straight. so many different walks of life from sun or balmy and often tried. to come straight from the heart. of. the russian internet czerny to death starts june 18th d.w. . hello and welcome to in good shape coming up. lupus what makes this auto immune disorder so difficult to diagnose chronic constipation why it's so important to figure out the cause. and parkinson's disease why exercise can help.

here's your host dr coston lake. we're in good shape and this is tight she the ancient heart which is still popular in china and actually in germany people are using it here for neck tension lower back pain just to relax but this year is very special because here at the building charity doctors are using it to treat parkinson's disease and this is what i'm going to talk about today with dr patricia kuhl is an ent no condolence welcome to the check.

exercise is key in parkinson's disease and long term benefits on sin can redact and quality of life. dopamine is a neurotransmitter in our brain it's important for muscle movements patients with parkinson's disease leg therefore they suffer from movement disorder so it's a good idea to give them to can mean as a medication but it's also a good idea to prescribe some exercise. suddenly he found himself short of breath it proved to be the 1st symptom of parkinson's. it was still young when he was diagnosed that was 15 years ago but he keeps fit and exercise helps him counter the effects of the disease he can still run 10 k. easily you know what i think everybody has to decide for themselves how to deal with it sometimes i even forget that i have parkinson's. parkinson's disease is a degenerative neurological disorder the cause is still unknown. but we do know

that the brain cells that produced open mean gradually die off. a lack of dopamine disturbs the link between the brain and muscles physical activity becomes more difficult. danniella bag a parkinson's expert at the university of keele in northern germany knows that exercise can protect nerve cells that's why she rides her bike to the clinic every day when my ardently kind yet if you exercise a lot new neural pathways in the brain which we see in imaging studies then certain areas of the brain are reorganized. nathanson nerve cells make new connections and movements can be performed in better in different ways. and then the brain has to learn to do that and only learns by exercising 13 and by exercising you can mobilize unused potential in your brain and that's particularly important for

parkinson's patients those who start early can possibly help slow the progression of the disease. overall mobility in everyday life and the progression over a period of months or years a simply much improved. lord has become more agile has improved his balance and is less prone to falling than other parkinson's patients who don't move much. his progress is monitored in the motor functions lab. to try for my 1st impression as soon as a patient walks through the door some people help themselves others don't every day activities are psychologically beneficial to people who are active cope with the disease much better and enjoy life much more. it was devastated when she found out she had parkinson's but that changed after she came to the paracelsus clinic and was now book where they have

a special parkinson's program. and i notice that i'm stiff when i don't exercise regularly. but when i do exercise it starts to become easier to stretch my body everything expands . yet. the so-called big therapy has patients make big movements media louden schlager started the therapy right after getting her diagnosis. on the to her prior to the therapy ms loudon schlager i could see that you were able to swing your right arm much. less than your left arm. around your gate was a bit unsteady it wasn't a certain and focused as it was later on. for weeks later after taking medication and taking part in big therapy she was much better. you walking symmetrically with both arms swinging it's completely balanced you have

a very large stride and you're walking straight as if you were on a line. with medication alone improvements like that aren't possible. and what i mean reducing medication levels or just starting therapy isn't nearly as successful as big therapy. parkinson's disease and sports don't preclude one another they belong together. i mean if the bird in charity was dr coles in record warrants and a group of parkinson's patients and what happens here so we tried to close the gap between the in and outpatient clinic care so far we offer our patients multidisciplinary team consisting of the physicians in their progress on numerous speeds and physiotherapists nutritionists and of course the training of tittie and there we would like to analyze the individual needs and resources of each

patient after admission and to then creates an individual and so to say customized treatment for each patient very close to every day life to the t. so this is kind of excess so serious exercise how important is exercise and parkinson's disease. exercise is important in your logical does or does nearly at any time and parkinson's disease is a movement disorder and so patients really benefit from any kind of movement. in the lead to medication medical problems or deep brain stimulation. and we highly recommend any any activity. on the patient so let's focus 1st on the so and know what you like to join us please so you're doing more calls here and it's very important in the treatment of parkinson's but

