Blog written by Parkinson's author, advocate and speaker, Kirk Hall, that addresses subjects of interest to the Parkinson's community including living with PD, research developments and more.
Monday, February 3, 2020
Tremble Clefs Grant
I contacted the two CA groups and learned that they were already working
on proposals, so I forwarded the information to Jim and Sun Joo and asked
if we had someone in our group with grant writing experience. They were
keen on the possibility of a grant, but said we didn’t have anyone with
experience in this area. Jim asked if I would be willing to do it. Though I
had never written one, I had some experience with them from my
consulting days. I told Jim I would give it a try.
I read through the application and started to work on it. I remember
debating about how much to ask for (anything up to $25,000). As I
reviewed the guidelines that talked about what they were looking for, I
realized that our chances of getting approved would be much higher if we
could come up with a plan that involved incremental benefit to the PD
community in the Phoenix area (beyond what we were currently doing).
At the same time, I thought it was important for them to know that we
are completely self-funded and that a lot of work (by our group members)
goes into making ends meet on a yearly basis. All this without the
support or encouragement of a regional support organization, which in our
case is Parkinson Network of Arizona (PNA). Due to the nature of this
relationship, we had recently applied for and received 501c3 non-profit
status. This turned out to be a good thing as it was one of the application
requirements.
I thought it might be a good idea to estimate the potential demand for PD
services such as TC by looking at PwPs (people with PD) as a % of the
national population and applying that % to the population of Maricopa
County. That showed that, even with the growth of our existing groups,
there were MANY potential new members. I also cited the growth we have
been experiencing year over year in our existing Sun City group and that
our resources were “stretched to the limit”.
After meeting with Sun Joo and Jim, we decided to propose a plan to add
a second Sun City group. I also remembered Sun Joo talking about a
group that wanted to “come on board” in the Chandler area. So the
combination of this proposal for two new groups in the context of what
was already being accomplished faced with a variety of challenges became
the focus of the application for a $25,000 grant.
Another factor that I was hoping would help was the already-existing
significant working relationship I had with PF and previously with PDF
(they had merged the previous year). I really don’t think this affected the
outcome, but they did “cut me some slack” after the proposal had been
submitted by asking for additional information and clarification.
In the end, I was able to respond to these requests as a result of the hard
work and cooperation of members of our group. I think it was in April that
I received word that our proposal had been approved for $20,000. They
explained that they were unable to fund the full request due to the volume
of worth applications they received. While there was no guarantee of
ongoing support, it was clear that they like what we are doing and implied
that the support could be ongoing assuming we live up to our end of the
agreement (do what we said we are going to do). The first $10,000 check
has been received. The next step will be to provide a progress report in
October.
Another important part of the context for this proposal was a detailed
description of the benefit of participating in TC to our members including
the inspiration, community, support, strengthening of our voices,
multi-faceted therapy provided by Sun Joo and, most of all, the joy that
singing brings to our lives. With that in mind, I shared with PF a vision of
TC becoming a national program and my opinion that they are uniquely
capable of helping make this happen!
So far, so good…………..
More Time
We have all known friends or family who died with little or no warning. Whether it
is a heart attack, a car accident, or something else unforeseen, we feel badly for
the person and his or her family. Of course, there is the pain and loss associated
with the event. Beyond that, we wish for their sake that it had been different.
We wish they would have had more time. More time to spend with people they
loved and who loved them. More time to finish things that were left undone.
More time to spend doing the things they loved most. More time to say goodbye.
And yet, if we were given the opportunity to know in advance when we are going
to die, most of us would probably say no. Why ruin the time we have left because
we know that the “clock is ticking”. It is something we would rather not think
about because we fear death. That is human nature.
While living with PD is no picnic, we have traditionally been told that it will not kill
us. We have been told that we will die “with” PD, not “from” it. And yet, PD is
the 14th leading cause of death in the U.S. And up to 75% or more of PwPs
will develop dementia, which is terminal, during the course of their disease. And
we know that aspiration caused by PD swallowing problems can be fatal.
The following is from the Michael J. Fox Foundation website:
Will I die from Parkinson's disease?
