LeConte’s Healthy Lifestyles is a health and wellness publication printed twice a month in local newspapers serving Sevier County and South Knoxville. And here online! We hope you find this information healthful.
Table of Contents
Keeping Parkinson’s Disease at Bay
Living with Parkinson’s
Pump Up the Volume with LSVT LOUD
Mark Your Calendars!
LeConte Medical Center Receives Patient Satisfaction Award from PRC
Thomas Foundation Hosts Another Successful Evening of Elegance
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‘BIG’ and ‘LOUD’ programs give patients hope
A former broadcaster who often spoke to large conferences of up to 500 people was losing his ability to be heard. A 65-year-old pastor could no longer hide his trembling hands and soft voice from his congregation.
These are just two patients who discovered the value of “LSVT BIG” & “LSVT LOUD,” therapy programs for those diagnosed with Parkinson’s disease. Available at almost all Covenant facilities and at LeConte Medical Center since 2014, the four-day-a-week, four-week program uses the acclaimed Lee Silverman Voice Training (LSVT) technique established in 1987 and named after a Parkinson’s patient in Arizona.
Parkinson’s disease is a chronic and progressive motor system disorder caused by the loss of dopamine-producing brain cells. It usually affects people in their 60s. Parkinson’s is marked by a stiffening of the body, short shuffling steps, tremors, shrinking handwriting, lack of facial expression and softening of the voice.
The hour-long sessions (and “homework” that comes with them) seek to improve motor skills by recalibrating the brain through a regimen of exaggerated motions and speech. Each BIG session features seven standard exercises in which the goal is not only to get the maximum range of motion for a particular move, but also to get maximum effort from the patient.
LeConte therapists can also tailor exercises to help the patient with tasks that have become increasingly difficult for them.
“We have the ability to create individual exercises based on the patient’s desire to improve their movement in an activity that’s significant to them,” said Sara Albert, one of three LeConte therapists certified in the therapies. “We have created exercises for people to improve their handwriting, ability to get in and out of a car, opening medication bottles, buttoning buttons, even cutting a steak so the person’s spouse doesn’t have to do it for them in a restaurant.”
In addition to the exercises during the 16 sessions, patients also must perform five functional tasks at home that they would do in their daily lives, such as rising to standing from a sitting position.
“Once a person learns the concept of LSVT BIG, they can adapt virtually any activity they do during the day to improve upon it,” said Albert. “It’s giving them the tools to continue being active in the future. The program is convenient to do almost anywhere. Our last patient went camping with her family and was able to do the exercises at the campground. She even told us she had other campers joining her.”
While a physician referral is required for the program, it draws patients from a wide range of ages and disabilities. “Some patients are newly diagnosed and want to learn the exercises to prevent future problems,” said Albert. “Other chronic patients have heard of our program and want to try it to see if it can help them with activities they are having difficulty doing. My patients, over the past year, have ranged in age from 54 to 78 years old. All of them have varied in degree of physical ability. One of my patients still works full time, and one had recently had to stop working because his Parkinson’s had affected his ability to work.”
“I feel it can be beneficial for all stages of PD,” she added. “Someone who doesn’t have a lot of deficits may delay or inhibit deficits in the future. A person with a lot of deficits can improve their function, flexibility, and fine motor skills, so they are able to move better throughout their day and accomplish the activities that are important to them.”
More than 20 years of research funded by the National Institute of Health has documented that LSVT LOUD improved vocal loudness, improved speech intelligibility, increased facial expression and improved confidence.
Still, patients newly diagnosed with Parkinson’s disease might question whether exaggerated arm and leg movements to “BIG” proportions can help fend off a disease so unrelenting it affects one million Americans – more than the combined number of people diagnosed with multiple sclerosis, muscular dystrophy and Lou Gehrig’s disease. About 60,000 Americans are diagnosed with Parkinson’s disease each year.
“I would not say patients are skeptical,” said Albert. “I would rather say they are hopeful that there are treatment options besides medication now to help them. If they are skeptical, it’s not long before they can see objectively improvements in their movement.”
Albert has seen the evidence with her own eyes.
“We have seen our patients improve their walking, balance, coordination, size and their legibility of handwriting, among other things,” she said. “Some have even surpassed the timed goals I had set at their first appointment. It’s often times still a surprise for us at how much a patient can progress in just a month’s time.”
