Given my optimistic disposition, you probably already know the answer to the question – A RESOUNDING NO.
 
When Symptoms, Perception, and Data Align
But the fact remains that my symptoms had worsened. I could feel it, others could sense it, and the data reflected it. It’s ultimately how you feel that matters – you manage the disease, not the numbers – but when feelings, perceptions, and data converge, it is very likely that your feelings tally with the objective truth. So whilst I certainly wasn’t happy with my deterioration, I was pleased to know about it and the form it took. After all, knowledge is power… but only if it is acted upon.
 
Why I Track My Parkinson’s Symptoms
As those of us in the monitoring and evaluation field like to say, “what gets measured gets managed.” So as soon as I was reasonably certain I had Parkinson’s, I looked for meaningful and convenient ways of tracking my symptoms in order to manage them as well as possible.
 
What Is the PRO-PD Score?
The PRO-PD symptom tracker (Patient Reported Outcomes in Parkinson’s Disease), developed by Dr Laurie Mischley, fitted the bill. For nearly three years, I have been frequently monitoring my Parkinson’s symptoms using the PRO-PD tracker. It is a self-rating system consisting of 30 common PD symptoms. The score for each symptom ranges from 0 (symptom not present) to 100 (severe). Individual scores are tallied to produce a total score that ranges from 0 to 3000. Parkinson’s-related quality of life is rated as Excellent if you have a total score of less than 500, Good if between 500 and 1000, Fair if between 1000 and 1500, and Poor if above 1500.
 
A Sudden Jump in My PRO-PD Score – Should I Be Alarmed?
On 16 November, my score was 355, an increase of 70 points from my previous score on 12 July. 70 points is quite a jump, especially considering that the typical score increases at a rate of about 38 points per year. So why the lack of panic? Several reasons – Parkinson’s does not necessarily progress steadily, the scores are somewhat subjective, I might have made data entry errors, and last but not least, the data, whether good or bad, can engender important insights.
 
Rather than a straight line, the progression of Parkinson’s resembles a sawtooth, as shown in the graph of my scores. There have been equivalent upward and downward jumps before. So it is par for the course. Encouragingly, when you plot a best-fit line through the data points, the overall trend remains positive.

​There is no doubt that the ratings are somewhat subjective, and at that time, I was working on several quite intensive assignments. This meant a lot of travel, multitasking, and an inevitable decrease in downtime. All this is likely to have some impact on Parkinson’s symptoms.
 
Digging Deeper – Which Symptoms Actually Worsened?
However, I was still curious about the reasons for the increase, so I interrogated each symptom. Of the 13 symptoms that scored above zero, none had improved, and five had worsened. Three of these were related to movement, one to speech, and another to urinary symptoms.
 
The next step in the process was trying to find reasons for the individual symptom changes. Slowness and Walking were both affected by a long-standing left shin injury, which flared up following my flirtation with belly dancing (not a pretty sight)! I loved the coordination benefits, but those repeated ankle twists did me no good. The score for Dressing, Eating and Grooming was interesting because my previous score had been zero. That was quite an anomaly, as I have scored something on all previous assessments, I cannot recall dressing, eating and grooming with ease for a very long time. So I think that score of zero on 12 July was an error. Data entry errors happen – we are all human. My speech had declined because I was doing a lot of public speaking, so a vicious circle had set in. Urinary Symptoms mirrored the issue with Dressing, Eating and Grooming. So I think, if you factor in my July 12 carelessness, my score had only risen by 30 points. That 30-point increase is accounted for by general slowness, reduced walking quality, and worsening speech quality. This certainly aligns with my feelings and others' perceptions, so I trust these numbers.
 
Turning Insight into Action
So what to do? I systematically reflected upon my various “Outpacing Parkinson’s” practices. In most cases, I didn’t feel I could make any meaningful changes. However, there was some room for manoeuvre in my speech exercises. I doubled down on my SPEAK OUT! home practice sessions, doing a daily session rather than five days per week, and I have been more consistent with my daily singalong practices. I also added more dance moves to my exercise practice while still minimising manoeuvres that stressed my shin. I added a daily assisted headstand, and I have increased my level of intent when running up and down stairs. The quality of my movement has certainly improved as a result.
 
The Role of Diet and Ketosis in My Parkinson’s Management
But possibly the most significant change I’ve made is returning to a ketogenic diet. I hadn’t deliberately wavered from keto, but it had been a long time since I tested my blood glucose and ketone levels. In light of my November PRO-PD scores, I decided to monitor glucose and ketone levels more closely and found that they were mostly in the “low level of ketosis” range. This prompted a search for high-carbohydrate sources in my diet. And the culprit turned out to be yoghurt. Pretty obvious in hindsight, but it is easy to lower one’s guard over time. Cutting out yoghurt made a huge difference, and for the past month, I have been consistently in high therapeutic levels of ketosis.
 
The Results – Managing Symptoms, Not Numbers
This is all very well, but we are managing symptoms, not numbers. So what are the symptoms telling me now? The voice has improved, my movements are faster, and my dexterity is better. And the numbers? On 16 December 2025, my PRO-PD score was 315, down 40 points from the previous month.
 
What gets measured gets managed!

References
Mischley, L.K., Lau, R.C. and Weiss, N.S. (2017) ‘Use of a self-rating scale of the nature and severity of symptoms in Parkinson’s Disease (PRO-PD): Correlation with quality of life and existing scales of disease severity’, npj Parkinson’s Disease, 3(1), pp. 1–7. Available at: https://doi.org/10.1038/s41531-017-0021-5.

​Norwitz, N.G., Hu, M.T. and Clarke, K. (2019) ‘The Mechanisms by Which the Ketone Body D-β-Hydroxybutyrate May Improve the Multiple Cellular Pathologies of Parkinson’s Disease’, Frontiers in Nutrition, 6, p. 63. Available at: https://doi.org/10.3389/fnut.2019.00063.
 
Please note
The information provided in this article is for information and educational purposes only and is not intended as medical advice. Always consult a qualified healthcare professional before making any changes to your health regimen or if you have any concerns regarding your health. Individual results may vary, and the author does not assume any liability for the information presented.

