The Hunger Games, Parkinson's Style

For most of my life, I woke up hungry. It didn't matter if I ate a large meal right before I went to sleep. I'd still wake up hungry. There was never an argument about who got to use the bathroom first; because I was going to eat before I did anything else. If I could have figured out a way to have my bowl of cereal with the cold milk in it on my nightstand, I would have gobbled it down before I even climbed out of bed. I always ate within ten minutes of getting up. Always. 

Cereal on nightstand

Then came my Parkinson's diagnosis and a carbidopa-levodopa (Sinemet) prescription that needed to be taken as soon as I woke up AND on an empty stomach. The medication made me feel a bit queasy so my cereal got delayed by an hour and I lost a few pounds.

A few years later, I started taking a dopamine agonist along with the Sinemet. Soon after, I found I was hungry for sweets and I gained a few pounds.

Then I had my DBS surgery and stopped taking the agonist and my hunger for sweets slowly disappeared. However, I kept gaining weight. How much? Almost 15 pounds!    

Prior to having the DBS surgery, I heard stories from others that weight gain afterward was common. My Parkinson's specialist confirmed this phenomena, but didn't know the exact reason.

Then I realized that I was NOT waking up hungry. In fact, I never felt hungry. I was eating because my Wonderful Hubby would say it was time to eat. If I had extra milk in my cereal bowl, I'd add more cereal, but not because I was hungry. Instead of eating a few potato chips, I would eat the whole bag but not because I was hungry. I'd just keep putting more servings on my plate until everything was gone. Not only did I not feel hungry, I wasn't ever feeling full either. No wonder I was gaining weight! The part of my brain controlling hunger and fullness wasn't working correctly. 

Was the DBS to blame? Maybe? 

I had to do something. I started to control my portions. No extra cereal for breakfast. I count out my potato chips. I allow myself one low calorie healthy evening snack, usually oatmeal or a frozen fruit bar. I am now back down to my pre-surgery weight and I'm still never hungry. 

Looks like I won the Parkinson's Hunger Game! 

PS Has anyone else with DBS experienced the same thing? 

Clicking on the colored words will open a new window and take you to a different story or website.

Shoulder Pain with Parkinson's

My shoulder problem began more than two years ago when it was time to put on my pajamas. I went to take my pullover shirt off, using the two-handed crossover method I'd used all my life and...OUCH!

There was a pain in my left shoulder joint. I reached back with my left hand to unhook my bra and another OUCH!  

I tried to remember if I had done anything unusual recently but there was nothing. When I went to put my left arm under my pillow for sleeping, this was also painful, so I slept on my right side all night. 

By morning, I was a grumpy Parky. I could find no humor in this situation. I didn't want to aggravate my left shoulder, so I chose a button-up shirt. I was careful not to raise my left arm too high or behind my back.  

Thinking that it might be a Parkinson's disease rigidity problem, I tried taking more carbi/levodopa. All that did is cause more dyskinesia. I tried increasing my left side DBS settings, but that didn't help either. 

I made an appointment with Ana, my primary care provider. She did an exam and suggested trying a course of methylprednisolone and gave me some exercises to try. I went back 6-weeks later, nothing had changed, so she gave me a cortisone shot. This didn't work either. 

I made an appointment with an Orthopedist that Ana recommended. He took x-rays of my left shoulder  and it was normal. A month later, I had a CT scan with contrast done on my left shoulder. It was also normal (of course.) 

He said there MIGHT be a small bone spur that's causing the problem. He suggested exploratory surgery, but I declined. So he gave me a cortisone shot in the left shoulder and said if it doesn't work, come back when you want surgery. This cortisone shot didn't work either and there was NO WAY I was going to have someone go digging around looking for something that might not even exist. I would just continue to be careful how I moved my left shoulder.

