“Holistic Health and Wellness” – Lecture Notes

“Holistic Health and Wellness” – Lecture Notes

“Holistic Health and Wellness” was a session presented by Stanford movement disorder specialist Dr. Maya Katz at the “Better Lives, Together Summit.”  The summit, held in late February, was organized by the Fresno Parkinson’s Support Group. In her session, Dr. Katz reviewed the concept of total health. She said that physical, psychological, social, and spiritual health all need to be addressed by your care team. 

Dr. Katz noted that 50% of the time, mood or mental health problems with Parkinson’s Disease (PD) are not treated by the care team, and that the care team’s main focus is on motor symptoms. She stressed the importance of communicating with your doctors, community and family.  Finally, Dr. Katz noted the wellness strategies that could be beneficial to those with PD. 

As part of the wellness strategies, Dr. Katz mentioned exercise and nutrition. Here are links to the relevant webpages on the Stanford Parkinson’s Community Outreach website:

Please see below for notes on the February 25th lecture.

Regards, 

– Joëlle Kuehn


“Holistic Health and Wellness” (part of the “Better Lives, Together Summit”)

Speaker:  Maya Katz, MD, movement disorder specialist, Stanford University

Summit Host:  Fresno Parkinson’s Support Group

Date:  February 25, 2021 

Summary by Joëlle Kuehn, Stanford Parkinson’s Community Outreach

Total health combines physical, psychological, social, and spiritual 

  • Medication can’t be used to treat everything. In the US, medication is used as a lot of treatment options, but since there are other aspects to health that can’t be “fixed” with medication, alternative care is required
  • Normally physicians are focused on physical health and miss a lot of things
  • PD affects every aspect of our well-being so in order to have health total health, you need to address all of the aspects equally

Symptom burden is when many symptoms aren’t visible. Motor symptoms of PD are just the tip of the iceberg. The non-motor symptom burden is not addressed well, and the non-motor symptoms usually affect quality of life more. 

Psychosocial distress:

  • Changing family dynamics
  • Loss of autonomy
  • Isolation – common with any type of serious illness
  • Difficulty accessing care

Spiritual distress:

  • Grief and loss.  Loss of being able to do things you loved, or of people, or your sense of self
  • Guilt.  Lots of caregivers feel guilt “not doing enough”
  • Existential crisis.  “Why me?” questions
  • Question to measure spiritual health:  Are you at peace?

Planning and preparing for the future causes a lot of stress.

Care partners also experience stress, not just those suffering from the illness.

Connection is protection:

  • We are wired to connect (empathy circuit)
  • Connection to community that you have
  • Connection to self
    • What makes life worth living for you
    • Hopes and goals, spark, etc.
  • Nature, surroundings
  • Finding what brings you the sense of peace/connection/awe is vital
  • More time with sense of awe improves quality of life with people with neurologic illnesses
  • Important to know what you need to stay engaged
    • Volunteering – stay engaging in your community
    • Find something to bring you that connection that makes your life worth living

Communication is part of the treatment

  • Make the most out of your doctor’s visit!
  • Make a plan – prepare for your visit by writing out a list of questions or concerns
  • Most non-motor symptoms go unaddressed – you need to bring it up
    • 50% of time, mood or mental health problems with PD are not treated
    • Not treated bc doctor didn’t ask, or they didn’t bring it up because they didn’t think it could be related to PD, so a lot of issues that affect quality of life are not raised
  • Think about changes can help
    • Has anything changed recently?
    • Have you or your family noticed a change in weight/appetite, new symptoms or increased difficulties with daily tasks?
    • Discussing this with your doctor can help you get the support and guidance you need
  • Any new symptoms?
  • Share what goals and values are with your doctor
    • What do you enjoy?
    • What do you look forward to?
    • Goals you want to ensure you can still do?
    • What do you do that is important to you?
    • Where do you find meaning in your life – a goal is to keep this up!
  • Communicate doctor with any concerns about future
    • Lot of time, doctor’s don’t ask
    • Concerns, worries, or fears about the future
      • I’ve always wanted to do X, can I still do it?
    • Are you struggling with sadness, guilt, anger, frustration, or loneliness?
      • If yes, tell your doctor
    • If you have a difficult emotion, natural instinct is to withdraw, but you want to do the opposite and connect
    • Anticipatory guidance – guide about things in future
  • Ask for help, ask for questions
    • Do you or your family feel overwhelmed? Do you need more support at home?
    • Do you have questions about your illness or how it might progress?
    • Sharing your concerns with your doctor can help you get resources and support.

