Parkinson’s and the Gardener’s Shadow

Every year about this time, I begin to look out at the frozen tundra of our garden and wimper, “everything’s dead ….”

 

"Everything's dead ..." Photo: S. Marshall

“Everything’s dead … ” Photo: S. Marshall

But the magic always returns in the spring with snowdrops and crocus shoots emerging even before the snow and ice have fully receded. I marvel at the resilience of the flora that survives in the Ottawa Valley.  In the gardening parlance of plant hardiness zones, we are mostly in zone 3 but plants hardy to zone 4 and 5 often survive in specific microclimates. 

I don’t know why I am surprised, because I grew up in the even harsher climate of the Manitoba prairie where zone 2 would be the order of the day with some zone 3 locations.  And my family in The Pas, Manitoba and Humboldt, Saskatchewan (in sub-arctic zones) would snort at any suggestion that the Ottawa climate is “harsh” compared to what they live through.  Nevertheless, they do try to rationalize their choice to continue living in such a climate by citing the old saw that theirs is a “dry” cold, and therefore they are not really that cold.  However, anyway you slice it, the mean annual temperature of The Pas – 0.3 C (31.5 F) compared to Ottawa 6 C (42.8 F) tells the story.  Ottawa is cold and The Pas is damn cold – ‘nuff said.

It is small wonder that humans have spent considerable effort to overcome their environment by developing a variety of shelter options and energy uses to provide protection from the cold, and heat in other parts of the world. Of course, there is considerable evidence that we have not been effective stewards of planet earth in our efforts to protect the very environment we are protecting ourselves from, so to speak. I will not address that issue today but, rest assured, it will return to these pages in the future. It is too important to ignore.

There are many who would avow that nature should always be allowed to take her own course without human intervention.  Of course, this idea, unfettered and taken at its extreme, cannot be achieved. It would mean that humans could never intervene in the course of nature in order to better the human condition, or indeed to survive. Humans have always sought to “tame” nature, to “overcome” nature, to “improve upon” nature, to “protect” them from nature’s wrath as well as to “benefit” from nature’s bounty. 

There are countless theses and dissertations written in disciplines as varied as engineering, philosophy, environmental science, sociology, psychology, architecture, and literature to name but a few, exploring the relationship that humans have with nature. I don’t plan to engage in an academic exercise of outlining all of the issues and conducting some sort of meta-analysis by formulating hypotheses and reaching conclusions – believe me, I am as thankful for this as you are. My observations are, as usual, anecdotal and unscientific but hopefully thought provoking.  

It is important to understand that the gardener always will tinker in the garden and always will intervene to alter the course of nature, sometimes for the better and sometimes for the worse. And sometimes just to show that we can. It was reported recently that a man in Chidham, West Sussex in the UK has successfully grafted 250 varieties of apples onto one tree over the course of some 24 years. Don’t believe me? Google it.  

Upon reading that account, I was reminded of my watching, as a young child, my paternal grandfather (Bob) grafting what seemed to me to be twigs onto various types of trees in his orchard.  He meticulously demonstrated how to prune the spear being grafted at a precise angle to be inserted into an incision in a branch of the receiving tree. It would be bound with twine or a piece of bark and covered with a type of rooting hormone and gum to cover the tender incision.  I am told he was successful in grafting more tender varieties of apples onto hardier rootstock and even produced some apricots in a climate not favourable to such tender fruits in southern Manitoba.

That is a fine memory indeed but do you know what I really remember?  I remember my grandfather’s hands as he manipulated his old pocketknife (sharpened on a foot powered treadle grinder in the farm shop) in a gentle but firm procedure. I remember his thick thumbs and fingers, seemingly incapable of such dexterity, being more than adequate to slip the young scion into the incision for the graft. Those fingers had often used that same pocketknife to cut a slice of apple, proffered to me with pride, from one of the many varieties grown in the orchard on his farm. And amazingly, even though Parkinson’s has diminished my sense of smell considerably, the crisp scent of that apple still tingles in my olfactory lobe. Tart and clean.

Not even sure what kind of apples these are.  Must get my pocket knife. Photo: S.Marshall

Not even sure what kind of apples these are. Must get my pocket knife. Photo: S.Marshall

But more than that, I remember those same thumbs and fingers on my father’s hands as he tended his flowers and vegetables in Manitoba and Saskatchewan. A short growing season, but loam rich soil and many hours of sunshine made for a fast transition from spring planting to fall harvest. Dad also had a pocketknife which he used to cut into various fruits and seeds in his efforts to provide an education on gardening (if not horticulture) to a mostly unreceptive teenager – me. I watched his hands grow old in the garden, in his workshop, and in his efforts to keep his mind sharp by filling out every crossword and Sudoku puzzle he could find, in pen. 

