John got an excellent opportunity to John got an excellent opportunity to speak to wounded veterans and their speak to wounded veterans and their care takers along with about 50 other care takers along with about 50 other

military personnel and civilians in military personnel and civilians in Tampa Florida this summer.  He spoke Tampa Florida this summer.  He spoke

on the similarities of treatment with on the similarities of treatment with Parkinson’s and head trauma and Parkinson’s and head trauma and

how music therapy and specifically the how music therapy and specifically the playing of the Native American playing of the Native American

flute may help.  Please enjoy the flute may help.  Please enjoy the PowerPoint used in the speechPowerPoint used in the speech

CARE COALITION CARE COALITION RECOVERY PROGRAM, RECOVERY PROGRAM,

MENTOR TRAINING MENTOR TRAINING SESSIONSESSION

MY NAME IS JOHN MY NAME IS JOHN YONUSHONIS AND I HAVE YONUSHONIS AND I HAVE

PARKINSON’SPARKINSON’S

Intangibles of Music as TherapyIntangibles of Music as Therapy

I can not rotate my right hand over I can not rotate my right hand over from palm to backfrom palm to back

My stamina and breath shortens with My stamina and breath shortens with timetime

I can not sequence my right thumb to I can not sequence my right thumb to my right finger but I can play the my right finger but I can play the Native American FluteNative American Flute

WHAT IS A PERSON WITH A CHRONIC, WHAT IS A PERSON WITH A CHRONIC, PROGRESSIVE. NEUROLOGICAL PROGRESSIVE. NEUROLOGICAL DISORDER LIKE PARKINSON’S DOING DISORDER LIKE PARKINSON’S DOING SPEAKING AT THIS CONFERENCESPEAKING AT THIS CONFERENCE

While there is no similarity in While there is no similarity in Parkinson’s and Traumatic Brain Parkinson’s and Traumatic Brain Injury in it’s occurrence, …Injury in it’s occurrence, …

there is great similarity in the there is great similarity in the challenges of both.challenges of both.

Our Goal is to Increase Our Goal is to Increase Quality of Life Through Quality of Life Through

Alternative TherapyAlternative Therapy

To Help Reach Our Goal Of To Help Reach Our Goal Of Improving The Life Of Service Improving The Life Of Service

Men And WomenMen And Women Share my story on Parkinson’s and the Native Share my story on Parkinson’s and the Native

American FluteAmerican Flute Compare Parkinson’s to a general trauma and Compare Parkinson’s to a general trauma and

establish a connection in treatmentestablish a connection in treatment Establish music therapy as a viable source of Establish music therapy as a viable source of

healing, learn its historyhealing, learn its history The advantages of the Native American Flute in The advantages of the Native American Flute in

Trauma in healingTrauma in healing

The WalkThe Walk

This is a story about a man’s walk This is a story about a man’s walk in life with a flute that helped him in life with a flute that helped him overcome some of those physical overcome some of those physical and mental obstacles …and mental obstacles …

And a hope it may help many And a hope it may help many others with neurologic difficultiesothers with neurologic difficulties

Who Am I?Who Am I?

I am not a Doctor and I am not a I am not a Doctor and I am not a Music TherapistMusic Therapist

I am a man with a chronic I am a man with a chronic progressive neurological disease, progressive neurological disease, that has no cure, who has that has no cure, who has experienced a change due to a music experienced a change due to a music experienceexperience

I want to share that experienceI want to share that experience

Text of speech for next slide:

When I was in elementary school, I will never forget a story I read, and for the life of me, I hope someday to remember its title. It was about a dog and it’s VISION OF A ROOM with one door and what it felt like when the door closed and it was alone. It could not open the door, could not see through the door, could not see around the door and, most of all, could not do anything to change its destiny until the door opened again. All the little dog could do was hope. All it could do was work to overcome the fear that no one would ever open the door again. All the little dog could do was wait.