Wellness Strategies:

  • Mindfulness based stress reduction
  • “You can’t stop but wave but you can learn to surf”
  • Headspace app – mindfulness for beginners app
    • Teaches you how to meditate
    • Mindfulness can be a pain relief technique – be more present and don’t focus on pain
    • Also can help with sleep
  • Book: “How to relax” – Thích Nhất Hạnh
  • Strategy: Practice gratitude
    • Name 2-3 things every day that you appreciated that day and be specific 
      • Specific moments or things that just happened that brain
    • Has a very powerful effect on brain  – “positive psychology”
      • After a few weeks your brain shifts and begins to look for things you are grateful for 
    • Doesn’t take long – do it at dinner, when brushing teeth
  • Strategy: Daily intentions
    • In the morning/start of day, set what tone you want for your day
    • What is a way of being you want to hold as a goal throughout the day
    • Can be practical (ex. Mindfulness in my body about having good posture), or simply calmness
    • Can have the same intention for a month
    • If you are feeling unregulated, try to reflect on what intention you made that day
    • Reflect that night and the next day try again 
  • Strategy: create goals for the week
    • Set specific goals for physical, social, mental, spiritual health for the week
      • I will do X every day for 5 days
  • Having a buddy system is good for accountability
  • Going back and seeing if you meet your goals and if you do, it is very enforcing and encouraging
  • Try to smile more
  • Cognitive leisure activities (puzzles, crossword)
  • Get enough sleep
    • Is restorative
    • Try for 8 hours/night
    • If you can’t, be sure to talk to your doctor about it 
    • If you don’t get enough sleep, it can progress the disease faster
  • Nutrition is also important
    • Having a nutritionist is helpful
    • The Mediterranean diet is the most healthy for the brain 
      • Little red meat (once a month)
      • Limit simple sugars
      • No white bread
      • Want whole grains
      • Simple carbs increase risk of pre-diabetes, and that makes PD progress faster
      • Heart health is brain health
        • Keeping cholesterol, blood sugar levels, blood pressure are important in brain health
      • People in this diet have bigger brains, lower risk of developing brain diseases, and live longer
    • Try to avoid:
      • Fried and processed foods
      • Non-organic dairy
        • All dairy is high risk because it accumulates pesticides even if it is organic
        • PD risk can be predicted based on amount of milk someone takes in their life
      • Simple carbs
      • Animal meats and fats
      • Limit alcoholic beverages 
  • Exercise program is crucial 
    • Balance, stretching, strengthening, aerobics
    • High intensity aerobics has been shown to delay PD progression
    • 120’s/130’s is goal heart rate but it depends on your age
    • 2.5 hours a week
    • Tai Chi is helpful
    • Your brain will tell you you can do less than you actually can
  • Dual tasks are helpful
    • Lot more benefit than if doing cognitive and motor tasks separately
    • Helps with cognition and balance 

Question & Answer:

Question: Is palliative care an interchangeable term for holistic health?

Answer: Yes. The palliative care founder is the founder of the idea of total health.

Question: What are things you would recommend to make a Mediterranean diet accessible (if on a budget)?

Answer: Access to healthier food is a problem. It doesn’t have to be all or nothing. What you can do, you should do.