Posts

Cancer Chronic Illness Q&As The Good Fight

How Music Heals

A new partnership between the National Institutes of Health and the John F. Kennedy Center for the Performing Arts explores the many ways music can heal the body and mind.

It has long been suspected that music can strengthen and improve the body and mind. But it is only in recent decades, with advancements in brain measuring technologies like fMRIs, that science has been able to prove how. One recently launched initiative, which straddles the border between the scientific and creative worlds, hopes to educate and inspire more research into the topic. Called Sound Health: Music and the Mind, it explores how listening to, performing or creating music involves brain circuitry that can be harnessed to improve health and well-being. It is a partnership between the National Institutes of Health (NIH), the largest public funder of biomedical research in the world, and the John F. Kennedy Center for the Perfoming Arts, a renowned creative arts institution in Washington D.C.

Heavily involved in the initiative is renowned soprano Renée Fleming, a 2013 National Medal of Arts winner and artistic advisor to the Kennedy Center (most recently, she sang at John McCain’s funeral). “The first goal is to move music therapy forward as a discipline,” she says of the initiative. “The second is to educate the public and enlighten people about the power of music to heal.”

In supporting the initiative, Fleming has been giving talks about it at her performances (nineteen thus far), often including local music therapists or researchers. She has also taken part in a brain imaging experiment focused on creativity and improvisation, where she spent hours inside an fMRI machine under the guidance of an NIH researcher. It was the exact kind of research which Sound Health encourages. In the machine, she was given three different instructions: to sing, to imagine singing, and to listen to music. “In my case the findings were a little bit surprising because the most powerful of the three in terms of brain activation was imagining singing,” she says.

We reached out to Fleming and NIH Director Dr. Francis Collins to hear more about this fascinating project.

What are some findings or impacts of the initiative thus far?

Francis Collins

Francis Collins: Over the last few years, I’ve been hearing some interesting reports about researchers using music to improve people’s health. But these were mostly anecdotes, and what was really needed for the field to grow and expand was scientific evidence. NIH, with its mission to improve health and ample funding, is in an ideal position to help build that evidence. And the fact that Renée Fleming and the Kennedy Center were interested in the intersection between music and health was a good indication to me that this topic could get people excited about scientific research and the future of medicine. So we joined forces to create this important partnership.

Music can help Parkinson’s patients walk with a steady gait, help stroke survivors recover the ability to speak, and give cancer patients relief from chronic pain.

Out first goal with the Sound Health partnership was to educate each other and the public on what we’ve learned from research in this area so far. We held an unprecedented scientific workshop at the NIH with some of the world’s leading music and health researchers. Some were investigating how music could help Parkinson’s patients walk with a steady gait, help stroke survivors recover the ability to speak, and give cancer patients relief from chronic pain. It was clear that there was some exciting research in this space.  We’ve since held two public events at the Kennedy Center to share this science with everyone. You can see recordings of the scientific workshop on the NIH website and read a summary here.  Recordings of some segments of this year’s Kennedy Center event are posted on YouTube.

Based on what we’ve learned, the NIH is supporting future research on this promising topic. We’ve announced the availability of $5 million in funding in fiscal year 2019 to support a wide range of research into the effects of music therapy on various health conditions. Because that research hasn’t been done yet, the most exciting results are yet to come.

How is music beneficial to young minds?

Renée Fleming.

Renée Fleming: Music activates more parts of the brain than any other activity, which is amazing. For education one of the things they’ve proven is that children benefit from learning a musical instrument; some of the reasons are obvious: the discipline, the practice. But the scientific piece is that eye-hand coordination through the ear helps them develop academically, with better aural comprehension and better academic outcomes overtime. It seems to be very powerful. It’s a fascinating project and there’s an endless number of things we can explore with it.

What do you hope the initiative will accomplish?

FC: I hope Sound Health will help determine whether and how music could be an effective part of a doctor’s toolkit. At the NIH, our goal is to better understand how our bodies work, then to use that understanding to help people live longer, healthier lives.  And we do that through research. We just issued these funding opportunity announcements about music and health to encourage scientists to submit their best research ideas.

I also hope that our partnership with the Kennedy Center and the National Endowment for the Arts will get people excited about this topic and the role science plays in it. So many people have made music a part of their daily lives, and they’re curious about why it has this profound effect on them. The public events at the Kennedy Center, which you can watch online, will help you learn more about yourself and share in our excitement about how music may play an important role in medicine.

