The Very Real Cost of Denial, Apathy and Complacency: Don’t Wait for the (Sinemet) Honeymoon to be Over!

This post was originally published in the PD Gladiators newsletter.

When you’re first diagnosed with Parkinson’s disease, it’s typical to go through the stages of grief. Without counseling, many view the diagnosis as a death sentence, with nothing to do but take medicine to mask the symptoms until the disease progression robs you of your mobility and independence.  But the latest scientific research reveals a very real cost to delaying a more proactive approach to your treatment.

By the time of diagnosis you’ve lost more than half your dopamine producing capacity. Those neurons continue to die at a steady pace, so every day lost to denial, apathy or complacency has a real and potentially unrecoverable cost if an intervention could otherwise slow the pace of cell death.

The latest scientific literature (see text box) makes a compelling case that vigorous and varied exercise may slow the progression of PD. Naturally, the best time to start exercising is as soon as possible after diagnosis, before fatigue and mobility issues make it harder (but not impossible!).

The PD Gladiators Metro Atlanta Fitness Network [Ed. Now operated by the Parkinson’s Foundation] focuses on group exercise adapted for people with PD because (a) the classes are targeted towards PWPs’ particular impairments, (b) there’s a sense of camaraderie that develops among the group because the participants are fighting a common battle that is not completely understood by others–a support system many find more natural than in a formal support group setting, (c) many PWPs don’t feel as uncomfortable if they start exhibiting symptoms than they would in a general population class, and (d) PWPs are more likely to adhere to their exercise programs because they look forward to seeing their new friends in class.

Network group exercise classes are offered by independent fitness instructors and most metro Atlanta YMCA branches. The YMCA also offers an excellent, free exercise adherence program called THE COACH APPROACH. But if you can design an exercise program on your own (or with the help of a physical therapist and/or a Network certified personal trainer) and have the discipline to stick with it, that’s fantastic.

But whatever your exercise preferences, don’t delay! Unfortunately, the PD won’t disappear and the neurons won’t stop dying while you’re on your Sinemet honeymoon or just going about the ordinary business of living while you’re still relatively unimpaired. The best way to fight back is by creating an effective, fun and sustainable exercise routine and sticking to it.

The Neuroscience: Exercise May Offer Our Best Hope of Neuroprotection. The Petzinger, Ahlskog and Farley & Hirsch scientific articles on exercise, PD and neuroplasticity featured on our website suggest that actual changes in the brain resulting from exercise may slow progression, produce compensatory mechanisms to restore functions lost to PD impairments or even rejuvenate or regenerate lost neurons. Exercise gives us hope that PWPs can take back some control from this terrible disease. Vigorous aerobic exercise produces a brain chemical called brain-derived neurotrophic factors, which may create the ambiance for more finely-tuned, goal-directed activities–those that directly address the mobility, balance and coordination deficits we face–to burn new neural pathways that compensate for those deficits. This suggests the ideal exercise routine for a PWP is consistent with the American College of Sports Medicine’s guidelines, combining optimal amounts of cardiorespiratory, neuromotor, resistance and flexibility activities.  

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