165 posts in the category “Parkinson’s Disease”

“My expertise is as a person with Parkinson’s”: Member Lisa brings the patient voice to drug development

Posted April 28th, 2017 by

Member Lisa (lcs), a Team of Advisors alum who’s living with Parkinson’s disease, has found her advocacy niche: involving patients in drug development.

Parkinson's Disease patient

Lisa Cone, PatientsLikeMe member living with PD

Diagnosed with PD in 2008, Lisa served as a patient thought leader and co-author of a published journal article called “Increasing Patient Involvement in Drug Development.” She worked on the publication along with Maria Lowe, Pharm.D. – a health data and drug information clinical specialist at PatientsLikeMe – and other pharmacists and Ph.D.s.

“I hold my co-authors in the highest regard,” Lisa says. “That said, not one of them was a person with an incurable, progressive neurodegenerative disease. My expertise is as a person with Parkinson’s.”

 

Maria says that having a patient co-author was “crucial” to the publication. “We wanted to look at how drug developers were incorporating patients into drug development activities and recommend some best practices,” Maria says. “How could we possibly do this without ensuring we were representing what matters to patients?”

The value of partnering with patients

In addition to teaming up on the research paper, Lisa and Maria also both participated in a webcast on April 12 on PDUFA VI and the Patient Voice.

PDUFA stands for the Prescription Drug User Fee Act, which the U.S. first enacted in 1992 to allow the FDA to collect fees from pharmaceutical companies to help fund the FDA’s drug review and safety monitoring processes. PDUFA VI, the pending update to the legislation (up for renewal in September 2017), would require drug developers to include more of the patient perspective in the early stages and overall process of drug development. (Read more about it here.)

Maria Lowe

Maria Lowe, Pharm.D., health data and drug information clinical specialist at PatientsLikeMe

Lisa says that the FDA has been trying to drive a higher level of patient participation in the trial process and the drug approval process. New leadership and budget changes in Washington could shift or delay the FDA’s focus on patient-centeredness, but Lisa still has a message for pharmaceutical industry leaders:

“I urge you not to confuse the value of partnering with patients with the requirement to partner with patients.”

 

But she adds that low participation in trials often stems from problems in the study design from the get-go. Involving patients early and often in trial design and drug development can pay off big time, Lisa says. “The time and resources it takes to bring a single new therapy to market are significant,” she says. “Because of this investment, failure to assess the needs of patients early in the development process can mean marginal success or frankly disastrous results when taken to market.”

On becoming a patient thought leader, plus a few pointers

Lisa had professional experience in the healthcare field — before leaving the workforce, she was an executive responsible for understanding the business of and policies affecting healthcare providers.

“I do not, however, believe that these experiences are required to be an effective advocate. I believe having knowledge of your condition beyond your personal experience is the primary requirement, which is not complicated,” she says.

On PatientsLikeMe, 23,512 patients say they’re interested in advocacy. Lisa’s advice? Find a “role that most suits your gifts,” such as fundraising, lobbying or speaking. She also puts her her physical and emotional health first. “This means taking time to relax, play with my dog, visit with friends and family and getting physical activity,” she says. “I’m not always successful in this endeavor as I have a tendency to ‘over volunteer.’”

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Could the Rolling Stones be part of Parkinson’s disease management? (Check out Pamela Quinn’s blog)

Posted April 26th, 2017 by

It’s Parkinson’s Awareness Month, and we’re continuing to find meaningful stories in the world of PD. Did you tune into our recent podcast featuring Pamela Quinn – a professional dancer who’s living with Parkinson’s? She teaches dance classes in New York City for people with PD. Now, she’s taking her dance and movement tips to a broader audience online in a cool new blog (psst – Rolling Stones fans, read on…)!

Pamela Quinn Parkinson's

Some members have noted in the PatientsLikeMe PD forum that they’ve attended and benefited from dance classes for people with PD (even ones that reference Pam’s teachings!). But what if you have PD and live where classes like this aren’t available – or if dance classes just aren’t up your alley? Check out Pam’s blog, PD Movement Lab.

Songs to step to

Pam uses visuals, like photos and videos, in a series of mini-lessons for moving and walking with PD. In one of her first posts, she shows how walking to music can make a big difference, and offers a playlist of her favorite songs to walk to at varying tempos, including:

  • “Fever,” Peggy Lee (68 beats per minute)
  • “Clarinet Concerto in A Major,” Mozart (94 bpm)
  • “Moon Rocks,” Talking Heads (124 bpm)
  • “Brown Sugar,” Rolling Stones (129 bpm)

(Hint: You can find out the tempo of your own favorite songs using this neat BPM calculator, and then create your own playlist.)

“We can put it back together”

Pam’s blog is all about empowering people with PD to keep moving, although she knows first-hand that it’s not easy (she has lived with PD for more than 20 years).

Dancing for Parkinson's

“Why are we breaking a walk down into all these bits and pieces?” she says in her latest blog post (about arm swing – featuring Judy Garland). “It’s because with Parkinson’s, we lose the ability to move unconsciously. But if we understand how things work, we can put it back together. It may require a conscious effort but at least we have the opportunity to move with coordination, fluidity, skill and awareness.”

Do you have any tips for moving or walking with PD, or favorite songs that keep you moving? Make a comment below!

On PatientsLikeMe, dozens of patients have reported trying various forms of dance to help manage their condition. Take a look.

A note from Pam: The content of this post is intended to provide experiential advice from a fellow patient about ways of moving to help manage your PD. It is in no way intended as a substitute for medical consultation. Be sure to check with your healthcare provider before engaging in any new exercise program. Pamela Quinn or PD Movement Lab will not be responsible for any injury or harm you sustain in performing any exercises or following any advice presented here in. 