I have now talked to hundreds of people with NEUROLOGICAL DISORDERS and their story is the same: We all became the little dog in the room with no way to open the door. We only had fear to begin with, but with the help of our friends, our fear turned to hope. FOR ME IT WAS THE Muhammad Ali Parkinson, Center, MY WIFE ANN AND THE PLAYING OF THE NATIVE AMERICAN FLUTE that taught me that the room I was in was no longer small. The room I was in became a room with a window and then it became ROOM WITH AN OPEN DOOR

When I Was Young When I Was Young I Read a StoryI Read a Story

Promise To Myself After Promise To Myself After DiagnosisDiagnosis

I would never be embarrassed by the I would never be embarrassed by the diseasedisease

I would tell everyone so as to create I would tell everyone so as to create awarenessawareness

I would live every day to its fullestI would live every day to its fullest I would reach out to help othersI would reach out to help others

DroolingDrooling Stiffness in right sideStiffness in right side Bradykinesea (slow)Bradykinesea (slow) Anxiety/DepressionAnxiety/Depression DystoniaDystonia Speech DifficultySpeech Difficulty Lack of tast and smellLack of tast and smell Mycrographis (Can not write)Mycrographis (Can not write) Decreased facial expressionsDecreased facial expressions

What Do You Know About Me What Do You Know About Me Now That You Know I Have Now That You Know I Have

Parkinson’s? Parkinson’s?

TRAUMATIC BRAIN INJURY TRAUMATIC BRAIN INJURY FROM THE CARE WEB SITEFROM THE CARE WEB SITE

TBI can cause a wide range of functional TBI can cause a wide range of functional changes affecting thinking, sensation, changes affecting thinking, sensation, language, or emotions.Thinking ( memory language, or emotions.Thinking ( memory and reasoning);Sensation( touch, taste, and reasoning);Sensation( touch, taste, and smell);Language (communication, and smell);Language (communication, expression, and understanding); and expression, and understanding); and Emotion( depression, anxiety, personality Emotion( depression, anxiety, personality changes, aggression, acting out, and changes, aggression, acting out, and social inappropriateness) social inappropriateness) 

Text of speech for next slide:

Several years after my diagnosis my wife Ann and I were vacationing in Taos New Mexico. As with any malady there is a great challenge is in the early stages when life, life style and medicine all seem to conflict. my tremors were increasing to the point I could hardly hold a cup of coffee my wife Ann pointed out the fact that she read folks with Parkinson’s could dance even though they could not walk; we stopped into a shop at the pueblo owned by Robert Mirrabell and I bought my first Native American flute it was a challenge to learn because my right side was so much slower than my left, and breath control was difficult, but an interesting thing was happening, the more I played the less my tremors became prevalent. And if they came back I would pick up my flute and the tremors would go away then I made the flute part of my life, life style and it has opened many doors

My Story: Input From My My Story: Input From My Wife, Ann, At Taos PuebloWife, Ann, At Taos Pueblo

Modern HistoryModern History

James Parkinson James Parkinson Essay on the Shaking Palsy - 1817Essay on the Shaking Palsy - 1817

Involuntary Tremulous Motion, with lessened muscular Involuntary Tremulous Motion, with lessened muscular power, in part not in action and even when supported; power, in part not in action and even when supported; with a propensity to bend the truck forwards, and to with a propensity to bend the truck forwards, and to pass from a walking to a running pace; the senses and pass from a walking to a running pace; the senses and intellect being uninjuredintellect being uninjured

Tretiakoff – 1919- discovered deficits in Tretiakoff – 1919- discovered deficits in the SNthe SN

Late 1950’s and 60’s – dopamine Late 1950’s and 60’s – dopamine significance recognized significance recognized

Who Gets PD?Who Gets PD?

