck will be the winner of the grand Prize, a personally autographed copy of "My Degeneration" custom-signed to commemorate your awesome victory. This is, of course, STRICTLY VOLUNTARY. But what have you got to lose, besides your balance? Our motto: We can do MORE!

Also, an early warning. We will have a special meeting August 18 at 5:30 pm at our usual spot in the pioneer Home. The subject will be the Duopa levodopa/carbidopa gel pump. The speaker will be Kendall Cook, a representative of Abbvie, the maker of this continuous delivery method of administering levodopa/carbidopa.

There will be no Telehealth conference next month. I assume they are catching their breath. Telehealth broadcasts will resume in September.

That's a wrap,

PetePeter Dunlap-Shohlhttps://email@example.com:blogger.com,1999:blog-8336643719537144495.post-3061911915754470582016-06-06T16:30:00.000-07:002016-06-19T10:26:26.762-07:00Once Again, Off and On Picked as a Best Parkinson's Blog for 2016 (Along with 14 others)The invisible hand of Healthline, a San Francisco-based Web site has ransacked the darkest corners of the internet on a desperate quest to find the best blogs on Parkinson's. When every sack had been ran, it turned out that, once again Off and On was chosen for these particular laurels. To the winners go cash prizes of... heh, just kidding. The winners get this nifty graphic "badge" to append to their blog in a suitable spot, and a temporary vacation from that vexing question "Why am I doing this, anyway?"

The Website posted about the criteria for selection, and had this to say about the winners

 "We've carefully selected these blogs because they are actively working to educate, inspire, and empower their readers with frequent updates and high quality information. If you would like to tell us about a blog, nominate them by emailing us at email@example.com!"

 Here is what they had to say about "Off and On"

"...learn about symptoms, download charts that can help you manage your medications, and much more. Because the blog's been active since 2008, and because the writing is so entertaining, you could literally spend hours here."

Thanks to Healthline, and to the readers of this blog, without whom the question "Why am I doing this anyway?" would be way harder to answer.
Peter Dunlap-Shohlhttps://firstname.lastname@example.com:blogger.com,1999:blog-8336643719537144495.post-15586864581140770562016-06-02T12:21:00.000-07:002016-06-02T12:21:04.688-07:00Parkinson's Activities for Anchorage-Area Persons of the Parkinson's Persuasion
So what will Anchorage People-with-Parkinson's-about-<wbr></wbr>town be doing this month? (aside from tremoring, festinating, and taking pills, I mean.) Myself, I hope to be swanning around with the in crowd attending the Parkinson's Telehealth broadcast. The subject is "Thermography, non-invasive and comfortable imaging for detection of breast Cancer for PD, Caregivers, and more" The event is June 13th, 2016, at 1:00pm. To find the Anchorage area broadcast of this live and interactive hour-long session, head to the Piper Street side of the Providence Hospital mega-plex, go to the second floor, walk down the lonnnnnnnng hall that stretches South from the cafe and look for room 2401 pretty much at the end of the hall on your right. Then rest up for our next fabulous event, the Summer Picnic Potluck at my house, 9601 Elmore Road (Directions: Beware of construction on Abbott Road. It's best to take Elmore South to the lighted intersection with Abbott. Continue South through the intersection and look for 9601 Elmore about a quarter mile later, roughly halfway up a small hill, on your left. Our house is directly after a largeish house with a chain link fence around the front yard. Come up our semi-long driveway and you're there!) The picnic will take the place of our regular meeting June 18th at 3:30. We'll have cold cuts, paper plates and utensils, you bring whatever you think will taste good on a sunny afternoon in early Summer.

I hope you all are enjoying this fine weather, and that none of you spontaneously combust in the heat!

