A Rose by any other name... Parkinson's and gardening.. Dispelling the myths!

Dr Subramanian, one of the co-editors of this blog space, has a penchant for roaming in her neighborhood in sunny Southern California searching for the latest treasure trove of blooms . When she is not snapping pictures of gorgeous flowers, she can be found at the Center of Excellence (PADRECC) in Parkinson Disease at the West Los Angeles Veterans Administration or at UCLA. We picked her brain for this blog post.

By Jonny Acheson MD

There has been some controversy about the benefits of gardening and we have had persons with Parkinson’s ask us why we recommend this to for PD. Though there is very little data specifically focusing on PD, here are some myths that we can try to dispel.

1. Gardening should be avoided in people with PD.

Since there has been a worry about PWP and exposure to pesticides, some persons with PD have been reluctant to try to get out into their gardens. To date, the one study we have on gardeners comes from Denmark. They followed a registry of 3124 male members of the Danish Union of Gardeners from 1975-2008. In this study, there was a very weak association between gardening and the risk of getting PD. However, there is no data to support avoiding gardening after one is diagnosed with PD. Here are some safety tips to consider from Sherri Woodbridge and Parkinsonsnewstoday.

• Make sure your tetanus, diphtheria, and pertussis (Tdap) vaccinations are up to date.

• Have a good set of gardening gloves to lower the risk of skin irritations and cuts and to keep you safe from nasty stuff lurking in the soil.

• Apply sunscreen. People with Parkinson’s have a higher risk of skin cancer. Wear a wide-brimmed hat to protect your head from strong rays.

• Steer clear of chemicals. Use organic methods to rid your garden of pests instead of using pesticides that have been linked to Parkinson’s disease (but also remember you already have Parkinson’s!).

• Stay hydrated. Overheating can lead to heat stroke and other health risks for PD. Take a break and enjoy a glass of iced tea while you admire your flowers. Appreciating the results of your efforts is an essential part of gardening.

2. The benefits of gardening are only seen if you

get your heart rate up and get high intensity cardio

while gardening.

The benefits of gardening can be seen appreciated even if you do not get your heart rate up tremendously. There are a number of exciting benefits-

(i) planting flowers- mindfulness meditation around smells, sights

(ii) exposure to sunlight on circadian rhythm and increase your vitamin D level

(iii) Potential social aspects of group gardening with member of your community in a community garden or with family or friends

(iv) dietary benefit of eating fresh fruits and vegetables

(v) exercise- According to the Centers for Disease Control and Prevention, you can burn about 330 calories doing one hour of light gardening and yard work. In fact, you can burn more calories gardening than you can while walking at a moderate pace for the same amount of time.

3.     There are no proven benefits of gardening on the

body.

In general populations, gardening has been shown to have benefits on blood glucose levels, cortisol levels, heart rate variability, blood lipids and salivary cortisol. Most of these lab indicators are signs of improving the effects of stress on the body.  There have been reports of improvements in total body fat, body mass index and systolic/diastolic blood pressure as well from gardening.

4. Gardening is only good for my physical health-

There are many studies that have looked at the benefits of gardening on mental health. Studies have shown that growing food can help combat stress and reduce associated depression. Bragg et al identified that gardens and subsequent activities can help improve mental health. There have been a number of reports of positive emotional and social improvements for those who participated in a gardening programs including increases in individual's life satisfaction, vigor, psychological wellbeing, positive affect, sense of community, and cognitive. There have been reductions in stress, anger, fatigue, and depression and anxiety symptoms. The improvements in depression severity, life satisfaction and cognitive function have persisted at 3-months' follow up after the therapy, indicating that gardening has a persisting influence on health.

5.     Since my doctor encouraged me to garden and I

have PD, I do not need to take any precautions. 

The main safety precautions involve fall risk and blood pressure dysregulation. It is important to hydrate well if you are working in the garden since PWP are prone to orthostatic hypotension (drop in blood pressure when they stand up). Some PWP feel dizzy when they stand up quickly and can have near or frank passing out episodes that can get worse in the heat. Additionally, due to the uneven surfaces in the garden and presence of garden hoses and overgrown plants— there may be more risk of tripping and falling. 

https://www.parkinsons.org.uk/information-and-support/your-magazine/spotlight/can-gardening-help-manage-parkinsons-symptoms

Top tips for gardening with Parkinson's taken from Parkinsons.org.uk

Adapt your garden

• Widening pathways may help, especially if you use a wheelchair or walking aid.

• Narrowing flower beds reduces the distance you have to reach.

• Raised beds mean you don’t have to bend so far to tend to plants or vegetables.

Choose plants and tools to suit you

• Long-handled tools or high-stemmed plants mean less bending.

• Ground cover planting, gravel or shingle can all help reduce weeds, meaning less time kneeling.

• Consider carrying your tools – a simple apron with large pockets, a tool belt or wheelbarrow can save you time and effort.

• Create a relaxing environment with lavender plants or the sound of a water feature.

• Stay safe

• Stretching and regular breaks can stop you getting too stiff or straining your muscles.

• Remember the effect your medication may have on your ability to garden. Think about times you’re ‘on’ – and don’t forget to take your tablets while absorbed in gardening.

• Try taking a pill timer or reminder alarm to help you stay on track.

To read more books and articles by Michael S. Okun MD check on Twitter @MichaelOkun and these websites with blogs and information on his books and http://parkinsonsecrets.com/ #Livingwith Parkinson’s #EndingPD #Parkinsonsecrets #LessonsFromTheBedside

He also serves as the Medical Advisor for the Parkinson’s Foundation.

To see more on Dr. Indu Subramanian she does live interviews of experts in Parkinson’s for the PMD Alliance.

The blog artist is Jonny Acheson.