why does it help. and if you will child she is a form of movement that originated in china it was a martial art developed for the battlefield today the martial aspect is less important because nowadays we tend to focus on health and living a healthy and balanced life and tight she has a lot of benefits in that respect it can help improve balance in motor control and it's relaxing and improves concentration that's exactly what parkinson's patients need all so it's a duty that up a special form of tenchi called keep moving and what's so special about it. this is what tai chee movements look like if i do them myself or what touchy sequences might look like this is a bit too complicated for participants of complexity time and they don't need to do this to start out at all this here is a simpler version of the focus here is on improving balance and of course strengthening your leg muscles along. kleis convinced all spawn are. by

muscular towards accepting or this is what they keep moving principle is all about until you reduce or eliminate the superfluid aspects in make it all simpler one big for the patients that serves as a bridge point to get access to tie gene as a form of exercise some buying of course they can later expand on this some of my patients at the arm movements but to start with that doesn't make much sense. there was a study that showed that parkinsonian patients who were training regularly type she were better off with their daily activities after just half a year of training so that's check on that. it's so. does it really help as it helps a lot. had parkinson's for 10 years and as i'm doing tai chief for about 2 and a half years when you look at me i look relatively normal. not if i skip 3 weeks or so for example on a holiday i feel was. important because it improves my balance for me i can

definitely recommend it. so you're motivated and don't have to force yourself no not at all along with the exercise i really appreciate how it relaxes me how you find inner peace that's just as valuable. i spit what does tides he do for you. does she concentrated lang's them and then he's been treated slow movements help me relax right away and i know and it's the diet and that gives me a kind of inner peace and balance. or and. the agony of it brings a sense of calm and serenity to my life and. i took to it immediately. action. there's really mazing but there are different exercises that could be really helpful like dancing and this one dance which is especially helpful it's

tango. yourself with. her. first the warm up. and then it's time to get down to business. to him now impairs. recent clinical studies indicate that the tango can help fight parkinson's disease. neuroscientists have discovered that it significantly improves the patient's gait and balance. going to hire nico hopes that he'll benefit greatly from tango dancing to temper i know that when i am struggling with my pastor on the one hand and then i have to get my legs to do what they should be doing. unfortunately i don't always manage but my partner is helping me and that makes things better on the side.

and the dancers really have to keep on their toes. the tango therapist often throws in new exercises. we clean the was like this that's how the therapist to solve all consolidates describes this coordination exercise. i don't catch it. so the. first rule that make it disappear. that's good. goals are to take bigger steps unusual and achieve the best possible posture. teacher and student are both pleased. my you are my friend next week you'll come here and be taller than i am could want you to be.

here after 2 hours of tango good to run you couldn't really walk tall. studies show that tango improves balance and majority abilities and dancing is fun you can do it in groups so whole importance of group activity and fun group this group activity is always help too to maintain to the program and to keep motivated and they may help to network socially and on the other hand dancing is a very helpful for patients with parkinson's disease as external cues such as visual or acoustic use help in. improving movements and in tight she is about concentration and focusing on the task is important to. yes of infile yes definitely it's totally important because the body can only

function if it can relax so relaxation is the basis for everything and parkinson's patients often suffer from muscle rigidity so relaxation is especially good for them and it's the same when it comes to concentration but only super good can also smear it's accepted wisdom in asia that when body and spirit harmonize or work together in a directed manner then daily life functions better than unfortunate for instance you want stumbles who often or forget where you put your keys money wise what the other facilities are so what other kinds of movements and exercise and sports what you recommend for parkinson's patients so in general no limits are set when you are not healthy you should start with prescription for physical therapy for example. when when when you're healthy you can go jogging you can do nordic walking cycling

weight training as i said earlier or you just use the said home or even computer games imitating sports so if our viewers want to start now what's the 1st step they're so should the 1st step is to leave the house the longest journey begins with a single step when you've signed a tight she teacher close to where you live to do a trial session to get an impression and if you like it there's nothing to stop you so it's all just about doing it and get moving so please get moving get up and go to your computer and send us all your questions to our experts. on an upcoming show we'll be looking at the power of meditation breathing and relaxation exercises are said to help reduce stress in everyday situations how does meditation work and what kinds are there send your questions to in good shape at the dock. dot com just right meditation in the subject line we look forward to hearing from you.