Sweatily,

Peter

Peter Dunlap-Shohlhttps://firstname.lastname@example.com:blogger.com,1999:blog-8336643719537144495.post-5671954985940872812016-05-05T12:46:00.000-07:002016-05-05T12:46:01.965-07:00Parkinson's Report for Anchorage and Environs, May 2016
Hello friends, Wondering what we're going to do this month to remind ourselves that we have a rare and debilitating disease? That's the spirit! You can show your contempt for this sorry, so-called pathetic excuse for a malady by attending the Telehealth seminar on Monday, May 9th, at 1:00. The topic this time is the World Parkinson's Conference, to be held in Portland, Oregon this September. They will address registration, accommodations, sessions and travel. To find the Anchorage telehealth interactive broadcast, proceed with all deliberate speed to Providence Hospital oncology wing on Piper St. ( Go to the second floor, walk down the lonnnnnnnng hall that stretches South from the cafe and look for room 2401 pretty much at the end of the hall on your right.

The monthly support group meeting will be held May 21st, at 3:30 in the luxurious fifth floor lounge of the Anchorage Pioneer Home. It will probably be an "open mic" session for you to air your PD questions and concerns. If nobody has any questions or concerns about the disease we will take up the topic of "If we're not worried about this. then why do we have a support group anyway?"

Thank you for your attention, now please return to what you were doing before I so rudely interrupted,

With ceremony, ruffles and flourishes, this is your President-Pro-Tem-For-Life, Generalissimo Pedro Del Dunlap-Shohl, signing off.Peter Dunlap-Shohlhttps://firstname.lastname@example.com:blogger.com,1999:blog-8336643719537144495.post-1309166980534749062016-04-28T15:43:00.000-07:002016-04-28T15:43:42.565-07:00Another Parkinson's Disease Quiz! (Originally Appeared as a Post For the Northwest Parkinson's Foundation.)I just ran across this forerunner of the PD Trivia quiz. I wrote it some time ago for the NWPF, and decided it is worth republishing here. Beware: it has a bit of attitude. But at least it's short.

QUIZ: How well do you know your Parkinson's Disease?

To complete the quiz, you'll need a pen, a pencil, or a stick to mark your answers; an encyclopedic knowledge of Parkinson's disease, or access to a reliable search engine; a dogged perseverance; a sense of humor. Choose as many of the answers as seem true to you.

1.) Among the earliest signs of Parkinson's Disease are:

A.) A shaking of an extremity that lessens when moving
B.) The sudden appearance of strange new vocabulary, with foreign-sounding words like "Dystonia" and "Festination"
C.) Constipation

(Answer: C. Constipation. People can have this as a PD symptom a decade before other signs emerge.)

By the time a diagnosis of Parkinson's Disease is made, a typical Parkinson's patient:

A.) Has been misdiagnosed with so many other diseases that denial seems not only reasonable, but downright sensible.
B.) Has lost the use of as much as 80% of the cells that make dopamine in the substantia nigra
C.) Is ready to slug their doctor

(Answer: B. Cell loss. This is a tough one, but as only some patients suffer frequent misdiagnoses (as many as 30% of those who don't see a movement disorders neurologist) and only a few feel like slugging their doctor, I'm sticking with B.

3.) Parkinson's researchers divide symptoms of the disease into the following categories:

A.) motor and non-motor
B.) serious and frivolous
C.) sinister and hilarious

(Answer: A. Motor and non-motor. Motor symptoms are those like tremor or stiffness that affect movement. Non-motor symptoms involve other aspects such as emotion, with the onset of depression, or cognition, with the loss of ability to cope with complexity. And if you answered B or C, shame on you, cynic.)

4.) The number of people diagnosed with Parkinson's in the United States is:

A.) Around a million
B.) Way, way too many
C.) Not getting any smaller, that's for sure.

(Answer A, B, or C. Any of these is a defensible answer. The problem is that with the slipperiness of a PD diagnosis, and the consequent number of misdiagnoses, we really don't know the exact number. A million seems to be the most common number tossed around in articles on PD. Answer B. way too many, goes without saying. C, not getting any smaller, is unfortunate but true as the baby boom generation is now entering its prime years for diagnosis.

