Medical Mis-Adventures

Sometimes the road goes uphill more than you anticipate. I was prepared for the summer’s predicted heat to be challenging for a couple of reasons:  1) elderly people are greatly affected by hot weather—at 80, I am officially “elderly”—and 2) heat is stressful and any kind of stress exacerbates symptoms of parkinsonism.

I didn’t expect to be stopped in my tracks. I had plans—workshops I was going to teach, research I was going to do. Instead, I spent vast amounts of time reading detective novels and taking long afternoon naps.

Dehydration

Because it affects the autonomic nervous system, PD has numerous non-motor symptoms that are less well-known than the tremors and stiffness—bladder control, for example. This challenge is common with old age, hence the drugstore shelves stacked with adult underwear. Thank heavens I don’t need those, but I do sometimes drink less water than I should because it’s tedious to keep running to the restroom. More than you wanted to know, I’m sure.

In July I became dehydrated, a condition that resulted in orthostatic hypotension. This means that when you go from sitting to standing your blood pressure falls enough to make you dizzy.  It’s a common PD symptom. The first time it occurred I was getting out of a swimming pool. Luckily there were bars beside the steps that I could hold onto until I felt steady.

This new adventure happened just after I had managed to chase away a pain in my knee (see earlier post) and was ready to get back to the boxing workouts I enjoy so much. Not just yet, my dear: you can’t go chasing your target heart rate with your blood pressure in this pickle.

A Dizzying Month

One thing led to another.  First, more fluids, of course, and electrolytes.  More fluids did what more fluids always do..., and the electrolytes gave me the “runs”.  But I was still getting dizzy.

Parkinson’s medications can lower blood pressure. So the doctors reduced the amount of medication I take for mild hypertension, a condition I’ve had for years. The good news was that this change did not make my blood pressure spike, but it didn’t stop the dizziness. Neither did wearing compression sleeves on my calves.

I got tested for BPPV (benign paroxysmal positional vertigo), the most frequent form of vestibular dysfunction in the elderly.  But there was no debris in my inner ears.

Meanwhile I checked my blood pressure three times a day. It leveled out and stopped doing that orthostatic thing—but I still felt dizzy much of the day. My own body awareness advice for staying grounded was indispensable:  “heavy malleoli”, “weighted rami”.   

Medical Advice from My Inner Self

After a month of this, I had a dream.  About once each decade I have what I think of as a “true dream”, one that gives me good advice. 

There’s back-story to this. A year ago, based on blood testing, my doctors lowered my thyroid medication.  For 35 years I’d been taking 120 mg. per day until these doctors decided I was over-medicated and reduced it to 90.  Great, I thought, the fewer meds, the better.  But then, six months later, they suggested I go down to 60 mg. This seemed odd to me, so during my travels last Spring, I stayed at the higher dose.  But when I returned home I followed the doctors’ orders. 

Then I forgot all about it.

Thanks to Dr. Google, I’ve since learned that thyroid medications take longer than other drugs to fully affect the system, either going up or down.  So it might be four to six weeks before I felt the effect of the lowered dose.  And guess what?  Six weeks later is when I started being dizzy, spending every afternoon napping, and letting my enthusiasm drain away.

In my dream I was told that I had a choice between 60 or 90.  It was only after I woke up that I remembered the changed medication. I immediately put myself back on 90 mg.  Within a week, no more dizziness. No more unreasonable fatigue, and most gratefully, a return to the outlook on life that I hadn’t known I’d lost. 

The American Medical System

I like my doctors.  My neurologist is a well-known researcher on the effect of high intensity exercise on lowering PD progression.  I’m lucky to have her.  My naturopath has spent years researching the effect of diet on PD progression.  So again, I’m lucky.  And my internist is great because she doesn’t object to my many alternative medicine choices. 

All three doctors see patients who are in desperately worse shape than I am.  Perhaps my complaints don’t make much impression because, comparatively, I’m doing so well. All three doctors were rushed when I saw them and two were leaving the next day on vacation. Not one of them took the time to check the thyroid change in my medical history. 

This is not their fault. The pace of modern living has made mental distraction a normal state. And Covid has been overwhelming for all medical personnel.

My advice? Know that as you grow older, s...t will likely happen no matter how well you’ve managed your health with good nutrition, Chinese medicine, Ayurveda, homeopathy, or other wellness alternatives. You may one day require the assistance of mainstream medicine, and you’ll need to be able to advocate for yourself in that world. Learn to research things on your own. That doesn’t mean you can trust everything you find on Dr. Google. But if you look at scientific journals—even if you barely understand the synopses at the tops of the pages—you’ll find questions to ask your doctors. Don’t assume that doctors will think of everything.

 © 2022 Mary Bond