1 in 100 over 60 years of age1 in 100 over 60 years of ageAverage age of onset 60 years of ageAverage age of onset 60 years of age15% diagnosed before 50 years of 15% diagnosed before 50 years of

ageageSlightly more men than womenSlightly more men than women

What is Parkinson’s Disease?What is Parkinson’s Disease?

Chronic progressive neurological Chronic progressive neurological disorderdisorder

Certain brain cells or neurons in the Certain brain cells or neurons in the substantia nigra (SN) substantia nigra (SN) die or are die or are impairedimpaired

Those neurons produce dopamineThose neurons produce dopamineResponsible for coordinated Responsible for coordinated

movement and balancemovement and balance

Our BrainOur Brain

Circuits formed by living cells called Circuits formed by living cells called neuronsneurons

50 billion neurons50 billion neuronsOn average 10,000 ends to each On average 10,000 ends to each

neuronneuron1/2 transmitters1/2 transmitters1/2 receptors1/2 receptors

Our BrainOur Brain

Neurons not directly connected to Neurons not directly connected to one anotherone another

Tiny gap between the transmitter Tiny gap between the transmitter end of one cell and the receptor end end of one cell and the receptor end of another cellof another cell

Gap is called a Gap is called a synapsesynapse

Our Brain - MessagesOur Brain - Messages

Neurons act as a communication Neurons act as a communication network by using chemicals called network by using chemicals called neurotransmittersneurotransmitters

Carry the message across synapses Carry the message across synapses from one neuron to anotherfrom one neuron to another

Allow nervous system to Allow nervous system to communicate with muscles and communicate with muscles and translate thought into motiontranslate thought into motion

MovementMovement

Normally we don’t think about how it Normally we don’t think about how it is possible for our bodies to moveis possible for our bodies to move

It just happens when we want it to!It just happens when we want it to!

Dopamine Dopamine

Helps transmit messages from the Helps transmit messages from the SN to the striatumSN to the striatum

Initiates movement Initiates movement Controls movement and balanceControls movement and balanceMakes sure:Makes sure:

Muscles work smoothly, Muscles work smoothly, Under control and Under control and Without extra or unwanted movementsWithout extra or unwanted movements

Loss of DopamineLoss of Dopamine

SN degenerate SN degenerate decreased dopamine decreased dopamine lack of regulation of movement control lack of regulation of movement control

centers in the brain centers in the brain striatum fires excessively striatum fires excessively loss of control of movements loss of control of movements

Cardinal signs become apparent at Cardinal signs become apparent at 70-80% dopamine loss70-80% dopamine loss

Other Signs of PDOther Signs of PD Small handwritingSmall handwriting Changes in posture – stooped and lack of arm swingChanges in posture – stooped and lack of arm swing Decreased facial expressionDecreased facial expression Speech changesSpeech changes Difficulty swallowing and drooling Difficulty swallowing and drooling Depression/anxietyDepression/anxiety Pain Pain Sleep disturbancesSleep disturbances ConstipationConstipation Urinary frequencyUrinary frequency Sexual dysfunctionSexual dysfunction Low blood pressureLow blood pressure Fatigue/loss of energyFatigue/loss of energy Changes in mental function over timeChanges in mental function over time

TBI Long TermTBI Long Term

TBI can also cause epilepsy and TBI can also cause epilepsy and increase the risk for conditions such increase the risk for conditions such as Alzheimer’s disease, Parkinson’s as Alzheimer’s disease, Parkinson’s disease, and other brain disorders disease, and other brain disorders that become more prevalent with that become more prevalent with age.age.