many people think that they are constipated one out of 3 things that he or she has a lazy colon but the real data are different just one out of 10 is really constipated so it's off the patient just a gut feeling. is a doctor's assistant so she's on the move the entire day it doesn't matter if she stands or sits or moves are not the 49 year old has been suffering from constipation for decades i've always had problems going to the toilet as a young girl during my pregnancies and afterwards as well she has the most problems when she needs bread and meat at 1st she thought it had something to do with her diet so she tried changing it. finished soaker i reduced my sugar intake and ate a lot of vegetables and fiber things to get my bow moving i've tried it all but

it's never really worked 100 percent and also could be at about 1 o'clock said he is and. even though daughter truckies lots of vegetables and whole grain products she only has about one movement every 5 days and that has weighed on her quality of life. the problem is when i have constipation i begin to have flatulence and that's not very pleasant the gap which has made this is the understand. for years she has felt constipated she's turned to doctors for a gastroscopy has colonoscopies pancreas examinations as well as tests for lactose and fruit dose intolerance all without success she still has constipation and her infrequent bell movements have led to another problem. i feel the urge to go to the toilet but i can. on a visit to another doctor that is told that it's often quite difficult to find the

exact cause of constipation so additional tests are needed. there are many different causes of constipation such as medication and other diseases for example neurological disorders and parkinson's disease. multiple sclerosis hypothyroidism and diabetes can also lead to constipation tracks dr is able to rule out all of these as the causes for it. now a simple x. ray with these capsules that contain metal markers should show whether the problem is in the intestine. the human colon is always in motion shoving clumps of partially digested food back and forth 6 to 12 times a day there are stronger muscle movements that move along the digestive tract. motor neurons control the process and sometimes this is disturbed in people with

chronic constipation. that causes can also be found in the colon itself changes in the home and nervous system or the muscles and. that can lead to less peristalsis reduced intestinal movement so there is a delay in the transport at the digestive tracts content. or neurological or muscle disorder can cause constipation suddenly. it's also possible that infections in the intestinal area that we encountered during our lives can lead to changes chronic changes to the intestinal nervous system causing chronic constipation. x. ray indicates that she doesn't have a serious neurological disorder in her intestine because only a few metal markers are left in there that means the colon is slow but not diseased . so if it's not

a neurological disorder what is the cause and examination of her rectum indicates that she suffers from an intestinal voiding disorder she's unable to have a proper bell move. 'd probably the problem often concerns the pelvic floor muscles responsible for opening the sphincter during a bowel movement often don't function properly and that's related to a pelvic floor weakness. a change of diet didn't help towards luck so now she's undergoing a combination therapy a laxative as a subpar satori will help empty her rectum psyllium a soluble fiber helps to the passage. if those on hand if the cellular absorbs 40 times its own volume of water and this water will remain in the fecal matter so it doesn't become hard and the intestine

can transport it better as a transport you can. now do which lack is on the right path she's more physically active and following a healthier diet. she takes the psyllium every day and every 2 or 3 days a laxative if you have any if i could go to the toilet every other day that would be a success i hope things get going. and. do you sometimes feel tired without an obvious reason or have joint problems. rash the reasons for this and mostly harmless but this could be signs of a dangerous disease like lupus. going down a long flight of stairs can be a risky business for as out about tom she sometimes stumbles for no obvious reason . the smart ones would affect my can't always feel my body so well especially

