Waxing physically and philosically...

After literally years of deliberation, and as a result of some delicate and some less delicate prodding, this blog is my effort to organize - to bring together - my thoughts about my work as a conductor and as a personal trainer, to rant and rave as necessary, to celebrate the little things and the larger moments of brilliance, and to share some conductive magic and life lessons gained through 'waxing physically and philosophically'.

Saturday, July 23, 2016

With a song in my heart ...

Last Thursday I went to a Parkinson's singing and voice group that is hosted locally by the wonderful RZ, a professional singer accompanied on piano by her husband MG.  The group is attended by several people from my Conductive Education Parkinson's exercise group and from my Counterpunch Parkinson's classes.  

On the day I attended there were 17 or 18 people sitting in RZ's living room -- and I am told that several were missing -- I'd like to think that it wasn't the thought of listening to me sing that kept them away... This photo doesn't do justice to the wonderful site of two rows of people - two rows of people with Parkinson's and some of their husbands or wives smiling, laughing, chatting, sitting up straight (and sometimes standing), and of course, singing. 

I enjoyed taking part in the singing and I enjoyed being in a room full of people singing -- and for the rest of the day I had songs in my head, a smile on my face, and a song in my heart.  Actually I still feel that song singing in my heart every time I think about the experience.

There certainly are physiological benefits of singing and voice work for people with Parkinson's -- improvements in speech and voice control, articulation, volume, facial expressions, breathing, and posture -- but these almost seem like a side effect to the psychosocial benefits of making of music and merriment,  to the act of defiantly raising voices in song instead of being hushed by Parkinson's, to the positive mantras the singers were being encouraged to shout or sing when energy or volume started to lag offering messages that echoed and resonated well into the next song, to the way that singing together reaches in and touches people's souls and connects these souls to each other.

"I sing sometimes like my life is at stake, 'cause you're only as loud as the noises you make.  And I'm learning to laugh as loud as I listen, 'cause silence is violence ... And we can make music like we can make do..." -- Ani DiFranco, My I.Q.

My heart from the experience of singing, not just with any people, but with this group of people. My heart sang from the experience of watching RZ passionately lead the group through song and voice work -- for the opportunity to sit at the feet of a master of her craft and to listen to her sing and to be a part of a group that she was running, and the sense of gratitude for the opportunity.

And, my heart sang with pride - for RZ is not just a wonderful singer and teacher, RZ is one of my Conductive Education students, a woman battling her own Parkinson's.  My conductor's heart sang watching my participant in her orthofunctional glory standing in front of all of these other people teaching, giving, leading, conducting, encouraging, motivating, and singing.  Thank you RZ, from the bottom of my heart for what you are doing for your singers, and for showing us all what it means to rise above, and to raise our voices in song.

Here are two of my favourite songs that make my heart sing, and here is to you and your singers RZ!

Sing, sing, sing                        Singin' in the Rain

Tuesday, July 19, 2016

Exercise and the brain...

 Exercise recommendations for people with neurological conditions like MS and Parkinson's have changed drastically in recent years.  We know a lot more about neurological conditions, we know a lot more about exercise, and we know a lot more about neurology - and we know that we are only at the tip of the iceberg about what there is to know about all of these things and their interactions.  It is actually really important to understand that exercise recommendations have changed for everybody - the general population, athletes, people wanting to lose weight, older adults, people managing injuries, people with illnesses - so it really should be no surprise that the recommendations have changed for people with neurological conditions.  

When it comes to exercise as a tool for promoting brain health, it actually doesn't matter if you do or do not have a neurological condition -- the exercise recommendations are the same.  Though we talk about the benefits of exercise for people with neurological conditions, it needs to be made clear that these guidelines are for everybody who might be looking at exercise as something that might discourage disease progression, that might protect our brain cells from ageing, that might encourage our brains to continue to adapt throughout our lives, or that might promote healing of damage or injured brain tissue, the exercise.    The right exercise may in fact help us stave off or delay onset of neurological conditions by making our brains healthier and more able to fight disease, and exercise habits learned and enjoyed before the onset of a neurological condition  are easier to sustain and adapt than to introduce after a diagnosis.  