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World Parkinson’s Day: Meet Eileen, a PatientsLikeMe researcher with a passion for PD

Posted April 11th, 2017 by

Researcher Interview on Parkinson's Disease

Today is World Parkinson’s Day, and 2017 marks the 200th anniversary of the identification of Parkinson’s Disease (PD). Meet Eileen Mack Thorley, a research scientist with a passion for PD research. By day, she works on a variety of research projects at PatientsLikeMe. On her own time, you might find her doing FaceTime with her dad to help him practice his physical therapy exercises for living with Parkinson’s. He was diagnosed with PD more than 10 years ago.

Eileen said her father’s PD diagnosis inspired her to get involved with the Team Fox Foundation Young Professionals of Boston (part of the Michael J. Fox Foundation), and ultimately led her to venture into PD research as part of her day job.

Eileen has a master’s degree in public health and specializes in epidemiology, data analysis and public health research. She has been working in the field for 8 years, previously focusing on the areas of substance abuse and maternal and child health.

“Where I want to be now is focusing on Parkinson’s research and community health – living with the disease and bringing the patient experience into research,” Eileen said. In addition to a focus on traditional medical breakthroughs in Parkinson’s research, she has a personal interest in the area of complementary therapies for PD management – especially music and relaxation. “There’s a growing body of research on the benefits of relaxation.  How can we better understand and apply these benefits as part of disease management?”

Eileen attended the 4th World Parkinson Congress in Portland, Oregon, this past fall and wanted to share some highlights from the conference.

What was it like to attend the World Parkinson Congress as both a researcher and a family member of a person living with PD?

On a professional level, I was excited for the opportunity to attend this conference to expand my current understanding of the latest in research and medical advancements with the aim of applying new insights to our research. The conference brings together researchers, health care practitioners and patients living with Parkinson’s around the current state in Parkinson’s research, science and care.

Personally, it was also a meaningful experience to me to have exposure to this conference and community as I have a family connection. My dad has been living with a Parkinson’s for over 10 years.  Parkinson’s certainly has had a profound impact on our family and it’s difficult for me to adequately express how important improved care, treatment and any discoveries that improve daily life are to me.

Could you walk us through an overview and some highlights of the conference? Did the conference feel patient-centered? How so? 

Over 4,500 attendees from 67 countries were present, including over 2,000 patients living with Parkinson’s, their care partners, and family members. It was encouraging to reflect on how many people are working on different ways to make life better for those living with Parkinson’s with an ultimate eye toward a cure.

 

“Being in a huge convention space filled with physicians; care providers; non-profits; clinicians; scientists who dedicated their lives toward care, research and support in Parkinson’s – alongside others who experience this disease first-hand in daily life – was truly powerful and humbling.”
–Eileen on attending the 4th World Parkinson Congress

 

From my view as both a researcher and a family member, I appreciated that there was a combination of technical discussion on the latest in treatments and research along with a presence of the patient voice and experience. After a plenary discussion on the latest in deep brain stimulation (DBS), including ultrasound as a developing, non-surgical approach (albeit mainly for tremor, including other caveats), there was a presentation from a patient named Andy McDowell who went through DBS and he shared his story. Some of the other research themes included wearables and apps to track movements; immuno-therapeutic approaches and targeting alpha-synuclein (this was a particular focus in drug development as it could be helpful across a range of conditions including but not limited to Parkinson’s); and genetics research (primarily on the LRRK2 gene).

I appreciated that the conference highlighted non-drug and complimentary therapies in addition to medical care including a focus on exercise, relaxation and wellness services for patients; the conference included a “Wellness Way” section where patients could sign up for massage, reiki, yoga (‘yogadopa’), boxing (with Rock Steady Boxing), singing/vocal exercises, dance, breath-work and more.

 

“I sat in on one of the wellness sessions to observe with the aim of picking up any insight to share with my dad. An atmosphere of support among patients was palpable and touching.”
–Eileen on the wellness sessions at the WPC

 

All together, these elements helped set a nice tone for the conference – research and applied practice; clinical care and daily life once you are home and no longer in the doctor’s office.

What were some of your biggest takeaways from the conference? Can you apply anything you learned at the conference to your job at PatientsLikeMe? 

While the conference highlighted many of the advancements and the current work is promising, we know much more work is needed. There is a large community and network of efforts around care and research, and we all have a role to play. The conference underlined the importance of bringing the patient voice to technical research and these projects. There are so many unknowns. There’s so much we need to learn from your experience.

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Checking in with member Bev – “Laughter and comedy are still a huge part of my health management.”

Posted January 17th, 2017 by

Remember Bev (YumaBev), who we met back in 2012, after she’d just had deep brain stimulation (DBS) surgery? She told us about her blog Parkinson’s Humor and a book of stories from her blog, Parkinson’s Humor: Funny Stories about My Life with Parkinson’s. Well we recently caught up with her again to see how things have been going since we last spoke.

Check out the latest with Bev to see what she had to say about being an eternal optimist, connecting with other “Parkies” and the power of laughter.

It’s been a while (4 years) since we last caught up! How have things been going?

The last time we spoke, I had just had the first part of my DBS surgery. The surgery was an eventual success, but I had some minor complications. The skin on my scalp was so thin, it pulled apart where it was sutured. There was never any infection, but it did require several surgeries and a plastic surgeon to finally get my scalp to stay closed and heal properly. Right in the middle of all these scalp surgeries, I was diagnosed with breast cancer and the tumor was just below my DBS generator, so that made the cancer surgery a bit tricky. I also had a slight complication from the cancer surgery, in that the nerve in my right arm was pinched, so I had limited use of my right arm for about 6 months. Then my DBS settings were encroaching on the mood part of my brain, causing a severe depression. Needless to say, most of 2013 was definitely not a good year!!!