Today, I look down to see those same thumbs and fingers on my own hands as I deadhead spent flowers, root out troublesome weeds, and dig with an old spade to move, remove, or replace various perennials. But there is no pocketknife in my hands. The era of security checks at airports have diminished their numbers, although I am pretty sure that I have one or two tucked away in my ‘odds and sods’ drawers (yes, more than one drawer.) However, unlike my father’s or grandfather’s, my hands often shake and my fingers fumble to meet the task at hand. Parkinson’s is never far away if it is not immediately present.

But I am not disturbed by my inadequacies. Rather, I am heartened that I had the great fortune to witness those hands fly across three generations with a destiny to toil in a vocation (for my grandfather) and an avocation (for my father and me) to assist nature in creating beauty, joy and satisfaction.

Humans have long put their own stamp on ‘gardens,’ witness the many and varied formal and informal garden types neatly categorized within a nationalist typology: English, French, Japanese, Dutch, Korean, Spanish, Persian, Chinese, Italian, etc. All are created with plants and hardscape endemic to their namesake nations, if not to their immediate environs. But most have unmistakable human influences that, while artificial, are evidence of efforts to “improve” upon nature. I was reminded of this during a short walk we took recently in the Gatineau Hills north of Ottawa.

William Lyon Mackenzie King was Prime Minister of Canada for a remarkable 22 years in total during the years 1921 – 1948 and developed a country retreat at Kingsmere north of Ottawa in Quebec. He bequeathed that estate to the people of Canada and, among other things, the public is welcome to view his attempts at creating “ruins” on the property. He salvaged portions of buildings and landmarks being demolished in Ottawa and relocated them to Kingsmere. It is widely known that Mackenzie King was quirky to say the least, and some may think that these “ruins” are folly but most visitors would likely agree that they are creative enhancements to nature’s already established beauty.

Does this ruin the View? Photo: S. Marshall

Does this ruin the view? Photo: S. Marshall

Still, anyone who gardens knows that nature is not always beneficent and we sometimes intervene deliberately with the intention of altering the trajectory of a phenomenon that is harmful. On a very small scale, I am trying to root out some very invasive vinca minor (periwinkle) that is threatening to take over and choke an entire bed of hostas and other innocent victims. Periwinkle, in its place, is a very fine, hardy ground cover that can thrive in considerable shade and has a lovely, small flower (periwinkle of course.) Unchecked, it wants to take over the world.

Vinca minor (periwinkle) would like to take over the world. Photo: S. Marshall

Vinca minor (periwinkle) would like to take over the world. Photo: S. Marshall

Whether I like it or not, I have Parkinson’s Disease, a natural phenomenon with no known cure. It is neurologically invasive.  Many organizations are working diligently and relentlessly to fund and conduct scientific research to achieve a cure. Success would mean a monumental change in the course of history for millions of Persons with Parkinson’s (PwP) and their families, and for those who are at risk for Parkinson’s. I do not expect to benefit personally from this work. The time frame is too short; the disease is too advanced. No matter, it is critical to continue to pursue a cure. Scientists, Parkinson’s support groups, fundraising organizations, fundraisers, caregivers, family members of PwP, individuals and philanthropists are all in agreement that a cure is our primary goal. But there are at least three corollary ‘meantimes.’

In the first ‘meantime’, we continue to use the gold standard of levodopa along with an array of other pharmaceuticals to keep the disease in check and to help us remain upright in a never-ending struggle to defy the inevitable.  Chemical assistance works to a certain degree but there are long-term and short-term side effects, and drugs do wear off. 

In the second ‘meantime’ we pursue strategies to alter the functioning of the brain.  For example, Deep Brain Stimulation (DBS) is an invasive brain surgery that has brought relief to many PwP.  I am privileged to have met someone recently who had DBS although at the time of this writing he has yet to have the stimulus unit fine-tuned to its final settings. Nevertheless, it is a pleasure to witness the improvement in his tremor even without the full effect. It was also a pleasure to witness the genuine excitement and relief that he and his spouse exhibited throughout a lengthy process of being accepted, having the surgery, and in the immediate post-surgery period. I am confident that the next time we meet they will be wildly satisfied with the outcome.

There is also hope that a newer, less invasive ultrasound brain procedure will be as effective as DBS by focusing ultrasound waves on a specific part of the brain killing the cells causing the tremor. This procedure requires neither invasive surgery nor a general anesthetic and holds great promise to alleviate some symptoms and provide a much improved quality of life for PwP and their families. 

I am under no illusion that DBS or ultrasound is a “cure.” They are not. Some of the more problematic characteristics of Parkinson’s are decreased but not totally eliminated.  Most patients receiving the treatment still require drugs such as levodopa but usually in much reduced quantities. DBS or ultrasound is not for everyone. In my own case, I do have considerable tremour when the medication wears off but my major concern is cramping and pain in my legs and feet. I am not sure that these can be changed through these procedures.

Other research seeking to unlock the genetic code of PD is underway and may well lead to the discovery of ‘markers’ allowing for earlier identification and treatment. All scientific research must continue.