Most doctors say that Parkinson's disease itself is not fatal. You die with
Parkinson's disease, not from it. However, as symptoms worsen they can cause
incidents that result in death. For example, in advanced cases, difficulty
swallowing can cause Parkinson's patients to aspirate food into the lungs, leading
to pneumonia or other pulmonary conditions. Loss of balance can cause falls that
result in serious injuries or death. The seriousness of these incidents depends
greatly on the patient's age, overall health and disease stage.
I don’t think this information is designed to be purposely disingenuous (what a
great word!), but it smacks of “word-mincing”. By the way, similar verbiage is
found on all the national PD websites
Please don’t book a one-way ticket on a “lemming express” (small arctic rodents
that stampede, following each other over the edge of a cliff) after reading this.
OK, I’ll say it. We are all going to die! Big deal, right? Everybody knows that.
OK, everybody take a deep breath. Then review my opening comments about
wishing for more time. You could still get hit by a truck tomorrow or die from an
unrelated cause. Otherwise, PD will get you eventually. If you choose to accept
the idea that PD is an “end-game” proposition, you have given yourself the gift of
“more time”. How much more is an estimate depending on your symptoms and
how advanced they are, but you get more time regardless.
How will you use that time? I came to the conclusion I outlined here a few years
ago and this is what my care partner and I have done (I am 69 and was diagnosed
ten years ago):
Linda and I have become “members” of the PD Palliative Care (PC) Clinic at
University of Colorado Hospital. The PC team (PC doctor, nurse, social worker, and
chaplain) has helped us make end-stage choices and plans based on our
preferences designed to minimize chaos-related stress when the time comes.
We both receive customized care, counseling, or other service based on our needs.
Sunday, January 26, 2020
New medication for constipation
Thursday, January 2, 2020
Legacy
It is 4:30 in the morning. I do a lot of my “deeper” thinking during the night. It seems like I have better “clarity” at that time. Possibly because there is less mental traffic to clog my circuitry. Another possibility is that my judgement is not great at that time, which leads to ideas that “lose their luster” in the light of day,
In any case, I have been thinking about the above topic since writing the piece yesterday morning about Robin Williams. I think most of us, or at least some of us, think about what our legacy will be from time to time. That may lead to thinking further about what we would like it to be. I spent a lot of time in my business career doing strategic planning. One of the most important parts of this process was deciding “where you were trying to go” as an organization. Later in my career I had a business that helped people with career planning which often started with the individual answering the question “what do I want to be when I grow up”. In other words, developing an individual strategic plan.
That is all any of us can really do when it comes to our legacy. Imagine someone describing our legacy at some point in the future and what we would like to hear them say. Then we at least have the opportunity to do things that might lead to those comments after we are gone. Because legacies can’t really be built. They are described in hindsight.
When I look back at my career “pre-PD”, it seems to me that much of what I did in my business career was preparing me for what I have been trying to do as a PD advocate (my current job description). If I had died at 59 instead of being diagnosed with PD, I can’t imagine my legacy being very memorable when it comes to my career. Actually, I think my legacy would have been the wonderful boys that Linda and I raised. I still believe that will be our most important legacy.
So where am I going with this? I better get back to that or I will lose the thoughts that got me out of bed. Regarding my “advocacy career”, I feel that I am doing work that is personally meaningful for the first time in my life. That is a real gift! I don’t spend a lot of time thinking about what I am going to do. One thing leads to the next thing and so on. It has been that way since I was diagnosed. It has become more challenging to maintain my “forward momentum” the last couple years. But each time I have “slowed down”, it seems that I eventually have been motivated to “re-enter the fray”. I don’t really know if anything I have done or will do has any lasting value. That is not and can’t be my motivation. That will be for whoever is in charge of describing my legacy to decide. I am just grateful to have had the opportunity to finally do something that seems important.
Robin Williams’ Legacy
Robin Williams will be remembered by the general public for his “unearthly” spontaneous comedic wit as well as superlative acting in movies that include Dead Poet’s Society and Good Will Hunting (I loved both of these, but would also include another personal favorite, the classic comedy movie RV).
In the PD world, I believe his legacy has been “etched in stone” thanks to a letter written by his wife, Susan, to the Neurology journal. I posted this link of my PD facebook page last week. It has been viewed over 1000 times and has been shared 11 times. For my FB page, this is an enormous response, which made me wonder: Why?