What are some questions you’ve always had about music and its impacts?

RF: This potential of music to connect us with our emotional life. That’s valuable and not really well understood. Also the connection to music and memory. Our senses are hardwired to be used in terms of memory and music is one of the most powerful of these triggers.

As a health official, what interests you most about music and its impact on the mind and body?

FC: I’m fascinated by the ways that music overlaps with other processes in the brain. When you sing or play an instrument, it doesn’t just activate one part of your brain: a whole constellation of brain areas becomes active. And some of these musical areas are partially shared with activities like speaking, which if disrupted can have devastating consequences.  An amazing thing about this overlap is that when the normal speech pathway in the brain is damaged, music can sometimes be used as an alternate path.

When you sing or play an instrument, it doesn’t just activate one part of your brain: a whole constellation of brain areas becomes active.

This finding inspired something called “melodic intonation therapy.” When someone has a stroke that damages the left side of the brain, it can cut off the normal language pathway and make it hard for the person to speak. Therapists will work with stroke patients to sing phrases like “I am thirsty” to use that alternate, musical path instead of the damaged one. It takes a lot of work and practice, like using a different muscle, but stroke survivors have used this technique to learn to speak again.

Scientists have been working hard to understand the complex pathways in the human brain. And here is a payoff where we might use these pathways to improve mental health without drugs or brain stimulation. What’s more, music doesn’t just overlap with language: it also shares brain areas with movement, memory, motivation and reward. These things are hugely important to mental health, and researchers are trying to use this same concept of an alternate pathway to address new categories of mental disorders. If they’re successful, that would be a significant breakthrough for patients around the world.

Essays Mental Health

Fairy Tales And My Father’s Parkinson’s

When I was a kid, my dad made collages of Rapunzel, Rumplestiltskin, and Hansel and Gretel for my bedroom wall. I still think of them as I confront his Parkinson's.

Growing up, my dad’s hands were a source of magic Painting, calligraphy, photography, carpentry—they were endlessly capable of producing beauty. This wonder was summed up for me by the three framed collages he made when I was a baby and hung in my childhood bedroom: bits of paper, painstakingly torn and lovingly formed into vibrant, colorful illustrations of Grimm’s fairy tales. They’ve been lost to time, but I still think of them. Not just as a representation of his extraordinary artistic talent… but as a record of who he was before his Parkinson’s, as a creative mind and as my father.

The first collage was of Hansel and Gretel, the children approaching the witch’s gingerbread house. It was my favorite because it was the most colorful and had all the candy. But it was also the scariest, because it had a witch. As a child, I would focus on the candy for as long as I could, until my eyes inevitably crept to the witch. Then, I would feel distinctly uneasy. She was scary, lurking there, waiting. A malevolent presence just biding her time.

The witch never moved, but we did. My mom and dad divorced when I was 15 and I saw him every other weekend. It wasn’t until much later, then, that the malevolent presence made itself known.

I was in my mid-30s when I got a birthday card that was addressed to me in an unfamiliar handwriting. I turned it over to check the return address. It was my dad’s. Something gnawed at me, a scary witch feeling. The handwriting was awkward, forced-looking; this wasn’t my father’s penmanship, which was always unusually graceful and elegant. Soon after, he told me that he’d been diagnosed with Parkinson’s. The tremors were starting to affect his fine motor coordination. It was a small side effect for most people, but my dad spoke through his hands.

That small change in his handwriting spoke louder about what was haunting him than words ever could. He was always a man of extraordinary artistic ability, whether it was penmanship or cake decorating. But now, this dexterity was being taken from him, locked away.

My father and I dancing at my wedding.

He was always a man of extraordinary artistic ability, whether it was penmanship or cake decorating. But now, this dexterity was being taken from him, locked away.

The second collage on my wall growing up was of Rapunzel. She was in the tower, isolated and alone—but the distance kept Rapunzel safe from the witch. At first, just like Rapunzel was removed from her witch, I felt removed from my dad’s disease. We were separated by half of the country; so many miles away, I could pretend that it didn’t exist. When we talked on the phone, he sounded the same; if we just didn’t talk about it, it was almost like the illness was a bad dream.

