My Life as a Woman with PD parallels Being a Woman in Medicine By Maria De León

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“It is not easy to be a pioneer- but oh, it is fascinating! I would not trade one moment, even the worst moment, for all the riches in the world.” Elizabeth Blackwell

Living with Parkinson’s as a women is a lot like being a woman in the field of medicine rare. (I must say I well am versed in the challenges of both) Although both seem to be increasing these days. Perhaps because we are beginning to take notice of the remarkable attributes, talents, and passion women possess. But, most importantly because we are now learning to stand up for ourselves for what we believe and fight for our own well-being and happiness. We are becoming better self-advocates in both arenas.

As a Hispanic woman interested in medicine, I was always teased and discouraged about pursuing a career in a “men’s” field. When I first developed symptoms of PD, I again was ridiculed for my outlandish claims of having Parkinson’s as a young woman; after all this was supposed to be an illness of predominantly older white men.

Apparently, I have never been one to conform to norms. I have always fancied myself somewhat of a pioneer for no matter where I am I always seem to be the exception to the rule (in who I am, what I think, and what I do- always sticking out as a sore thumb). Nothing seems to cause so much shock in people as me being a Hispanic female neurologist. Not unlike being a young woman with PD. Both usually cause some type of disbelief followed by wonder and amazement. How did I do it? How do I continue to do it? How do I seem to “have it all?”

Breakthroughs:
It is hard for me to imagine a time when women simply were discouraged from becoming doctors when nearly half of all medical students at present are women. It is equally difficult for me to imagine a time when I did not know a number of young women with Parkinson’s. Despite these facts we women still continue to face challenges and have barriers to break.
When I first embarked in this Parkinson’s journey as a patient more than a decade ago, I set out to find answers for the differences in gender and published my first book on the subject: “Parkinson’s Diva: A Woman’s Guide to Parkinson’s disease.” For it seemed to me that many neurological illnesses like strokes, migraines and epilepsy had unique characteristics tied to specific gender. Women with these illnesses thus required special treatment tailored to their own needs. Similarly women with PD independent of age have different characteristics which separates them from their male counterparts. Many of the challenges women face with any disease unfortunately are directly or indirectly linked to socially imposed norms. For young women with PD, the challenges seem a bit more complex just like starting out in the field of medicine. We need to find our place while pursuing our passions, goals, and attempting to strike a so called ‘balance’ between work and family or on this case home and living with PD. If we don’t have the right support we can easily get swallowed up by our circumstances and barriers.

Although, I feel I have achieved many of my dreams and faced many stumbling blocks both as a professional as well as a patient – I have also been privy to many breakthroughs. I am glad to see so many embracing these differences and attempting to learn from these to enhance the lives of us who live with this complex disease.

Legacy of those that went before us: (especial thanks to Dr. M Schiess and to Dr. A. Nunez)
We must draw on the legacy of women all around to continue to make way in both arenas. These great women have been our mentors who have paved the way by showing me and others how to be a physician, a teacher a mentor, a mother, wife and now a patient. Because of their unwavering devotion and commitment to better lives of other women. They stood by me and supported me in my decisions to pursue my area of interest and nurtured my passion. They gave me the skills to look beyond what is before us to what might be. Not knowing that someday, I would use these skills to empower me and other women to become better patient advocates.

What we share in common:
We as a gender independently of our back grounds are united by the fact that multitasking is our way of life. One of the biggest impacts for me as a physician and woman has been the difficulty in multi-tasking that I have experienced since developing PD. It is this inability to carry more than one complex task at a time that has made me unable to continue to practice my beloved profession. But, it has also made me realized that this disruption in task performance can be extremely detrimental as a mother, wife, and daughter. Even when we delegate some of these tasks (like cleaning, cooking, shopping) to others because of our disease we are still ultimately responsible for the “emotional” work that goes into it. We still have to plan, organize, supervise the household, our work as well as our kid’s schedules and activities; while we make sure we assist their school meetings, performances, and keep up with their social and emotional growth. After all it is up to us how our children turn up as adults. We want strong confident, well-grounded sympathetic and caring adults (Not an easy feat even when we are healthy).
As a female physician, I knew that it was up to me to find that “balance” between home and career. Over the years, I have learned than that it is impossible to have it all. The balance in life comes not in being able to do everything and have everything but spending your time doing what matters most with those that are most important in your life. This is the true balance. This is also where being a woman doctor and a woman with PD parallel one other. In order to be successful at either, we must begin by setting priorities. We must learn to make decisions without allowing social norms to interfere with or dictate what the rules of our own life and home should be. What works for me may not necessarily work for someone else. I am lucky to have a husband who is a good provider but is also not afraid to help out with household chores when the need arises. He does not make many demands on me – however there are task which he simply won’t address, most of the time because as a man he does not think are important or necessary. He will chauffeur my daughter but rarely knows her schedule.
For all female physicians just like for all women with Parkinson’s having a strong support system is crucial to being able to weather any storm and share the daily burdens of trying to “have it all” or do it all. I dole out my energy to the most important things in my life. For instance being present in my daughter’s life is of the utmost importance. Everything else comes second. When deciding is like doing patient triage, I think about what needs my most immediate attention at the moment and what can wait. Practice doing this and I guarantee that some stresses will begin to melt away from your life.