However, my scalp stayed closed and my hair grew back, my arm fixed itself, the cancer is gone (so far) and once my DBS settings were adjusted, the depression quickly disappeared.

Now my DBS settings are controlling almost all my Parkinson’s disease motor symptoms. I’m taking way less Parkinson’s disease medicines and I am back to sleeping 8 hours a night, which is something I hadn’t done in many years. Everything is about as good as it can be with Parkinson’s.

In your profile you mention that it took 8 years to get a diagnosis. Can you tell us a little about that journey?

My early Parkinson’s symptoms were not the typical resting tremor common in more elderly patients. The first symptom that sent me to a doctor was upper back pain near my shoulder blade/spine. I was referred to an orthopedist. Next came the inability to double click my computer mouse at work (more orthopedists.) Difficulty writing followed and then a tremor, but only when my hand was being used. (Think food flying off my fork and across the room.) After being x-rayed, CT-scanned and MRI’d, with everything coming back normal, I was finally referred to a neurologist. He diagnosed essential tremor (ET) and prescribed propranolol. This helped the tremor, but nothing else. My dad had been diagnosed with Parkinson’s the year before, so I asked if it could be Parkinson’s and was told, absolutely not. (Guess he was wrong.)

As my symptoms progressed, I confounded many more doctors, mostly general practitioners and more orthopedists. I even asked my dad’s neurologist if I might have Parkinson’s and he said, “Don’t waste my time, your problem isn’t neurological.” (Guess he was wrong, too.)

My symptoms kept slowly worsening, I needed help putting on a jacket and getting up from a chair. I startled very easily and had difficulty cutting my food. I was very stiff and rigid. My step-daughter, who I saw only once a year or so, was shocked at how much worse I was each visit.

Then my symptoms started progressing rapidly. I was losing the ability to do things daily. I needed help dressing. I could no longer drive. I had difficulty brushing my hair. I walked like I’d had a stroke and my right hand and arm were always curled. My GP was on maternity leave and not wanting to start over with a brand new GP, I took matters into my own hands. I KNEW it had to be neurological, everything else had been ruled out. I also knew it wasn’t ET because the tremors moved to my other arm.

I got a list of neurologists within 300 miles of where I lived, off a medical website. I typed a letter, detailing my medical history and symptoms, and started sending them out alphabetically. I’d send out about five, then wait to see if I heard back. Then I’d send more and wait. When I got to letter W, I almost gave up. But I sent the last few and waited. Dr. Zonis’ office manager called me, said they knew exactly what was wrong and had me come in the next day. They were right in the same town I now lived in, Yuma, AZ. He said Parkinson’s, gave me carbi/levodopa and five pills later, I could move again!

Now, to be fair, we moved around a lot, so the first neurologist I saw was in Colorado, my dad’s was in Florida, and the last one in Arizona. But MANY young onsets don’t have the same symptoms as elderly patients. Dr. Zonis was in his mid-60’s and I was the first young onset he’d ever seen in his practice.

In your last interview you talked about the power of laughter. What role does comedy play in your life now?

Laughter and comedy are still a huge part of my health management. Laughter stimulates your brain to produce more neurotransmitters, like dopamine, so it really is good medicine. And with no side effects! Well, you might pee your pants, but then you laugh at that, too.

You describe yourself as an eternal optimist – how has that influenced your experience with Parkinson’s?

Some people have optimistic tendencies, some have pessimistic ones. I think it is part of you, just like eye color or skin tone. I have always been optimistic, but I know what depression is like (from my DBS induced depression) and I can now empathize with people who feel depressed. It is awful, your whole body aches. You wake up feeling like you’ve been boxing all night with Mike Tyson. You have no hope and you feel down.

Everyone with Parkinson’s disease is different. We progress differently and have different symptoms, but I think my positive attitude explains why, after being symptomatic for 20+ years, I am doing so well.

What’s it been like connecting with others on PatientsLikeMe? Has it helped you manage your condition?

Connecting with others with Parkinson’s disease is essential to living well with the illness. Your doctor doesn’t have the time or knowledge to help you figure out how to live with Parkinson’s disease, they only know how to write prescriptions. People with Parkinson’s disease know the best local doctors, dentists, therapists and helpful tricks and are willing to share their life experiences. For example, replacing medicine bottle caps with the flip top ones that come on vitamin bottles. Parkies also can tell you if this symptom is common or if this side effect is dangerous.

 

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Meet Gary from the PatientsLikeMe Team of Advisors

Posted January 12th, 2017 by

Meet Gary (tupelo), a husband, father and grandfather who lives with Parkinson’s disease. Gary’s also a member of the 2016-2017 Team of Advisors. He believes that physical exercise slows the progression of Parkinson’s and practices Tai Chi and Qigong on a regular basis.

Check out Gary’s story and his outlook on life with Parkinson’s: “Accepting your condition doesn’t mean you must resign yourself to it.”

 What gives you the greatest joy and puts a smile on your face?

There are many things that give me joy in life. In my personal life, I love sports, reading a good book and drinking a glass of good wine.  In my professional life, I’m motivated by taking on the challenge of new opportunities, taking an idea and creating a business around it, or public speaking. However, nothing gives me more joy in my life than my family. They are the reason I push myself so hard to understand all there is to know about Parkinson’s Disease while searching for a way to stop or slow the progression. My phone, my computer and my desk all contain pictures of my two young grandsons.  That’s what brings a smile to my face each day.

How would you describe your condition to someone who isn’t living with it and doesn’t understand what it’s like?