But of course, just like the witch at the base of Rapunzel’s tower, Parkinson’s was still there, lurking. I could see it in the increasingly labored and enlarged lettering on my dad’s envelopes. And, over time, I saw that the Parkinson’s witch had begun her ascent, slowly creeping up the tower of my dad’s mind. I learned he’d had to quit his job and go on disability. He lost his health insurance. What was I supposed to do? How was I supposed to help? With three time zones between us, I felt like I was playing a game of Telephone—badly: half-informed, half aware. I hung up the phone after our conversations and fumed for hours, frustrated that I had so little to offer, angry at the disease and my own inability to help.

The third collage was Rumplestiltskin—the story of the crafty little man who extorted what was most precious, who could only be undone by the guessing of his real name. Names are powerful. After my dad told me he had Parkinson’s, I spent months stewing in impotent fury before I put a name to what I was really feeling: fear.

I was scared of losing my dad—in death, yes, but also in increments, as he was slowly reduced from the man I’d known. I was scared of what his diagnosis meant for me and my own children, who are now 9 and 13. The hereditary nature of the disease means that this could be our future as well and, while remarkable research is being done, there is still no cure. More immediately, I was scared that my father wouldn’t be able to get the assistance he needed and that I wouldn’t be able to do anything to change that.

Names are powerful. After my dad told me he had Parkinson’s, I spent months stewing in impotent fury before I put a name to what I was really feeling: fear.

I can’t change his Parkinson’s or its effects. Like the falling apart decay of the collages,  my father has lost many of his artistic abilities: he’s had to give up much of his detailed work, and now he contents himself with painting in large, Mondrian-like blocks of color. But he still treasures art. A year ago,  he came to visit; he wanted to go to museums. It was my first time pushing him in a wheelchair. He tired quickly, but before the illness caught up with him, he spent a few hours discussing art with his grandsons. The joy radiated from him, sharing this love with my boys.

 

Some of my father’s post-Parkinson’s art.

The art in his soul is still there. It hasn’t been lost; its expression has just changed. His painting now is different, but it’s still clearly his, like everything from my fairy tale collages to the decorations on my birthday cakes. And in that sympathy for light and feeling, I realize that Parkinson’s has not destroyed him as an artist… nor has it changed who he is as a person.

I miss what my father once could do with his hands; I know he does as well. But I am proud of what he persists in doing still, refusing to be undone by witches and secret names that tell us to be afraid.

Creative Commons photo by Janyn Berame

Neurological & Cognitive Disorders Profiles

What Happens To A Marriage After Parkinson’s

Every marriage has its own dynamic, but what happens when a motor system disorder turns that relationship upside down?

Framed by winter-stripped trees, the Rabinowitzes’ modest brick home sits on a quiet street in North Atlanta. Inside it’s warm and comfortable: artwork and family photos dotted around the walls and furniture. Two cats–Mookie and Vito–prowl around the room, swatting at spots of sunshine. Allen Rabinowitz maneuvers out of his chair.

“Morning isn’t my best time of day,” he says.

Allen sits down at the kitchen table next to his wife Jan, who is clasping a cup of coffee in her hands. The last few months have been difficult, she says, although the hardship doesn’t show on her smooth, unlined face. She’s sixty-three, but looks much younger. That’s down to genes: her mother had the same soft skin.

Two years older than his wife, Allen, too, looks younger, although his body tells a different story. He lifts his shirt to reveal surgical scars: two incisions either side of his chest where battery packs sit, part of the deep brain stimulation (DBS) system that keeps shakes and tremors in check. Cables run from his chest, up each side of his neck to the top of his skull, forming two bumps, like horns about to come through.

Rock ‘N’ Roll Youth

Allen tells the story of his rock ’n roll youth with a frank, unblinking gaze… a side effect of Parkinson’s Disease, he says later.

Allen tells the story of his rock ’n roll youth with a frank, unblinking gaze… a side effect of Parkinson’s Disease, he says later.

Brooklyn-born and -bred, his love of music writing started in college, eventually leading to career that saw him work as a roadie, band manager and finally, music editor.

New York City in seventies and eighties was an exciting place and time for music lovers and Allen had a front-row ticket to the action. He met The Kinks and the Beach Boys’ Dennis Wilson, as well as witnessed the birth of punk.

Inevitably, there were a few rock ‘n’ roll adventures, including a memorable stand-off with Patti Smith, Bruce Springsteen and the New York Fire Department during his stint as box office manager at legendary music venue CBGB.