When it comes to implementing lifestyle changes to outpace Parkinson’s, there is so much that can be done, but there’s only so much one can do! If you try too many things, you may not be able to maintain these practices, and consistency is key. Additionally, if you make too many lifestyle changes at once, you won’t be able to distinguish what is effective from what is not. So, I have adopted an incremental change approach – trying to add only one new practice at a time, assessing its effectiveness, then maintaining it, tweaking it, or parking it depending upon the results. It is far from a precise science. In the absence of clones in my closet, there is no replication, and my assessment of effectiveness is inevitably somewhat subjective. My adoption of lifestyle practices to outpace Parkinson’s is based upon the following fairly systematic process:

• Learn about approaches that people have done to outpace Parkinson’s via scientific and popular literature, social media, word-of-mouth, etc.
• Learn about the putative mechanism of action of the approach, which helps establish credibility in my eyes.
• Adopt the practice.
• Observe any changes in PD symptoms in the ensuing weeks and months.
• Depending upon the results, keep, park or adapt the approach.

The reason I use the word 'park' rather than 'abandon,' 'drop,' or 'reject' is that I may reinstate the approach at some point, so it is good not to be too definitive in my judgment.

In this blog, I introduce the current top ten lifestyle changes I believe are helping me to outpace Parkinson’s. The list is in no particular order as ranking the practices implies spurious precision. I also list certain practices that I’ve parked for now, as well as others that I still practice, which I cannot say have made a tangible impact. Next, I list some practices that I may explore in the future.

It is important to note that this blog only provides an account of things that I do, and it should not be considered medical advice. That is the domain of your healthcare providers.

Lifestyle changes I have implemented that appear to have a tangible impact on my PD symptoms

• Dopamine replacement therapy
• Ozone therapy
• Exercise
• Osteopathy/massage
• Ketogenic diet and fasting
• Speech therapy (SPEAK OUT! Therapy)
• Restoring circadian rhythms
• Meditation
• Tapping
• Magnesium supplementation

 
Lifestyle changes that I continue to implement, but for which I’ve not noticed any tangible impact on my PD symptoms

• Cold therapy
• Sauna therapy
• Drinking hydrogen water
• Vitamin D lamp (UVB)

I’ve maintained these practices due to their widely documented overall health benefits and negligible recurring costs.

Practices that I’ve parked for now

• High-dose B1 supplementation
• Lithium supplementation
• Ginkgo supplementation
• BeechBand

I’ve parked these practices because they’ve shown no clear benefits to me and incur tangible recurring costs in terms of time, money or inconvenience.

Practices that I may explore in the future

• Therapeutic use of psychedelics
• Red light/near-infrared light therapy
  
• Low-dose naltrexone
• Neurolinguistic programming (NLP)
• Hyperbaric oxygen therapy (HBOT)
• Facial yoga
• Medical marijuana
• Spooky 2 rife machine
• Biomagnetic Pair Therapy
• Brown’s Gas (aka HHO or HydrOxy)
• Nicotine patches
• Vibration plate

I am still in the learning/research phase, with time and cost implications in some instances.

There can be no doubt that dopamine replacement therapy has massively enhanced the quality of life for many people with Parkinson’s (PwPs) in the half-century or so since it became widely available, at least to people in more developed parts of the world.
​
Dopamine replacement therapy (DRT), as the name suggests, supplements natural dopamine, which is in short supply in PwPs. Initially, I did not observe any beneficial effects, but a few weeks into my treatment, I noticed that my tremors appeared to ease. I did not feel any other symptom relief. However, at various times, I have inadvertently or deliberately reduced the dose, and I have found that tremor and neuropathy symptoms do increase, although the effect is somewhat delayed. Dopamine replacement therapy does not delay Parkinson’s progression, but it helps to provide a window of opportunity during which you can practice lifestyle interventions that go beyond symptom relief. Despite its imperfections, I’m very grateful for DRT. Levodopa/carbidopa is a safe and effective treatment option for Parkinson’s. In stark contrast, despite enormous research investment, there is no equivalent for Alzheimer’s disease.

While dopamine replacement can alleviate PD symptoms, exercise of various kinds can actually reduce Parkinson’s rate of progress and even, in some cases, reverse specific symptoms. While there is widespread disagreement on the efficacy of many therapies for PD, the medical establishment is unanimous in its support for the benefits of exercise. There are various opinions on what the most effective exercise regimes are, and numerous studies have examined the benefits of single exercises or combinations. When it comes down to it, the most effective exercises will be those that people end up doing on a consistent basis. As somebody who has exercised throughout my life, a lack of motivation/apathy is not a major issue for me, but this can be quite a barrier for many people with Parkinson’s. Dopamine plays a central role in motivation, and PwPs produce insufficient dopamine. Dopamine production, in turn, is stimulated by exercise, which, in the best-case scenario, can create a virtuous circle. Of course, the converse also applies; many PwPs are caught in a vicious circle from which it is difficult to escape.

But while motivation is not a limitation in my case, I do have an issue that constrains the amount and intensity of my exercise. I have a congenital heart issue, hypertrophic cardiomyopathy (HCM), which never gave me any problems in my youth, but now limits my ability to do very strenuous workouts. So, things like high-intensity interval training, which I used to thrive on, are now beyond me.
​
My exercise regime, however, is very consistent, consisting of regular morning dog walks, weight training, cycling, swimming, Qigong, dancing, and play-fighting (also with our dog). I notice an increase in sluggishness and rigidity if I miss a day or two of exercise.

Ozone therapy has been successfully employed for a variety of conditions, ranging from cuts, bruising, and contusions to COVID-19, and even Ebola haemorrhagic fever. It is not a new therapy, having been used since the late 19th century, but it fell out of prominence with the rise of antibiotics, although it has experienced a resurgence in recent years. Ozone gas (O3) can be administered through various means, including blood transfusions, ozonated water, ozonated oil, and rectal ozone. Its healing effects are believed to work through its role in the modulation of cellular antioxidants and inflammation, among other mechanisms. 

I invested in a home ozone setup in May 2024 and almost immediately felt the positive impacts. Among the symptomatic benefits I noticed were diminished anxiety levels, reduced neuropathy and increased flexibility. Setting up the equipment takes some time and expense, but ozone generation is straightforward once the setup is in place, and the running costs are minimal. The mainstay of my ozone therapy is ozonated water, which I drink every day. I also have a small portable infrared sauna into which I discharge ozone gas. I find the sessions to be very invigorating, but I cannot say they are any more effective than drinking the ozone water.