One of the reasons is Williams’ popularity and the tragic nature of his death. There has been a great deal of speculation about his illness and what may have motivated his actions at the end. Susan fills in the blanks in a thoughtful, informed letter she sent in hopes that, by doing so, awareness could be raised that will help others in the future.
So, the second reason is that, by sharing Robin’s experience in painful detail, she has done the PD and Lewy body dementia worlds a great sevice. As an advocate with (at least) mild cognitive impairment, the distinction between PD and dementia with lewy bodies (DLB) is something I have been personally interested in for almost ten years. It motivated me to write a book on this subject that included my personal experience. It led to my relationship with the Lewy Body Dementia Association (LBDA) and participation in a webinar designed to build awareness about LBD/DLB in the Parkinson’s world.
The type of dementia experienced by most people with Parkinson’s (PwPs) falls into the LBD category. This is something all PwPs who want to be active participants in the management of their disease need to know as 85% or more of PwPs will experience LBD/DLB during their lifetimes.
LBD is not the same thing as Alzheimer’s (AZ). LBD is the second leading type of dementia after AZ. It is a terminal condition. LBD falls into a category of illness called “atypical parkinsonism”. These illnesses have symptoms similar to PD, but the causes and treatment are different. Some medications used for PD can be very harmful to people with atypical parkinsonism, therefore it is very important to get an accurate diagnosis. This poses a problem as “parkinson’s plus syndromes” (as they are also known) are usually difficult to diagnose. This is yet another reason why it is crucial to work with a movement disorder neurologist as opposed a general of different specialty neurologist.
Awareness around this subject is growing which is a very good thing. For more information, visit the LBDA website.
A Difficult Subject
Confessions of a Hobbit-wannabe
I probably read all three books five or six times over the next ten years. I do believe that on at least one occasion, I started the first book (Fellowship of the Ring) immediately after finishing the last book (Return of the King). I wasn’t just reading those books, when I picked them up I was in Middle Earth. If by doing this, I was “escaping” the real world for a time, that’s OK with me. That is one of the things a good book is for. I have gradually become aware over the years that, whether it’s a personally engaging book or movie, when it’s over I feel like I was there. Sometimes it takes me a while to recover afterward, because of the impact the book or movie has had on me. These feelings have been amplified the last couple years, I am sure due to PD.
As I got older, I would read at night before going to sleep. Another favorite reading time was on long airplane trips for business. During my “free time” when I wasn’t working I was busy going to watch our son’s games, running (I jogged wherever we lived and on trips-I can remember jogging in Tokyo, Las Vegas, Los Angeles, Detroit, Buffalo and lot’s more), playing tennis or golf, or doing yardwork (with the help of my reluctant staff-our boys).
For example, I remember getting into James Clavell’s Noble House books about Hong Kong on several flights back and forth to that great city. I was a big fan and ardent reader of Stephen King for many years until I read Pet Semetary (I don’t think I have fully recovered from that one to this day). I can remember reading the Agony and the Ecstasy (if I remember correctly, it was about the life of Leonardo DaVinci). One book that had a big impact on me in the early 1990’s was The World Is Flat. It helped me to understand the “big picture” of how the world was changing at an accelerating pace and the challenges we would face as a result.
Fast forward to the more recent past when I became a fan of Tom Clancy and John Grisham, in particular. I read very little in the few years after my PD diagnosis. I tired easily and basically gave up on it. As time has gone by, I have “re-engaged” in many ways including reading. I started reading on a much more regular basis the last couple years. Books that I found to be particularly memorable included A Man Called Ove which was made into a memorable movie (mostly shown at small “art” theaters).
My son gave Linda and me their children’s used Kindle Fires for Christmas last year. After getting over the initial intimidation factor I experience with any new technology, I found that a fabulous door had been opened for me. I learned how to up or download (I can’t keep straight which is which) ebooks from the library to my Kindle Fire using Overdrive.com. It still takes me a long time to navigate the system, locate a book that I would like to read and actually get it sent to my Kindle, but I have persevered. I have really enjoyed Bill O’Reilly’s Killing books and found more good Grisham books.
I just started a fascinating (and controversial) book that was loaned to me by my younger son’s father-in-law (and good personal friend), 1421: The Year China Discovered America, that makes a convincing case that China became a major force in world exploration in the early 1400’s before the time of the famous European explorers.
If you have PD and have “given up on reading” like I did, you might want to give it another shot. I am glad that I did.