Challenges ahead:
Although we still have much to learn about gender differences in the area of PD. This is an exciting time. We are slowly beginning to see a shifts in the way we approach women’s health issues and gender differences in relation to PD. Yet, I like to see the minority gap close and the time to actual diagnosis of women be dramatically reduced.
But know that the strength lies within each one of you. Surely you can remember a time when you thought it was impossible to achieve something or get through a circumstance that seemed insurmountable but like me once I achieved my goal of becoming a doctor all the pain and struggle was worth the effort. You should hold on to your victories and triumphs to build your future upon. You were strong once you will be strong again! Use that knowledge to get through the toughest days with PD or any other challenge in your life and don’t ever give up. What has gotten me through all these years first through medical school and now through life with a chronic illness is first Faith followed by a bunch of perseverance and determination. Follow your passion whatever that may be …for me having a purpose to wake up every morning as made all the difference first in becoming a doctor now in being the best mother I can be along with building a legacy upon which all women especially those with PD can have a more fruitful and fuller lives. We all know it is not easy breaking stereotypes, forging new paths, and bringing awareness to issues previously considered taboo.
Learn to roll with the punches and learn from them…there is always a new dream even when the old one seems to have faded away.

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All rights reserved by Maria de León

Parkinson’s disease and dealing with other medical problems: By Maria De Leon

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“When the winds of change blow, some people build walls others build windmills”- Chinese Proverb

Lately, I have been a bit distant from my social media sites and blogs and I must ask for forgiveness. After a month of joyful celebration on the occasion of my birthday, I have discovered that even the good times can end up in flames and the best things can go up –up-up into the stratosphere in a split of a second. At that time, we stop and try as best we can to reach and hold on to the good times and fond memories before they are completely out of our reach till the wind changes once again bringing us back the things we love.
So, at present the winds of my sail have slightly shifted into some rough waters and I am struggling to hold onto the elusive butterfly of good health ( as much as one can have good health in the midst of a chronic illness like PD) waiting for a favorable wind once more.
Funny thing is that as we all live with a chronic illness, we tend to worry about things that will most likely never happen; yet the things we never see coming can take us for a loop and blindside us especially when they come unexpectedly on a Tuesday afternoon as most unexpected things do.
After a month of pancreatitis followed by a wonderful month of birthday celebrations, reuniting with old friends and working on the things I love writing, speaking, sharing stories over coffee with other fellow Parkinson’s friends, I got a most unexpected call. You have a “mass” in an unexpected place- my liver.
As my life came to a scratching halt, I have come to realize a few things.
First, how lucky I am to have a wonderful husband, daughter, family as well as wonderful friends such as you guys.
Second, despite the fact that in this country we are experiencing a terrible health crisis, we are still very lucky to be able to have choices regarding what doctors to see, multiple treatment options even for those of us with low socioeconomic means due to many charitable organizations which help many individuals and families pay for costly treatments. Recently while at the medical center in Houston, I happened to run into a patient who told me she had traveled alone from Australia after selling a great deal of possessions just to be able to make the trip to this country. She said she came here because ‘the US has the best doctors and medicines in the world!’ She was visibly desperate to find answers and new forms of treatments for her cancer. She told me that in her native country although medicine is socialized and free for all, the waits are long and they don’t have many choices …it is first come first serve and one treatment type for all. In her case for her type of cancer. I felt so sorry for her and wished that I could help somehow. After all we know, prognosis and treatment plans really need to be individualized because not a single one among us is the same as the other. Even when we have the same disease or cancer our responses to treatment are entirely unique partly due to our genetics, our sex, as well as our cultural imprinting and belief system.
I referred her to several programs which typically help people with cancer not knowing if they could help her since she was not from this country. All the while hoping and praying they could offer her the assistance she needed to help her chances of recovery and fight her cancer with the best treatment options available.
Little that I know that a few months later I would find myself in a similar situation trying to find the best doctors and treatment options for my own disease. Unlike her, I do have insurance in this country but if it turns out to be a malignancy I will also need some form of assistance from some charitable organization since according to my healthcare provider I am already in the catastrophic range for this year. I thought I was doing great!
Thus my worries at this time are concentrated only on finding the best team of physicians to help me get back to doing what I love; spending time with family and taking care of people with PD. Thank God for the fact that although out healthcare system is in desperate need for an overhaul, we have many entrepreneurs who are willing to help fill in some of the gaps. Nevertheless, we still need our government to step up their efforts so that we don’t end up in a country such as Mexico where medicine like the rest of the country is ruled by the have’s and have –nots creating a sense of laissez-faire attitude in most of the population- why seek care if won’t be able to afford treatment?
Third, dealing with my doctors over the last few weeks, I have once again confirmed the need for self-advocacy. This seems particularly true in this day and age of high physician burn -out and demands within the practice of medicine. This undue stress is imposed especially on those who treat chronically ill patients. That is because the patients with the most medical problems like myself eventually become Medicare recipients. As with any government agency there are always more regulations, restrictions, and demands on the physician. These demands have in turn left physicians stretched so thin that more things are apt to fall through the cracks then previously over the last 2 decades. Abnormal tests can be over looked easily at times…
Hence, when dealing with chronic illnesses have a voice that can advocate on your behalf if you are unable to. It takes time and effort particularly if you are already feeling bad to keep up with doctors’ appointments, insurance bill’s, tests, medications, and so on. Keep a diary, ask specific questions, keep problem issues to no more than 3, make more frequent appointments (don’t settle for I will see you in 6 months if you have ongoing problems), when getting tests done ask specifically what this test will show or help with and during follow up ask again by name the results of that test (e.g. what did my MRI brain show?). If you know you are waiting on test results make sure you schedule to follow up also if you have gotten a new treatment. Always call if in doubt or with questions. Remember to practice patience, which is the most difficult thing to have in the midst of bad news or new procedures. All things in medicine take time especially the more complicated the procedure, the history of the patient, or the findings – which is always my case. Most likely you will have to wait weeks for an answer even when all things are running smoothly – keep your cool, rest, eat well and follow up until you get the desired answer.
This too shall pass and the wind will once again blow in our favor!
when the wind blows don’t be the one fighting it rather be the one to harness it and find a new direction…

