Understanding the Transient Nature of the Parkinson’s Experience
Coping with the unpredictability and randomness of Parkinson's symptoms
Mornings may be broken with Parkinson’s disease, but the entire day isn’t shot. There are ugly days that land me in bed, but there are also lucid windows that help me write. The lived Parkinson’s experience changes from day to day, and on any given day, fluctuations can occur in “off periods.” The Parkinson’s experience is transient, always flickering.
The problem with the transient Parkinson’s experience is that so often it’s unpredictable. This unpredictability ends up being a disabling symptom of its own.
In “Counterpunch: Duking it Out With Parkinson’s,” author Gil Thelen describes how difficult the unpredictability of the transient experience can be on family:
“An […] impediment to our marriage was my adjustment to Parkinson’s unpredictability and randomness. I could not count on anything about tomorrow, including being alive to see it. Today is all I have. Past and future matter much less than they did pre-PD.”
The transient experience of Parkinson’s may occur because the dopamine neurons don’t all die instantly. They flicker like a worn-out lightbulb, eventually failing over time. A dying neuron makes its way to neural heaven slowly.
Why is stress so devastating to people with Parkinson’s? Because these flickering pathways are asked to perform in demanding situations — physical, mental, emotional. On those ugly days when I’ve been stressed during my off period, it feels like my world is imploding.
My goal in managing Parkinson’s has been to reduce the impact of the worst of times. Understanding and then using the transient nature of the Parkinson’s experience helps me find the tools and plot the course. The flicker effect of this chronic illness is my biofeedback tool. The transient nature of Parkinson’s helps me learn what makes the flicker worse, and what makes it less problematic. I can’t stop it, but I can steer it.
In addition to its usefulness in biofeedback, another benefit of the transient Parkinson’s experience is that it gives Mrs. Dr. C the opportunity to say, “This too shall pass” and mean it. We regularly check in with each other to see how things are going. It’s a friendly, nonjudgmental conversation. I can share where I’m at in that moment. Often I can judge how long the worst will last. I share that with her during the check-in. It makes enduring the worst easier on both of us to know that it will end, and when.
Mrs. Dr. C and I have been able to work through the randomness of these ugly times by paying attention to triggers that we know will cause a flare in Parkinson’s symptoms, such as being in the car on a hot day or being in the overly crowded grocery store on the weekend. Avoid the triggers and the worst is a bit easier. Cancellations occur less often now because of our understanding of the transient Parkinson’s experience.
When I came to understand the flicker effect, I became better at predicting its occurrence. Let’s break it down. The following affect the transient experience:
- Shifts in homeostasis
- Shifts in emotional states and state shift surges
- Bio-clock distortions on both daily and monthly cycles
These modifiers can be manipulated, to a certain degree, using the Parkinson’s self-management toolkit. If I’m mindful that these events can occur, I can offset the worst by being aware of triggers. Even though I can’t always avoid a trigger event, I can affect the degree of uncertainty connected to the transient Parkinson’s experience.
We have not been shy about sharing what triggers I need to avoid (if possible) with family and friends. We set limits on how much driving we can do and factor that into the total experience of sharing time with others. There is hardly a time when we won’t show up. We are present in the moment as best we can manage.
On ugly days that feel impossible to manage, I repeat to myself, “This is transient. This too shall pass.” I need the promise of ordinary calmness to help get me through the worst of the transient episodes.
A note of thanks to our readers who follow the Dr. C columns. Mrs. Dr. C and I are taking a short hiatus from column-writing during September to recharge our batteries. Our big project is finishing book two in the “Possibilities with Parkinson’s: Using the Self-Management Toolkit” print version. We will be back on Oct. 14 with new and fresh ideas about possibilities with Parkinson’s.
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.