Living with a chronic, progressive disease is basically like having a new full-time job. Managing medication, scheduling medical appointments, keeping up with current literature and research, keeping involved with my Parkinson’s advocacy and volunteer work, while making sure I exercise daily can become exhausting.  The greatest obstacle and challenge I have living with Parkinson’s is doing all of this while also trying to maintain my professional career and leave time to continue to live and enjoy life to its fullest.

If you could give one piece of advice to someone newly diagnosed with a chronic condition, what would it be?

The best advice I can offer to someone newly diagnosed with a chronic illness is do all you can to take control of the situation. Research the condition, put together the best medical team you can find, search out all the options for treatment and control of the disease, make your support team (family and/or friends) aware of your condition and lean on them when needed, and do whatever you need to do to fight for your health.  Then, after you have taken control to the best of your ability, remember to GO LIVE YOUR LIFE. You had no choice in getting your condition, but you have plenty of choices in how you live your life afterwards. Accepting your condition doesn’t mean you must resign yourself to it.

What made you want to join the PatientsLikeMe Team of Advisors?

 Since being diagnosed with Parkinson’s Disease almost five years ago, I have been actively involved in the PD community.  I’ve spoken publicly on a variety of topics, including drug development, clinical trials and patient volunteers, government regulations, resource allocation, access to records and information, interaction with healthcare providers and overall patient treatment and care.  Along the way I’ve come to learn how difficult it is for patients to have their voices heard and their opinions considered.  I’ve also realized how difficult it is to change any bureaucracy, and our healthcare system is right out the top of the list.  I was thrilled to join the Team of Advisors because I’ve seen firsthand what PLM has been able to accomplish in both helping patients and influencing change. As patients dealing with chronic conditions, we all share similar concerns, problems and issues.  We will be much more successful in producing meaningful changes as advocates of a combined patient community than we ever could individually or as separate disease communities.

Has there been any positive impact to your life from living with Parkinson’s Disease?

On first thought, it’s hard to imagine how someone could have a positive impact from a progressive chronic disease. However, I had several positive changes because of my diagnosis. First, I’ve come to appreciate and enjoy life much more than I did prior to diagnosis. As a Type A personality, I spent way too much time and focus on my career and had all the associated stress that came with the job.  I now try to eliminate stress as much as possible.  I control what I can and let go of what I can’t. Second, I spend much more time with my family, rather than time in the office. Finally, by becoming involved in advocacy for my condition, I’ve made friends with people from all over the world.  Our paths in life would never have crossed if not for our conditions.  There is no better example of that than the Team of Advisors and how quickly 11 strangers with different conditions bonded together over a long weekend. So yes, it is possible to have a positive impact that can coincide with all the challenges and problems that occur from living with a chronic disease.

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PatientsLikeMe Welcomes Next Patient Team of Advisors

Posted November 14th, 2016 by

 

CAMBRIDGE, Mass, November 14, 2016PatientsLikeMe has named 11 members to its patients-only 20162017 Team of Advisors, which this year will focus on elevating the patient voice. Team members will share their stories, participate in community initiatives, and give real world perspectives to our industry and research partners.

“Each year, our Team of Advisors has proven an invaluable source of inspiration and support for the PatientsLikeMe community,” said PatientsLikeMe CEO Martin Coulter. “We look forward to learning from this year’s team as we partner to identify how we can change healthcare for the better.”

More than 500 PatientsLikeMe members submitted applications for this year’s Team of Advisors. Those selected represent a range of medical and professional backgrounds and ages. They are living with a cross-section of conditions, including amyotrophic lateral sclerosis (ALS), autonomic neuropathy, bipolar disorder, epilepsy, fibromyalgia, idiopathic pulmonary fibrosis (IPF), lung cancer, lupus, multiple sclerosis (MS) and Parkinson’s disease. Members named to the team include: Cris Simon, Gary Rafaloff, Ginny Emerson, Glenda Rouland, Hetlena Johnson, Jacquie Toth, Jim Seaton, John Blackshear, Kimberly Hartmann, Laura Sanscartier and Lindsay Washington.

John Blackshear is living with multiple sclerosis (MS) and looks forward to the opportunity to share his story with others, and collaborate with PatientsLikeMe and other members of the Team of Advisors. “My experience with PatientsLikeMe has been filled with exploration, information and conversation. My health journey has been positively impacted through my connection with other members, by the various tools for tracking and logging health data, and by opportunities just like this – to participate in an advisory capacity.”

The 2016-2017 Team of Advisors recently kicked off their 12-month collaboration with PatientsLikeMe in Cambridge, Massachusetts, and will convene several times during the upcoming year. This is the third Team of Advisors the company has formed. The 2015 team focused on redefining patient partnerships and established new ways for the healthcare industry to connect with patients to deliver better care. In 2014, the inaugural group provided feedback to the research team and discussed ways that researchers can meaningfully engage patients throughout the research process.

About PatientsLikeMe

PatientsLikeMe is a patient network that improves lives and a real-time research platform that advances medicine. Through the network, patients connect with others who have the same disease or condition and track and share their own experiences. In the process, they generate data about the real-world nature of disease that help researchers, pharmaceutical companies, regulators, providers, and nonprofits develop more effective products, services, and care. With more than 400,000 members, PatientsLikeMe is a trusted source for real-world disease information and a clinically robust resource that has published more than 85 research studies. Visit us at www.patientslikeme.com or follow us via our blog, Twitter or Facebook.