5.) The most effective underutilized measure to cope with Parkinson's Disease is:

A.) Exercise
B.) Exercise
C.) Exercise

(Answer: You can't go wrong with exercise. Nutshell version: regular exercise can help with balance, mood, cognition, and can very likely moderate the progression of the disease. Studies have found that the earlier regular exercise is implemented, the more gradual the patient will decline, compared with those that cannot or will not exercise. Also it is inexpensive, has no side-effects when properly done, and can actually be fun.

BONUS QUESTION: Which of these dictators suffered from Parkinson's Disease?

A.) Adolph Hitler
B.) Ferdinand Franco
C.) Mao Tse-Tung

(Answer: All three! Maybe the urge to conquer the world should be considered a non-motor symptom of PD.)

Interpreting your score: 4-5 correct: PD Maven, put yourself in charge of your support group. 2-3 correct: PD Journeyman, put yourself in charge of snacks for your support group. 0-1 correct: PD Pre-K, Congratulations, you know as much about PD as the average American! Disagree with an answer or the scoring of questions? Comments are welcome below.Peter Dunlap-Shohlhttps://firstname.lastname@example.com:blogger.com,1999:blog-8336643719537144495.post-16649411441833554562016-03-20T10:48:00.000-07:002016-04-27T15:36:13.553-07:00Parkinson's Trivia: A PD Activity You Can Do With Your Support GroiupThe question comes up every month. What to do for the support group? I've hit up the voice pathologist three times now, the dietitian twice, and the kindly movement disorders doctor twice, too. I need something fresh, that hasn't been done to death. Something to get the group interacting with each other. After beating my defective brain out, it came to to me: Parkinson's trivia!

I set up a few categories, did some light research on the Web, and, hey, presto! Instant meeting. You're welcome. Here are the questions and answers.

Category 1: Well-Known PWP

1.) This Man was the subject of a bio pic starring Will Smith.

Answer: Muhammad Ali

2.) This British actor, who starred in 1960's films like "Monte Carlo or Bust" was noted for his roles as an upper class cad. Answer: Terry Thomas

3.) Possibly the worst person in history, ___________ was a frustrated artist who rose to power in the 1930's in Germany. Answer: Adolph Hitler

4.) This dictator was the subject of as running joke on Saturday Night Live "_________ ______ _________is still dead." Answer Generalissimo Francisco Franco

5.) This dictator was known for his "Little Red Book" A: Mao Tse Tung

6.) This Photographer was noted for her Depression-era images During her unique career, __________________ was torpedoed in the Mediterranean, strafed by the Luftwaffe, stranded on an Arctic island, bombarded in Moscow, and pulled out of the Chesapeake when her chopper crashed. She was the first Western photographer to document Soviet industry after the revolution, to create a travelogue of Czechoslovakia and other Balkan states just before Hitler moved in to ignite World War II, and was stationed in Moscow just before Germany bombed its former ally. A: Margaret Bourke-White

7.) Author and disillusioned Communist, _________ _______ is most famous for his novel attacking Stalin's regime, "Darkness at Noon", but wrote on Science, Judaism, and the paranormal as well.
A: Arthur Koestler

9.) Surrealist Painter, known for walking his anteater on the streets of Paris. A: Salvador Dali

10.) This evangelist preacher was known for his association with presidents like Nixon and Johnson. A: Billy Graham

11.) This man was the leader of one of the world's biggest Christian denomionations A: Pope John Paul

!2.) Champion American cyclist started a foundation to inspire and inform People with Parkinson's A: Davis Phinney

13. A neurologist, and the first person to run a four-minute mile A: Roger Bannister

14,) American Writer and Journalist, formerly of The New Republic And Slate A: Michael Kinsley

15,) American actor who specialized in Macabre, creepy roles A: Vincent Price

16.) One pf the great singers to come out of Rock and Roll, this 11- time Grammy winner later went on to sing standards and perform in Gilbert and Sullivan on Broadway A: Linda Ronstadt