Then June 2019 came and I had my DBS battery replaced. I increased my DBS settings on my right side because my right foot was dragging. The small amount of carbi/levodopa I was taking, half a 25/100 pill every other day, caused severe dyskinesia. I cut back to twice a week, then once a week, and finally stop taking it completely. 

YumaBev with arm behind back

Shortly thereafter, without thinking, I reached back with my left arm to unhook my bra and there was no pain. I reached my left arm above my head and no pain! Yippee!!  

YumaBev with arms raised up

I asked my Movement Disorder Specialist when I saw her in December if my left shoulder problem could have been caused by the carbi/levodopa?

Yes, she said. You probably developed what is known as levodopa-induced dystonia. Isn't that interesting?? Just what we Parkies need...another medication side effect. 

Cell Phones, iPads, Tablets, Laptops, YumaBev...Things That Must Be Charged

It's been four weeks since I had my Medtronic DBS for Parkinson's disease IPG (battery) replaced with a rechargeable version. The incision is completely healed and all the bruising is gone. Dr. Norton cut right along the previous incision so there's still only one little scar. In my opinion, it looks better than before. 

New rechargeable IPG

It certainly doesn't protrude as much as the previous non-rechargeable unit, and that is a good thing.

Old IPG

What else is different? Not much, except now I have become just like all of my electronic devices: I have to be charged regularly. 

My male friends have warped senses of humor and have suggested hooking me up to a Jump Starter or perhaps adding a super-charged turbo to it. They've also wondered what would happen if I got Tasered (I hope I never find out.) This is what happens when you hang out with car guys who are retired FBI, Military and Police, but they sure do make me laugh. 

The screen on my Patient programmer looks different. Instead of a screen showing the battery life in Voltage, it shows a percentage of how much charge I have left (much like Wonderful Husband's tablet.)

I have 75% charge left

I keep all our chargers in one spot. I keep my DBS Patient programmer there too.

Cell phone & tablet chargers & patient programmer

Now I just added the DBS charging system. It is kind of bulky. 

DBS charging system on the left

Medtronic provided me with a carrying bag. It might work okay, if you take out all the manuals and extra items you won't ever use, but it's bulky.

Medtronic DBS carrying bag

So, I did what I do best! I went thrift store shopping and found a cute little soft-sided bag with a zipper top for less than a dollar. 

YumaBev's cute little 'Charger' bag

Everything fits with room to spare and since it's see-through, you can easily to find whichever charger you need.

Plus the new little bag with everything in it only weighs a little more than the empty Medtronic one.

I'm all charged up and ready to go, just like the Energizer Bunny! 

The Energeezer Parkie Will Need a New Battery...Soon

Several years ago, I wrote a story where I used rechargeable batteries as a way to describe what life is like with Parkinson's disease. Using my warped sense of humor, I changed the famous Energizer Bunny to the Energeezer Parkie. It thought it was a pretty good analogy. Once I had DBS surgery, my 'Parkie' battery was pretty close to 100% every day. 

I knew my Medtronic Activa-PC DBS generator battery would need to be replaced some day. The average lifespan is 3 to 5 years. Mine was six years old in October 2018. 

At the beginning of 2016, my battery level was 2.97v. At the beginning of 2017, my battery level was at 2.91v. At the beginning of 2018 it was 2.85v. It was averaging a drop of .06v a year, so I figured I'd have several more years until it reached the ERI (Elective Replacement Indicated) warning you get when it drops to 2.61v, I was wrong.

I had been in the habit of checking my battery level using my patient programmer about every three months. April was 2.83v and July was 2.81v, right on target. So you can imagine my surprise when I checked it at the end of October 2018 and saw that it was down to 2.76v.  

I started checking it monthly, then weekly and now daily and I wasn't liking what I was seeing. The amount of time between voltage drops was decreasing. 

As of today, January 21, 2019, it's now at 2.69v. That's a drop of .07v in less than three months. If the voltage drop continues to accelerate, I will get the ERI warning in a few months!!!