Before Parkinson’s, Patti Smith

“It was the night before New Year’s Eve and we had Patti Smith. Bruce Springsteen was a surprise guest. Someone alerted the fire department that there were too many people. These beefy guys came down, all these big galoots. They wanted to stop the show,” he remembers. “Patti Smith was shouting ‘do you know who I am? There will be a riot! Blood will be on your hands!’ Everyone was in uproar.”

“There was a stand-off, I tried to calm things down. They agreed to let Patti and Bruce finish a couple of songs. Patti wouldn’t stop shouting about wanting to play more songs. She was a bit of a brat, she had an attitude.”

Another highlight was when Mink DeVille, a band that Allen worked as a road manager and publicist for, was signed by Capitol Records. “I even sing on their record,” he says. (“He can’t sing,” Jan chips in.)

Inevitably, there were a few rock ‘n’ roll adventures, including a memorable stand-off with Patti Smith, Bruce Springsteen and the New York Fire Department during his stint as box office manager at – the CBGB Second Avenue Theater, an offshoot of the legendary music venue CBGB.

A Fresh Start With A New Wife

But the good times came to an end. Tired of being broke, living on his uncle’s couch, Allen left New York thirty-eight years ago for a fresh start in Atlanta. He had no connections, but armed with a Brooklyn attitude, he landed the job of his dreams: a gig as the music editor for Atlanta’s Marquee Magazine.

“It’s amazing what you can do if you have chutzpah,” he says.

It’s amazing what you can do if you have chutzpah.

The couple met twenty-eight years ago at a singles night, when, in a story as old as love itself, eyes met across a crowded room. Later, they found themselves in a conversation about dogs.

“I said I loved dogs, but I didn’t want one because they’re too much work,” Jan says. “He thought it was funny.”

“You were funny,” confirms Allen.

“I’m not as funny anymore,” she says.

They exchanged details and after a whirlwind romance became engaged, then married. Their son Joey was born a few months later.

The Early Signs

The next few years of life, work and childrearing passed in a happy blur. The first inkling Allen had that something was wrong came in 1998, watching a baseball game on the television.

“I was watching the World Series. It was the Yankees. All of a sudden I saw my boss on TV. I reached for the phone to phone him, and I saw my hand was shaking. Then it went numb.”

Allen saw a doctor, who told him it could be anything, so he waited. When his symptoms became worse, he saw a neurologist.

“The neurologist was a young woman. Within five minutes she diagnosed me with Parkinson’s Disease. The first words out of my mouth were ‘I want a second opinion’.”

The next doctor, a veteran in the field, took just two minutes to confirm the diagnosis.

“I was numb. The hardest thing was telling Jan and Joey, who was nine. The first thing Joey asked was: am I going to get it too?”

What Happens When Parkinson’s Takes Over Your Marriage

The first couple of years after the diagnosis weren’t too bad. But when Allen’s father died in 2001, the stress sent his symptoms up a notch, and eventually, the disease took over their lives.

“He had no quality of life,” Jan says. “He weighed a hundred and twenty pounds. He had a moustache before, but he became the moustache, all skin and bone. The sweat would drip off his head. It got to the point where he couldn’t sit in one place for more than a few minutes. He couldn’t drive, he couldn’t read; his leg would constantly be moving, it would move the rest of him.”

[Parkinson’s] was like an earthquake going on in my body.

“It was like an earthquake going on in my body,” Allen adds.

The cocktail of drugs to address Allen’s symptoms came with their own problems.

“One dopamine agonist, Mirapex, gave him paranoia,” Jan says. “It was hardest on Joey, who was fifteen or sixteen at the time. One time, Allen decided he was leaving. He had Joey take empty suitcases down to the car. He went to a hotel and called every half an hour.”

And then there was the incident where Allen accused Jan of having an affair. “There is a REM Behavior Disorder caused by the disease, and you act out your dreams. One night, when he started going nuts I put my arm out to stop him and he bit my thumb. Then he told me I was having an affair.”

Love After Parkinson’s

In 2011, Allen elected to have brain surgery to install a Deep Brain Stimulation system, which can help control the most debilitating symptoms of Parkinson’s. During the five-hour operation Jan watched as surgeons drilled holes into her husband’s skull, implanting the electrodes that send electrical impulses to targeted parts of his brain to help motor function.