17.) This Country Music legend was known as "The Man In Black". A: Johnny Cash

18.)English actor who made his reputation as a tough guy in movies like "Mona Lisa" and "Who killed Roger Rabbit?" A: Bob Hoskins

Category 2: Symptoms

1.) PD symptoms involving the ability to move are called "________ Symptoms"
A: Motor

2.) PD symptoms that do not involve moving are called"__________ symptoms" A: non-motor

3.) The loss of this sense can precede onset of motor symptoms by a decade. A: Smell

4.) Diagnosis of PD depends on what three symptoms? A: Tremor, slowness, stiffness

5.) REM ________ disturbance can be one of the early symptoms of PD A: sleep

6.) By the time motor symptoms appear, PD Patients have lost _______ percent of the dopamine producing neurons in the deep part of their brains A: 65-80

7.) Involuntary dance-like movements that some people with PD exhibit are not a symptom of the disease, but a side-effect of what medication? A: Sinemet

8.) A soft, hoarse ____________ is a frequent symptom of PD. A: Voice

9.) The tiny handwriting associated with PD is called _______________. A.) micrographia

10.) The parkisonian gait, characterized by a rapid shuffling of the feet is called __________ A: festination.

11.) A symptom that appears often before the onset of motor symptoms is _____________, which can be treated with prunes. A: constipation

12.) ________________ are a non-motor symptom that involves seeing things that don't exist. It is more common in older patients, or those with dementia than those who do not have dementia. A: hallucinations

13.) "Bradykinesia" means _______________ A: slow movement

14.) A resting remor" characteristic of PD diminishes when muscles are ____________ A: moving.

15.) "The Pull Test" a moderately forceful backwards tug is performed by doctors to assess _______________ A: balance problems

16.) It is difficult to read the emotions of many PWP because of "Facial ___________" A: masking

17.) The often painful involuntary tensing of muscles common in PD is known as _________ A: dystonia

18.) Reduced swallowing in PD leads to _______________ A: drooling

Category three: Treatment

1.) Sinemet known as the "gold Standard" for PD treatment is a combination of what two substances? A: levodopa and carbidopa

2.) Carbidopa is added to levodopa to prevent patients from __________. A: vomiting

3.) Drugs like Requip and Mirapex are drugs that act as replacements or helpers to dopamine in the brain are called "dopamine ______________ A: agonists

4.) Carbidopa And Levodopa, or "Sinemet" was first developed in what decade? A.) the 1960s

5.) Obsessive gambling, shopping or sexual activity have been unwanted side-effects most associated with what type of PD drugs? ______________ A: dopamine agonists

6.) DBS is an acronym for what? A: Deep Brain Stimulation

7.) Exercise, when done properly can reduce symptoms by as much as __________ A: 35%

8.) Before the introduction of Sinemet, A patient lived _________ years after diagnosis with PD A: 10-15

9.) With Sinemet a person can reasonably hope for a _______ life span. A.) Full

10.) Disqualifications for Deep Brain Stimulations include __________ response to Levodopa. A: poor

11.) Loss of balance can be countered by ___________ A; exercise like Tai Chi and Yoga

12.) Phasing in a new medication by slowly increasing the dosage over an extended time is called ___________ A: Titrating

14.) The drugs known as MOA-B inhibitors block a chemical in the brain that ________________ dopamine in the brain A: breaks down

15.) What is the best form of exercise form of exercise for PD? A: Whatever you will do regularly and stick with.