on the left side and then if i don't watch out i can have problems with my coordination. that's what happened this time one moment of inattention i put my foot down wrong and it was broken because it stunk when my. hose mysterious condition 1st appeared 11 years ago she came down with scarlet fever then she kept getting sinus infections she had surgery and took lots of antibiotics but the infection kept recurring along with bouts of debilitating fatigue. it was the 1st as a kidney get up it's like coming down with the flu quotes when i get a high temperature and all the other symptoms that go along with it i wasn't terribly tired not just a bit sleepy but really exhausted. that leads to problems with concentration even looking for small changes tiring so here is of a pace with the bill but she's glad she has the energy to go shopping at all and is

no longer suffering from extreme fatigue. she had the condition for 6 years before rheumatologist had much zones and finally diagnosed it as systemic lupus erythematosus an autoimmune disease servants and says diagnosis isn't easy the symptoms can be so varied and diffuse that patients are not always taken seriously . how are you feeling today you ask it i can feel it's time for an infusion of the fear of something done lots of doctors think the patients of mentally ill they're full of usually have a new flavor together to anyone who has so many complaints is mentally unstable and conclude there's nothing really. be wrong with them it's all in their head. and that's what happened with her this is the office she had. one quite typical symptom of a butterfly shaped facial rash went unnoticed. in lupus the body's

immune system produces antibodies that attack the person's own tissues. that can result in inflammation of the times skin and joints. the brain and internal organs such as the kidneys lungs and heart can also be affected . but there is some hope for sufferers a medication called. a monoclonal antibody is the 1st drug developed especially for lupus. to target certain amused cells known as b. lymphocytes thereby suppressing the excessive immune response and reducing some of the symptoms. every 3 weeks zafir gets an infusion of the drug suppressing her immune system has side effects that makes her more vulnerable to infections. and the advantage is that she doesn't need to take as much immunosuppressant cortisone. and this sort of

a listen vic it's not as if it's all gone but i need far less cortisone and fewer painkillers and that enhances my quality of life to discourage t. gets less intense so i can actually get out of bed it is over i think that's when you know the kind of fatigue i had before was indescribable i couldn't take care of myself at all but now i can again 100 percent media to not put tend as hired the person hit doesn't cure lupus there is no cure for these conditions but it does reduce the symptoms. and it protects the organs from further damage that seems to be established of interest no hope. garbett sees that kidney inflammation is reduced and kidney function improves the inference and it's clearly very effective as a gun's klara see over some. heads not have been treated earlier she might have been able to continue to pursue her profession as an occupational therapist but now

thanks to the drug she can at least work in an office for a few hours at a time. that's it for today see you next week and until then let's all try to stay in good shape. explain. please.

explain them going to. closure filled with garbage a serious health hazard in my world we reverse engineer the environmental damage begins right at the shores and by the creatures labeled. it is a completely publicly funded. the government has done next to nothing about this

problem told local residents should decide to take action. treated as an audience on t.w. . the fiction piece of. sound or sally. who claims it's mob scene a show the crisis. in a call to social entrepreneurs are changing the lives of the 4 providing schooling and hope. the readers see is mission to the movies in exchange for good is a voluntary more from the parents. in 60 minutes on d w. i'm scared that the a more than tired and in the end is a me you're not allowed to stay here anymore we will send you back. are you

familiar with this. with the smugglers would lie and say. what's your story ready. i'm a woman i was and women especially of victims of violence in terms of take part and send us your story we are trying in all ways to understand this new culture. another visitor not the guests you want to become a citizen. in for migrants your platform for reliable information. innovation. but can it conquer the major issues of our society. the 3rd season of founders down the dunk of the holy ghost meets modern day heroes in asia. ready to take on this challenge with their unique ideas. and those 2

problems and make them one solution. to the season finale this week on t.w. . up. this is deja vu news live from berlin anger in the u.s. after a black man a shot dead by police had a fast food restaurant the site where richard brooks died has become a makeshift memorial police have released body and dash cam footage showing the moments leading up to the struggle that would ultimately cost him his life. also coming up thousands of people rally of crossed.