Contact
Katherine Bragg
PatientsLikeMe
kbragg@patientslikeme.com
617.548.1375


Patients as Partners: Member Jeff on teaming up with your doctors

Posted April 28th, 2016 by

This year, the Team of Advisors has been thinking about partnerships in healthcare. They introduced the Partnership Principles, outlining ways to make the most of your relationships with the many people you encounter in your health journey — medical students, clinical trial coordinators, and “normals.” Now, they’re each sharing personal stories about these principles in action to kick off conversations about partnering. First up, during Parkinson’s Awareness Month, Jeff (Deak80) shares his experiences finding the right doctor and looking for “red flags,” communicating effectively, and sharing responsibility in his care.

 

As part of the Team of Advisors, we’ve been tasked to think about how we partner in our healthcare. Here are some examples of where, and more importantly how, I put the partnership principles to use. Remember that using the partnership principles is not a quick fix nor for one-time use. It’s important to establish a strong base through consistency of use and recognition that an effective partnership is based on a mutual respect and building a long-term relationship.

Know your needs in the partnership

Starting last December, I had the opportunity to put the partnership principles to use. Changes in my Medicare Part D prescription provider were driving me to change my Primary Care Provider (PCP). My previous year Part D insurer eliminated one of my Parkinson’s drugs from their formulary list. When I reviewed my options for prescription coverage (i.e., all my medications on an insurer’s formulary list), I had only 1 Part C HMO plan which met the requirements. (Those familiar with the basic construct of Medicare know that with a Part D plan you pair Medicare Supplemental Insurance to get complete coverage, or you use a Part C Advantage plan which covers both Health and Prescriptions).

Fortunately, my Parkinson’s specialist was covered under this HMO, but my PCP was not, so I began the search. I used the insurance company’s “Search for a Doctor” capability against a set of basic requirements:

  • Within 10 miles of my house
  • Has an internet healthcare rating of 3.5 or greater. (There are multiple rating services, I use this as a guide, not a rule.)
  • If they are part of a doctors group that has provided care to me in the past, was it a good or negative experience?

Using this basic approach, I was able to identify two doctors at the same practice as a potential PCP. I called, and the one with the first available appointment became my PCP. Notice that the selection process of my PCP was short and not overly taxing. One reason for the expedited process is that during the first few appointments I am watching for “red flags” or areas of concern. If I encounter too many “red flags” I move on to another doctor. As indicated below, I did encounter too many “red flags,” and quickly selected another PCP. The only change I made to the new search is I expanded the range to 15 miles. I have met with my new PCP and I can tell that this PCP will be a much better match to the partnership principles than the first. 

“As patients we may have to put more effort into the partnership to make it work…I am OK with this since I have the most to gain in the partnership.”

Establishing an effective patient-doctor partnership requires effective and efficient communications and recognition that a 50/50 partnership never exists. What this means is, as patients, we may have to put more effort into the partnership to make it work (>50%). Personally, I am OK with this since I have the most to gain in the partnership.

I look for effective and efficient communications within the doctor’s practice in two areas:

1. Does the office administration team communicate effectively with each other?

I have left more doctors due to poor office support and the office’s inability to manage a schedule than doctor/medical issues. The office administration is a key member of the doctor’s team. They are responsible for a lot of the information getting into your medical record as well as managing your access to the doctor. Some of the red flags to look for with the office administration are:

  • Is some erroneous information sneaking into your medical file? A recent experience of mine in this area is that my birth date was entered incorrectly. Although I appreciated being 10 years younger, a lot of medical decisions, tests, etc., are driven by your age. I called three times over four weeks and they still had not corrected when I changed PCPs.
  • Does the office run on time? I don’t mean necessarily to the minute, but are they even close? After relocating from Seattle to Boston, I selected my Parkinson’s specialist based on the recommendations of my doctors in Seattle. Although the doctor was medically very good, the office frequently ran over two hours late in the afternoon. These delays caused me significant stress. I was also working full-time at this point so the delays were also impacting work. Needless to say I changed specialists to one that was medically very good and the office runs almost always within 15 minutes of being on time.

2. Does the doctor’s office have the tools to communicate effectively with the patient?

You will hear phrases such as “patient portal” or “electronic medical record” (EMR) or “electronic health record” (EHR). In either case, these are referring to the system that a doctor typically uses to communicate with the patient. Usage varies between doctors. The PCP I now have is an active user of the EHR system. Even if your doctor is not an active EHR user, make sure you are. Access to this system provides you direct access to medical records (test results, surgeries performed, etc.).

Communicate effectively

Typically, I send an email about a week before my next visit to my Parkinson’s specialist. This approach provides me the opportunity to:

  • Document how I have been doing since the last session
  • Outline the objectives for this session
  • List the questions I have for this session
  • Allow the doctor to engage other resources if needed

More importantly it helps me organize, prioritize. Additionally, there is a much better chance of me remembering to cover everything in this email versus remembering onsite. Although my memory is still pretty good, relying only on your memory is setting yourself up for a disappointing meeting.

Share responsibility

Take personal ownership of my health. I am always trying to improve my situation. I attempt to eat right, get enough sleep and exercise regularly. I also put the effort into an effective patient/doctor partnership. As I mentioned above the patient/doctor partnership is not 50/50. I am not sure what the ratio is, but since the patient has the most to gain, logically they have to put the most into the partnership.

Finally, I found there’s a lack of real partnership in a lot of medical decisions. This lack of partnership is not just limited to the patient/doctor relationship. If you have multiple specialists involved, you may have to get them to meet together to discuss your case. Until you do, I have found that doctors follow a very linear process, and that joint decision making often does not occur.

You are your best patient advocate, so step up and take charge.

 

 

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“Seesawing Libidos”: A podcast for Parkinson’s Awareness Month

Posted April 11th, 2016 by

April is Parkinson’s Awareness Month, and this year we’re getting personal.