Having been a competitive athlete for much of my life, I have never been too far away from injuries of various sorts. There are the aches and pains that come from exercise and day-to-day activities, as well as those associated with ageing and those associated with PD. It isn't easy to disentangle cause and effect. Whatever the root causes, these various aches and pains, if not addressed, could prove to be barriers to regular exercise. This is problematic for everybody, but the consequences of physical inactivity for PwPs are particularly severe.

My fortnightly osteopathy and massage sessions help to alleviate aches and pains, mobilise my limbs, which have become far less fluid since PD raised its ugly head, and correct my posture, which would otherwise become more stooped and asymmetric over time. This is more than a cosmetic issue, as these changes reduce our ability to undertake simple day-to-day tasks, increase our vulnerability to falls, and impact our self-confidence. 

​Additionally, osteopathy and massage are likely to enhance the benefits of other lifestyle practices. One of the tenets of osteopathy is the ‘rule of the artery is supreme.’ In other words, improving blood flow by moving things around and stretching tight muscles that impede local capillary flow enables nutrients to reach the cells more effectively. Therefore, one could envisage that all the other beneficial effects of practices such as magnesium supplementation and ozone therapy are enhanced by the manual therapeutic benefits to blood flow.

I am lucky to have access to the services of Esther Barton and Braam van der Walt of Wrington Vale Osteopaths, who are outstanding practitioners and wonderful people. I cannot recommend them highly enough.

What is the point of having a mind if you can’t change it? This statement very much applies to me and my opinion of the ketogenic diet. Long story short, simple carbohydrates formed the foundation of my diet from my days as an endurance athlete until recent times. Last year, I first encountered the work of Matthew Phillips on the benefits of the ketogenic diet for people with Parkinson’s. In the words of Gloria Gaynor, “At first I was afraid…” and considered this to be a fad approach. It was only in 2025, after watching a video by Nick Norwitz — A Ketogenic Diet for Parkinson’s Disease: Shaking Up the Science — that I became receptive to the idea of the ketogenic diet. I dove into the admittedly limited research literature and became convinced that this approach could be beneficial.

In a nutshell, it is thought that people with Parkinson’s do not process glucose efficiently but can become more metabolically healthy by using ketones as fuel. A state of nutritional ketosis can be induced by a high-fat, moderate-protein, low-carbohydrate diet and fasting. Since adopting this practice only about three months ago, I have found much greater levels of mental clarity and an amelioration of numerous PD symptoms. It is early days, but it appears that the ketogenic approach, coupled with intermittent and prolonged fasting, is also alleviating my hypertrophic cardiomyopathy symptoms. I sincerely believe that I will maintain a predominantly ketogenic diet for the rest of my life.

As the saying goes, “If you see one person with Parkinson’s, you have seen one person with Parkinson’s.” In other words, every PwP manifests the condition in a different way. Some people are initially troubled by tremors. Others are overcome with anxiety. My most debilitating symptom from the outset has been a deterioration in the quality of my voice. I tried various therapies with mixed results until I came across SPEAK OUT!® Therapy as pioneered by Parkinson Voice Project – a not-for-profit organisation based in Dallas, Texas.

SPEAK OUT! Therapy is based around a daily home practice which consists of several exercises which help people with Parkinson’s and related conditions retain and regain their speech and swallowing. The exercises make use of the fact that you can consciously activate your intentional motor system, which is less dependent on dopamine, to override the dopamine-based automatic motor system. Thus, activities such as speech, which are automatic for most people, can be made intentional through consistent, purposeful practice. The importance of the intentional system to PwPs and its role in retaining and regaining speech and swallowing is beautifully explained in the 25-minute video What is Parkinson’s? Which I recommend to everybody with a skin in the Parkinson’s game.

It is important to work with a certified SPEAK OUT! Therapist, both for an initial evaluation and periodic refresher sessions. I have been working with Louise Lim of Recommunicate Speech who provides excellent support.

​Meditation has become mainstream in the Western world in recent decades, and convinced of its value, I have long maintained a stop-start practice. In recent months, my practice has become much more consistent because of the clear positive impacts on my anxiety levels. If my masked face represents the visual signature of my Parkinson’s, and the slurred speech represents its auditory signature, it is heightened anxiety levels that represent an internal, largely invisible, but highly significant aspect of my condition. Whether it's breath work, mindfulness, or balancing the chakras, meditation helps in the moment and beyond. Its calming influence is the incentive that I need to maintain the practice. It has now become a non-negotiable.

Tapping or Emotional Freedom Techniques (EFT), sometimes known as “acupuncture without needles,” is an energy healing and talking therapy. Involves tapping with your fingertips on various meridian points whilst saying how you feel about a particular issue that is troubling you. Despite the name, the problem does not have to be purely emotional. My issues de jour are usually work-related and involve anxiety, which leads to procrastination and further anxiety! The tapping sends calming signals to the brain, thus bringing down anxiety and ushering in a resourceful state, which enables me to do the work at hand and further reduce my anxiety levels. For those who are interested, I often practice the WOOP-Tap, which I summarised in a blog a few years back. Tapping is an invaluable tool for anybody, but I think it has particular value for people with Parkinson’s, many of whom suffer from chronic anxiety, which is untouched by dopamine replacement therapy. Full disclosure: my wife Julie is a qualified EFT therapist and her expertise and support help keep me on the straight and narrow... in all aspects of life!!

Most of our physiology is tied to the predictable cycles of night and day. The importance of these cycles of light to life has given rise to the discipline of Chronobiology – the study of the biological rhythms that exist in all living organisms. Biological rhythms are classified according to their cycle length into three main types: (1) circadian rhythms (from the Latin circa diem – about a day, characterised by a period of approximately 24 hours), (2) ultradian rhythms (period shorter than 24 hours, e.g. hours, minutes or even seconds or fractions of seconds), and (3) infradian rhythms (period longer than 24 hours, e.g., days, weeks, months, or years). Circadian rhythms are the most studied of these rhythms and ultimately govern almost every aspect of our biology.