The surgery helped Allen regain a semblance of normal life, although he says Parkinson’s brings a few “wonderful surprises” to keep them on their toes. Insomnia is a constant and unwelcome guest, affecting not just Allen but Jan’s sleep quality too. However, the insomnia had its own unexpected side effect.

“One of the weird things about Parkinson’s Disease is that it opens up aspects of creativity,” Allen says.

One of the digital artworks Allen has been experimenting with since Parkinson’s.

Once, during a three-night run without sleep, he began manipulating images with Photoshop.

One of the weird things about Parkinson’s Disease is that it opens up aspects of creativity.

Allen leaves the room and returns with four binders, which he places on the table. He leafs  through his work, pointing out his favorites. The carefully numbered print-outs feature real and imagined cityscapes, pop-art style images of his music idols, bright crowds of people and rows of yellow taxis.

A New Creative Life

Although the days of nine-to-five are long gone– “work went to hell in a hand basket”– the creativity’s still flowing. Along with his Photoshop art, Allen’s still writing: short stories, and two novels based around his youth in 1960s New York City.

Jan is matter-of-fact about the toll caring for Allen has taken on her. Until 2011, she worked in market research. It was a career she loved, but the stress of caring for Allen–as well as other pressures like her elderly mother beginning to need more care–overwhelmed her. She still struggles each day, she says.

“I’m sleep deprived. I’m overwhelmed. I’m overweight, because I eat my stress. I can’t keep up with anything. I have depression, high cholesterol and blood pressure, and sleep apnea. I see a therapist and psychiatrist.”

How Parkinson’s Changes A Marriage

Jan says Parkinson’s has forced the couple to confront a permanent shift in their relationship dynamic.

“One of the reasons I married Allen is because he has always been very protective of me, and he told me he will always take care of me. Unfortunately, he can no longer care for me in the same ways he used to. He takes medication to help him sleep, so he is unable to jump up out of bed and walk around, so if we hear a noise in the middle of the night, I have to check it out.

“I know he’d like to still take care of me, and he tells me this all the time. It just isn’t possible the way it used to be.”

Separating the disease from the man she married is a daily challenge, she says.

One of the reasons I married Allen is because he told me he will always take care of me… [but] it just isn’t possible the way it used to be.

“Parkinson’s affects the entire body – every system. There are lots of new eating noises, shuffling, falls, he’s slower to process information, he has poorer sense of direction, differences in eyesight,” she says. “All of these things impact our relationship. It just isn’t the same.”

“Patience is very difficult to come by when interacting with Allen. He is often telling me to stop yelling at him. But yelling is what I do first [when I’m scared]: when he falls, for instance.”

Jan and Allen don’t talk about this new dynamic, but there is a deep understanding between the couple, Jan says.

“Allen is so perceptive that I think he understands without my having to voice it. He still takes wonderful care of my psyche, which is more basic anyway.”

Finding Support

For a long time Jan struggled on her own, until the chance discovery of a book in the public library. It was called Mainstay by Maggie Strong, and detailed the journey of a woman who had multiple sclerosis. Mainstay mentioned a support group for spouses of carers called the Well Spouse Association. Jan Googled the name and found a chatroom, where she’d post when she couldn’t sleep. In 2005 she went to the Well Spouse conference, and when she came home, she decided to start an Atlanta group.

Now, she’s national co-president, a role that’s rewarding, but stressful: the administration, endless politics and the problem of dwindling membership are a constant headache. “But it’s the one thing I’ll never give up.”

While Allen likes that the group gives Jan an outlet, not everyone feels the same way, she says.

“Some spouses don’t like their partners joining the organization. Some even join in secret. They’re jealous, or worried they’ll find a new partner.”

Jan sees some sad cases within the group, especially with older people. “People over seventy are often in more traditional roles, and the carers are often treated like slaves. A lot of lives are ruined: twenty percent of caregivers die before the sick person they’re caring for.”

Paying The Bills

Twenty percent of caregivers die before the sick person they’re caring for.

As with many others in their situation, money is always at the back of their minds. The state of Georgia doesn’t have provision for caregivers, so the two of them live on Allen’s disability. And they’re bracing themselves for the worst: if the Affordable Healthcare Act is repealed, Jan will likely lose her medical insurance. She’s already made compromises to the detriment of her health care for the sake of cost: switching expensive branded medication for cheaper, less-effective generic brands, while some meds she’s had to give up altogether.

“It’s been the worst couple of months. Every day I get up and pray Trump hasn’t done anything [to the Affordable Healthcare Act].”