Seesawing libidos,” an episode of WBUR Boston’s Modern Love podcast, explores an unexpected side effect of a Parkinson’s medication: an overactive sex drive. The story comes from comedian Marc Jaffe, whose wife Karen was diagnosed with Parkinson’s 15 years into their marriage.

Before Karen’s diagnosis, Marc was the one with the stronger libido, but their roles would reverse after she started her medication. Compulsive behavior was a side effect, and in Karen’s case, it manifested as hypersexuality. Marc shares, “Those pills would change our lives more than Parkinson’s.”

Eventually, Karen was able to channel her obsessive behavior into fundraising and advocating for Parkinson’s. Check out the podcast to hear more of Marc’s reflections on how a medication could affect his marriage in such an intimate way.

Have you ever experienced a side effect that changed your personal life? How did you cope? Jump in the forum and share your story.

 

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Meet Jeff from the PatientsLikeMe Team of Advisors

Posted January 20th, 2016 by

Say hello to Jeff, another member of your 2015-2016 PatientsLikeMe Team of Advisors. Since he was diagnosed with Parkinson’s disease (PD) 20 years ago, Jeff does his best to stay active—in both exercise and advocacy.

Keeping up with his two teenage daughters is challenging enough, but when he’s up to it, Jeff also golfs, plays tennis and practices Tae Kwon Do (he’s a 3rd Degree Black Belt). And as an advocate for PD education, he’s participated in a panel discussion sponsored by Beth Israel and Deaconess Hospitals and given a presentation at Harvard Medical School.

Here, Jeff opens up about his biggest frustrations and encourages other patients to stay active and engaged.

What gives you the greatest joy and puts a smile on your face?

I have always enjoyed living life day by day and not taking myself too seriously. I believe that there many things that can be serious (i.e., health conditions, living conditions, world economics are a few), but people’s basic construct should be less serious. For example, watching my two daughters enjoy daily life at home puts a smile on my face.

What has been your greatest obstacle living with your condition, and what societal shifts do you think need to happen so that we’re more compassionate or understanding of these challenges?

A corollary to my not taking myself too seriously is my belief that the vast majority of people in a 1 to 1 relationship are compassionate and willing to learn about the day to day challenges of living with a disability. The challenge is keeping that compassion as we move from the individual to groups of people, larger organizations, etc. As groups grow in size, the compassion shrinks almost to nothing.

The one thing that I have the greatest frustration with is the frequent difficulty I have communicating with other people. My speaking ability can be so poor that I perceive my audience questions my mental faculties.

How has your condition impacted your social or family life?

My world in some ways has become smaller. My wife and I don’t go out as frequently as we once did, nor do we entertain at home as much. In either case, going out or entertaining at home has become a bigger responsibility for my wife. One of my PD off-periods can occur at any time and more occurrences happen during the evening than during the day causing additional work load for my wife.

If you could give one piece of advice to someone newly diagnosed with a chronic condition, what would it be?

The voyage of Life continues. It is better to be an active participant than a sideline observer.  Get engaged, exercise, do things. Don’t sit at home feeling sorry for yourself.  Always take the extra step.

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A patient’s perspective: member Gary reports back from the FDA public meeting on Parkinson’s disease

Posted October 27th, 2015 by

Back in September, Sally Okun, Vice President of Advocacy, Policy and Patient Safety, and community moderator Molly Cotter, attended the FDA public meeting on Parkinson’s disease (PD) along with PatientsLikeMe member Gary (tupelo).

We posted some interesting developments from the meeting in the forum, but we also caught up with Gary for his perspective on the event. Here’s what he had to say:

Why did you want to be part of the FDA public meeting?

On the day I was diagnosed, back in 2012, I spent a great deal of time reflecting on my life. I thought a lot about how Parkinson’s disease will impact me and my family in the future. On that day I made a commitment to myself that I was going to take control, to the best of my ability, on the course of the disease progression, and would do anything possible to find a cure. I was determined to educate myself as much as possible about the disease, put together the best possible health care team, learn all I could about treatments currently in research, and participate in clinical trials. Parkinson’s was a new challenge in my life and I intended to tackle it like I would any other challenge that I had faced in the past. Along the way in this new journey, I became more publicly involved as a PD advocate, both for advancing research as well as supporting newly diagnosed patients. So, when I noticed the FDA announcement regarding the meeting, I decided to send in my comments and thoughts in hope that they might be helpful, to whatever degree, in moving research along for better treatments.

What did it mean to be accepted?

When I submitted my comments I never expected to be asked to participate on one of the panels, nor was I intending to attend the meeting, which was on the eve of a religious holiday. I was quite surprised when I was contacted by the FDA, but was caught in a dilemma. Participation meant missing an important time with my family. However, when we discussed it, we all agreed that this was such a great opportunity, and honor, to be able to represent the needs of the millions of Parkinson’s disease patients worldwide to the FDA. There was no way I could turn down that kind of invitation.

What was it like being there as a patient representative at the FDA event? Did you feel like your voice was heard?

I’ve participated in a number of seminars and conferences in the past, so there wasn’t much difference with the arrangement for this meeting. If anything, it was much more low key. Nevertheless, I definitely had a sense of awe when I arrived at the FDA complex. There were multiple buildings all over the sprawling campus. It immediately reminded me of the importance of this event compared to others I’ve attended. We were going to be presenting to the Director of the FDA’s Division of Neurology Products and nine other senior staff members. This is about as high up as we could go in our advocacy to advance Parkinson’s disease research.