Thomas Edison’s first commercial incandescent light bulb was invented in 1879, launching a change unprecedented in planetary history, the health effects of which are only recently being elaborated. Re-establishing natural circadian rhythms can be challenging, but it can be hacked in various ways, such as using apps that reduce blue light, wearing blue-blocking glasses, taking regular breaks outside to bask in natural light, walking barefoot on the ground, and using circadian-friendly nightlights.

Unlike many people with Parkinson’s, I sleep very well at night, which is something I do not take for granted. However, for as long as I can remember, I have suffered a massive post-lunch dip in energy. This post-prandial tiredness became a thing of the past once I adopted a suite of circadian rhythm hacks. I do still indulge in the occasional afternoon nap, but it is now more of an optional extra rather than a near necessity.

For a detailed account of the health impacts of unnatural light regimes and how to mitigate these impacts, check out my recently published Big Book of EMFs: Everything You Need to Know about Electro-smog to Optimise Your Health without Living in a Cave. 

I am not a big fan of supplements, as in an ideal world, the vast majority of our energetic and nutritional needs should be met by food and exposure to natural light. Unfortunately, however, the world we live in is far from ideal and nature and the food we eat are very different from what our distant ancestors would have experienced. Even still, I prefer nutrients contained in food to those synthesised into a pill. However, I do have particular go-to supplements, and I find that magnesium is beneficial for various PD symptoms. 

Magnesium is a common deficiency in people with Parkinson’s and indeed the population as a whole. Magnesium is essential in many physiological processes, including sleep and the maintenance of circadian rhythms, as well as the regulation of our autonomic nervous system, thereby impacting stress levels. Additionally, a vicious circle appears to exist, with increased stress heightening magnesium loss, thereby exacerbating the initial magnesium deficiency.

​The most obvious benefit of magnesium to me is its ability to mitigate restless leg syndrome at night. I take a daily dose of 1000 mg 6 in 1 magnesium (providing 300 mg of elemental magnesium) and magnesium glycinate (providing 200 mg of elemental magnesium) every day. I virtually never get restless legs, except if I forget to take supplemental magnesium. The twitching and discomfort are cues to take the magnesium, and within half an hour, things return to normal. I cannot speak to its effect on anxiety levels, but I would not be surprised if it is helping in that regard as well.

This may seem like quite a daunting to-do list. Indeed, it can be, and in the absence of multiple clones against whom to monitor treatment effects, I cannot objectively verify that any of it is working. All I can provide is anecdotes – I can do my tie up now whereas I couldn’t last year, I can eat food in an aeroplane without fear of spilling things everywhere whereas I couldn’t last year, I virtually never choke my food now, and I am overtaking people on the bicycle now whereas I wasn’t last year. All very subjective, but to my mind, the plural of anecdote is evidence, so my positive felt experience in multiple dimensions is sufficient proof for me.

Another subjective but useful indicator of symptomatic change is the Patient-Reported Outcomes in Parkinson’s (PRO-PD) score, a self-reporting scale that assesses the nature and severity of Parkinson’s disease symptoms. It combines the scores of 35 symptoms of PD to give a rating of up to 3,500 (0-100 for each symptom). I test myself periodically. At diagnosis, I had a score of 468. At the time of writing, my score was 285.

​Currently, I am able to find enough time to do all that I seek to do, work-wise, home-wise and outpacing Parkinson’s-wise. That said, I cannot continue to layer intervention upon intervention, unless I wish to become the Bryan Johnson of Parkinson’s – a prospect that does not appeal to me. So, I do not envisage adopting many new practices unless there is compelling evidence for their efficacy, or they are neither time-consuming nor expensive to implement.

I will post some more detailed, referenced descriptions of each of these interventions in the coming weeks. In the meantime, I would love feedback from people with Parkinson’s on the positive impacts of your favourite lifestyle intervention(s). I’m very keen to learn from the community.

​I have a terminal condition that causes progressive diminution of physical and mental capacity and eventual death. It is a universal condition, commonly known as ageing. I have also been diagnosed with Parkinson’s disease (PD). Many of the symptoms of these two conditions are interchangeable, with each condition accelerating and accentuating the other. And many of the practices I’m adopting to manage my PD also help manage the symptoms of ageing. I officially received the PD “prize” in the neurological disease lottery on 27 July 2023, but the outcome was about as surprising to me as a Harlem Globetrotters victory over the Washington Generals. I had seen it coming for some time, but it still took me a while to process.

In this article, I explain how PD affects me, why there is reason for optimism, and some of the things I do to “Outpace Parkinson’s.”

​Although not quite “diagnose and adios” a PD diagnosis can feel like the beginning of the end. It is presented as incurable, meaning that there is currently no pharmaceutical or surgical intervention to eliminate the symptoms. It is true that the symptoms of the vast majority of people with Parkinson’s (PwP’s) progress but there is a significant minority whose symptoms remain steady over many years, and the symptoms can even reverse in certain instances. So rather than seeing PD as an inevitable progression, I prefer to reframe it as a constellation of symptoms that may or may not progress. This goes beyond mere semantics, as words create worlds - hope helps build dopamine, the limiting neurotransmitter in PwP’s. This hopeful outlook feels empowering, engendering a possibility/growth mindset, which encourages me to learn from the behaviours of those who have experienced the best outcomes. There are, of course never any guarantees, so I must trust the process despite the inevitable moments of doubt.

​As a template for action, I have leaned heavily on Dr Laurie Mischley’s research in which she has correlated disease outcomes with lifestyle practices. A particularly revealing output of her work is the chart of her patient’s progress over time. The chart shows the typical progress of the disease but what is interesting to me is the outliers - those individuals who buck the trend. And there are many of them. Mischley’s research is dedicated to uncovering the modifiable lifestyle factors that contribute to these outliers – the “positive deviants”. My task is to take the results of this research and incorporate them into an approach that can work for my unique circumstances... To quote Brian of Nazareth “we are all individuals” so there is no one size fits all. I summarise some of the components of my approach below.

​Medications can only offer symptom relief, but this can be pivotal. Medications can buy time during which you can find the motivation to pursue the activities that can halt, slow, or even reverse disease progression. Lack of dopamine can contribute to lethargy which is the opposite of what is required to outpace Parkinson’s – a vicious circle for PwP’s. Medications to increase the availability of dopamine can help break the vicious circle, thus facilitating empowering actions. My forays into Parkinson’s meds thus far have led to unwanted side effects but, together with my neurologist, we are exploring all options.

