…If It Ain't Got That Swing

It’s that time of year again. I’m hoping it is just a bug I have had as my right shoulder and arm have been quite sore and achey and for my neck I’ve been using the wheatbag (microwaved) a lot. Haven’t been to the gym for a couple of months. When I started I had an uncomfortable ache in my right upper arm which seemed to wear off with the exercises

I’m not in a hurry to sign up again. After paying quite a bit for some repairs on my trike (crashed into a parked van when my eyes were closed…) I thought I should use it more. I had also tried Yoga & Zumba classes at the gym but enthusiasm was waning. Yoga was such a struggle. My arms were going everywhere & hopeless trying to keep my right arm in particular on the mat for ‘down dog’. And I haven’t managed to get rid of a pain in my left wrist which meant I didn’t want to put weight on it. Still waiting to hear if I can see hospital physio for that one.

In Zumba my attention was flagging and I would just come to a standstill. Walking the length of the gym afterwards was getting pretty dodgy too – my feet sticking to the floor and catching. I asked a couple of times if they might get a walker and leave it at reception but no dice.

20/12/02 Sulpiride NEUROLEPTIC

5/5/03 stiff shoulders, right arm tense while walking. stiffness chest & between shoulder-blades

6/03 tingling right forearms, stiffness.

16/9/03 stiffness shoulders, tight in chest, right arm stiff.

22/9/03 ride bike arm v. stiff. Arm aching when I write

29/9/03 Hospital physiotherapist noted: No armswing right… Flexed at elbow. Leftarm: active armswing

5/12/11 Community Neurophysiotherapist wrote to GP, “ her right shoulder and elbow flexors were painful and tight.”

30/3/12 GP wrote to my consultant : She demonstrated an intermittent rest tremor in her right arm as well as slowing of the movement in the finger and foot tap tests especially on the right hand side. She is complaining of postural instability and stiffness in her right arm and neck muscles.

A double blind trial of sulpiride in Huntington’s disease and tardive dyskinesia N.Quinn and C.D.Marsden Journal of Neurology, Neurosurgery, and Psychiatry, 1984, Vol 47, 844-847

…signs of emerging or worsening parkinsonism were seen in seven of the nine tardive dyskinesia patients. In five of them it was evident after only two weeks treatment with sulpiride

Movement Disorder Society-Sponsored Revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): 2008 Part III: Motor Examination

3.10 GAIT: Testing gait is best performed by having the patient walking away from and towards the examiner so that both right and left sides of the body can be easily observed simultaneously. The patient should walk at least 10 meters (30 feet), then turn around and return to the examiner. This item measures multiple behaviors: stride amplitude, stride speed, height of foot lift, heel strike during walking, turning, and arm swing…

UK Parkinson’s Disease Society Brain Bank Clinical Diagnostic Criteria (Hughes AJ et al. J Neurol Neurosurg Psychiatry 1992;55:181-4)

Inclusion criteria Bradykinesia (slowness of initiation of voluntary movement with progressive reduction in speed and amplitude of repetitive actions) And at least one of the following:

Muscular rigidity

4-6 Hz rest tremor

Postural instability not caused by primary visual, vestibular, cerebellar, or proprioceptive dysfunction

Supportive criteria (Three or more required for diagnosis of definite PD)

Unilateral onset

Rest tremor present

Progressive disorder

Persistent asymmetry affecting side of onset most

Excellent response (70-100%) to levodopa

Severe levodopa-induced chorea

Levodopa response for 5 yr

Clinical course of 10 yr or more