When we are talking about exercise and brain health, we are talking about more than efficiency of oxygen supply or muscle strength or mental health or cardiovascular endurance.  We are asking if exercise might promote neuroprotection, promote neuroplasticity, or even encourage neuroregeneration.  And more and more, based on the little bits and pieces that we do know, we think that the answer to that question is yes.  However, just as we know that certain exercise is better for promoting muscle growth or weight loss, we also know that exercise for brain health needs to meet certain criteria.  Let's explore this further.

One of the new guidelines for people with neurological conditions is that at least for short intervals, exercise should be at a high intensity - high enough to get their heart pumping and for them to feel puffed.  This is because when exercising at this intensity our muscles produce a nifty little protein called cathepsin B.  Cathepsin B travels to the brain, and in the presence of cathepsin B, our brain cells start to produce neurotrophins which kick start new cell growth - also known as neurogenesis.  The research also indicates that long term consistency of exercise involving periods of high intensity, over weeks, months, and years, is more important than the duration of individual training sessions when it comes to this effect.  

We also know that strenuous exercise might influence how certain genes function in the brain.  For example, strenuous exercise encourages our brains to make a substance called "brain derived neurotrophic factor" or "BDNF".  When BDNF levels are low, we are more likely to see cognitive decline but when BDNF levels are sufficient or high we see brain cells grow and remain healthy and vigorous and we see more efficient connections between brain cells allowing the brain to function better.  But that isn't all - if someone is sedentary the genes responsible for BDNF production may be muted or get gunked up by other molecules.  However, during higher intensity exercise ketones are produced.  Ketones -- byproducts of our bodies using fat as an energy source -- protect the BDNF gene by stopping other molecules from being able to gunk that gene up - an example of how exercise can be neuroprotective.

The idea of neuroplasticity is even more exciting - especially because the guidelines and reasonings are 'more tangible' and less 'neurochemical'.  Neuroplasticity refers to notion that our brains are capable of change over our lifetimes, that our brains reorganise themselves physically and functionally in response to learning, our environment, our behaviour, our thinking, our circumstances including injury or trauma, our motivation, and our needs.  Neuroplasticity is also, paradoxically, a scary idea - because in the same way that we can do positive things things to encourage our brains to be more adaptive and to grow and change, we can do negative things or do nothing which actually will reinforce negative changes and patterns.  By this token, "use it or lose it" really applies to brain health; if we use certain connections they will get stronger and more plentiful and the connections we do not use will weaken and wither. 

In order for exercise to promote neuroplasticity it needs to be challenging, frequent, mentally and emotionally engaging, reinforced by positive feedback and positive results, fun, specific, worthwhile, and relevant or goal specific.  This type of exercise includes trying new things, leaning new skills, having fun, and being fully present and engaged while we are doing so.  Regardless of whether we do or do not have a neurological condition, this type of exercise is really important to brain health.   We are never too old for it, and from a human and psychological point of view it is exciting to think that by challenging ourselves and being engaged and having fun we are also promoting brain health.  

These are just some of the emerging ideas about exercise and brain health, and why the exercise guidelines for people with neurological conditions as well as those for the general population are changing.  It will be really exciting to follow the research in these areas over the next few years and to see how the health, fitness, and education practice shifts as a result.

Some light reference reading can be found here:

How Exercise May Help the Brain Grow Stronger

The 10 Fundamentals of Rewiring your Brain

Does this exercise protein boost your brain power?

Exercise triggers brain cell growth and improves memory, scientists prove

Thursday, June 23, 2016

Digging into Neuroplasticity

Last year I attended a conference about muscular dystrophy.  Despite what may sound like gloomy subject matter, it was incredibly exciting with researchers talking about what they were working on and what they have achieved with such positivity and hope.  In and amongst this positivity and hope and details about amazing new findings were honest discussions about what we don't know.  One researcher, talking about genetics of muscular dystrophy, said that genetic research was like digging a hole - as you dig deeper, you unearth more information but you don't necessarily get to the bottom of the hole, you just get a bigger hole with more possible information to unearth, and that at present the hole still seemed bottomless.  