@copyright 2018
All rights reserved by Maria De Leon

4 Easy Ways to de- stress and Improve your Well-being while living with a chronic illness like PD: by Maria De Leon

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For those of us who live with a chronic illness like PD by now I am sure you have discovered as I have that stress whether physical, emotional, or physiological can have a detrimental effect on our mood and on our symptoms. It is for this reason that many people with PD feel as if they have fluctuating symptoms on a daily basis despite the fact that Parkinson’s is a slowly progressive neurodegenerative disease.
Learning to deal with stress and finding ways to prevent it in a healthy fun way can lead us to a happier more balanced life. Subsequently, by managing our stress we may be able to experience less ups and downs with our already complicated illness.

The first thing we can do to improve our tension levels is listening to music – but not just any music. A specific type of music like baroque which is characterized for the most part by 60 beat per minute tempo also known as ‘larghetto’ not too fast and not too slow – in fact just right.
This coincides with the rhythm of our hearts at a calm state because in fact some scientists believe that a heart rate of 75 and greater, which was considered within normal range in the past, carries a higher risk of having a heart attack.
Not only will this tempo relax us by calming and synchronizing our breathing with our heart rhythm but will also improve blood flow to our brains. Subsequently, this may be one of the reasons listening to this type of music increases our concentration. As we all know, poor concentration is a big issue in those of us with Parkinson’s – part of it could be that we are so run down we don’t even process the information around us. But being totally stressed can also play a major role. Multiple studies have shown that music with 60 beat per minute causes an immediate sense of well-being and even boosts our IQ levels. This was seen on subjects tested while listening to baroque music. Moreover, when we feel relaxed, we are more prone to have a positive outlook. A positive outlook on life is everything, I always say. When we have a bright outlook makes more likely to consider all the alternatives giving us more sound judgement avoiding rush decisions. I know personally when I am tired or in pain, I don’t want to be bothered with details or complex decisions. Sometimes when I find myself in these situation, I tend to rush to an answer without considering consequences fully leading to more problems down the road. I have learned not to make any important decisions including filling out paper work which is vital. However, if baroque music is not your cup of tea then find music that appeals to you but with similar tempo.music notes

Secondly, laughter is a great stress reliever. We have all heard that laughter is the best medicine. Not only does laughter strengthen our immune system but is a great coping mechanism to relieve pressure. I often say that I laugh because it beats the alternative. Because laughter plays such a crucial role in healing, many scientists have looked at laughter to assess its benefits and effects on tension. Interestingly, laughter decreases stress differently in men and women confirming once again that gender is a crucial topic we must take into account when prescribing treatments for various illnesses. In men laughing actually decreases the stress directly by dissipating the distress. However, this does not occur in women, rather by laughing we women gain insight into a situation which then helps us cope better with the stressful factors. Despite differing mechanisms, the end result is the same – we both feel better with a good laugh. Go ahead find some friends and laugh or simply learn to laugh at your own mishaps as I have. You will feel better, I guarantee.

Thirdly, painting– I have never been much of an artist. However, even though I still am far from considering myself as any good at painting I have discovered that you don’t have to be good at something to derive pleasure from it. You don’t even have to paint your own art work rather simply fill in the colors of someone else drawing to feel the benefits. I think that this is why coloring has become so popular. We remember the pleasure coloring as children, well as an adult I have regained that same sense of accomplishment when coloring a drawing turning into my own masterpiece. Art therapy in all is forms is something I have fully embraced over the last decade as a useful alternative therapy to dealing with neurological diseases for many reasons. One of which is a sense of empowerment one achieves through the use of colors, and creativity. Moreover, painting and other art therapy can not only provide a momentary distraction; but it also relaxes the mind when you set everything else aside and focus on the task at hand. Besides being fun, it is a great coping mechanism through which emotions can be effectively worked out releasing anger, anguish, and frustration with a few strokes.kandinsky21

Fourthly, enjoy nature / green – when I was a young girl living in Mexico, my grandmother always used to say to my grandfather that she needed to go out to the woods to look at the trees and the greenery around. She would get so excited every time she saw how green everything was. Well, it turns out my grandmother was wiser than most. Subconsciously, she knew that seeing green or being surrounded by nature provides an excellent calming effect on the brain and body. Since green is a color reminiscent of nature, spring, growth, peace, and financial prosperity is believed to diffuse anxiety and have a calming effect by producing a harmonious sense of well-being. Being surrounded by green forests, trees also improves concentration and clarity increasing creativity by actually improving our brain waves. Improves reading ability …perhaps that’s why I and many feel so alive in spring when everything is blooming. I guess, I inherited my grandmother’s intuition because my writing room is green (pale yellow greens and beige greens are the most soothing). In 2010, a study in Environmental Health and Preventive Medicine found that a stroll in the woods versus the same time spent strolling in the city had a greater impact of decreasing stress hormones like cortisol and lowering blood pressure. This simple fact, maybe why I like Central Park strolls or near parks in the city and in the woods like my grandmother. nestledown

Go ahead start decluttering your life and getting rid of unwanted tensions and preventing worsening of symptoms due to stress by using one of these simple methods of relieving tension in your life. I have celebrated a huge milestone in my life this last week for which I am forever grateful to my God. As such, what better way to be reminded of His grace in my life than to feel His presence admiring the beauty of creation surrounded by thousands of giant sequoia trees.
These threes have not only stood the test of time but weathered many storms losing a branch here or there but never lose its hope it will stand for another 100 years.