16. If you suffer from, and are not treated for ______________ , this non-motor symptom will make it difficult to effectively treat the other symptoms of PD A: depression

17.) The earlier one intervenes in treating PD, with medicine or exercise, the better _____________ A: one will handle the disease over timePeter Dunlap-Shohlhttps://email@example.com:blogger.com,1999:blog-8336643719537144495.post-77043948062603824672016-03-15T10:35:00.000-07:002016-03-15T10:35:31.161-07:00Library Journal posts starred review of My Degeneration, A Journey through Parkinson's DiseaseAt Library Journal, they know books. So it has to be a good thing that they gave a starred review to My Degeneration, right? Here is where I would ordinarily pivot and confound reader expectations by arguing otherwise. But what author in his right mind would argue with this? "Dunlap-Shohl's journey of setbacks and triumphs contextualizes key disease information within a narrative suffused with emotion and wry humor. PD patients, families, and caregivers will find it valuable; those who enjoy memoirs will appreciate its compelling real-life drama." Not me.

Here is the review. Peter Dunlap-Shohlhttps://firstname.lastname@example.com:blogger.com,1999:blog-8336643719537144495.post-80689946614866100092016-03-11T10:17:00.001-08:002016-03-11T10:17:52.584-08:00March 19 Meeting Agenda- Parkinson's Trivia!
Hola Amigos! I'm back from the Southern hemisphere, re-energized, and and ready to ...uh, take a little nap. But before I do, ...ZZZZZzzzzzzz... oops, sorry, where was I? Oh yeah, South America, where they are borrowing Summer from us, but plan to return it by June. What do we do in the meantime? Let's put on a meeting! Let me check the big board, campers, for the date of the third Saturday in March, ...and it looks like March 19, 3:30 at the Pioneer Home is the date, time and place. We will play Parkinson's Trivia, so don't miss this bang-up opportunity to strut your PD IQ! And, looking ahead, mark your calendars for the May meeting, we'll have a guest from the group PD advocates. Their mission is to get good information about Parkinson's care and treatment into the hands of PWP, and to work with individuals with Parkinson's anywhere in the country to help them with any PD-related issues. It sounded too good to be true, but I checked them out and they come with high recommendations from people who work with them.

That's all for now, see you the 19th!

Peter
Peter Dunlap-Shohlhttps://email@example.com:blogger.com,1999:blog-8336643719537144495.post-43048755624174342772016-02-03T18:18:00.002-08:002016-02-03T18:19:18.527-08:00February and Parkinson's in Southcentral Alaska
Hello Friends, it's time once again to take keyboard in hand and dish the PD scoop for the month. To lead with good news, it's NO LONGER JANUARY!

I think we can all agree that's a good thing. See? we're making progress! So what's in store for February? Well, as usual there will be a Telehealth interactive broadcast on February 8th 2016 at 1PM (To find the Alaska meeting, proceed with all deliberate speed to Providence Hospital oncology wing on Piper St. ( Go to the second floor, walk down the lonnnnnnnng hall that stretches South from the cafe and look for room 2401 pretty much at the end of the hall on your right.) The speaker will be Sabina Gonder CHC Topics: Sleep Health and Hygiene. Learn why getting enough sleep is so important to your overall health, and steps to get more sleep every night.

Our regular support group meeting is set for February 20th. I will have to miss the meeting because I will be in South America, (really!) but there is no reason that everyone else should not show up, talk with one another, offer each other support and, most important, plot the coup that ousts me as leader while I'm not there to cheer it on.
Adios, Amigos!