The concept of neuroplasticity has made its way into pop culture, seemingly without the same honest discourse about the bottomless hole of what we still don't actually know, what has yet to be unearthed.  One minute the earth is flat, the next minute it is round end of story...  I feel like everybody has jumped on the neuroplasticity wagon - and the promise of neuroplasticity is being used to sell everything from exercise to rehabilitation to learning an instrument to counselling to crystal healing to healthy food without anyone knowing or understanding the concept as anything more than 'something that's good for your brain'.  

Certainly my professions, Conductive Education and exercise, have both been linked to neuroplasticity - so I suppose I should be excited that what I do is so avant guard and cutting edge that it makes your brain grow.  It isn't that I don't think these things, my things might actually promote neuroplasticity.  It's more that I cringe when something so interesting and important as a concept as neuroplasticity is being bandied around without real meaning; I almost expect to see things like 'neuroplasticity guaranteed' or 'book now so you don't miss out on your chance for this neuroplasticity opportunity'.   I also cringe at the reductionist idea that something as all encompassing as education or exercise or well-being can be reduced to neurobiology as if neurobiology trumps every other psychosocial or human experience.  What if, when we are actually able to assess whether a practice or intervention promotes neuroplasticity, we find that dancing the tango is just dancing? Does the music stop?

Don't get me wrong - neuroplasticity is exciting business, especially for people with neurological conditions or brain injuries, the people who love them, and the people who work to support and rehabilitate them.  That our brains are capable of protecting, rewiring or repairing themselves and that there are things we can do to promote, nurture, enable, and even enhance these processes are amazing and fascinating and exciting.  And yes, we understand a little bit about some of these processes, and yes we are digging deeper and unearthing more, but we have only just started digging and the hole is only getting bigger - the bottom is nowhere to be seen.  I actually hope that we never find the bottom of this hole - that we never understand everything about our amazing brains, that neurobiology doesn't explain everything... that we continue to unearth mysteries about our minds, our souls, and ourselves as humans.

My original intention when I started writing today was to open the conversation about what we do actually know about the effects of exercise on the brain... Sorry, I have digressed.  I will revisit that topic in my next blog post.  But for now...

Sunday, June 19, 2016

When life gives you Parkinson's, COUNTERPUNCH

The last few months have been busy, and a bit all over the place for me, to say the least, and my blog has been sadly neglected.  Resuming private practice and building a business that is sustainable and reflective of the work I want to be doing in Conductive Education and personal training while trying to get a semblance of work life balance have been energy and time consuming processes.  My business is starting to take shape - some conductive groups, some private clients that I see in their homes, some personal training at a groovy gym with a great team of fitness professionals, some consulting, and lots of boxing groups for people with Parkinson's.   I'd like to tell you a bit about what I'm doing with boxing groups for people with Parkinson's, why this appealed to me in the first place, and about why I love and value this aspect of my work so much.

For the past several years I've been reading about the work of an organization called Rock Steady Boxing based in Indianapolis, USA - in recent months I'd say seldom a week passes when they do not come up in my RSS feed.  Starting serendipitously - one person with Parkinson's boxing intensively with a trainer and seeing dramatic improvements - Rock Steady literally have taken the idea that non-contact boxing might be a useful exercise modality for people with Parkinson's and put it on the map.  They have developed programs, they have upskilled fitness and allied health professionals, and now have over 150 affiliated organisations and gyms offering their program in North America.  

Part of what caught my attention about the Rock Steady program is that it seemed to bring together disconnected parts of my two professions.  I have been working with people with Parkinson's in Conductive Education classroom settings for nearly 20 years.   As a personal trainer with boxing qualifications, I have been using boxing based training with many of my clients and have enjoyed adapting boxing drills to make them wheelchair friendly - and love boxing as part of my own fitness work too.  So at this very base level the idea of boxing groups for people with Parkinson's was exciting, and the idea niggled at me, kept calling me, and I decided to try to get a program running here in Auckland based on my own knowledge and experience, so I could see for myself how it might work.  