Jan 2019, battery at 2.69v

My neurosurgeon, Dr. Norton is in the same office as Dr. Bradley, my Movement Disorder Specialist and I have an appointment with her in mid-March. I have already contacted Norton's assistant because I didn't want to wait until March and then find out that he's going to be on vacation or something else that would make him unavailable. Norton's assistant said they could get me on his surgery schedule within two weeks, but I should call if I get the ERI warning before my March appointment. 

Looks like the Energeezer Parkie will soon be getting  a brand new generator. 

The generator won't stop working when the ERI warning appears. There's a built in cushion of time, it doesn't stop working until it gets to 2.20v.

If you have a Medtronic Activa DBS generator and don't know how to check it, click on the link above. You don't want it to suddenly stop working.

Clicking on the colored words will open a new window and take you to a different story or website. 

Jury Duty with Parkinson's Disease

The notice arrived in early May. It was a juror questionnaire form, asking me to respond online. I could have asked one of my doctors to write me an excuse but I did not. I think I would like to serve on a jury. I never have. The notice said I may be called any time after July 1st.

On August 11th, I get my Official Summons in the mail. I am to report at 8:15 AM on August 20th. I am a tad bit excited. Maybe it will be a murder trail, or a bank robbery or something else interesting. 

Here comes the Judge...Jury Duty Summons

Soon I realize that I will have to get up early enough to take my thyroid pill on an empty stomach, wait 30 minutes to eat my breakfast, take my Parkinson's disease pill and get dressed in business casual type clothes. My typical hot weather attire of shorts and tank tops are not allowed.  

I also hadn't factored in the thirty minute drive down there or what I was going to do about my second meal of the day. On a normal day, I eat breakfast around 10 AM and then Wonderful Husband cooks us a big meal which we eat about 2 PM and at night we have a salad, or cheese, or snack on some fruit. All of a sudden, Jury Duty was losing its humorous appeal.

The morning comes, I get up when the alarm goes off at 6 AM, get ready, and pack a peanut butter sandwich and fill my Yeti cup with ice and water. Since Wonderful Hubby and I are together 98% of the time, we only have one cell phone, so I leave it at home with him. The other 2% of the time, one of us is using the bathroom (hee-hee.) I park in the courthouse garage, grab my sweater (in case it's cold in court) and walk to the entrance. It's 8 AM and already 90° outside. 

Yuma County Courthouse

I walk through the entrance doors and feel like I'm at the airport screening. People are taking off their belts, watches and emptying their pockets. Bags, briefcases and purses go through the scanner and people walk through the metal detector. I stand to the side and tell them I have a pace-maker type device. It's easier than trying to explain my DBS implant. I get the hand wand treatment instead.

I show my ID and sit down in a large room with about 250 other people. There are TV screens everywhere, all tuned to a channel devoted to houses; remodeling, selling or buying bigger homes. After 10 minutes of that, I am bored, so I people watch instead. There are twice as many men than women and more in their 40's than in their 20's. I see one obviously very pregnant lady with a toddler in tow, two people on crutches and only a few with gray hair. There are quite a few with tattoos, piercings and bright hair colors of blue, green or purple.

A bailiff comes in, asks everyone to stand and introduces the Judge. The Judge has us all raise our right hands and puts us all under oath. He then tells us it will be a medical malpractice civil trial (yuck) and they hand out forms for us to fill out. After we fill them out, we can leave. If we don't hear anything, we are to report on the date listed on the form.

I realize now that I have a problem, my handwriting is so terrible, I can't even read it myself. Most of the pages have yes or no boxes to check, so that's okay. Then there is a page with the trial dates listed; three whole weeks in September and early October. They want to know if I am unavailable on any of those dates and if so, why. I don't have our cell phone with the calendar on it, so I don't have a clue what may be scheduled a month from now. I can't remember what I'm doing tomorrow or next week without checking my calendar! 