If there is one thing that all PD schools of thought agree upon it is the role of exercise as the best PD medicine. When it comes down to it, all exercise is good, and the best exercise is the exercise that you will actually do! My current favourite is Dr Joachim Farias’ Dystonia Recovery Program which consists of a diverse mix including dance, yoga, tai chi, and other modalities. My morning dance routine is a sight to behold! The programme is not specifically designed for PwP’s, but the exercises promote neuroplasticity which is critical in PD management. My other exercises include the daily dog walk, cycling (to be rekindled after a winter break), weight training and taking opportunities to move throughout the day. Weight training is particularly important for PD as muscle wastage is common given the characteristic diminished speed and coordination. PD does not directly affect your strength, but it compromises day-to-day movements which contribute to strength. I am very blessed to have overall good health which allows me to exercise. Other PwP’s with comorbidities are less fortunate.

One of my most important exercises is ongoing speech therapy, initially provided by an excellent speech and language therapist who has been trained in the clinically proven SPEAK OUT! Technique as provided by the Parkinson Voice Project (PVP). The technique demands daily practice, which is facilitated by PVP’s daily YouTube speech exercise videos. 

​Parkinson’s is the world’s fastest growing neurological disease, and contrary to what you may hear in certain circles, this cannot be entirely explained by the increasing numbers of elderly people. There are likely to be multiple causes of what could be a constellation of diseases. One such cause is the growth in environmental toxins, such as heavy metals, pesticides, and plastics. The herbicide paraquat has been strongly associated with PD - incidentally paraquat has not been authorised for use in UK since 2007 but it is still manufactured in the UK and exported to countries such as the US, Japan and Australia, and much of the developing world.

Consumption of canned fruits and vegetables has been associated with faster PD progression.  Bisphenol A (BPA), a known endocrine disruptor, is widely used in the inner coating of food cans, while aluminum is an established neurotoxin. Toxic metal tests revealed that I had high levels of aluminium in my system. I have also been exposed to large quantities of pesticides, notably when working in the Philippines to help farmers step off the pesticide treadmill. There is nothing I can do to change these past exposures, but I can minimise toxic load going forward.

Other avenues I’m exploring, to manage toxins of all kinds, include mind-body healing, increased social support, speech therapy and breath support.

Berry, S. et al., 2020. Personalised REsponses to DIetary Composition Trial (PREDICT): an intervention study to determine inter-individual differences in postprandial response to foods [online]. Protocol Exchange. preprint. 

Doidge, N., 2007. The brain that changes itself: Stories of personal triumph from the frontiers of brain science. Penguin.
Doidge, N., 2015. The brain’s way of healing: stories of remarkable recoveries and discoveries. Penguin UK.

Mic the Vegan, 2018. 5 Ways a Vegan Diet Can Help Parkinson’s Disease. Available from:  https://www.youtube.com/watch?v=bSxdNJk-ej0

Mischley, L. K., 2023. Parkinson’s disease "What do successful people do to slow down PD progression?”, 2021. Available from: https://www.youtube.com/watch?v=LdpfNnnAzKI. 

Mischley, L. K. et al., 2023. Parkinson Symptom Severity and Use of Nutraceuticals. Nutrients, 15 (4), 802.

Mischley, L. K., Lau, R. C. and Bennett, R. D., 2017. Role of Diet and Nutritional Supplements in Parkinson’s Disease Progression. Oxidative Medicine and Cellular Longevity, 2017.

Mischley, L. K., Lau, R. C. and Weiss, N. S., 2017. Use of a self-rating scale of the nature and severity of symptoms in Parkinson’s Disease (PRO-PD): Correlation with quality of life and existing scales of disease severity. npj Parkinson’s Disease, 3 (1), 1–7.

Mischley, L. and Rountree, R., 2019. Preventing and Slowing the Progression of Parkinson’s: A Clinical Conversation with Laurie Mischley, ND, MPH, PhD, and Robert Rountree, MD. Alternative and Complementary Therapies, 25 (2), 59–67.

Müller-Nedebock, A. C. et al., 2023. Different pieces of the same puzzle: a multifaceted perspective on the complex biological basis of Parkinson’s disease. npj Parkinson’s Disease, 9 (1), 1–11. 

Python, M. The Life of Brian, 1979. HandMade Films.

Sharma, P. and Mittal, P., 2024. Paraquat (herbicide) as a cause of Parkinson’s Disease. Parkinsonism & Related Disorders, 119.

In Monty Python’s Life of Brian, the eponymous hero exhorts the adoring Judean mob to think for themselves because “you are all individuals”. “We are all individuals” shout the mob in unison! Like the mob, we can easily ignore the fact that we all have different needs, aptitudes, inclinations and personalities as we follow the herd or try to mould others according to our preconceptions. I feel that it is imperative that we get to know ourselves as we make our way in the world so that we can grow to live in alignment with our unique disposition. There are a number of personality tests out there that can help us in this regard. I am a big fan of the Myers–Briggs Type Indicator (MBTI) which is probably the best known of these instruments but, in my opinion, it is not simple to grasp without a fair bit of homework. A similarly powerful yet more intuitive and relatively straightforward schema is Tony Robbins’ six human needs framework. I have used this framework to understand my own aptitudes and those of the people I work with as part of a strengths-based approach to personal and organisational development.
​
Tony Robbins has built on the work of John Burton and Abraham Maslow to develop human needs psychology. In essence, Robbins believes that everybody’s actions are driven by the need to fulfil one or more of six basic human needs. By definition, these are needs that we all share, but everybody is unique so we do not value all needs equally. Different people will emphasise different needs and this emphasis often shifts as we go through life.
The six fundamental human needs are as follows:

1. Certainty – that things will unfold as imagined.
2. Uncertainty – that life will serve up its share of variety.
3. Significance – the sense of being special or unique.
4. Love and connection – the feeling of togetherness or intimacy.
5. Growth – the feeling that we are making progress.
6. Contribution – that we are part of something bigger than ourselves. 