LeConte Therapy Services provides two convenient locations including a Sevierville clinic located in the Dolly Parton Center for Women’s Services adjacent to LeConte Medical Center, and a Seymour clinic off of Chapman Highway.
For more information about LSVT BIG and LOUD, call our LeConte office at (865) 446-9750.
Coping with Parkinson’s disease can be frustrating because of its common symptoms — trembling, stiffness (often called rigidity), slow movements, and the loss of balance and coordination. A good deal of that frustration comes from the loss of control that you once had over your body. It can also be emotionally overwhelming to know that there is currently no cure for the disease.
Nonetheless, people have a number of tools to better manage the symptoms of Parkinson’s disease and live a healthy, enjoyable life.
Eat smart: Eating a healthy, balanced diet and drinking plenty of water are important for everybody, but especially when you have Parkinson’s disease. That’s because people with Parkinson’s are more likely to get bone fractures from falling, have constipation, or have trouble maintaining their weight. Staying hydrated and getting the best possible nutrition through fruits, vegetables, whole grains and protein can help counteract these effects.
Stay on top of your medicine: Medicines for Parkinson’s disease have come a long way. Often a combination of drugs is successful in replacing the naturally occurring brain chemical dopamine that is in short supply when you have Parkinson’s. Certain drugs improve only certain symptoms, and you’ll want to work with your doctor to find the best combination for you. Know that as the disease progresses, you may need to try other drugs and other combinations of drugs.
A treatment called deep brain stimulation, approved by the FDA, seems to provide additional relief for some people. It involves implanting a small electrical device in the brain that can ease Parkinson’s symptoms.
Talk with your doctor about which of these options might be the right treatment approach for you.
Work with a physical or occupational therapist: A therapist is an important member of your treatment team. Working closely with this medical professional will help improve your quality of life. A therapist will typically meet with you to review your daily routine, and provide you with techniques and tools that will help you carry out your activities of daily living more effectively, even with the challenges presented by your illness.
Get daily living aids that can help you stay independent and safe: Among the tools that an occupational therapist might recommend are railings around your toilet and bathtub, a seat to use in the tub or shower, a pump soap dispenser instead of bar soap, an electric toothbrush and razor, a cordless phone that you can carry around with you, nonskid socks and Velcro-closure shoes, and an appropriate cane, walker, rollator or wheelchair to help you move around effectively.
Get a good night’s sleep: Studies show that about 3 in 4 people with Parkinson’s also have sleep problems, but it’s crucial to your overall health to get a good night’s sleep. Try strategies like creating a relaxing bedtime routine, going to bed at the same time every night, making your bedroom comfortable, dark and cool, and avoiding stimulants, such caffeine, alcohol, exercise and even watching TV, right before bedtime.
Have an educated helper: Most people with Parkinson’s disease need the help of one or more caregivers to get through the day. If you are a caregiver, one of the most important things you can do is read up on Parkinson’s disease, so that you can understand what your loved one is going through. Also, be involved by attending doctor’s appointments and therapy sessions. Often, these professional healthcare providers will have tips and advice for the caregiver as well as the person living with the disease.
Just as LSVT BIG enables a person with Parkinson’s disease to move more freely, LSVT LOUD is turning up the volume for those patients whose voices have been all but silenced by the disease.
In fact, a soft voice – not the signature tremor of the hand – is often the first sign of Parkinson’s disease.
Of the six million people around the world with Parkinson’s disease, 89 percent have a speech or voice problem such as reduced loudness, hoarseness, vocal tremor and/or monotone quality. As a result, patients with Parkinson’s often feel they are shouting when, in fact, their voices are so soft that others have difficulty hearing them.
Ann Lee, an LSVT-certified speech therapist with LeConte Therapy Services, says the patient’s inability to be heard and understood often leads to frustration, embarrassment and social isolation. But LSVT LOUD does not train patients to yell or scream or to use a forced voice. Rather, the speech clinician trains a voice to be louder with appropriate voice quality.
LSVT LOUD differs from traditional forms of speech treatment. It requires intensive, high-effort speech exercises combined with a simple, redundant and salient treatment targeted to improve conversation in daily living. The standardized protocol for LSVT LOUD embodies many of the fundamental principles of exercise and motor training that have been shown to promote neural plasticity and brain reorganization in animal models of PD.