It would be an understatement to say that PwP, families and caregivers are praying that a cure can be found. Those of us in our mid-sixties or older know the likelihood of a cure within our lifetimes is exceedingly slim. Perhaps those with early onset Parkinson’s will see the development of a cure. Realistically, that would be my greatest wish and the best possible outcome.

In the third ‘meantime’, we must focus on other measures such as exercise to delay the progression of Parkinson’s and to alleviate some of its immediate effects.  The October 2013 World Parkinson’s Congress in Montreal brought together research scientists, physicians, PwP and their families, caregivers, therapists, health and social work professions, health policy analysts, fundraising organizations, advocates, and many others from around the world to inform, discuss, analyze and make recommendations.  I did not attend but followed the congress on various websites and Twitter postings.

At the time I did not know many PwP personally but still the excitement about the Congress was palpable, driven by a sense that all players in the Parkinson’s equation would meet on common ground to share critical information to make a quantum leap towards enhanced quality of life for PwP and their families, and a cure.

The concept of exercise – moving our bodies in some deliberate physical manner for at least 30 minutes each day – was pervasive at the Congress. It is beneficial to those facing a wide variety of physical and mental illnesses. Parkinson’s is one of those.  I am not fooling myself into thinking that exercise can cure any disease but it appears that its greatest benefit is to delay the progression of some of the most problematic symptoms e.g., rigidity, stiffness, slowing of gait, feelings of weakness, imbalance, etc.  As long as these can be delayed, changed, or improved, exercise is a good prescription. There is even a very good campaign in the UK to have physicians prescribe exercise as per guidance issued to the National Health Service by the UK National Institute of Health and Care Excellence. (See Exercise Works! http://www.exercise-works.org/.)

Exercise for PwP can take a wide variety of forms with walking, Nordic pole walking, cycling, running, x-country skiing, downhill skiing, snowshoeing, aerobic exercises, rowing, Pilates, yoga, dance, Tai Chi, and boxing being among the most popular.  The National Ballet School in Canada and the Mark Morris Dance Group for PD in New York have specific ballet and dance classes for PwP.  Each type of exercise has its adherents and specific selling points – cardiovascular, flexibility, balance, strength, concentration, etc.  Nevertheless, they are all in agreement, exercise is critical to physical and mental health in PD and to delaying the disease.  (Nevertheless, Anne and I do have a good chortle when we imagine me doing arabesques or pirouettes. Don’t underestimate the importance of laughter in the medicine cabinet.)

Rather than ballet, I have been developing a regimen of cardiovascular training using a NordicTrack machine, some light weight training with free weights, along with aggressive gardening (attacking weeds and invasive plants with vigour.)  Coupled with good nutrition and eating habits, I lost over 35 pounds since January 2013 and I feel better. Or at least I did until recently when I seem to have developed some issues with sciatica and/or right hip. My neurologist is clear it is not PD related so I continue to explore the problem with other doctors. This new development, while somewhat painful, has me very much frustrated that I am not able to continue my regular exercise routine. I take this frustration to be further anecdotal proof of the thesis that exercise is beneficial as it has a negative consequence when withdrawn. I am currently awaiting results from x-rays and will be seeking further medical attention in the coming weeks.  Stay tuned.  

You know, I have always thought that I was ‘progressive’ but I didn’t really want to have progressive aging along with a progressive neurodegenerative disease – both incurable by the way.  In any case, it is sometimes difficult to discern which symptoms are related to PD and which are just related to getting older. PD itself is a series of ups and downs, good days and bad days. Growing old just adds to the fun! Ain’t life just peachy that way?

I once told a student that he should always write something to signal that his paper has a conclusion, or is coming to a conclusion. His next paper succinctly intoned: “Here comes the end.” So, take heart, the end (of this post only!) is near.

Today, we have drifted perilously close to some heated philosophical debates about humans and nature without having ventured so near as to melt our wings. We will need those wings for other flights into the worlds of Parkinson’s and gardens, as they do meet regularly but mysteriously.

Just as every gardener casts a long shadow and a watchful eye over the garden in the belief that we can improve on nature, every person touched by Parkinson’s tries to cast a shadow over this hated disease to alter its natural course.

I leave you with these questions: Can humans partner with Nature on an equal basis to create beauty? Can humans win the struggle with Nature to eradicate the ugly?

The gardener's shadow is omnipresent. Photo: S. Marshall

The gardener’s shadow is omnipresent. Photo: S. Marshall

 

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2 thoughts on “Parkinson’s and the Gardener’s Shadow

  1. Funny,you should talk about dads’ hands in this blog. I have been thinking about them a lot lately. I have noticed my fingers getting quite thick this last year and having difficulty handling small things. when that happens I think about dad doing the same. I also watched him grafting one apple twig to another as you have. He would take us for a tour of the garden and explain how it was done and which branches were from what apple tree. I miss it sometimes.

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