In October of last year SM, a colleague in the fitness industry, and I trialled a Parkinson's boxing group at the local YMCA where she worked -with some of the wives of my boxers and my husband helping out as program assistants.  The program went from a handful of brave participants all known to me to a large group in a matter of months.  We quickly outgrew the space we were using at the YMCA and I approached Shane Cameron, the owner of a local boxing gym and a New Zealand boxing champion about bringing my program over to his facility. I showed Shane what Rock Steady were doing in America and he came to watch my boxers - and he saw the magic that I saw.  

One of my boxers taking on Shane

Shane and I are now working towards emulating the Rock Steady model here in New Zealand, customising a program we have called COUNTERPUNCH PD and developing a training module for fitness professionals, and working to make COUNTERPUNCH PD available to people with Parkinson's nationally in NZ - watch this space for more details.  I will travel to Indianapolis to do the Rock Steady training course in August and am so excited about that; I am equally excited about experimenting with and encorporating Conductive Education tasks and methodology in a boxing environment and about making this program my own.  

Research has qualitatively and quantitatively supported the Rock Steady program.  However, the anecdotal and human interest stories featuring people with Parkinson's talking about what they get out of boxing groups speaks far louder to me.  It has been exciting and affirming to see my boxers make improvements and speak of the same results.  

It should also be noted that they exercise guidelines for people with Parkinson's have changed a lot over recent years with higher intensity exercise such as boxing being recommended, and the idea that the right exercise can be neuro-protective and promote neuroplasticity has been thrown around - I will address those concepts in a blog post in the very near future.  

From a Conductive headspace, there is so much about boxing for people with Parkinson's that makes sense to me - the use of visual cuing and rhythm for movement, the use of voice with movement, having something tangible as a target for movement; directly addressing movement challenges of Parkinson's such as complex coordination, agility, balance, speed and size of movement and practicing them and working to make them better instead of accepting them as problems; working in a positive and social group of peers; having fun; being challenged and being expected to rise to the challenge; the idea that there is an active and empowering approach that enables people to feel like they can do something to take control of their Parkinson's; the allegory of literally fighting Parkinson's - of being able to COUNTERPUNCH - and the sense of hope that comes from fighting. 

I love all of those aspects - boxing for people with Parkinson's makes clinical sense and is effective. But what I love most is that every session people with Parkinson's walk into the gym and as they put on their wraps and gloves and head out to the heavy bag or speed bag to warm up they transform into boxers, or kids happily playing, or some amazing combination of both.  I almost forget that they have Parkinson's - but more importantly, at least for that hour they seem to forget that they have Parkinson's.  It is amazing, magical, and transformational - and so much fun to be a part of.

Wednesday, October 28, 2015

Faith, Trust, and Pixie Dust

It makes me sad that so many well intentioned charities and non-profit organisations struggle because they rely on old school models of financial viability - begging, donations, hand outs, grants, and philanthropy -- instead of developing sustainable models of self sufficiency through things like social enterprise and responsible capital ventures. It makes me sad that these organisations are so stuck in this old way of doing things that even in times of financial crisis that threaten their very survival they cannot change. In the same way that a practice like Conductive Education is a paradigm shift from a medical model approach to managing disability, charities learning to think like businesses is a paradigm shift and it makes me sad that there is so little help for charities who need to come around this corner if they are going to survive.

Don't get me wrong - I like the idea of living in a world made of "faith, trust, and pixie dust" as much as the next person. In fact, those who know me well would probably tell you that in my head and in my heart that is the world that I live in, and I would respond by saying that believing in that world influences the way that I choose to move through this world. This world needs people who create potential for "faith, trust, and pixie dust" by creating ways to make important things happen -- and that includes finding ways to cover the costs of whatever these important things are. We don't have to all agree on what those important things are, but we do have to agree that sometimes opportunities need to be created and where appropriate capitalised on, so that more important things in this world can get done -- so that there is more pixie dust to go around. That is my personal definition of entrepreneurship.