In fact, brain changes induced by LSVT LOUD, as measured with PET imaging, reflect improvements in the basal ganglia, limbic system, prefrontal cortex and right hemisphere functions. These neural systems are involved in vocalization, loudness regulation and vocal learning, which collectively may account for the significant and long-term effects of LSVT LOUD on speech in individuals with Parkinson’s.
It may also help explain why the training has also improved a patient’s ability to swallow. In addition, research studies have also documented the therapy’s effectiveness in improving the patient’s ability to control facial expression.
LeConte’s Lee says LSVT LOUD improves vocal loudness by stimulating the patient’s voice box (larynx) and speech mechanism through a systematic hierarchy of exercises. Using special LSVT software, she guides the patient through a series of sustained and high/low “ah” sounds, along with repetitions of functional phrases.
The first week of the four-week program concentrates on shorter, simple words and phrases. By the second week, the patient is working with sentences. Week three has the patient reading aloud. And by the end of the month, the patient is engaging in longer, more complete conversations.
Individualized calibration exercises are incorporated into daily home activities to build on those “aha!” moments when the patient truly understands the benefits of his or her hard work and effort. The exercises have been shown to improve respiratory, laryngeal and articulatory function to bring the voice to an improved, healthy focal loudness without straining to do so.
Oct. 5, 7 a.m.-4 p.m. | Oct. 6, 7 a.m.- 2 p.m.
This fundraising sale hosted by the hospital volunteers features beautiful sterling silver jewelry, clothing, accessories, handmade children’s bows, and other fun merchandise! The sale will be held in the hospital classrooms, and convenient parking is available in Lot A.
Masquerade $5 Jewelry Sale
Oct. 27, 7 a.m. – 5 p.m.
Oct. 28, 7 a.m. – 3 p.m.
This fundraising sale hosted by the hospital volunteers features fun jewelry and accessories all priced at only $5! The sale will be held in the hospital classrooms, and convenient parking is available in Lot A.
SUBWAY® Race Against Cancer
at World’s Fair Park, Knoxville
The Race Against Cancer is a 5K run/walk that supports the Thompson Cancer Survival Center’s Outreach Program. Online registration is available at www.raceagainstcancer.org.
LeConte Medical Center has been recognized for patient satisfaction by Professional Research Consultants (PRC), a nationally known healthcare marketing research company headquartered in Omaha, Nebraska. LeConte was one of nine Covenant Health member organizations to receive patient satisfaction awards.
PRC researches the opinions of former Covenant Health patients via a confidential phone survey which assesses perceptions of patient care. Covenant Health organizations use the research findings to continually improve and enhance patient satisfaction.
This year LeConte Medical Center was recognized with a 4-Star Award recognizing the hospital’s outpatient services. Four-star awards are given to facilities, departments or service areas that score in the top 25 percent based on number of patient ratings for excellence in overall quality of care.
The board of the Dr. Robert F. Thomas Foundation salutes the businesses, volunteers and community leaders who generously supported our 27th annual Evening of Elegance fund raiser. Thank you for your contributions to improve the health of our friends and neighbors across Sevier County!
Proceeds from sponsorships and the event’s silent and live auctions will support both LeConte Medical Center’s stroke initiative – providing comprehensive stroke care from diagnosis to treatment and rehabilitation – and prescription medications for patients of Mountain Hope Good Shepherd Clinic. Additionally, more than $19,000 was raised to provide scholarships for patients in need of outpatient cardiac rehabilitation at LeConte Medical Center.
Steven Dronen, MD, spoke to the audience about the prevalence of strokes in our area and Covenant Health’s system-wide commitment to the stroke initiative, early detection and new treatment options. Steve Dill, MD, and cardiac rehab therapist Jay Jordan presented a video outlining the importance of cardiac rehabilitation.
To learn more about the work of the Dr. Thomas Foundation, visit www.drthomasfoundation.org or call (865) 446-9627.
2016 Evening of Elegance Sponsors
Citizens National Bank
First Tennessee Bank
Knoxville News Sentinel
The Blalock Companies
Burchfiel Medical Park
The Mountain Press
Riverstone Resort & Spa
Sevier County Bank