Denver-area Parkinson’s patients find help with exercise, brain surgery

Parkinson’s patients find help with exercise, brain surgery

Posted 9/21/15

For Robert Rynerson, walking down a sidewalk without tripping and falling over the uneven concrete is a major accomplishment.

Rynerson, 68, a Denver resident who has Parkinson’s disease, thanks his exercise class for that.

“The classes …

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Denver-area Parkinson’s patients find help with exercise, brain surgery

Parkinson’s patients find help with exercise, brain surgery

Posted

For Robert Rynerson, walking down a sidewalk without tripping and falling over the uneven concrete is a major accomplishment.

Rynerson, 68, a Denver resident who has Parkinson’s disease, thanks his exercise class for that.

“The classes help with being specific to the needs of Parkinson’s,” with their focus on better posture, balance and control of his body, Rynerson said.

Rynerson was diagnosed with Parkinson’s in January 2013, while he was still working for the Regional Transportation District. He retired in July 2014 after 29 years of service.

“I was able to complete my part in those career-long projects,” he said, referring to the light rail system’s West Line and the Union Station renovation. “But my colleagues could tell I was running out of energy, and it was time for me to look after myself.”

Parkinson’s disease is a progressive and degenerative brain disorder that affects a person’s muscle movement. An estimated 4 million people worldwide have Parkinson’s, and nearly 1 million of them live in the U.S. An estimated 60,000 new cases are diagnosed in the U.S. each year, according to the Parkinson Association of the Rockies.

The most difficult challenge of the disease, said Denver resident Brian Hyde, 66, who has dealt with Parkinson’s for about 11 years, is “overcoming the feeling that you can’t do the things you used to be able to do.”

No cure exists for Parkinson’s disease, but there are ways for people to improve their quality of life. A regular exercise regime that focuses on neuroprotection, protecting neurons in the brain from degeneration, and neuroplasticity, getting different areas of the brain to do the work, can help. Deep brain stimulation surgery, or DBS, which was approved by the U.S. Food and Drug Administration for Parkinson’s disease in 2002, can alleviate motor symptoms that affect those with the disease.

“You want to see people doing stuff,” said Erica DeMarch, a physical therapist who has been teaching an exercise class for Parkinson’s patients for the past four years. “You don’t want them to stop just because they have Parkinson’s.”

People who attend her Edgewater class have seen results, she said. One climbed a Colorado fourteener. Another took a trip to Disney World. Still another traveled to China.

“People can do a lot more when you expect more from them,” DeMarch said. “It’s important for people to know — and feel — that they can do it.”

The most rewarding part, DeMarch said, is “to see the smiles — and when people tell me how much better they feel.”

DBS can back up symptoms about 10 years, said Dr. David VanSickle, who performs about 100 DBS surgeries a year, mostly through his Denver DBS Center, which is an affiliation of South Denver Neurosurgery headquartered at Littleton Adventist Hospital.

The operation can help most motor symptoms of Parkinson’s — tremor, rigidity, slowness — but does not help non-motor symptoms such as sense of smell or balance, for which some Parkinson’s patients may still need medication.

Some Parkinson’s patients must take 20 to 30 pills a day, VanSickle said. But after DBS, that amount can usually be cut by at least half.

One of the surgery’s most favorable results, according to patients, is the ability to regain facial expressions, VanSickle said. “That helps them with their relationships. It might sound superficial, but people are always happy with that.”

The surgery entails implanting an electrode into the patient’s brain and connecting that to a neurostimulator, a device similar to a pacemaker, implanted in the chest near the collarbone.

Marilyn Cloud, 78, underwent DBS surgery about six years ago to treat essential tremor, a nerve disorder characterized by uncontrollable shaking. Similar to Parkinson’s, essential tremor starts gradually and “creeps up on you,” Cloud said. Hers began with one thumb in the latter years of her 60s.

Also like Parkinson’s, the affliction worsens and has no cure. But Cloud found her answer with DBS surgery.

“When my stimulator is turned off, it’s essentially like I have no hands,” she said, “because I can’t do anything with them.” She can’t write or type on a keyboard, put in earrings or apply makeup, and she is unable to eat “very gracefully.”

DBS truly can improve a person’s quality of life, VanSickle said.

“It works, it’s safe and it’s minimally invasive,” he said, noting risks include about a 2 percent chance of infection and a rare chance of stroke.

But, he added, before and after DBS, exercise also has proven benefits.

Hyde and Rynerson agree.

“The best days for me are the days I come to class,” Hyde said.

And the group exercise atmosphere is helpful, Rynerson said. “I tend to get busy. The group activity reminds me that I have to keep doing it.”

It’s all about regaining a feeling of independence.

“This helps us get back some of that control,” Hyde said. “The more we can do for ourselves, the better for our families.”

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