And of course, while Allen’s still pretty independent, this will likely change. Recently, he’s developed walking problems. While making a sandwich, he fell and broke his finger. Another day saw him smash the glass in the front door when he couldn’t stop after rounding the corner in the hallway.

The Future Unknown

What will happen when Allen’s care is too much for Jan?

A balding man with silver hair  in a red collared shirt, and his wife, a blonde woman in a green t-shirt, smile at the camera and hold up a framed photo of the man's computer art, showing a New York

Jan and Allen, posing with one of his artworks.

There is a brief silence, and Jan and Allen look at each other across the table. “We need to discuss what to do,” Jan says. “But we’ve decided when he starts needing help with personal care he will live in a facility.”

Outside, Jan sighs at the crumbling plant pots by the front door, filled with dry, cracked earth. “I need to do something about these,” she says apologetically. But she doesn’t have the time or the energy for gardening.

Then she smiles.

Lucky in Love

“We probably say ‘I hate Parkinson’s’ to ourselves or each other every day. But we’re lucky. I know we are. It could’ve been worse, there are others far worse off than we are.”

It’s been difficult explaining the impact of Parkinson’s Disease to family members, they agree. Some have been less than sympathetic.

“My father said ‘No one in our family has it, you don’t get it from us,’ says Allen. “I also heard: ‘why are you walking that way?’

“I was visiting my mother in Florida and I had a tremor. ‘Stop that,’ she said. ‘I can’t, I have Parkinson’s Disease,’ I said.” He smiles, wryly, at the memory. “She responded: ‘Well, at least take your hand off the table.’”

 

Health & Fitness Neurological & Cognitive Disorders

Wheels Of Change

After a diagnosis of Parkinson’s Disease, Kim Spletter thought she’d never ride a bicycle again. Now she’s teaching others how to pedal through their illness.

It’s mid-morning at the YMCA of Frederick County in Frederick, Md., and a group of 13 people are poised on stationary bicycles as a catchy Beach Boys song plays on the speakers. Kim Spletter, who teaches the Pedaling for Parkinson’s class sits on a bike at the front of the class, acting as half drillmaster/half cheerleader as she encourages class participants to pedal fast and maintain speeds of 75 to 80rpm.

Kim Spletter.

When Spletter of Frederick, Md., was diagnosed with Parkinson’s disease at the age of 45, she thought her days of bicycling were over. An avid athlete who had enjoyed biking since she was a child, Spletter had always looked forward to her daily 20-mile rides, and found them to be the perfect way to unwind after a busy day.

All of that changed seven years ago when Spletter began experiencing an array of physical symptoms ranging from tremors and stiffness to a complete lack of muscle control.

“I couldn’t balance on my bike and the tremors and muscle rigidity prevented me from pedaling,” Spletter says. “I was always an athletic person and suddenly I saw my life shrinking.”

I was always an athletic person and suddenly I saw my life shrinking.

Her doctor diagnosed her with Parkinson’s disease, a chronic and progressive neurological disease that occurs when nerve cells in the brain don’t produce enough of a brain chemical called dopamine. The Michael J. Fox Foundation for Parkinson’s disease says the degenerative movement disorder affects over one million people in the U.S. Although the average age of onset is 60, people are diagnosed as young as 18.

While there is currently no cure for Parkinson’s, medication and therapy are used to treat symptoms of the disease including tremors and shaking, stiffness and slow movements.

A retired sheriff’s deputy, who was used to an active lifestyle, Spletter had a hard time accepting her diagnosis and the realization that suddenly nothing physical was easy for her.

“I couldn’t walk for any distance, and I had trouble dressing myself,” she says. “All of my joints hurt and the dopamine replacement medication that I was taking for Parkinson’s made my dyskinesias (abnormal involuntary movements) worse.”

Mourning her loss of independence, Spletter felt hopeful when her doctor suggested she take part in a new clinical trial at the University of Maryland Medical Center. The study would use a noninvasive approach called focused ultrasound, to target and heat the abnormal brain cells associated with dyskinesia.

Over the course of four hours in September, 2015, Spletter received a series of focused ultrasound waves that passed harmlessly through her skull to kill a targeted group of cells. After the 11th wave, she had regained 70% of her strength on the left side of her body, and while Spletter had been taken by wheelchair into the procedure, she was able to walk out on her own after it was completed. In addition, her symptoms of trembling and shaking subsided almost immediately.