Sources:

Stress relief from laughter- it’s no joke. Mayo clinic
psychological effects of forest walking in healthy adults

@copyright 2018
All rights reserved by Maria De Leon

Dealing with the 7 Invisible signs of living with chronic illnesses: By Maria De Leon

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“Love the people who see you when you are invisible to everyone else.”

We all know that having a chronic illness like Parkinson’s disease makes dealing with all other aspects of our lives much more complicated. Handling our personal, social, emotional and financial situations can turn into a bigger challenge, if we don’t learn to recognize and deal appropriately with the symptoms others can’t see like pain, anxiety, irritability, and depression. In turn these issues can lead to more serious problems of isolation, strained relationships and agoraphobia.

Learning to live and cope with all the ups and downs of a chronic illness takes skill and a great deal of support from our friends and loved ones. However, sometimes is the invisible symptoms which cause us a great deal of pain and hardship especially if we are not in tuned to these problems as a family or person living with PD.

I don’t know about you; but sometimes besides not feeling well physically I just wake up angry or sad for no apparent reason. When this happens not only is it tough to deal with being off mentally, but also having to act and carry on activities of daily living like nothing is wrong. So what happens? Either we take it out on our loved ones by becoming extremely irritable making it hard for others to get near us or being on edge and exploding at the slightest provocation. In this scenario everyone hurts and suffers. Best way I have found is to isolate myself for that time as to avoid hurting anyone’s feelings. Sometimes a good cry for us women is all it takes. But, in my experience, this is a sign that something is amiss with our bodies and brain function such as our levels of dopamine have faltered or we have an underlying problem such as a cold, urine infection or dehydration. Meditating, listening to happy tunes if sad and faking a smile till you feel it always works for me. Sleeping is also another wonderful remedy for when things are not going well or seem out of sorts. Once you wake up from a good nap, things always look brighter. Otherwise feeling irritable can create much friction especially if you have children or other people who depend on you for care. Hug your children, spouse and loved ones this also eases the irritability.

Other times irritability comes from being in pain. Sometimes we can barely stand being inside our own skin much less deal with any outside factors or demands. Don’t be afraid to talk to your doctor to provide adequate pain medication so it does not turn chronic. Many times increasing the levodopa is all that is needed to handle the pain. However, if pain is due from dyskinesia’s causing strain on your neck or back then the opposite is required with possible DBS and other treatments to manage symptoms.

If we are to avoid having strained relationships with those who matter most, we must learn to communicate our feelings without projecting on others our frustrations and disappointments. Since pain tends to color our perspective and alter the way we view things – we have to tell our loved ones “I am in pain right now and having trouble dealing could I have some time to myself or can we not make any major decisions at this moment.” Tell them you appreciate their concern but need alone time or time to heal without blaming them for what is going on your bodies. Unfortunately, many divorces and break ups have occurred because not only do we take out our frustrations on those closest to us when we hurt but we feel that they are not doing enough to help us. However, must remind everyone that it is about us not them. If you are honest and open they will understand and give you the space you need. If you do this and they still leave because you are not dedicating 100 percent of your life to them, then they do not belong in your life. Let it go and move on. Embrace the people who love you and stand by your side unconditionally.

The other thing that happens is that as we begin to have physical problems with PD like freezing resulting in falls and injuries, experience loss of conscious due to orthostatic hypotension, someone looks at you funny while on the floor rather than helping, or says something because you are too slow,or shaky making you feel no bigger than the size of an ant. instead of hiding from the world the rest of your life to avoid feeling this way again, let us find ways to improve the symptoms cause so much social anxiety which could lead to agoraphobia if not treated properly. This sometimes can be a subconscious reaction to having several bad or traumatizing experiences in public in which you felt publicly humiliated. So the mere thought of venturing out and having another episode occur in which you feel helpless induces anxiety and downright panic. I have had a mild experience with this early on when I was dealing with issues of orthostatic hypotension and disequilibrium. I fell down one too many times and was stuck unable to get myself off the floor when alone that for a while I would not phantom the possibility of going anywhere alone much less on a plane. this was devastating in so many levels. As with any fear, the key to conquering and overcoming is baby steps into that which causes the anxiety; sometimes medication is required and other times behavioral therapy might also be warranted. The main thing is not to let the fear and anxiety take over your life. Find a way to get back to doing the things you love independently or if needed a friend that will reassure you to continue being active.

Even though, most of us have experienced all or some of these at one point or another in our illness, the key is to recognize them, talk to your physicians about them asap and also with your loved ones to prevent them from robbing you of your happiness and peace of mind.

It’s time to remove our invisibility cloaks and be seen for the wonderful women and men that we are!

@copyright 2018
all rights reserved by Maria De Leon

The Beauty of Self-Care: By Maria De Leon

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“Self care is not self indulgence. Self care is self respect and an act of survival.” Lorde

I am not sure about you ladies, but as of late I have been wobbling on an emotional precipice between the recent negative medical news of my husband, my daughter going away to college (perhaps far from home in a world where there appears to be increased chaos at each turn), my mother’s declining cognitive status, and my own current relentless wave of medical trials and tribulations. Sometimes as my dad would often say, “too much is too much.”