During the meeting, it was difficult for me to tell how our presentations were going and whether they would have an impact on the FDA’s staff, although it appeared to me that they were listening intently. I was certainly concerned about the limited amount of time I had to speak. Several days later, though, I watched the webinar presentation of our event and I felt that we hit on the large majority of the most important areas of concern that our community has regarding current and new treatments. Only time will tell if the FDA will act accordingly with our hopes and suggestions. One small item that I noticed which suggests that they were listing involves a question on the Patient Questionnaire at the meeting. We were asked to choose from a list of Parkinson’s symptoms the ones that were most impactful on our lives. In my presentation, along with several of the other panel members, we noted that they didn’t include pain or orthostatic hypotension, two very common symptoms, on their list. I did, however, see that on the new follow-up survey the FDA is conducting, they have added both symptoms to the bottom of the list. So, at a minimum, they were listening as we spoke about these debilitating symptoms.

What did you learn while you were there?

Well, I can’t say that I learned much about the disease while I was there, but, of course, that wasn’t the purpose of the meeting. Our presentations were intended to educate the senior staff and decision makers of the FDA. That being said, what I did learn was the amazing dedication and effort that members of our Parkinson’s community will undertake in order to be heard at a forum. Members with severe difficulties traveled from all parts of our country in order to be able to speak for a few minutes. I was truly honored, and most definitely humbled, to be part of a panel with these dedicated individuals. If you haven’t yet seen the archived presentation of the meeting online, I suggest that you at least watch the members of the first panel speak to the FDA about their symptoms, it was amazing.

What are your hopes for future research in Parkinson’s disease?

We were asked by the FDA to limit our answers to their questions in the context outside of finding an actual cure. In addition, we were mainly directing our responses to the FDA’s role of controlling the approval and distribution of prescription drugs, more so than studying the potential impact of alternative therapies such as exercise, vitamins or other supplements, or the development of new medical devices to assist with symptomatic control (all of which are needed). So I’ll stay within that premise.

I see the need for a three-direction approach for future research. First, we need to continue and expand research into the biological science of Parkinson’s disease, as well as other neurological diseases with similar developmental processes, such as Alzheimer’s and ALS. With a better understanding of the disease cause, pathways, and progression, we will have a much greater chance of finding better treatments and potential cures.

Second, I would like to see research into the development of better symptomatic treatments. These treatments should be effective for multiple symptoms, have fewer disabling side effects, and have extended release and longer term activity. Although today’s treatments are somewhat effective treating motor impairment, they are greatly lacking in effectiveness for many other non-motor symptoms. Many of the drugs have side effects that can be more disabling than the symptoms they treat. In addition, it would be desirable for new treatments have ease of administration, such as oral, sublingual or inhalable as opposed to invasive surgery or device implantation.

Third, and most importantly, we need research to discover interventional treatments that can slow or halt the disease progression, if not totally cure it. This research should target the development of new drugs and vaccines that can intercede along all of the numerous biological pathways as the disease progresses. For example, we would find means to either stop the misfolding of proteins, prevent proteins already misfolded from accumulating in brain cells, or eliminate misfolded proteins which have already accumulated and are leading to cell death. Finally, I would like to see more research in alternative treatments, such as stem cells and human growth factors, in addition to traditional drug development. It’s imperative that the FDA allow our scientists to be as innovative as possible as they attempt to find treatments and cures for the most complex illnesses we have in brain diseases. With new interventional disease modifying drugs, along with improved symptomatic treatments and a proper exercise regimen, most, if not all of us dealing with Parkinson’s disease would be able to live active and productive lives for many years beyond our diagnosis.

For more information, check out the full video of Gary’s panel. And don’t forget to visit the site to connect with Gary and the more than 11,000 other PatientsLikeMe members living with Parkinson’s disease.

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Recapping with our Team of Advisors!

Posted June 19th, 2015 by

Many of you will remember meeting our inaugural Team of Advisors from when we first shared about this exciting team last year! This group of 14 were selected from over 500 applicants in the community and have been incredible in their dedication and desire to bring the patient voice directly to PatientsLikeMe. As the team is wrapping up their year-long term as advisors, we wanted to make sure we update the community on all the hard work they’ve done on your behalf!

First Ever In-Person Patient Summit in Cambridge
Your team of patient advisors travelled from all over the country to join us for 2 days here in Cambridge. They met with PatientsLikeMe staff, got a tour of the offices and began their collaboration together as a team!

Blog Series
The advisors have also been connecting with the broader community as part of an ongoing series here on the blog! This is an impressive group and we hope you’ll read through to learn more about the team.  Some of the interviews featured so far include profiles on BeckyLisaDanaEmilieKarla, Deb, AmySteve, Charles, Letitia and Kitty. If you haven’t had the chance to read their stories and what they’re passionate about yet, feel free to check these out!

Best Practices Guide for Researchers
As part of their mission, this group discussed how to make research more patient-centric and ways that researchers can learn to better engage with patients as partners. Out of this work, the team developed and published the ‘Best Practices Guide for Researchers’, a comprehensive written guide outlining steps for how researchers can meaningfully engage patients throughout the research process. You can hear more about the whole process in this exciting video from some members of the team as they discuss their experiences with the creation of this guide:

Community Champions
The advisors have been wonderful community champions throughout the year, providing invaluable feedback about what it’s like to be a person living with chronic conditions and managing their health. This team has weighed in on new research initiatives, served as patient liaisons and been vocal representatives for you and your communities here on PatientsLikeMe. Whether it was sitting down with a research team to give their thoughts on new projects, discussing their experiences with clinical trials, giving feedback about medical record keeping or opening up about patient empowerment – this group has been tireless in representing the patient voice and PatientsLikeMe community!

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Update and results – the Patient Voice Analysis study

Posted April 27th, 2015 by

About a year ago, the PatientsLikeMe Parkinson’s disease (PD) community started something totally different: a study to compare the sound of their voices to their self-reported PD Rating Scale (PDRS) on PatientsLikeMe. It’s called the Patient Voice Analysis (PVA), and we teamed up with you, Max Little, Ph.D. and Sage Bionetworks to get it done.