Pedro Peter Dunlap-Shohlhttps://email@example.com


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Forum - View topicWhat is your favorite anime that is not animated well?
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Posts: 1576
Lupin III: The Woman Called Fujiko Mine:The animation is simply horrible,and in some episodes it has very hectic editing in hopes of covering up weak animation,but in the end it just makes it look like shit.To top it all of its designs are drawn by Takeshi Koike,and they look just so amazing.The last time his art was animated it took people 10 years to do that (Redline),but here they needed to that on a much,much,much smaller budget in a very busy schedule,so even that made animation look worse than it actually is.However,anime as a whole was brilliant,and there were some beautifully directed pieces along with great subversive writing.
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Posts: 977
Location: Łódź/Poland (The Promised Land)
After comparing Mine to other pieces of Lupin III universe I think it was rather a stylistic choice- there has always been something uncanny about Lupin, but some people may find it applying.
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Posts: 2206
I'm usually pretty insensitive to badly animated material if I find the story compelling. Lots of people complain about the animation of Bartender which remains among my favorites to this day.
However nothing can redeem the collapse in animation quality that occurred midway through Shion no Ou. That's Shion over there in my avatar in a cute shot from early in the proceedings. Somewhere along the way Studio DEEN must have reassigned their illustration staff because the character models took a plunge downward in the latter half of Shion. The illustrators seemed to have a particular problem with noses. They all looked like the kind of sharp protuberances that you see in drawings by young children.
The staff of Space Brothers has some issues with noses as well. Serika this week looks especially ugly in one profile shot, as do some other cast members.
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Posts: 223
It certainly had times where it didn't look the best but it didn't seem particularly horribly animated to me. I do love that show though.
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Posts: 4118
Has anyone mentioned Bleach yet? THe animation is just so-so but some of the character art is just ghastly. Orohime and Rukia, the supposed lead female sex objects, are about as sexy as a rancid half melted fudgesicle. I don't think they have one artist working there that knows how to draw a face or a boob.
Yet I have stuck with it over 350 episodes so far. It's creativity resides in its outlandish plot and theology (for lack of a better word) but certainly not in its art. I will say (as others have) that they do manage to produce an astonishingly wide array of independently recognizable characters.
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Jose Cruz
Posts: 1216
Location: Serra Gaucha/Minnesota
Serial Experiments Lain has very limited animation and a very contained overall visual style. Legend of the Galactic Heroes has also very limited animation. Two very impressive series.
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Posts: 251
Location: Anchorage, AK
What I know about Bleach's animation is this:
I'm neither a fan or not a fan of the overall style, but the quality in the animation itself fluctuates like crazy bananas. Some (most) of the filler has just blech animation, washed-out colors and a real noticeable drop whole others, such as spoiler[Ichigo going H2 against Ulq or his first real fight against Grimmjow] were flipping amazing.
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Posts: 688
Trigun, definitely. Although I don't find it badly animated (I actually enjoy the looks of it quite a lot), but it is indeed very limited. However, it doesn't diminish my enjoyment in the slightest since the story and characters are so incredibly engaging.
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Posts: 4136
Location: Ottawa, Canada
In general, any favourites of mine that are longer fall into this, at least in some episodes, for obvious reasons. I've recently been rewatching NANA and there are some moments that aren't terrible but also aren't great. However, the writing and voice work is awesome and there are moments when they really get do put more effort into the visuals which really makes the character designs shine.
A few other favourites fall in the same trap, where they only look good some of the time, though they do have very good designs, IMO. Fushigi Yuugi and Vampire Knight come to mind, though the latter, IIRC, looks good most of the time.
And I also agree with Trigun, which has a few good visual moments but these are few and far between.
I can't think of many others but this is likely due to the fact that most of my favourites tend to be shorter which in general means less stretching of the animation budget (assuming there was a decent budget to begin with).
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Posts: 14563
Location: Indianapolis, IN (formerly Mimiho Valley)
I think you'll find some very strong disagreement on this one.
Crest of the Stars wasn't among the greatest on animation quality but it was hardly bad enough to deserve to be brought up on this list. And while Kaze no Stigma wasn't a good series overall, its animation was not one of its main problems.
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Collector Extraordinaire
Posts: 3082
Location: New York state.
Would likely go along with Koi Kaze. The animation's not top-notch, fluid or richly detailed as well-animated works of the time period like Gungrave, Kurau: Phantom Memory or Ghost in the Shell: 2nd GIG. But it does its part to compliment the down-to-earth and realistic look into the increasingly forbidden relationship between siblings Koshiro and Nanoka with the series being a rarity in tackling the taboo of incest in a serious and tasteful light compared to other titles that exploit it for either cheap melodramatics or perverted antics to be found in an ecchi or hentai title.
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Posts: 140
Space battles aside, there were plenty of places where Jinto/Lafiel were drawn in ways that made me laugh. I'm not saying Crest is bad, and frankly I don't know many shows where the animation is outright awful and I still like it, but I do think a lot of things about it were immersion breaking.
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Posts: 977
Location: Łódź/Poland (The Promised Land)
There were lots of places where they looked like suffering from hydrocephalus.
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Posts: 140
I laughed again.
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Posts: 4118
Some fight scenes are pretty good, but when they di they could never resist stretching them out for about 9 episodes and those recaps at the beginning of each one.
As for Orehime, what can you say when her peak moment is here. I forgot to mention that before.
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The Mike Toole Show - Hollywood Blues
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Miss Hokusai BD+DVD
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Robert de Vere, 6th Earl of Oxford
From Wikipedia, the free encyclopedia
|Robert de Vere, 6th Earl of Oxford
Hedingham Castle, Essex, seat of the Earls of Oxford
|Margaret de Mortimer
Sir Thomas de Vere
|Noble family
|De Vere
|Robert de Vere, 5th Earl of Oxford
|Alice de Sanford
|c. 24 June 1257
|before 17 April 1331
burial at Earls Colne, Essex
Robert de Vere, 6th Earl of Oxford (c. 24 June 1257 – 17 April 1331) was the son and heir of Robert de Vere, 5th Earl of Oxford, by his wife Alice de Sanford.
Robert the younger took part in several of the military campaigns of Edward I, Edward II and Edward III in Wales, Scotland and France. His coat of arms appears in the 1298 Falkirk Roll at the Battle of Falkirk. He was married to Margaret Mortimer, daughter of Roger Mortimer, 1st Baron Wigmore. He also officiated at the Coronation of Queen Isabella, wife of Edward II, in 1308. His only son Thomas died before him, and when Robert died in 1331, he was succeeded by his nephew John de Vere, 7th Earl of Oxford.
- Richardson, Douglas (2011). Magna Carta Ancestry: A Study in Colonial and Medieval Families, ed. Kimball G. Everingham. IV (2nd ed.). Salt Lake City. ISBN 1460992709
|Peerage of England
|Preceded by
Robert de Vere
|Earl of Oxford
|Succeeded by
John de Vere