As one of the first Parkinson’s patients in the United States to undergo the procedure, doctors told Spletter that while the focused ultrasound procedure would make her symptoms less debilitating, they weren’t sure how long the results would last. Spletter, however, was undeterred by the uncertainty of her prognosis and determined to make the most of her second chance at mobility. Today, over a year and a half after her treatment, many of Spletter’s symptoms continue to diminish.

“The procedure turned back the clock for me,” says Spletter who decided to make the most of her newfound freedom. She began walking and biking, and taking spin classes at her local YMCA. She found that a regular biking regimen and spin classes were especially helpful in keeping her Parkinson’s symptoms at bay.

Research supports Spletter’s claims showing that cycling can ease the symptoms of Parkinson’s, and possibly even slow the progression of the disease.

Cycling can ease the symptoms of Parkinson’s, and possibly even slow the progression of the disease.

A 2012 study conducted by Dr. Jay Alberts, at the Cleveland Clinic found that patients with Parkinson’s disease benefited from exercise using stationary bikes. In the study, those who pedaled fast on a stationary bike, at speeds of 75 to 80 rpm, 3 times a week for 8 weeks, showed a 35% improvement in their symptoms including balance and gait. Alberts found the intense rhythmic motion of cycling helped Parkinson’s patients in the same way that anti-Parkinson’s medication to increase dopamine levels in the brain. Other high-intensity sports may also benefit Parkinson’s patients. Rock Steady Boxing, a program that uses modified boxing techniques to help people with Parkinson’s, was developed by a Parkinson’s patient and is now offered at more than 150 gyms across the country.

Even better, the benefits of cycling lasted from hours to days. Impressed by Alberts’ continuing body of research, many YMCAs across the country have started offering Pedaling for Parkinson’s classes.

Kim on a morning cycle.

Two years ago when the YMCA of Frederick County was asked if they might consider offering the stationary cycling program for Parkinson’s patients. They approached Spletter, who was already participating in spin classes at the facility, and asked if she’d like to teach the Pedaling for Parkinson’s class.

After obtaining online certification through Parkinson’s Cycling Coach, and learning how to teach a guided cycling class specifically for Parkinson’s patients, Spletter began teaching classes in late 2015, and became the first YMCA instructor to teach Pedaling for Parkinson’s that actually has the disease.

“A lot of people come to Pedaling for Parkinson’s that wouldn’t normally come to a regular exercise class,” she says. “They tell me their symptoms disappear while they’re on the bike, and that it’s the only place they don’t feel as though they have Parkinson’s disease.”

Unlike a regular spin class where participants may stand on their stationary bikes, Parkinson’s for Pedaling classes focus on strengthening legs and core and concentrate on cardio exercise. The results are nothing short of amazing, and Spletter says the benefits are similar to those she received from undergoing the focused ultrasound procedure.

“I’ve had Parkinson’s patients who have become sedentary and couldn’t complete even 15 minutes of the cycling class when they started and now find it isn’t a problem to go the entire 45-minutes,” Spletter says. “They say the classes make them feel stronger, less fatigued and improve a lot of their symptoms.”

Perhaps just as important as the physical effects, are the emotional benefits of such a program, and the fact that the classes allow patients to take an active role in managing their disease.

“I look at the Pedaling for Parkinson’s classes as a support group that also offers exercise,” Spletter says. “A lot of people who have balance issues as the result of Parkinson’s, are afraid to exercise but after taking this class, they feel confident enough to go on and try water exercises or light weights.”

Once a month, Spletter’s students who are men and women in their fifties and sixties, enjoy lunch after class.

I feel as if I’ve been given a second chance.

“My students have said they enjoy being in a class with others who can relate to the struggles they face with Parkinson’s,” Spletter says. “Although many are at different stages of the disease, they share a common bond.”

Because the Pedaling for Parkinson’s classes are still relatively new, researchers aren’t sure how long the improvements that occur as the result of cycling will last. But after years of being told that medication was the only treatment for Parkinson’s, patients such as Spletter are thrilled that options such as focused ultrasound and Pedaling for Parkinson’s classes are now offering hope.

“I feel as if I’ve been given a second chance,” Spletter says. “I’m hoping the focused ultrasound treatment, combined with the spin classes, will delay the progression of my disease long enough that researchers are able to find a cure for Parkinson’s.”