A little bit of background
Dr. Little had done some earlier work and compared the voice signals of people who were living with PD to those of people who were not, but we wanted to take that to the next level. With their PDRS, they shared how Parkinson’s was affecting them, and we were able to match their self-reported scores to the sound of their voice.

By matching a PDRS to voice samples, we might develop the ability to predict PDRS scores (which takes a few minutes to complete) by using the voice test (which only takes a few seconds). We might also be able to detect more subtle changes in people’s Parkinson’s through their voice than we can through the PDRS. This is what Dr. Little is working toward, and all the voice samples you donated will help make it happen.

Community results, starting with the basics
Who took part, from where, and how many PDRS scores could we match to voice recordings?

  • Most of the recordings came from the U.S. (81%), with others coming from the U.K. (12%), Canada (5%) and some from Australia and New Zealand, too.
  • 677 of you recorded 851 voice samples
    • Since our original goal was 500 samples, you blew that out of the water!
  • 114 of you took the test two or more times, and one community member even contributed 10 recordings!
    • For those that took part more than once, we can start to examine how your symptoms changed over time.

Why voice recording quality matters
For the PVA study, you were able to use your landlines, cell phones, even Skype or Voice-Over-Internet-Protocol (VoIP) to submit your voice samples. The recording quality varies depending on which type of call you used, occasionally creating technical issues in analyzing the voice samples.

For example, if you’re using a cell phone in a busy restaurant, your microphone will automatically get louder so that the person you’re talking to can hear your voice better and without distortion. But that also changes the loudness of the background noise. In this study, that automatic change could actually affect the quality of the voice recording, so we have to identify where this has been an issue and find ways to overcome it.

Partly because of this, we’re still analyzing the voice samples in detail. We’re looking for subtle markers of Parkinson’s, such as fluctuations in volume, pitch and breathiness. We’re also training intelligent algorithms to identify when the quality of the voice recording is strong enough so we can develop a consistent and repeatable process.

You be the researcher
To give you some idea of what we are looking for in these voice recordings, we wanted to share a couple with you. The first is someone living with severe Parkinson’s, who scores 55 on the PDRS. You can probably hear the noticeable tremor in pitch, and the occasional short breaks in voicing.

The second is a recording of someone with mild Parkinson’s, who has a very low PDRS score of 1.

Can you hear the subtle drift in pitch? This is, most likely, indistinguishable from normal pitch drift. Subtle pitch variations such as this are one of the kinds of symptoms that algorithms attempt to identify from these voice recordings, and they contribute towards making the PDRS prediction.

So, what’s next?
At this stage, the PVA project is still just a research tool and isn’t quite ready for clinical or diagnostic use. We’re still working on analyzing the data to compare the severity of voice patterns to the reported severity of Parkinson’s disease. But in the meantime, if you’re looking to share more info with your doctor, the most useful tool is your PDRS score on your PatientsLikeMe profile. It contains items that make sense to a neurologist. If your clinic has access to speech and language pathologists, they would also have the ability to map any vocal issues you may be experiencing as part of your Parkinson’s.

As we continue to evolve the tools, we hope to provide individual level feedback and information for clinicians. But before that can happen, we want to make sure that the data quality is high enough to support drawing clinical conclusions.

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You can make a difference in April

Posted April 3rd, 2015 by

Eight years ago this April, the PatientsLikeMe Parkinson’s disease (PD) community launched, and now, more than 12,500 people are sharing about what it’s like to live with PD. What better way to recognize this awesome community than to participate in Parkinson’s Disease Awareness Month?

Listen to Leslie Chambers, the president and CEO of the American Parkinson’s Disease Association (APDA), explain the facts about PD in the video below:

As she says, 60,000 people worldwide will be diagnosed with PD in 2015 – that averages out to 164 people every day, or one person every nine minutes.

This April, it’s not just about the 12,5,000+ PatientsLikeMe members living with PD, or the 60,000 people who will be diagnosed in 2015 – it’s about everyone who is living and has ever lived with PD, and all their family, friends and colleagues who have been affected.

You can make a difference. The APDA is running a “30 days, 30 ways” campaign all month long, so be sure to check their website daily to learn how to get involved. The Parkinson’s Disease Foundation is also participating in raising awareness, and they’ve created a great toolkit to get you started. And don’t forget to share through the #PDawareness or #Parkinsons hashtags.

If you’ve been diagnosed with PD, join 12,500 others in sharing to live better, together.

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Patients as Partners: Hallucinations and Parkinson’s disease questionnaire results

Posted February 26th, 2015 by

It’s time for another Patients as Partners post, and today, we’re happy to share the results of the Hallucinations and Parkinson’s disease questionnaire.

In March 2014, more than 500 PatientsLikeMe members living with Parkinson’s disease (PD) took part in an Open Research Exchange (ORE) questionnaire about their condition. They worked with Dennis Chan and Ruth Wood from the University of Cambridge to understand a symptom called an extracampine hallucination, which is the sense of a presence beside or behind you even when there’s nothing or nobody there. So, unlike visual hallucinations, the presence can only be sensed or felt, not seen.

Everything the community shared will help researchers develop a new tool to better measure this type of hallucination and alert doctors and care teams to ask about this symptom earlier rather than later. Read the results here.

What’s ORE all about again? PatientsLikeMe’s ORE platform gives patients the chance to not only check an answer box, but also share their feedback on each question in a researcher’s health measure. They can tell our research partners what makes sense, what doesn’t, and how relevant the overall tool is to their condition. It’s all about collaborating with patients as partners to create the most effective tools for measuring disease.

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