​I describe each of the needs in more detail below, including ways in which they can be met in healthy, neutral or unhealthy ways and some positive and negative personality traits that accompany each need.  I also provide details of a simple self-test that can be used to your pinpoint your human needs centre of gravity.

​Despite the exhortations of Bertrand Russell and Benjamin Franklin, everybody needs a level of certainty in their daily lives. If my next meal was not guaranteed I would probably not be writing this blog; if the ground beneath you started to shudder you would immediately stop reading this blog; and if heard that your significant other had been rushed to intensive care you would mostly likely drop everything and do whatever you could to try to help. All these situations threaten our sense of certainty, those things we take for granted that form the bedrock of our lives.

We all have the need for certainty but this need can be met in many different ways. Some feel they need a home to be certain, others need a million pounds to be certain, others may get their need for certainty by knowing that they always manage no matter what. We can meet our needs in positive, neutral or negative ways. For example, we can meet our need for certainty by feeling angry about world events which validates our belief system that the world sucks. Cigarettes, alcohol and drugs can be our faithful friends upon which we rely in times of struggle. Habitual actions like this meet our needs in the short term but have long term negative side-effects. We can meet our need for certainty by having faith in a something bigger than ourselves – God, the Universe, Nature, Justice, etc., or by exercising regularly or by a belief in our resourcefulness, all of which can be very positive ways of getting certain, assuming that our sense of certainty is not tainted by bigotry.
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People whose primary need is certainty are often highly organised, dependable and very knowledgeable in their chosen field. On the other hand, they can become stuck in their old routines, can be closed to new experiences, and may come across as unenthusiastic and boring.

​“Variety”, as the cliché goes, “is the spice of life” so a life of complete certainty hardly fires up the proverbial taste buds. Imagine you are a sports fan and you knew that your team was going to win every match and lift every single trophy they contested for the rest of your life. Initially, this would feel exhilarating but pretty soon you would begin to “tire of winning” to paraphrase a certain President Trump. So, we need a combination of certainty and uncertainty in our lives. Our need for both certainty and uncertainty explains why the standard Hollywood movie format is so popular and enduring. We are pretty certain that there will be a happy ending but we are uncertain about how the plot will unfold. We can get variety in positive ways such as by meeting new people, by taking on new challenges or by visiting new places. We can also meet this need in negative ways such as by taking new drugs, having multiple sexual encounters or by committing acts of violence.
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People whose primary need is uncertainty are often highly enthusiastic, spontaneous and love meeting new people and taking on new challenges. They can also be social butterflies flitting from person to person and relationship to relationship, become easily disillusioned, lose focus and quit before the job is done.

​The third human need is significance – that need to be, in José’s words, “a special one”. All of us want to be recognised for being special even if some of us protest this fact. One way to feel significant is by building something such as a business, a skill, a career, a philanthropic practice or a family. Another is by knocking down those who are trying to build something, either metaphorically through cynicism and negativity, or physically by attempting to damage or destroy people, property and nature. As Tony Robbins puts it “there are two ways to have the tallest building in town. One is work your ass off, take risks, build the tallest building. The other is, blow up everybody else’s building.” One path is easier, faster, cheaper and takes less intelligence. One is the path of the hero, the other is that of the victim. A third, and very common, way to feel significant is to have a significant problem. Problem sharing also builds connection. Some people are much more comfortable being around people who are feeling bad about themselves than being around people who are happy with their lives.

The need for significance has always been one of the main driving forces behind violence, mainly perpetrated by men. If a mugger puts a gun to your head they are certain that you will respond but uncertain of how and, in a heartbeat, they have become the most significant person in your life.

Although we all need significance, the need is usually greater in men than women. Men will die for significance which explains why almost all suicide bombers are men and why much greater numbers of men than women commit suicide when going through a financial crisis.

If we meet three of our needs in a single behaviour we may become addicted to that behaviour. Which explains why violence can become an addiction.
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People whose primary need is significance are often happy to take on leadership positions, will work hard to excel in their chosen field and can be fearless in the face of challenges. They can also be selfish and insensitive to the perspectives of others, and may neglect their nearest and dearest.

The fourth need is for love and connection. When we are afraid of love for fear of the pain of rejection, we settle for connection. Unless you are a highly developed soul, our hypothetical mugger is unlikely to be a recipient of our love as he puts a gun to our head, but he will be connected to us in the moment. So, violence can also meet the need for connection.

In a more everyday sense, when we are excited or agitated about something – we got that promotion, heard a juicy morsel of gossip, or experienced a life-changing event, what do we immediately want to do? Share the news with somebody. This is because we are social animals, even the most introverted among us.

Love and connection is often a dominant need in women. Men feel this too, but the bonds are innately stronger in the average women than the average man.
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People whose primary need is love and connection are often great team players, sensitive to the needs of others and supportive partners and parents. They can also be jealous, clingy and prone to neglecting their own legitimate needs.

The Greeks taught us that we are teleological beings, that is, we need targets – something ahead of us that we can aim for. We either grow or we shrink; staying still is not an option. Imagine you are perfectly content with your life as it is and you don’t want anything to change. Why is this an impossible dream? Because people become dissatisfied with stasis which is why retirement is a crisis for so many people. Unless they can invest themselves in a project, the newly retired person no longer has a goal that they are moving towards. This same phenomenon is exemplified in the numerous cases of Olympic gold medallists and other high level sports people who reach their goal only to fall into depression. It is pretty much universal that people are happy when they are making progress because it is the progress or growth that matters not the goal itself.

People whose primary need is growth are often great students and teachers, creative and innovative, and tenacious in pursuit of their goals. They also can become detached from others, intolerant of those perceived to be less accomplished, and prone to perfectionism.
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As a side note, perfectionism is widely thought to be a positive quality which it can be if it is defined as a commitment to high standards. However, if perfectionism means that everything we do always has to be all things to all people it becomes the lowest possible standard as we end up imposing unrealistic expectations on ourselves and everybody else. By this definition, perfectionism is a straightjacket and a sure fire way to succumb to a paralysing fear of failure which relegates us from a participant to a spectator in our game of life.