For some people, the important thing is about human exploration, getting people to mars; others try to invent things that will make our lives more efficient; some want to influence the world through the establishment of an essential service, for others the important things are to do with music and art. Everyone has their passions and priorities. In my world those important things that need to get done are around helping more people through Conductive Education and through exercise and movement. I've left the non profit sector because I believe that out here in the real world I can build something that will create more pixie dust; in the charity sector I was wasting time waiting for pixie dust, begging for pixie dust, and then having to filter my portion of pixie dust through hoops and red tape and then still bow down to the pixie dust purse holder who dictated how I could use that dust. By this time the pixie dust feels more like regular dust - the sparkle is gone.

I look to people in my field who seem to leave a sparkly trail of pixie dust wherever they go -- people who have created business models that have enabled them to conductively help more people, and to do so on their terms, while adding to the available pool of pixie dust. I always look to them for inspiration, to admire what they have done and created, to admire their work ethic, determinism, and can-do attitude, and to admire their courage to step into this world and to do something different instead of letting themselves wither in dystopia of the other. I look to these conductive entrepreneurs to admire their ability to cherish and uphold the ideals of "faith, trust, and pixie dust while carving their own path of "second star to the right and straight on 'til morning”. 

Thank you conductive entrepreneurs, and thank you J.M Barrie and Peter Pan too!

Thursday, October 22, 2015

Don't stop me now...

In just over a week I will be taking Transformations, my personal training and private Conductive Education business, to a new home base, to a brand spanking new facility with sparkling new state of the art equipment, to the new Les Mills gym that will open in Newmarket Auckland in November.  I was asked to apply for this contract -- to bring my combined experience in fitness and disability into this mainstream fitness arena.  It is such an amazing opportunity... for me professionally, for Conductive Education, and most importantly for people with disabilities or health conditions who are tired of being relegated to therapy and rehabilitation environments and church halls.  It is such an amazing opportunity to do something that I'm so passionate about, and I am so grateful for this opportunity, and I am so excited to get started, but as often happens when I'm excited about something I'm also really anxious, really scared.

So scared that I almost talked myself out of the application and interview.  So scared that I'm having to battle my inner fat kid who always comes a-knocking when I'm worried that I'm not good enough for the challenge ahead or that I might possible show that I'm human by dropping a ball as the balls get rolling.  So scared that I've actually taken genuine control of my own health and fitness for the first time in ages.

So yesterday, I was out for a run.  It was very windy, and a little bit rainy, and way too cold for this time of year and the hills seemed steeper than the last time I'd attempted them, but I had set a training target for myself and I went for a run. And today I'm baking brownies for a friend's birthday tomorrow and even though I actually think that I have mastered the fine art of ganache, I haven't licked the spoon to taste because I've taken control of my eating again and I'm feeling so much better or that.  Grant me the courage to to take charge and to change the things I can, something inside me whispers.  

So yesterday, while I was out for a run, and while I was feeling proud of myself for being out there, and in control of myself which is really the only thing I can control, this song came through my speakers...

And while I was running and singing along like a crazy gal, I started to notice that the scared was gone, and that I was feeling happy, and excited.  In this headspace I started to think about my pending opportunity again.  I started to think about the gift of being a conductor, and how as a conductor I have a skill set that makes me an excellent personal trainer.  I can patiently break movements down and teach them over and over again until I am understood until my client learns and I understand that it is my job to do this (thank you Conductive Education);  that when my words aren't enough I can teach with my hands and my voice and my facial expressions; (thank you conductive mentors operating in a language that was not your own); I notice and celebrate the tiniest of achievements and this motivates and instills confidence in my clients (thank you conductive pedagogy); that I know to meet people where they are at and do so honestly and realistically while always looking ahead to I can help them work towards their goals and their next step (thank you AS for teaching me about dynamic potential).