My natural inclination is to push forward on all fronts no matter how I feel. As a physician and a mother, I am used to taking charge during a crisis and stepping up as the caregiver placing my own needs at the bottom of the list. However, throughout my years of living with PD, I have discovered that not prioritizing myself however only leads to a slippery slope. My bottled up frustrations, stress, and malaise have a tendency to creep up to the surface like an erupting volcano seeping through every pore of my being (Curse you Parkinson’s disease, migraines and whatever other medical problem I have) causing me to become the true epitome of a fiery dragon. Just like a volcano can no more contain its pressure so do our feelings must find a way out – unfortunately when they do they cannot only be explosive but extremely lethal causing devastation in its wake, as we have seen in the news last few days with the eruption of Kilauea.

One of the things I always talk about in managing this chronic and any chronic illness is self-care and prioritizing once self. Easier said than done especially when you got all the burners on.
So, in the midst of all these new challenges, I have had to force myself to find time for me to heal in order to continue caring for all those who depend on me and get to the root of my ailments. An-empty-lantern-provides-no-light_-Self-care-is-the-fuel-that-allows-your-light-to-shine-brightly_-Unknown

Of course, this is much more difficult when you look and feel like you are ten months pregnant carrying twins! Yes, I got a partial small bowel obstruction-yikes! How did this happen? I was doing so well? For starters traveling lots, not keeping schedule on meals, along with increase stress did not help and possibly aided in my current predicament.

First order of business besides getting rid of relentless nausea and vomiting and prevent dehydration while reliving obstruction was to disconnect from the world- hence my lack of presence in social media as of late. I have also committed myself to spending more time with my daughter talking…this time is priceless.
Reminding myself and my family that frivolous time spent on one self like reading a favorite book, doing art, laughing with a friend, watching a favorite movie, listening to great music, or simply resting actually does more for the healing process than medications at times.empty cup

I have caught up on sleep. Allowing myself to sleep as much as my body needed to recover. I am doing better but not 100% back to ‘normal’ yet. Even in my “pregnant” state, I have continued my breathing treatments and meditation. These have helped me tremendously in calming my pain, anxiety and discomfort of having a huge belly.
I even had a manicure just to feel better- bright pink! Plus, even though I have been feeling like crap for the last 3 weeks, I found that doing some talks over the web helped my mood and my overall predisposition. Bringing smiles to others always brings back positive vibes into our souls.

Remember, that if we want to be ambassadors for those who have a chronic illness like PD and bring positive changes, we must first be good to ourselves and be happy behind the scenes when just you and no one else is watching. Do the things I have recommended often, like take time for yourself every day, make time for family and loved ones, do things that make you happy, pamper yourself (there are many ways of doing this without going broke). If you feel that the world is spinning out of control, go ahead and inject some kindness back into it.
Love to hear your own self-care strategies in dealing with chronic illness.

self care
Xoxo
Parkinson’s Diva

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all rights reserved by Maria De Leon

Parkinson’s mom diary: Maria De Leon

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” A mother is she who can take the place of all others but whose place no one else can take.” unknown

To my dear readers – first i want to thank everyone for making this journey more fun.. and for making this site one of your favorites.

As we near the month of May when we celebrate mother’s day both in this country and other countries around the world such as in my native Mexico, I thought i would write about being a mom with PD.

All of us who are moms know how wonderful and equally challenging is to be a mom; just when you think you have gotten the hang of a stage or phase – our children go on and change. Now imagine having a chronic illness like parkinson’s disease where although no objective fluctuations are noticed or documented we know for a FACT that fluctuations in our daily lives are a part of living with a chronic illness. Sometimes we just don’t know how we are going to feel the next minute much less the next day or month. As my daughter reminded me today when we were having a conversation in the car on way to school, “mom, I am glad you are feeling well these days but it wont last, is just a matter of time!” when i gave her a side ways look she replied: “you know is true. that’s what happens with your disease.”

As much as I protest this statement and try to reassure her (or rather) that this time will be different, i know that as long as i have PD i will have ups and downs which will interfere with my ability to perform my motherly duties. (secretly praying these deviations are few and far between).

However, these roller-coaster episodes has made me reevaluate my thinking and recommendations for women who have PD and want to be moms.

Motherhood as I said is a wonderful experience but is not for the faint of heart because each child comes with his/her own challenges and gifts to deal with; so having more or less is not necessarily the answer.

I was lucky I already had my daughter when I got diagnosed. Yet, because I was so young she has had to live with my illness practically her entire life. Plus, as a mom I have had to struggle much more than I would have should I had been a healthy mom in raising her and being a constant in her life. I was blessed to have friends and family to help me care for her especially during those times when the medication made me so ill i could not drive or the disease was so bad I could not stand to be touched much less cuddle her- something that broke my heart and still to this day feel guilty about.

So deciding to have a child once you are diagnosed with PD is not an easy think to decide and should not be taken lightly. Although, as far as me know fertility does not decrease with the disease and health of fetus is not affected by having PD, many of the medications currently used to treat the symptoms of Parkinson’s are contraindicated at least partially for lack of information on the short and long term effects of the fetus. Further, some of these medications also can be passed through the milk making breast feeding difficult after delivery.

