Exploring the right combination of treatments for Parkinson’s disease

Facing an increase in symptom-related challenges, a columnist looks for solutions

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by Doc Irish |

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In my last column, I discussed the importance of pursuing a collaborative effort with healthcare providers to develop a holistic and personalized approach to managing Parkinson’s symptoms. Today, I’ll delve into the ongoing trials and errors I’ve encountered in identifying the most effective combination of therapies to alleviate my symptoms.

Recently, I’ve faced increased challenges with pain, freezing gait, foot drop, left-calf dystonia, and a general inability to relax my body. A spinal MRI revealed herniated disks and a pinched nerve, prompting a multifaceted response from my healthcare team.

My movement disorder specialist prescribed amantadine to address the dyskinesia, or uncontrolled, involuntary movements, while my primary care physician opted for gabapentin to tackle the nerve-related pain. Additionally, a referral to an orthopedic specialist, recommendations for decompression therapy and an epidural steroid injection, and an appointment with a postural restoration-certified therapist followed suit. My physical therapist also emphasized strengthening exercises.

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The role of breathing

Simultaneously, I have started exploring the role of breathing techniques in improving posture and muscle tone. Could mouth breathing be contributing to my issues? Intriguing resources like the book “Jaws: The Story of a Hidden Epidemic,” by Sandra Kahn and Paul R. Ehrlich, and an app called Oxygen Advantage shed light on the significance of breathing and posture.

Acknowledging the complexity of addressing numerous interventions within a condensed time frame, the ideal scenario might involve isolating variables to test each therapy independently. However, the reality of a ticking clock compels me to pursue every reasonable option as soon as possible. In a world where my brain-body connection seems in constant flux, recalibrating all of the crucial inputs seems imperative.

Remarkably, I’ve already experienced a notable reduction in pain. While it’s impossible to attribute this improvement to a single reason, practicing the nose-breathing techniques seems to be having an impact.

I previously dismissed breathing as a trivial and automatic bodily function, but now I’ve started to consciously attend to nose breathing. The effects extend beyond the obvious ones, such as a reduced heart rate and lower stress. I’ve discovered a centering in my core, a sort of equilibrium between my lungs and hips that facilitates relaxation throughout my body. Rather than compensating with a flexed back to counteract stooped posture, I now sense a better internal balance as my diaphragm engages on both sides, inflating my lungs fully and stretching my spine. Walking becomes a more grounded experience, almost like riding on a fully inflated tire instead of a wobbly, flat one.

As we grind it out with Parkinson’s disease, time will tell what works and what doesn’t, and when. I’m thankful for the support and coordinated efforts of my healthcare providers. In this ever-changing situation, we continually adapt our approach based on personal results, recognizing that the target is always moving.

In closing, one of my sisters reminded me this week of the amazing capacity for resilience that we have. For my new personal motto, I’m borrowing a phrase from the Navy SEALs: “Embrace the suck!”

Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, BioNews, and are intended to spark discussion about issues pertaining to Parkinson’s disease.


Ted E Brim avatar

Ted E Brim

Move - "Motion is Lotion".

Doc Irish avatar

Doc Irish

Hi S.RAMASWAMY - please consult your personal physician for advice regarding treatment options.

Doc Irish avatar

Doc Irish

Hi Ted E Brim, RE: Move—"Motion is Lotion." I like it. I couldn't agree more; I personally feel that action-perception loops integrated from all the senses, with precise timing, are the critical mix. Here's another rhyme to consider: Instead of the old Hebbian mantra, "neurons that fire together wire together," think from a larger perspective of global patterns, "peripheral sensory patterns that perceive together weave together." Where active perception is a form of neurological motion but obviously doesn't replace physical lotion.

Laurie avatar


Thanks for the article. Trying to manage all the symptoms of PD and all the medication side effects is certainly a challenge.
"Embrace the suck"....yes, a good phrase to remember!

Nicholas Coldrick avatar

Nicholas Coldrick

I always enjoy your posts Doc Irish, thanks for this!

Terri Duffy avatar

Terri Duffy

EMBRACE THE SUCK is a great motto, thanks!

Re: mouth breathing. I do this mostly at night. Any advice is welcome. Seems to me that I’d have to tape my mouth shut, not ideal.



I am 72. I have Parkinson disease for the last 10 years. I am taking medicines regularly. No considerable improvement is seen from the symptoms.

Please suggest whether DBS surgery is advisable at this age and whether any risk factor is there in the surgery.

Doc Irish avatar

Doc Irish

Hi Terri Duffy - mouth breathing does seem like a ridiculous thing to focus on, and taping your mouth shut at night, at first, might feel even crazier. BUT... check out the myotape (https://oxygenadvantage.com/breathing-exercise-tools/#myotape) as one option on the Oxygen Advantage website referenced in the article - you'll see that "MyoTape sleep strips surround the mouth, and bring together the lips with light elastic tension. They do not cover the mouth." For me, it's less claustrophobic than I anticipated. Could be worth a try :)


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