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Bush, dogged by Cindy at his "ranch", will jet back to DC to deal with Katrina.
Dubya says he will cut his 5-week vacation short by a whole two days to watch over Katrina disaster relief funds. Wow. If only he would pay so much attention to the $ in Iraq, we might have been able to keep track of it all. I guess that's what Halliburton is for.
On a serious note, those folks on the Gulf Coast need our help, and the best way to do that is to donate a few bucks.
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Mick Deane, a 61-year-old father of two children, had worked for Sky for 15 years
A cameraman for Britain\'s Sky News was shot and killed in Egypt Wednesday covering the violence in Cairo, the news organization said
Mick Deane was part of the Sky News team working in Egypt, where scores died as soldiers attempted to clear protests by supporters of the Muslim Brotherhood calling for the reinstatement of Mohamed Morsi as president.
The head of Sky News John Ryley described Deane as the very best of cameramen, a brilliant journalist and an inspiring mentor at Sky.
Foreign editor Tim Marshall called Mick \"a friend, brave as a lion but what a heart ... what a human being,\" adding he was humorous and wise.
British Prime Minister David Cameron tweeted he was \"saddened to hear of the death of cameraman Mick Deane, covering Egyptian violence.\"
Express news based in the United Arab Emirates reported one of their staff reporter's, Habiba Ahmed Abd Elaziz, was killed in the Rabaa al-Adawiya Square in Cairo.
According to Express, Abd Elaziz was not on any official assignment and had gone to her home country on annual leave.
XPRESS deputy editor Mazhar Farooqui said the entire team is in a state of shock. "It's hard to believe she's gone. She was passionate about her work and had a promising career ahead."
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