Another thing, one must keep in mind is that PD symptoms can worsen during pregnancy. But, assuming that you are able to carry the pregnancy to full term there are many other issues to consider. Remember this is a progressive disease after all. You must consider not only the stage that you are in at the time of conception but be able to look ahead at the  age you will be and the stage you might be at when your children reach certain milestones like going to elementary school, high school etc. you must also consider your support group – is there a reliable one? Does this include a supportive spouse/ partner? In my early stages of disease I would not have been able to care for my toddler had not been for my husband stepping up and being mom and dad something not every father can do or is willing to do.

We all think about the sleepless nights with infants but for me the hardest years are once they become independent. The problems are bigger, more serious, and require much more involvement from a parent in establishing appropriate boundaries and guidelines. No matter the age children need clear boundaries. If you are too sick to reinforce the rules will only create problems for them as adults in the future.

I do more running around now that my daughter is a teenager than i did when she was younger plus on top of my illness i have increased age which makes me have less stamina and less able or willing to multitask as I did 5 years ago.

However, if you do decide to be a mom with PD make sure you know that you are NOT alone! that you have other women like me to guide and support you and know that it will be the greatest adventure in your life as well as the most rewarding. Plus, for me my child has served as the driving force for wanting to keep fighting and moving and never give up. During my darkest hours, I have relied on her love and smile to give me strength to hang on for one more day till the storm passed. In life there are many substitutions for things,  but there will never be a substitution for a mother’s love!

Happy Mother’s Day to all the beautiful women out there..cherish your kids, they truly are a gift from GOD!

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all rights reserved by Maria De Leon MD

Bridges & Scenic Roads: by Maria De León

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“Nothing comes ahead of its time and nothing ever happens that did not need to happen.” Byron Katie

As I sit here fighting another bout of bronchitis, yet again; I am inclined to feel a bit sorry for myself. But, all I have to do is stop and look at all the road I have covered over the last year to quickly shake this silly notion.

I have never been a very patient person especially when traveling. I like to zoom, zoom. I am a highway kind of girl. I remember the first time my husband and I took a trip toghter as newly weds to visit his family, he thought it would be nice to take the Natchez Trace Parkway. I nearly lost it; it seemed we had travelled for an eternity at a turtles crawl (can’t travel faster than 45mph). Had I been driving, I would have probably gotten several citations or found a way to get off faster than immediately.Image result for beautiful architectural wooden bridges

At the time, I was not interested in the beautiful sights we encountered along the way nor in the fauna present. I simply wanted to arrive at our destination. This was the state of my life at that time-pretty much rush, rush between work, family, commitments, conferences, etc.. I was always looking ahead at the next destination never really enjoying the moment for the most part until Parkinson’s decided to pay me a visit and make its self at home. Suddenly,  the breaks came screeching on putting a stop to all my senseless running around.Image result for beautiful architectural bridges of the world

Over the last decade, I  have had to learn to enjoy those backroads and not be so concerned about the destination. We all know that living with a chronic illness like PD  permeates into all aspects of our lives affecting everyone which comes into close proximity. thus, more than ever we have to learn to find a balance and enjoy each moment as it comes and not be paralyzed or fearful of what might happen next. Living with PD is truly unpredictable day to day and even hour by hour. Friday was another perfect example of this. I woke up feeling great attended a GO Red luncheon for women with my friend. We had a blast but by the  time I got home in the afternoon, I was out of commission screwing up all the evening and weekend plans.

Instead of worrying about reaching some obscure destination, or fretting over the plans that have been ruined (these days I prefer calling it altered rather than ruined). I have come to enjoy those unexpected detours along the way which may lead to unexpected finds like an old wooden bridge or a beautiful waterfall. These sometimes brief other times extended detours through backroads and scenic routes has helped me discover myself, my true friends, my family and many other people who suffer chronic illnesses which I might have not gotten to know otherwise. This weekend I got to enjoy the company of my daughter and husband although from a distance since I did not want to contaminate them.Image result for beautiful architectural bridges of the world

When I find myself feeling restless and impatient like today, I remind myself that those  eternally winding back roads are helping me build a bridge to my ultimate destination. As we know some bridges are short and some are much longer. Image result for beautiful architectural bridges of the world

Those bridges took years to build some even had to be rebuilt.  Meantime, i keep moving forward even if I feel it’s only one step a day. Someday my bridge will be completed and it will be a grand architectural monument just like those magnificent bridges, I love (e.g. Sydney Harbor Bridge, the London Bridge, and the Golden Gate Bridge to name a few).  My life like those grand architectural structures will stand as a testament of a victorious life which conquered adversity and overcame big odds to bring beauty and function to others.

Thanks to my illness, as my favorite poet Frost once penned, I have taken the road less travelled and this has made all the difference…

I hope today wherever you may find yourself, you find the strength and courage to enjoy those unexpected detours in life and beginning anew building those magnificent bridges.

@copyright 2018

all rights reserved by Maria De León

Need for Ongoing Affordable Access to Medical Care : by Maria De León

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I am a physician with many friends and colleagues still attempting to practice medicine throughout the country. It is particularly difficult for those who have chosen to remain in rural areas like the one I live in.  Due to the current hostile changes that have taken place in recent years, many physicians have been forced to move to the city to join academia.  Subsequently, we the patients are the ones bearing the brunt of the cuts and loss of specialist in many areas throughout the country.  With these changes patients are now forced to travel farther many miles to find a especially a specialist which believe me is not an easy feat to do as the disease progresses and also as our capacity to drive diminishes.