I see the first Monday in October is listed and realize that's our Parkinson Support Group meeting day. I manage to scribble why I can't serve on that date. I also scribble that due to Parkinson's, I'm not sure I could be in court every day, from 8 to 5 for three weeks in a row. By the time I finally get the form done, all of the other 250 people are in a line to leave. I am the very last person to hand my form in. I ask the bailiff to make sure he can read my Parkinson's scribble. It's only 10 AM and I'm on my way home and I am completely exhausted. What was I thinking?? I should have asked my doctor for a medical excuse. There's a huge difference between being at home all day and being in court all day. 

Once I get home and check my calendar, I find out  my step-daughter is coming to visit, I have a Doctors appointment and a teleconference all scheduled during those three weeks of trial dates. All I can do is wait and see. If I have to go, I will try to explain to the Judge why I didn't fill out the form when I was there. 

The phone rings a week prior to the trial start date, I don't recognize the number, so when the man at the other end begins to mumble quickly, I just hung up. I did a Google search on the number and realized it was the Court. I called back and was told that I did NOT need to report. Problem solved. Whew!

As much as I want to fulfill my civic duty and serve on a Jury, the reality is I can not do it, either physically or mentally. I would not be able to show up on time, for multiple days in a row and be able to stay alert. I would not be able to take handwritten notes and I'm no longer capable of remembering complex details. When it came to deliberating, I would not be able to express my thoughts clearly and would probably come across as being drunk, stupid or both. 

Looks like the Justice system will have to get along without me and that's okay. A criminal trial might have been interesting. A medical malpractice trial would have been sad and possibly made me angry. Neither would have been funny and if it doesn't involve humor, I'm okay with missing out. 

Clicking on the colored words will open a new window and take you to a different story or website.

I've Gotta Speakin' Problem

The title of this story reminds me of a country song by David Ball called Thinkin' Problem. The opening lyrics are: 
Yes, I admit I've got a thinkin' problem,
She's always on my mind, 
Her memory goes round and round, 
I've tried to quit a thousand times

My new lyrics would be: 
Yes, I admit I've got a speakin' problem, 
My words don't come out right, 
I sound like I've been guzzling beer, 
All day and all through the night

Hmm, maybe I've got the beginnings of a new humorous Parkinson's disease song parody? But the truth is, I never liked the taste of beer and I don't drink any other alcoholic beverages either. I have milk on my cereal and the rest of the day, I drink water. 

No matter how hard I try, I sound like I'm drunk. My upper lip just doesn't move like it should when I am speaking. Try putting a wad of gauze or a big piece of chewing gum between your teeth and your upper lip and then try talking. It isn't easy, is it?? And this isn't my only speech problem.

I also have a difficult time speaking in complete sentences. In some ways, my speech is reverting back to how you speak as a toddler. I will want to blurt out something like, "Hey, why don't we go to DaBoyz for lunch today" and instead it comes out, "Go Boyz lunch." It's extremely frustrating to me.

On top of those two problems, I also have a chronic frog in my throat, so sometimes the first few words I do get out sound scratchy. I am always clearing my throat. Add in a loudness issue and you can imagine how badly I sound. 

Then I saw an advertisement for a research study testing interaction via the internet with the SpeechVive device. SpeechVive is a device that you wear in one ear. It makes a babbling noise whenever you speak and stops when you stop. The premise is that you will speak louder because your brain will try to talk over the noise. Louder might also be clearer. I promptly signed up.  

I qualified for the study and they sent me a left-ear device, computer cords, a tape measure, a USB microphone, reading material, cartoons and instruction sheets. 

 

That black thing in my left ear is the device

I met with my online speech therapist in early January. Brianna had me set up the microphone exactly 12 inches from my mouth (hence the tape measure), take a deep breath and say Ahh for as long as I could. The she had me read a two page story about rainbows WITHOUT the device in. 

Then she had me put the device in my ear with the computer cord attached. She set the loudness of the babbling noise and adjusted when it would start and stop. 

