Q: I was just diagnosed with Parkinson's.

A: Parkinson's is hard to diagnose. There are no blood tests and Essential Tremor has Parkinson's like tremors. But if the diagnosis was made by a neurologist with a specialty in movement disorders, you most likely have early stage Parkinson's. A second visit or a second opinion is always in order.

Q: How fast will my Parkinson's progress?

A: Each case is different and it is a progressive disease. However, if you commit to a regime of vigorous exercise, daily if you can, the increased circulation to the brain creates new neurotransmitters and current thinking is that this can slow the progression. The best advice is to stay physically and mentally active.

Q: My voice is very soft. What can I do?

A: The Silverman method helps. It is practiced as follows. Say "ah" as loudly as you can and hold it on one breath as long as you can. Practice reading the newspaper in a loud voice. Try doing this in your car with the windows closed.

Q: My posture is stooped. Is this a result of Parkinson's?

A: Most likely. The forward stoop is a symptom of Parkinson's. See a chiropractic neurologist for help. The doctor will work on straightening the spine and will give exercises that help with walking erect.

Q: To get the benefit of exercise it is supposed to be vigorous. How do I judge what is vigorous?

A: Vigorous is measured by your heart rate. That is why it is important to train with a heart monitor. You should have a test that will tell you what your high heart rate should be and also how fast the heart rate comes down once you stop exercising. A good rule of thumb is 220 minus your age. 80% of that number is your maximum heart rate. Important: See your doctor for an "OK" on exercise and don't start before you do.

Q: What can I do to improve my balance?

A: You might see a chiropractic neurologist. The doctor will do spine manipulation and posture exercises. Ballroom dancing is also beneficial. Combining body movement to the music builds confidence. Also be sure to exercise your feet to maintain flexibility in both the feet and ankles. Rolling your feet over a tennis ball is an excellent therapy for feet and ankles. At all times be careful. Falls can be devastating.

Q: Dynacirc: A new study provides further evidence that calcium channel blockers used to control blood pressure may also lower the risk of getting Parkinson's disease. This new study comes from University Hospital in Basel, Switzerland. The study involved more than 7000 men and women. A study conducted by Northwestern University in Chicago had similar results with lab mice with Parkinson's'. The drug Dynacirc is a calcium channel blocker. Human trials are now underway.

A: When I heard about the effectiveness of Dynacirc, and with my internist's approval, I began taking a 10 mg tab of Dynacirc on August 1, 2007. The hope is that Dynacirc will help to slow the progression of the disease. I have had no side effects and on a recent visit to my neurologist stated I was doing extremely well. I will keep you informed as more information is released.

Q: I saw a report in the NY Times that people with Parkinson's benefited from dancing the Tango. What makes dancing the tango so great?

A: There are a lot of reasons. It helps One: first with balance and posture; Two: critical areas to help avoid falling. And you need memory to remember the steps. And its not just tango. Other dances such as quick step, swing and waltz are all good. And its fun and a socializing activity. Keep dancing.

Q: I've been hearing alot about calcium channel blockers and how they are so effective in slowing the progression of the disease. Why hasn't my neurologist prescribed it?

A: The research is coming out of Northwestern University. Calcium channel blockers have been extremely effective in protecting neurons against Parkinson's. Chiefly it is to protect against getting the disease. Now there is evidence that even if you have Parkinson's it will slow the progression. The trade name of the drug I take is Dynacirc and it is a blood pressure pill. Since Parkinson's lowers blood pressure on its own, taking a drug that lowers it further has to be monitored! Recently a study of 7000 men in England confirmed the effectiveness of calcium channel blockers. The clinical trial comes out of University Hospital, Basel, Switzerland I have taken the drug Dynacirc with the approval of my internist since August 1 , 2007. I think it is having a positive effect.

Q: Can the rate of change occur suddenly in someone who has been stable for a long time?

A: Rarely but sometimes a small change can seem big if it effects areas such as walking or talking. See your neurologist usually a small change in medication can help.

Q: I was recently prescribed Requip. I understand there is some evidence that it can cause compulsive gambling or hyper sexuality. What is the story?

A: If you look at the small print in the ads for Requip it urges caution for both such conditions. I have been taking Requip for 12 years and am generally free of the urge to gamble. I am 84 and have always had a strong libido. But I must say that there is something to it. I have not experienced hallucinations which can also ooccur.

Q: Of all the exercises you, Paul Green, do, which is most important?

A: I'd have to say rowing. (In the winter time rowing on the erg rowing machine). Wearing my heart monitor I can observe the heart rate and consequently am sure of the circulation to the brain. This is fundamental since it is the reason the brain receives the benefit of vigorous exercise creating new neurotransmitters. Other strength and stretching exercises are important but nothing increases the heart rate as quickly as rowing. Rowing also challenges strength, balance and flexibility. Just getting into and out of a racing shell is a challenge in itself. Recently I put pontoons on my outriggers and this provides security against tipping over. I recommend their use as long as the water is dangerously cold.

Q: My posture is terrible. I am bent over looking years older than I am. What to do?

A: Posture is a major problem taking all waking hours attention. We sit so much of the time and we tend to slouch whether its reading or using our computers. A good rhyme to remember is, "stick out your butt and suck in your gut". That action immediately improves your posture. The trick is to make it your habit so it becomes second nature. We have to strengthen the lower back muscles so a A good exercise is to take a light weight in each hand, and standing bend from the hips with a straight back to about a 45 degree angle and then come back to an upright position. Repeat 10 to 12 times. Be aware of your posture at all times (and remember, "stick out your butt and suck in your gut".)