Moreover, those physicians who are truly committed to patient care and remain not just in the field but in areas where there is a need quickly find themselves overwhelmed, frustrates, on the verge of a burnout. Why ? I believe this one of the few professions in which the expert does not only lack autonomy but has to constantly fight with everyone to be able to do what he/she was trained to do and what he/ she deems best for the patient. No wonder 42% of all doctors are facing burnout and symptoms of depression, to make matters worst nearly 1/2 of those physicians are neurologists! With the increase in Parkinson’s disease, Alzheimer’s dementia, and stroke in the aging population, we simply cannot afford to lose any more specialists.

Not only do we need to continue encouraging the US Congress to increase funding for research to halt these diseases but also provide adequate compensation for physicians managing these extremely complex entities, as well as provide funding and make necessary changes to the laws so that we can have tele-neurology availability  independent of where the patient or provider lives in the country. This form of care is essential for those that are too sick to travel, unable to drive, or have no other means of seeing a specialist because non exists within their state. The need for tele-neurology/telemedicine has become more pressing than ever before as we have seen this past year as several major catastrophe natural disasters have left many people stranded and afraid and without their much needed medications and access to medical care. thus, increasing morbidity and mortality in the chronically ill.

Another way we can decrease the stress level in our specialist and healthcare providers is getting rid of unnecessary red tape/bureaucracy. One example of this is allowing doctors autonomy to manage their patients medications as they see fit. Nothing creates more work and frustration,  for both patient and doctor than having to waste valuable time in getting pre-authorization and pre-approval of medications which have not been altered in years due to patients stability. of course if i went much longer without medication, I would no longer be stable ! This happened last week when ice storm hit 1/2 of country. Subsequently many offices including doctors and insurance companies were closed for days.

Meanwhile patients like me who desperately need their medications to continue functioning could not get a refill or even purchase a few til doctors were able to be contacted because price of each pill was nearly $100 ($3,000 for month supply- who can afford this?). It took me 5 days to get my medication and that’s only because I am a physician who could talk to her friend and to insurance  review committee without having to wait for medical records and could sit for hours on phone waiting to speak to someone otherwise it would have taken much longer given the circumstances. Many times, however, people that are sick neither have the savvyness to know who to call or dispute claim and/ or they lack the time, and energy required to carry out such feats. All I could think was that many people (such as doctor, pharmacist) were wasting valuable resources on me  trying to get a medicine i have been on for a decade when there are people out there who truly needed help because they were having problems and physicians offices closed, etc. walking thehalls

Sadly, as the problems and complexities increase in the field of  neurosciences/ and incidence of progressiveness diseases like PD augment, doctors and patients will continue to be stretched to their limits until someone breaks from pure physical and emotional exhaustion. Thus, I encourage everyone once again to contact their Congressional Representatives to help improve not only our quality of life by funding research ( which will not only help patients but also  provide salaries for clinicians who are doing research), the Raise Act (passed recently to help caregivers with financial burden), and telemedicine. Without your voice demanding  healthcare changes, there can be no hope for patients with chronic neurological illnesses to live better, healthier lives while maintaining access to their own specialists.

Join in me in March In DC as we (MJFOX public policy forum 2018) make our way to Capitol Hill to advocate for these salient issues. See you there!

Sources:

https://www.medscape.com/slideshow/2018-lifestyle-burnout-depression-6009235

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all rights reserved by Maria De Leon

Embrace the Possibilities: by Maria De León

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As we reach the end of another year, one thing is certain the one thing we can count on is change. Seasons change, fashion changes, friends come and go, our goals, our likes dislikes change and our health stands in the balance of a see-saw not knowing when we will go up or come down.

When I was staring my medical career, I knew I was in for a long haul of commitment and focus. I needed to get myself prepared for what laid ahead mentally. So my best friend from childhood and I decided to take a trip to Acapulco. No better way to replenish the soul and mind than by sitting at the edge of the ocean contemplating and listening to the sound of the  waves. After 27 hours, we finally arrived anxious to enjoy the beach, my friend and I ventured out in the evening as the sun was going down and the tides were beginning to pick up. Yet, all we wanted was to bask in the view and maybe get our feet wet a bit. I carefully laid out my beach towel, my clothes, sandals, and other possessions, I was about to sit on my towel when a huge wave crashed upon the shore engulfing my belongings. Our carefully chosen spot had proven to be not far enough from the rising evening  tides. Apparently, this was high tide season. As the waves retrieved, it carried with it all my possessions leaving me mystified.

As I watched all of my things being dragged into the ocean, I took off running after it. It had taken my wallet. However, the waves were not only faster but retrieved deeper into the bay. As we sat there a bit dumbfounded about how quickly it had all happened taking us by surprise and resigning myself that on my first day I had lost all my money.  When a few minutes later another huge wave happened upon the shore bigger than the first one as it crashing briskly upon us and the rocks but as it retrieved I began to notice a resurfacing of my things. Quickly my friend and I sprang to retrieve my wallet first before it could be engulfed again perhaps this time never to be seen an de completely ruining my vacation. Of course, everything was completely soiled. The large beach towel was filed with muddy sand, seashells and a few small crabs. I did not care all my things were back.

This event thought me that sometimes the change of the tides can take us by surprise leaving us discombobulated and dumbfounded, wondering were to go next or what to do.

But, just as surely as the sun rises and sets, if  we just keep breathing staying alive fighting for the things we want and keeping a watchful eye eventually the same tide will come again bringing back that which we thought was gone and lost forever. Better yet giving us a way to move from the shore to new lands and dreams because at some point all of us have to move person past the crest line.

as we start a brand new year with 365 blank pages to fill, remember that although we are not in control of when the tide comes in or how big the crest of the waves are, we are in control of how we allow the tides of life to impact us. In the same trip a couple of days later, my friend and I decided to eat at this mom and pop makeshift restaurant on the same beach while we ate barefooted. I enjoyed the coming and going of the waves past my feet underneath the table where we sat. To this day I savor the thought and wish to return to that place.