Then she had me do the Ahh again and read the rainbow story again with the device in. I definitely spoke louder. Then I had to make up stories, lasting 2 minutes, to go with the cartoons provided. Who would have thought I would EVER have trouble talking for 2 minutes about anything??

I agreed to wear the device daily and to talk a minimum of three hours a day, even if it meant reading out loud to Parky Raccoon and his friends Miss Bacon, Jerry Giraffe and Parky Penguin. They mostly paid attention and didn't interrupt me too much. 

Miss Bacon, Jerry Giraffe, Parky Raccoon, Parky Penguin

I did as I was instructed and had friends ask me if the thing in my ear was one of those Bluetooth cell phones or if it was a hearing aid. I tried my best to explain that it was to help me speak louder, but I don't think they understood. Most people don't know that Parkinson's affects our voices, too.

After six weeks, I had another online session with Brianna. Again I did the Ahh and rainbow story with and without the device and I was louder than the first sessions. We did the make up a two minute story about the same cartoons and then she just had me talk for two minutes about any topic. I chose talking about the years my Wonderful Husband and I travelled in a RV. She gave me some exercises to do about the upper lip rigidity and I agreed to continue to talk 3 hours a day.

Six weeks go by, and I have another online therapy session with Brianna. Once again I do the Ahh and read the rainbow story with and without the device and my voice is louder. We do the cartoons and a topic of my own (this time I tell her about my flight stories.) At the end of this session, she informs me the research study is done.

A few days later, the research coordinator contacts me and wants to know if I want to purchase the device for my own personal use or return it. I choose to return it. While it did trick me into talking louder, it didn't help with the other problems I have. I mostly ended up sounding like a loud drunk with a bad cold.

I will have one more follow up session, three months from now. I am still trying to facial exercises and have turned up the humidifier in my bedroom at night to see if I can help the scratchy throat. 

At least I can still type my thoughts clearly. Maybe I'll work on the rest of those song lyrics? Ahhhhhhhhhhhh

Clicking on the colored words will open a new window and take you to a different story or website.

Your Local Drug Dealer

If you have Parkinson's disease, you should get to know your friendly drug dealer, also known as your pharmacist. They know more about Parkinson's medications, side effects, as well as food, drug and supplement interactions than even the best Movement Disorder Specialist. Why? Because that's their job.

A local pharmacist named Kirti spoke to our Parkinson's support group. He used words we could all understand and even had a sense of humor. Who knew pharmacists could be funny? They always look so serious behind those partitions. Or maybe they are just working hard. 

Even I learned a few things. (I know you can't believe it. I was surprised too.)

During the question and answer part of his presentation, a lady asked if medications could cause brain fog. He repeated her question so everyone could hear it, using the microphone, but he said brain fart instead. The lady blushed and quickly corrected him. Then he blushed and everyone started giggling like first-graders. (We always try to laugh at our meetings.) 

Another lady asked about calcium supplements for osteoporosis and PD med interactions. He said, do not take more than 600mg of calcium at one time because your body cannot absorb more than that. Also, be sure to spread the doses out during the day. Buying those 1200mg tablets is wasting your money. 

He also stated that many minerals found in supplements (calcium, magnesium, aluminum, iron) can bind to the carbi/levodopa (Sinemet) and may interfere with its absorption. So if that one particular dose of Parkie meds doesn't seem to work as well, did you take it with that multivitamin? It's best to use the two-hour rule: take minerals two-hours before or after taking your Parkie meds. 

Woman's multivitamin

Contains lots of minerals

I guess we better dig out our magnifying glasses and read the fine print on ALL the over-the-counter supplements we take.

A man complained of morning dizziness. He said he takes his Sinemet as soon as he wakes up and then feels lightheaded for an hour or so. The pharmacist explained that our heart rate and blood pressure drop while we sleep and the Sinemet may also cause a blood pressure drop, and that might be the cause of his dizziness. He suggested the man move around some and wait an hour or so before taking the Sinemet. If that doesn't work, tell your Parkie Doctor. 

