July was the hottest month ever recorded worldwide.  With PFP’s audience joining us from all corners of the globe, I feel we'd be remiss if we didn’t address the effect heat can have on an individual with Parkinson’s. I’ve lived in Texas for 29 years; that’s 29 sunny summers with temps over 105 for days on end. This summer, the heat has been more exhausting than ever.  Personally, I’ve had multiple experiences with dehydration: my athletic kids have become dehydrated more than once, but more relevant to the PFP community is my experience with my father, who had Parkinson’s.

I’ve been thinking a lot about how the heat affects someone with PD.  In general, people with Parkinson’s are very susceptible to dehydration. Just about any secondary illness can throw off PD.  For instance, if you get a bladder infection or go through a surgical procedure, you may find your PD symptoms take a turn for the worse.  Dehydration can creep up on you and can be tricky to manage. 

People with Parkinson’s are at risk for dehydration for the following reasons: 

1. Not sensing thirst

2. Trouble swallowing

3. Urinary incontinence can make one drink less reluctant for fear of an accident.

4. Limited mobility due to symptoms of PD can make it hard to get to a bathroom on time, so people tend to drink less. 

Another critical factor that has to be considered with someone with PD is the risk of orthostatic hypotension.  Because your autonomic nervous system can be impacted by PD, you may develop this condition where your blood pressure can plummet rapidly when transitioning from lying down to a seated or standing position.  PD meds can also contribute to this condition, and finding the right balance can be very challenging. 

Some people will feel lightheaded and realize they need to sit down immediately, but other times, orthostatic hypotension can happen so suddenly that the person will pass out and fall.  A caregiver may see you develop a glazed look and not be verbally responsive or freeze.  I have seen this firsthand with my father as he experienced orthostatic hypotension often for several years.  Although there are a couple of medications that can help with this condition, our family found that lying him down with his feet up was the best remedy, but was hard to always do since he was a big man.  Hydration was essential, and if we could, we even added electrolytes or salt to boost my dad’s pressure.

Although dehydration is the most serious concern to someone with PD, isolation, and depression are next.  When it’s so hot outside, it’s hard to get outdoors, even for simple errands. Our world narrows when we can’t get out to take a walk and do our usual routine. The heat slows everyone down, but for someone with PD who is already moving slowly they may feel this even more intensely. Many people I know have compared this time of year to the lockdown we experienced during Covid.  With that recent experience, we’ve learned how important it is to keep up socially.  As hard as it may be, try to make daily phone calls to a friend or family to check-in.  Invite a friend over or schedule a coffee with a friend. Spending time with someone in person can make a world of difference.

Going hand in hand with the isolation, depression, and loneliness that are more prominent when the heat is so intense is inactivity.  That’s, of course, where Power for Parkinson’s really comes in handy.  Movement is medicine for Parkinson’s, but getting motivated to exercise is a challenge for most people. We always recommend an in-person class if there is one in your area.  If not, turn on YouTube and join us!  Even if it’s brief.  Research has shown brief bursts of exercise can help you feel better and manage your Parkinson’s.

If a full video feels too long, try exercising for ten minutes in the morning and more before or after lunch and dinner.  We also offer this playlist of shorter classes that may be less daunting in this heat.  If you’re just getting started with an exercise routine, you can start with this introductory playlist.  You can also try walking your hallways every hour, counting your steps, doing some squats, singing a song, or turning on some upbeat music to dance to!  Whatever you enjoy that gets you moving will hopefully add a little spark to your day!

Solutions to manage heat and PD:

1. Hydrate, hydrate, hydrate! - Keep a water bottle with you at all times and sip it regularly.  Drink 8 oz of water with each dose of your meds.

2. Use fans and A/C if possible

3. Socialize

4. Keep moving

5. For Neuropathic Orthostatic Hypotension - become educated and engage your care partner, friends, family, neighbors, and emergency responders for lift assistance or medical attention because when your pressure drops too low, you won’t be able to help yourself. Wear an emergency device or consider an Apple watch.