So as you find yourself face to face with an unexpected tide which might leave you Topsy curvy rather than panic or give up; wait awhile the tide will eventually change allowing you to move forward an din doing so take inventory and breath in the endless possibilities. Notwithstanding that It is our impossibilities that become our greatest gifts – it certainly has been the case for me having reinvented myself and enjoying my life fully despite living with pd for a decade.

Trust that nothing is ever wasted and in the end if you allow yourself to embrace the changes that the tides brings you will emerge softer, gentler, kinder, more courageous, and stronger than ever.

Happy Holidays!

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all rights reserved by Maria De Leon MD

A Year in the Parkinson’s Diva Life: By Maria De Leon

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A woman is strong because she has been weak; she is beautiful because she knows her own faults; and lives without fear because once she was afraid.”

Carolina Herrera

As we draw near the end of another year, I am prone to reflect on the good, the bad and the ugly that which has greatly impacted my life. Not everything that touches us or makes us who we are is necessarily good or at least not on the surface.

This year has been a year of great losses for many of us as well as great victories. Is my experience that these usually go hand in hand. The triumphs allow us to get through the sorrows and hardships while the devastating moments make the victories that much sweeter.

The year started strong with me finally getting better after last year’s pulmonary embolism and TIA (mini stroke) which took me nearly 6 months to fully recover.

Then it suddenly took a turn for the worst with my best friend being diagnoses with stage 4 cancer! a week after we had made all kinds of plans for the year…

Got to travel to DC see old friends, make new friends, and even meet a few celebrities such as MJFox while advocating for changes in public policy to improve research funding, and better more affordable health care at Capitol Hill.

Traveled to a new country with my husband and daughter and found the perfect city that made my hair look fabulous because there was no humidity. Who knew my hair could look good first thing in the morning?

After much prayer and seven long months of grueling chemotherapy and bone marrow transplant, my friend is finally cancer free- confirming that miracles still exist!

Saw two of my nieces and nephews graduate – one doing a master and one started college and i got to play the fun Tia (aunt) role throwing parties and even traveling with my niece to her new university. Since it all is connected somehow, I got to meet my new friends (Kate & Chris) at Health Union where I am now a contributing author on the health communities of  http://www.migraine.com and http://www.parkinsonsdisease.net; where I am cherishing the opportunity to work with like minded individuals who are just as passionate about making a difference in someones world.  For me doing something that I love doing aside from Parkinson is also a huge plus.

Let’s not forget that this year, we celebrated 200 year’s since Dr. James Parkinson annotated his observation on a disease we now call by his name. As such, I was a part of a huge campaign to bring PD awareness to the Hispanic community in this country by appearing on sites like Dr. Isabel show on Univision and was broadcasted around the country through the radio to several Spanish speaking station from Texas to Florida, Georgia and the Carolina’s. Plus, I now can boast of having two published books with my latest Spanish book on PD – Viviendo mas alla del parkinson was recently published.

Of course before the summer was over, I was down for over two months with a viral infection after seeing my doctor the day before, where he complimented my good health and said i did not need to see him till next year. Famous last words! this little viral infection caused me to miss my opportunity to travel to South Dakota. Fortunately, I was able to at least virtually meet a few of them including saying hi to my friends whom I like to call ‘the Mary’s!’

Lost an old friend and regained an old friend. But, as I was driving around the other day dropping off  and chauffeuring my daughter and classmates all over the place I realized is not such a bad life. Sure I can’t multitask to save my life, can’t remember even my own name a couple of hours after taking amantadine or even where I opened a bank account – “at some bank on a corner street”, I told my husband. “Which corner?”, he asked extremely perplexed since there is one in nearly every corner. “I don’t know,” I said. “I am pretty sure I will know when I see it.” Not comforting words to my husband or any other man.

I get frustrated easily and my goodness the heat is unbearable dripping droplets of water from my forehead on a regular basis but not a drop of fat lost- husband’s theory is that my body is conserving its nutrients because I seem to go into starvation mode for a few days at a time when my gastroparesis is at its peak. At any rate, I have learned to appreciate my curves and the moments when I am totally ‘me’ feeling as good as any young healthy person would – for which my husband has dubbed my life as the Curious Case of Maria D. When I am on top of my game and not choking on my own saliva and not  tripping over myself or running over the garage- I seem to be getting younger and stronger in his eyes!

Perhaps, I am not afraid of PD because I was once consumed with fear of the unknown; it no longer has a strong hold over me. Thanks to PD, I have learned to be more forgiving of mine and others shortcomings and have learned when to rely on my strengths and when to ask for help because I am weak- which happens a lot. I constantly get inspiration from strong, independent, beautiful, intelligent Hispanic Women who happen to be icons in their own fields such as Isabel Allende, Carolina Herrera. i identify with the latter because she began her career  in her 40’s, at an age when I too had to make a new transition in my life from physician/clinician to writer/motivational speaker and most important of all patient advocate.  And like her, I believe that fashion is an outward expression of ourselves free and unencumbered. But, the best garment any woman can wear is knowledge.

Aside from all this things for which I am truly grateful,  one of the greatest gifts and joys has been able to share my journey with all of you.

Thank you & Happy Holidays to everyone!

XOXO

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all rights reserved by Maria De Leon