Another lady complained about the high cost of one of her medicines. She said a one-month supply of rasagiline was over $600. The pharmacist whipped out his smartphone, used his GoodRx.com app, and found her a price of $172 at Walmart. (One of his competitors.) RxOutreach.org has good prices as well. 

He also warned her to avoid foods with tyramine while taking rasagiline or selegiline. Foods like: cured, fermented, air dried meats and fish, aged cheeses, sauerkraut, kimchi, red wine and tap beer. There was an audible groan in the room, right after he said wine and beer. 

Someone else asked if there was a difference between Stalevo versus taking Sinemet and entacapone (Comtan.) He said the only difference is that with Stalevo, it's all in one pill and it costs more. (I'm really starting to like this guy.)

Another person asked about excess saliva and drooling. He said there is a drug that may help dry up the saliva, but that it may also cause constipation, which can already be a problem with Parkinson's. 

Someone asked how to get info if you use a mail-order pharmacy like RxOutreach.org or through the Veterans Administration? He said any pharmacist will gladly answer questions about any medications, including over the counter ones, even if you get them elsewhere. 

Then people began to ask about other non-Parkinson's related medications. Heck, while we had him captive, we might as well get all our questions answered. 

Finally, he was asked if he could recommend a local physician for Parkinson's treatment. His answer was "Just like all Parkinson's medications have side effects, so does living in Yuma. The weather is great, people are friendly, but limited access to specialists is the side effect."

Get to know your local drug dealer, they can answer your questions and who knows, they may even make you laugh.

Where the Heck is Yuma?

There are many people who LIVE in Arizona who don't have a clue where Yuma is, so don't feel bad if you don't know. Yuma (pronounced YOU-mah) is in the southwest corner of Arizona. Occasionally, someone will call it YUMM-ah, which I find humorous.  The Colorado river separates Yuma from California. The border with Mexico is just 7 miles from Yuma at the closest point, although you have to go into California to cross that border legally. On the map below, the towns of Bard, Winterhaven & Felicity are all in California. Los Algodones is in Mexico. There are towns called San Luis in both Arizona and Mexico. I live east of the Yuma City limits in the area called Fortuna Foothills.  

This next map will give you a better perspective of where I live in relation to the large cities: 
Phoenix is 185 miles away
Tucson is 240 miles away
Las Vegas is 300 miles away
San Diego is 175 miles away
Los Angeles is 275 miles away

The closest Movement Disorder Specialists are in those large cities, so travel to see one becomes more difficult as our Parkinson's disease progresses and when we most need their expertise. 

When I tell people that I live in the desert, most think Yuma looks like these giant sand dunes, but they are about 30 miles west of Yuma, in California. 

Parts of Star Wars were filmed in these giant sand dunes

In reality, most of the undisturbed areas around Yuma look like this.

Rocky terrain, lots of cacti & native shrubs & trees

Unless we get an exceptionally rainy Winter and then the desert looks like this. This was back in 2004-2005. 

Here are some fun facts about Yuma:

We are the warmest Winter city in the USA, our daytime highs in Dec, Jan & Feb are close to 70°

We are the sunniest city in the USA with an average of 4133 hours of sun yearly. Some hotels guarantee sunshine or you don't pay for the night! 

Our airport has the longest civilian runway in the USA at 13,300 ft. The runways are shared by the military, commercial aviation (American Airlines) and private planes.

We are the driest city with average rainfall 2.94 inches. The wiper blades on our cars disintegrate due to lack of use. And if it does rain, we have to hunt to figure out how to turn the wipers on.

Yuma is home to a Marine Corps Air Station, where F-35 Lightning II fighter jets train. It is also home to the US Army Yuma Proving Ground, one of the largest military installations in the world, where all types of weapons, munitions and unmanned aircraft are tested. Living here is like having an air-show every day! 