We all have a need to contribute, to step out of our own personal drama. Even young children feel a great sense of satisfaction when they contribute. There are countless examples of people being able to do much more in the service of others than one can do when serving only oneself – the meals we cook for ourselves are usually pretty uninspiring compared to those we serve up for others. An example from my life is doing everything I could to secure my children’s future when my wife was diagnosed with motor neurone disease – part love and connection, part contribution. On a grander scale, Nelson Mandela’s fortitude during his 27 years in captivity was bolstered by his vision of how he could contribute to a free South Africa. The secret to living is giving. How can you make this world a better place using your gifts and talents?

A focus on contribution is a great inoculation against the “Affluenza” virus , the obsession for wealth, fame, beauty, power and possessions that redirects our energies and passions away from meaningful pursuits.
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People whose primary need is contribution are often selfless leaders, inspirational speakers and are able to work tirelessly in pursuit of something they believe in. They can also be intolerant of other people’s perspectives, neglect their own physical and mental health and the needs of their family, and are prone to burnout.

Understanding our human needs helps us to know which needs we habitually meet, which needs are not being met, which needs we want more of, and conflicts and trade-offs between meeting some needs at the expense of others. This understanding also helps us in our relationships of all kinds as we become less judgemental by acquiring a fuller understanding of the factors that motivate other people’s aptitudes, attitudes and actions.

You can assess your human needs with this online test devised by Chloe Madanes who has worked extensively with Tony Robbins to advance the thinking in the field. The results include detailed information on how your primary need and top two needs can serve you or hold you back. You can take the same test in the old fashioned paper format by clicking on this link.
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For those of you who want to know, I scored highest in contribution closely followed by growth with significance and uncertainty tied for third place. love and connection a little behind, and certainty bringing up the rear. Like all self-assessments, the tacit assumption is that we know ourselves which is, of course, never 100% true but the simple test can give us a fair the forces that drive us.

​My daily duel with the pleasure monkey
​​Everybody feels the pain of procrastination – when you have an important, but not always urgent, task to do but instead that you decide to just take a ‘just one minute’ to check the football results, look at Facebook, make a cup of coffee, anything to avoid tackling the job in hand. And one hour later you’ve followed the click bait trail until you are checking out 50 Hollywood actresses that are hot after 50! Then as the day progresses you decide that you’re a little tired so will invest your remaining working hours in clearing your desk and dealing with a few emails in preparation for tomorrow; the day when everything happens. Not such a problem if you act out this scenario from time to time but for the chronic procrastinator this is a daily occurrence which can, with no exaggeration, lead to a wasted life of tomorrows that never come.  

In his incisive and amusing TED Talk, Inside the Mind of a Master Procrastinator, Tim Urban, calls these ‘easy and fun’ diversionary tactics the Dark Playground. They are those things that are supposed to make us feel good but they don’t; because we know that we should be doing something else, plus we haven’t earned these “rewards” for doing what needs to be done so we feel a double pain. This is what Brian Johnson has termed ‘procrastipain’. Tim Urban jokes that we have two entities struggling for control of our brain – the ‘rational decision-maker’ who works for our long-term good and the ‘pleasure monkey’ who lives only for the moment. Oftentimes, extrinsic motivations, such as an impending deadline or a looming boss, help the rational decision-maker wrestle control of our brain from the pleasure monkey via Urban’s ‘panic monster’, and we move from the Dark Playground to productive work. Everybody has deadlines but not everybody has a boss. So which groups are most vulnerable to the pain of procrastination? In my humble opinion, higher education students and the self-employed?

Ways of winning the daily duel
As somebody who has spent many years in both categories, I think I know a bit about procrastination and over time I have discovered a number of ways to win my daily duels with that pesky pleasure monkey: Goal-setting including daily and weekly mini goals; David Allen’s two-minute rule – if it takes less than two minutes just do it; the Pomodoro Technique – set your timer for 20-25 minutes, get started and allow motivation to flow from action; becoming more attached to the process (the now) rather than to outcomes (the future and never entirely controllable results of the process), accepting the fact that I cannot multitask, etc. Most of the tools in my toolbox have been gleaned from others and if you suffer from procrastination like I do I would recommend you consult the references listed at the foot of this blog. But my go-to procrastination-busting tool is the WOOP-Tap, something that you won’t find in any text that I know of. I put it together a couple of years ago as a way of combining EFT (Emotional Freedom Techniques) or Tapping with the WOOP technique detailed by Gabriele Oettingen in her paradigm-shifting book Rethinking Positive Thinking. This new mind tool thus takes its place in the proud tradition of amalgamating two powerful entities to make something new and beautiful, alongside a lengthy list of notables including the teasmade, the sofabed and Brangelina.
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The WOOP Strategy: Mental Contrasting and Implementation Intentions
Before I explain my WOOP-Tap, I will give some brief background on its components. First the WOOP. Gabriele Oettingen, a Professor of Psychology at New York University and the University of Hamburg, sought to test the widely-held notion that positive thinking leads to success. Unfortunately, and contrary to what you may read in countless self-help books, the research was unequivocal; if you only focus on the positive you are less likely to achieve your intended outcome – losing weight, becoming rich, meeting the man/woman of your dreams, etc., etc., etc. Read the book for the full details of why this is but, in a nutshell, your brain cannot distinguish imagination from reality so positive visualisations trick your brain into thinking that the outcome has already been achieved. So why do the work when you are in a blissed-out state? 

These findings were a blow to Oettingen because she had hoped that her research would confirm the power of positive thinking. But here’s the good news. Oettingen developed a technique she called ‘mental contrasting’; visualising your objective and then immediately confronting these dreams with the realities standing in their way in order to “circumvent the calming effects of dreaming and mobilize dreams as a tool for prompting directed action.” Unlike pure positive thinking, mental contrasting did help people to reach their goals but with one important caveat. These goals had to be believable to those holding them. If not, the motivation levels of the mental contrasters fell below those of the dreamers. This is actually a good thing as it helps us to pursue realistic goals instead of forever chasing that crock of gold at the end of the rainbow.

The final piece in the WOOP jigsaw was provided by Peter M. Gollwitzer — a fellow Professor of Psychology at New York and Oettingen’s husband. His research findings indicated that if you added an “if-then” plan to the mental contrasting you further improved people’s power to attain their goals. The ‘if’ is the stimulus for action and the ‘then’ is the action: If my boss challenges me, then I will take a deep breath before responding; if I am tempted to look at Facebook when I should be working, then I will turn off the Internet; and my personal favourite, if I don’t feel like doing [insert task here], then I will just get started because I don’t need to have it all figured out in advance - ‘Just get Started’ mantra courtesy of Timothy Pychyl. 

