It happened agin. Parkinson’s is bad enough as it is. Falling makes it dangerous. One minute I was standing. The next I was on the floor on my back. Luckily I wasn’t hurt badly, just shaken and a little stiff but a number of PD people I know have recently suffered fall related injuries. What counts as a fall? Does leaning back against a wall to prevent yourself from falling or plopping down onto a chair or bed to stop yourself from hitting the floor? Does a fall require a trip to the ground often resulting in injury? A friend of mine says no bruise, no blood, no break, no ground means no fall. It sounds good but I disagree. A fall is any unintentional change in position where you end up on a lower level or the ground. Fall backs are falls and more important they are warnings that if listened to can help prevent injuries. Face it, you would have fallen if the wall or chair had not been there to catch you. Admitting that you have balance problems and determining to do something about it is the first step in fall prevention.
Balance is the ability to maintain the body’s center of mass over its base of support. It is dependent on good posture and body alignment, good vision, and a brain that works well. Balance requires the brain to integrate and respond to many sources of information received continuously and simultaneously from the rest of the body while moving and when standing still. Wonderful when it works but balance is a problem for most people with PD.
Most people with PD have balance problems and about 70% fall. Two thirds have recurring falls, and fall rates are twice that of same age people who do not have PD. Falls are the number one cause of injury and death from injury among people age 65 and older. In 2015 I posted another blog about falling. It is my most widely read post, the one with the most hits. At that time I wrote to my neurologist and asked “My balance is slowly getting worse over time. I exercise daily, do balance specific exercises, and Tai Chi. Is there anything else I can do?” He replied. “It is difficult to treat balance with medication. It works best for stiffness and tremor. The exercises are the best way to deal with balance so please continue with them,” In other words, nothing he can do and good luck to you. Come on doc, that is not good enough. Falling can be prevented. There are things that can be done to prevent or at least reduce falling.
There are many web sites that have fall prevention and balance exercise videos and a number of web sites that explain how to prevent falls and improve balance so I will only mention a few things. Don’t wait until you fall. Admitting you have a problem is the first step in prevention. Start now, even if you are not yet having balance problems. Fighting PD is about doing what you can to delay the progression of the disease. Safeguard your home environment for fall safety. Darkness promotes falling. Install night lights, grab bars, and no skid rugs throughout your house. Do balance and fall prevention exercises. Tai Chi is particularly recommended to improve balance as is a program consisting of balance exercises, light stretching, strength and gait exercises. It is also important to learn how to best protect yourself when you do fall.
Some things to consider. PD meds may make you unstable. Let your doctor know if you think your meds are making you lose your balance. The right medicine regime taken correctly is important. Try to maintain a healthy mindset. Depressed people have a greater incidence of falling. I know it’s hard but try to be positive and don’t unnecessarily think you are going to fall. You will fall if you think you are going to. Prepare your home environment for safety and ease of use. Use assistive devices. I just bought the best looking quad cane I could find. Calcium.
Be careful, be careful, be careful. Learn what not to do as well as what to do and learn how to coexist with PD. Don’t ignore or deny the problems PD is causing you. So much of surviving Parkinson’s is up to you.