And while I was happily running I was able to approach my scared, anxious inner fat kid conductively, from a place of kindness, the way that I believe in approaching my conductive and personal training clients.  We looked at our current health and fitness together; we looked at our disappointment with not being as fit and strong as we once were in the context of a few years of a stressful desk job and made peace with this disappointment so we could start to move forward, and we really thought about our current goals (feeling healthy and well again, exercising habitually, and enjoying that habit) and about how we might be able to judge our current self against those instead of against some imaginary standard that we had no actual motivation or interest in anyway.  One foot in front of the other, one step at a time over hills, through barriers to a place where my inner fat kid was no longer standing between me and my exciting opportunity.  And I let myself and my inner fat kid share in this feeling of excitement -- because after all she and I are in this together.  Grant me the serenity to accept the things I cannot change, which means making peace with who I am now, inner fat kid and all, so that I can continue to grow and thrive, something inside of me whispers.

In just over a week I will be taking Transformations, my personal training and private Conductive Education business, to a new home base, to a brand spanking new facility with sparkling new state of the art equipment, to the new Les Mills gym that will open in Newmarket Auckland in November.  It is such an amazing opportunity to do something that I'm so passionate about, and I am so grateful for this opportunity, and I am so excited to get started.

Monday, October 12, 2015

It Takes a Community...

School holidays have just finished here in Auckland, and we are now settling into the last mad dash of fast paced weeks leading into the holiday season and summer.  Normally when working with adults in rehabilitation or fitness settings the timing of the school holidays doesn't really have any impact on service delivery.  However, the lovely community centre where I hire space for my Parkinson's CE group runs a plethora of children's programs during the between term holidays, and my lovely little room is not available so we take a break.

Many of the people attending this group have been coming fairly regularly since last September and all but one -- who is moving out of town -- have signed up for the next term which starts this Friday.   Before we broke up at the end of the school term I surveyed them to find out what they were happy with, what parts of the program they enjoyed the most or found the most useful, what they didn't enjoy, what they struggled with, and what suggestions they have for future sessions.  I gave them the choice of anonymity so that they could be honest and open in their response.

I carefully listed out elements my carefully structured program for my clients to give feedback about in language that was clear and accessible (this is an incredibly intelligent bunch of people -- but that doesn't mean that they know or care what a task series or rhythmic intention is).  I listed things like learning to change position and to stand up fluently, seated exercises, arm and shoulder exercises, fine manipulation and handwriting, speech and facial expressions, walking and balancing activities, memory and concentration work, stretching, and I included the pre-program greeting round and the post program morning tea amongst my activity list.

I list these out because from my perspective each are so important and a lot of planning and thought goes into getting ready to lead a large Parkinson's group.  My clients were all happy with the program and with the balance of the activities and few had suggestions about what they wanted done differently.  They listed outcomes that included better balance and being able to get up from the chair easier or safer, or having less shoulder pain.  But when asked what the most important thing that they got out of the group was, not a single person listed an activity or something mobility related.  You guessed it - psychosocial outcomes were once again featured as the most important.

Here are some of the responses:

"Having Parkinson's feels more normal to me, I see that everybody is affected differently and I don't feel as strange in this group" said one person;

"I have more confidence in myself" said another.

"Realizing that exercise is more pleasant when done with other people" said VW;

"The way the others encourage me" said RH;

"Enjoyment of the group" stated BB, "Oh, and the laughing!"

TM wrote "companionship"; DS noted "fellowship"; JW agreed with one word, "friendship".

Two weeks later, I still get shivers reading these responses.  I feel so proud of this little micro-community, and of the positive and supportive environment that they provide for each other, which allows them to thrive and blossom despite having Parkinson's.  Two weeks later, and that really isn't a very long time, I realize that I miss them.  That I miss the community spirit of this wonderful group and their wives or husbands who often come along; That I miss the laughter, the fun, the games, and the fellowship, and that I'm glad that the school holidays are over and that I look forward to getting my dose of this wonderful community again this Friday morning.