General Motors also has their desert test track here, so we often see the newest versions of the Corvette and Camaro driving around in their camouflage wraps. It's never a dull moment.

But probably the most surprising thing about Yuma is how much we grow. Yuma is the Winter lettuce capital of the World (iceberg, romaine, leaf, baby leaf, spring mix, spinach.) Yuma county is large, over 5500 square miles and is larger than the state of Connecticut. It has some of the most fertile soil in the world and a thriving agriculture industry due to irrigation canals fed from the Colorado river. 

All that green is agriculture

There are over 175 different crops grown in the Yuma area year round! The list includes alfalfa, Bermuda grass seed, cotton, Medjool dates, lemons, tangelos, tangerines, watermelons, cantaloupes, broccoli, cauliflower, celery, red & green cabbage and wheat.

Desert Durum wheat accounts for 95% of wheat grown in Yuma County, and about two-thirds of that is exported to Italy for use in making premium pastas. Another unique fact about Yuma County is that some growers also cultivate kosher wheat to be used by Orthodox Jews to bake matzo. 

Our farmers stay busy year round. A drive past the farmland is an ever changing patchwork quilt of varying shades of green.

Even though it's a long drive to see my Parkie Doc, I'm happy to call Yuma home and proud to be called YumaBev! 

DBS Update: Four years later

Well, it is now FOUR years since I had DBS for my Parkinson's. 

My DBS stimulation settings are lower than they were a year ago and I am taking less Parkinson's medication and yet, I am doing better physically. 

This makes no sense to my former and current Parkinson's specialists or my Medtronic representative. I saw all three of them when I spoke to the Medical School students in November 2016.

According to the Medtronic rep, my DBS settings are below "clinical therapeutic values."  

I don't know why these settings work for me, but they do. 

DBS settings Nov 2016

I got a new camera since my three year update, and it isn't compatible with the Movie Maker software on my ancient PC, so I can't provide a video update. 

This was one day's worth of medication prior to DBS.

3 Requip, 7 Sinemet, 1 Thryoid

This is one day's worth now! 

1/2 Sinemet, 1 Thyroid

Quite a difference, right?

World Parkinson Congress - Final Day

We were up early today and had breakfast with Pertti and a grad student from India. That's one of the brilliant ideas behind the World Parkinson Congress. Doctors, researchers, grad students, therapists and people with Parkinson's and their care-partners are all treated as equals and may attend any program they want to. 

We grabbed my stack of books and went to my Poster presentation on how I use humor to educate about Parkinson's. I gave a free copy of my Parkinson's Humor book to everyone who stopped by.  

My Poster  presentation

When I was done with my presentation, I wandered through the exhibit hall and ran into James Beck, Ph.D (he's the Chief Scientific Officer at Parkinson's Foundation). James and I have been Tweeting back and forth for years, so it was nice to finally meet in person.

YumaBev and James Beck Ph.D

Soon after, Israel Robleto walked up and said hello. I know him from Facebook. 

YumaBev and Israel Robleto

I was tired, so we went back to our room for a quick nap. I'd been looking for Jill Carson for three days and finally found her at the closing ceremony.

YumaBev and Jill Carson

They announced where and when the 5th Congress will be: Kyoto Japan, June 2-7, 2019. If you get a chance to go, do it.

I posed for one last photo with Parky Raccoon, the World Parkinson Congress mascot.

YumaBev and Parky

We said our goodbyes to old friends and new ones and went back to our hotel. We head for home in the morning. Attending the 4th WPC was a once in a lifetime event for us. I missed the 3rd WPC in Montreal due to breast cancer and Japan is just too long a trip for me. I loved every minute and am so glad I got to meet so many Parkie celebrities in person.

PS I finally got my camera shy Wonderful Husband to pose for a photo.

Wonderful Husband