all the world's a stage

At first blush, you wouldn’t think that people who have Parkinson’s disease and actors in an improv comedy show have a lot in common.
Actually, they do. And the truth of that statement was driven home to me this week, when members of a support group organized by the Parkinson’s Albert a Society that I belong to attended a zany, funny improv performance at Calgary’s Loose Moose Theatre Company.
Improv comedy, as many of you no doubt know, is unscripted and spontaneous. In this case, the actors started out with lines of unrelated dialogue that audience members had scribbled on small sheets of paper before the performance. These lines were then scattered across the stage floor. The first one an actor picked up at random became the title of the play: ‘You Wouldn’t Understand It, You Weren’t in the War.’
Every so often, each actor had to in turn pick up one of the random lines and immediately use it in their performance, making for some hilarious, jarring plot turns in what turned out to be a tale about rescuing a financially troubled farm tractor company, an executive who lost his legs in the war, his loyal female administrative assistant and her ex-lover…well you had to be there to understand it all.
Afterwards, I thought about the similarities on the stage and in my life.
• Improv actors must do their best to shine with the lines they get. Likewise, people with Parkinson’s performing on the stage of life must find a way to cope with being dealt the unexpected ‘line’ of a PD diagnosis
• Both actors and PD patients must ‘go with the flow.’ Like an improv plot, sudden changes in your life come with Parkinson’s. Get used to it
• Nobody walks alone. Good improv actors need to help each other to make the play work; PD patients need their caregivers and support networks to make their lives work. Often we must learn to ask for help
• It really helps to have a sense of humour and the ability to live in the moment
• Crises can present opportunities. Improv actors can flounder and then just a moment later, confidentially launch the story in a new direction. Ditto for our lives with this disease
• There are no do-overs on the stage or in life. You can complain endlessly or resolve to make the best of it
• You may be surprised with what the actors fashion from the little they have to work with in the end. As someone with PD, I’m often amazed at what positive changes and experiences a rocky and steeper path has brought into my life
As William Shakespeare wrote in The Merchant of Venice: “All the world’s a stage, and all the men and women merely players.”
Me, I’m ready for some more improv. You know, laughter is therapeutic.

surgery could help control symptoms

I’m going to have brain surgery designed to help control my Parkinson’s disease symptoms.
It’s news that I’ve long hoped would come true and it leaves me feeling both frightened and fascinated. I’m frightened because, well, it’s brain surgery. And fascinated because it actually can be done successfully on people like me.
I truly will have some holes in my head, as some people may have suggested at times. The surgery -- Deep Brain Stimulation to a site known as the Globus Pallidus -- will be done at Foothills Hospital in Calgary, hopefully sometime early next year. No date set yet.
Electrical impulses generated by a pacemaker-like device implanted in my trunk will be conveyed by wire to the location deep in my brain, where muscle movements are controlled.
This procedure has been helpful in alleviating symptoms for hundreds of patients like me whose condition has grown worse due to PD’s progressive nature.
We may be experiencing abnormal involuntary movements, called dyskinesia, a side effect of the medication. Sudden and unpredictable periods of immobility can alternate with periods of too much movement. I know as I’ve experienced dyskinesia and immobility, and both are frustrating. The surgery may help.
Prime target of this surgery, though, will be to ease the dystonia in my neck -- powerful spasms that constantly push my head up and to the right. Currently, I receive Botox injections every three months to help calm those renegade muscles in my neck. I’ve gone from a 17-inch neck size in my dress shirts to a 19 ½ because my constant movement when I’m awake has built more muscle.
Any other positive results of the surgery – fewer tremors or improved walking – would be a welcome bonus. It's unlikely my medication needs will decrease. I’ll end up with a hand-held controller to turn the stimulator on and off and change its settings slightly.
I will be one step closer to becoming the Bionic Man, what with my heart pacemaker, metal hip joint replacement and new eye lenses inserted when I had cataracts removed two years ago.
Yes, the surgery does have risks, such as stroke or bleeding in the brain. Personality and mood changes may also occur. But the statistical likelihood of those risks is tolerable in comparison to the potential benefits, which I’ve discussed in detail with my neurologist, surgeon and family.
In Alberta, costs of the surgical procedure and any support services are covered by provincial health care. I consider myself fortunate to live in Calgary, where the medical staff with the expertise to do the procedure is experienced and accessible.
The multi-stage operation, pioneered in France in 1993, showed decreased severity of symptoms in subjects and reduction in dosages of levodopa, prime drug used to control PD. Since then, other medical centres around the world have documented similar results.
I will be awake for the first day of the two-part surgery – the implantation stage – as I need to assure the surgeon that the correct target in the brain has been reached. CT scan or MRI technology is used to plan and map the surgery as well.
Several days later in a second surgery, the electrodes will be tucked under my skin and the battery-driven stimulator installed. I'll be anaesthetized for this part.
I’ve already been through some pre-screening for the procedure, such as a battery of psychological tests to provide a baseline of my mental functioning prior to surgery. These results will likely be compared to results post-surgery.
It’s all very exciting and amazing, and I will keep you up to date on this blog as it all unfolds. I’ll need all the positive energy and thoughts that I can muster for the big event. For more information on this surgical procedure, visit http://www.medicinenet.com/deep_brain_stimulation/article.htm