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Playing bass motivatedLee Mapletoft to seekphysical therapy forParkinson’s disease.‘‘In myOWNvoiceLee MapletoftPhysical therapyfor Parkinson’s diseaseLee Mapletoft doesn’t know how he picked up Lyme disease, butwhen symptoms, including tremors in his jaw and hand, persistedlong after treatment, he was referred to Agnes Virga, MD, an Emersonneurologist. She diagnosed Mr. Mapletoft, who is 72, as havingParkinson’s disease, whose symptoms can be similar to those ofLyme disease. Medication to slow disease progression helped, buthe became concerned that he was losing flexibility and asked Dr.Virga about an exercise program. She referred the Acton residentto Emerson’s Center for Sports Rehabilitation in Concord, whereLinda Holland, PT, and Debra Lennon, PT, are certified in providingLSVT-BIG TM , intensive physical therapy for Parkinson’s that emphasizes“big” movement. It is proven to slow the negative changesassociated with the disease and improve flexibility and coordination.16“There’s no definitive test for Parkinson’s disease, so diagnosis is based onevaluation by a physician. In addition to the tremors, my handwriting wasgetting smaller, and my voice was getting softer – symptoms that are typicalof Parkinson’s. Dr. Virga put me on medication, and I saw an improvement.But I felt I needed flexibility exercise because my fingers were tending toclench up. The clenching was a problem as I play the string bass and performseveral times a week with different bands.“I needed to be careful of my hip. I had hip replacement surgery atEmerson in 2007, and I dislocated it two years later, when I was playing onthe floor with my granddaughter and got into a contorted position. In otherwords, I was doing something I wasn’t supposed to do, but I was having toomuch fun. Once your hip has popped out, there’s a greater probability of ithappening again.“When I met Linda, I told her what I wanted to accomplish, and she determinedwhat I could and couldn’t do. We modified several exercises to protectmy hip. We worked on areas where there was the greatest opportunityfor improvement. The first exercises she taught me included spreading myfingers out wide. The goal is to open up the muscles, which eliminates theclenching. Linda told me the nerves need four weeks to fully retrain, but Isaw an improvement in my fingers in less than two weeks. My handwritingalso is better.“The program included exercising at home to keep the progress going.Playing music was my motivation, because it’s very important to me, and Iwas happy to do the exercises. As Parkinson’s continues, you tend to stoop,and your shoulders lose flexibility, so we worked on my neck and shoulders,as well as my overall balance and legs.“Linda and Deb are great, and they’re a real team. Linda struck the rightbalance of pushing me and encouraging me, and when she was on vacation,‘‘Deb had some observations and ideas for therapy that were complementary.Because LSVT is a relatively new approach, they have gone back forrefresher courses, and they’ve recommended that I come back for a tune-up.I remember being impressed with the physical therapy at Emerson afterI had my hip replaced. That also was a good experience.“My fingers are better, and I continue to play with Dixieland, swing and easylistening bands. Every Thursday morning, our swing group of 16 people,who are mostly retired, plays dance music at the Peabody Senior Center for100 to 200 people. They have a wonderful time, and we have a wonderfultime. I also play with the Yankee Stompers, who have performed atEmerson events.“I had the good fortune of being able to retire early. I’ve remained active,and I want to continue to do so. About 12 years ago, I got involved withHousehold Goods Recycling of Massachusetts – an Acton organization thatsolicits donations of used furniture and housewares, which are distributedat no charge to people in need who are moving to independent living.About 10,000 people are helped annually; it’s a real success story. Acton isa great town.“Dr. Virga recently suggested I begin taking L-dopa, the medication thatreplaces the dopamine your body needs. I’ve seen more improvement.I’m optimistic, because I believe there’s a lot of progress being made withParkinson’s disease in terms of physical therapy and medical treatment.”
emersonAdvisoryour health questions answered by our experts.QOur family likes to ski. How can we avoid injuries this winter?Winter sports injuries, whether from skiing, snowboarding,sledding or ice hockey, can include traumato the head, shoulders, arms and wrists or knees andfeet. Depending on injury severity, treatment optionsrange from the use of medications and physical therapyto surgical repair. The majority of injuries we seeare in individuals less than 14 years old, so parentalguidance is important.Prevention is key. For any sport, appropriate trainingand equipment are essential, including use of theproper helmet – one that provides real protection toyour head. With skiing, it is important to get yourQWhy do I need to see a podiatrist due to my diabetes?body used to the movements that will put it understress. Training in jumping on and off a block andside-to-side exercises, such as jumping over a beam,can help build up leg muscles and knees.It is important to be aware of your surroundings –such as a clear runway – and of the weather, particularlythe temperature. And it is especially importantto recognize when you are tired. That’s when injuriesare most likely to happen.gavin bishop, mdSports medicine – Orthopedic AffiliatesPeople with diabetes are vulnerable to both loss ofsensation in their limbs – called neuropathy – andreduced blood supply, which can hinder healing.Their feet are especially susceptible to wounds ofwhich they may not be aware due to the neuropathy.Untreated minor cuts or abrasions may become seriousopen sores that can lead to gangrene and, potentially,the need for amputation.For this reason, you should maintain a relationshipwith a podiatrist who can examine your feet to detectproblems before they become serious. I emphasizeeducation on techniques of self-examination andwhen to make an appointment so that you can play arole in your overall wellbeing.When problems do arise, Emerson Hospital’s multidisciplinaryWound Care Center has an array of toolsavailable to treat them, from topical dressings andspecialized growth factors to hyperbaric chambersthat facilitate healing.Having diabetes doesn’t mean you cannot live a full,meaningful life. You have to understand your situationand take a proactive role. I’m here to help youdo that and avoid serious problems.sarah cantin-langlois, dpmPodiatry -– Massachusetts Associates in PodiatryQMy father was just diagnosed with congestive heart failure. What does that mean?In congestive heart failure [CHF], the heart cannotpump enough blood to supply oxygen to thebody, either because the heart muscle has becomeweakened and can only eject a reduced amount ofblood, or the heart thickens and cannot fully relax.Blood may back up into vital organs or extremities.Symptoms may include fatigue, faintness, shortnessof breath, abdominal bloating, swollen feet andweight gain.The good news is that there is much we can doto treat CHF today, often by dealing with underlyingcauses that strain the heart. Heart surgery orcoronary stents can correct narrowing of arteries,implantation of certain devices can control cardiacarrhythmias, and medications can manage symptoms.At the very least, our goal is to prevent thedisease from progressing.We try to empower patients to take a proactive rolein managing their disease through diet, exercise andlifestyle changes. My goal is to help my patients sothat, despite having heart failure, they can live life tothe fullest.stephen dyda, do, faccCardiology – Emerson Cardiovascular AssociatesFor more information on care at Emerson Hospital, call the toll-free Physician Referral Line: 877-9-EMERSON (877-936-3776) or visit the hospital’s website at www.emersonhospital.org.17
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Page 15: THORACIC SURGERYAshok Muniappan, MD
Page 19 and 20: Special ProgramsPrevention for thos

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