These implementation intentions when combined with mental contrasting became the WOOP Strategy: Wish, Objective, Obstacle and Plan. 

• Wish: What you want to achieve. The size of the goal and the time period is not important; it can apply to a life time goal, the next task you wish to focus on or anything in between.
• Outcome: How this achievement will benefit you.
• Obstacle: The internal obstacle or obstacles that are standing in your way.
• Plan: What simple action you can take to implement your wish.

I use the WOOP Strategy most days as a way of overcoming inertia when switching from one task to another, which includes the task of switching from not working to the task of working. 

My typical WOOP goes like this:

• Wish: Start to write an introduction to the report on x,y,z.
• Outcome: Build-up of momentum and the generation of a feeling of satisfaction.
• Obstacle: Inertia and lack of momentum.
• Plan: Set my timer for 20 minutes and just get started.

The ‘if’ in my plan is usually implicit. So, the full, ‘if then’ version would be ‘if I have feelings of inertia and lack of momentum, then I will just get started’. 

So where does the tapping come in?

Well, I tap as I WOOP so for those of you who do not know, I will explain the basics of Tapping or Emotional Freedom Techniques. 

Tapping or Emotional Freedom Techniques (EFT)
Thanks to my wife Julie, who is a Certified EFT Practitioner, I learned the basics of Tapping and, before I discovered the WOOP, I had been using EFT for some time when I felt emotional blockages, large or small. Tapping your fingers on acupuncture points on the face and body calms the amygdala (the part of your brain that triggers your fight or flight response) and helps energy to flow freely throughout the body. Tapping has been shown to provide effective relief for a myriad of issues such as anxiety, depression, obesity, high blood pressure and chronic pain. 
The classic EFT process involves tapping nine acupuncture points in turn and saying (aloud or to yourself) “even though I have this problem” [insert problem here], “I love and accept myself.” Following this ‘set up statement’, you come to name the problem, explore its root cause and find your own solutions while you are in a resourceful state, rather than sitting or lying passively. Tapping can be done on your own but it is better to work with a qualified therapist if you are a beginner or have complex issues to deal with. Tapping is easier to conceive of when watched rather than read about so I recommend that you consult the YouTube video  linked to below for a clearer idea of what it is all about and how to do it. 

WOOP-Tapping
Given that I knew a bit about tapping before I discovered WOOP, it seemed natural to combine the two. It is just a matter of tapping on the acupuncture points while articulating your wish, outcome, obstacle and plan. I generally do one tapping cycle of the nine acupuncture points for each letter of the WOOP but there are no hard and fast rules. My day to day WOOP-take about a minute but it will no doubt take a bit longer when you are starting out. Most of you would probably agree that tapping does looks pretty weird and it is probably not the sort of thing that you would be seen dead doing in the office. I’m lucky in that I work on my own in my garret so I do not have the ridicule of my colleagues to contend with. But for those of you who share a work environment, there are ways to WOOP-Tap in ‘stealth mode’. You can do it from the comfort of your chair, reciting your WOOP internally and tapping your thumb against each finger of one hand in turn (you have acupuncture points in your fingers). Not too obtrusive and, I think, equally effective.  If even this is too embarrassing, you can WOOP-tap during a toilet break or do a session before you go to work. WOOP-Tapping is likely to work for a variety of conditions but I’ve mainly practiced it to banish procrastination so I am not qualified to comment on its wider applicability.

So, if you suffer from procrastipain try WOOP-Tapping. What have you got to lose? 
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Just get started, feel the satisfaction as the pleasure monkey surrenders control of your brain, and do it; again, and again and again…

References 
David Allen (2002). Getting Things Done: The Art of Stress-Free Productivity. Penguin Group.

Stephen Guise (2015). How to Be an Imperfectionist: The New Way to Self-Acceptance, Fearless Living, and Freedom from Perfectionism. Selective Entertainment LLC.

Gabriele Oettingen (2014). Rethinking Positive Thinking: Inside the New Science of Motivation. Current. 

Timothy A. Pychyl (2013). Solving the Procrastination Puzzle: A Concise Guide to Strategies for Change. Tarcher.

Piers Steel (2012). The Procrastination Equation: How to Stop Putting Things Off and Start Getting Stuff Done. Harper Perennial.

In the fourth of an eight part series on the humble project management toolkit for better results in an uncertain world, I describe the second of two major causes of the ‘Planning Fallacy’ (why projects go over budget, over time, and fail to deliver according to specification… over and over again): - Complexity. Complexity concepts are explained using Ricardo Wilson-Grau’s ‘Fish Soup Development Story’ – why one plus one does not always equal two, and the implications of this for project management.

In the fifth of an eight part series on the humble project management toolkit for better results in an uncertain world, I describe the first of the toolkit’s ‘compartments’ – “Hesitate to Encourage Reflection” in which I outline the importance of developing systematic reflective practices to facilitate resourceful responses in place of knee-jerk reactions.

In the sixth of an eight part series on the humble project management toolkit for better results in an uncertain world, I describe the second and third of the toolkit’s ‘compartments’ – “Understand the Project’s Ecosystem” and “Manage in Alignment with the Project’s Ecosystem” in which I outline the importance of developing adaptive management systems that take account of: the landscape in which the project is embedded; the project’s objectives and the processes implemented to contribute to these objectives; and organizational practices.

In the seventh of an eight part series on the humble project management toolkit for better results in an uncertain world, I describe the fourth of the toolkit’s ‘compartments’ – “Bring in Diverse Perspectives” in which I introduce ways of integrating the viewpoints of a range of stakeholders into project processes.

In the eighth and final part of the series on the humble project management toolkit for better results in an uncertain world, I describe the fifth and sixth of the toolkit’s ‘compartments’ – “learn constantly” and “embrace uncertainty.” In the section on learning I outline four learning modes and emphasise the value of learning by doing and learning by teaching. In the section on embracing uncertainty I give examples of the positive consequences of developing a mindset that sees silver linings in the clouds of failure, and I outline some key components of a “navigation system” that helps us overcome the fear associated with uncertainty.