About 75% of TBIs that occur each About 75% of TBIs that occur each year are concussionsyear are concussions

RememberRemember

A brain that engages in music is A brain that engages in music is changed by engaging in musicchanged by engaging in music

Advantages Of Native FluteAdvantages Of Native Flute

RelaxationRelaxationCoordinationCoordinationBreathing ExerciseBreathing ExerciseSocial StimulationSocial StimulationFunFunPortablePortableFocus on now…TodayFocus on now…Today

Text of speech for next slide: While traveling through northern Arizona I often stop to play flute with my friend Tony, a Navajo Indian who plays and excellent flute. Tony lives in Cameron Arizona, a small community close to the Grand Canyon. Tony told me the story that his Grandfather would have him play when he would come home to visit from boarding school. By listening to the music his Grandfather would know what mood his soul was in; was it troubled, was it in control, was it sad or happy. This brings us to music therapy. we all have experienced an emotion when we hear certain tunes, the star spangled banner, an old song we heard in high school. A marching song, taps, music therapy for many years has become a viable alternative treatment to improve the condition of individuals, and it all started with the military

Tony In Cameron Tony In Cameron The Flute And His FatherThe Flute And His Father

The Profession of Music The Profession of Music TherapyTherapy

Began after WW I & Began after WW I & IIII

Musicians went to Musicians went to Veterans HospitalsVeterans Hospitals

Positive patients Positive patients physical & physical & emotional responseemotional response

First formal degree First formal degree program in Music program in Music Therapy began in Therapy began in 1950 in the U.S. 1950 in the U.S.

NIH/NLM US Army, Fitzsimons

MUSIC THERAPY MUSIC THERAPY

Music therapy is defined asMusic therapy is defined as““the the systematic application of systematic application of

musicmusic by the music therapist by the music therapistto bring about helpful changesto bring about helpful changesin the emotional or physical in the emotional or physical

health of the client.” health of the client.”

andand

American Music Therapy Association Defines Music

Therapy As: … the clinical and evidence-based use of

music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program.

Music Therapy is an established health profession in which music is used within a therapeutic relationship to address physical, emotional, cognitive, and social needs of individuals. 

Active Music Making andActive Music Making and Music Therapy Music Therapy Services:Services:

An Early Intervention and Readjustment Program Among An Early Intervention and Readjustment Program Among

Returning Military Personnel and Their FamiliesReturning Military Personnel and Their Families Sponsored by the American Music Therapy

Association and Provided to Families of Davis-Monthan Air Force Base, Tucson, AZ

Funded by NAMM, the International Music Products Association with additional funding by

the American Music Therapy Association.

In kind contributions provided by DMAFB

WHY IS MUSIC USEFUL WHY IS MUSIC USEFUL

PROMOTES WELLNESSPROMOTES WELLNESSALEVIATES PAINALEVIATES PAINMANAGE STRESSMANAGE STRESSOUTLET TO EXPRESS FEELINGSOUTLET TO EXPRESS FEELINGS IMPROVE COMMUNICATIONIMPROVE COMMUNICATION IMPROVE PHYSICAL COORDINATIONIMPROVE PHYSICAL COORDINATIONFORCES FOCUS ON TODAYFORCES FOCUS ON TODAY

How music promotes How music promotes the relaxation effectthe relaxation effect

BiochemicalBiochemical theory theorystates that states that musicmusic is a is a sensory sensory

stimulusstimulus that is processed though the that is processed though the sense of heaingsense of heaing..

Sound vibrationsSound vibrations are are chemicallychemically changed into changed into nervous impulsesnervous impulses thatthatactivate either the activate either the sympatheticsympathetic or orparasympatheticparasympathetic nervous system nervous system

How music promotesHow music promotesthe relaxation effectthe relaxation effect

MetaphysicalMetaphysical theory theory suggests suggeststhat music is that music is divine in naturedivine in nature..

Music TherapyMusic Therapythe “ability to experience an the “ability to experience an

altered statealtered state of ofphysical physical arousalarousal and subsequent and subsequent

moodmoodby processing a progression of by processing a progression of

musical notes ofmusical notes ofvarying varying tonetone,,rhythmrhythm, and, andinstrumentationinstrumentationfor a pleasing effect.” for a pleasing effect.”

THE FLUTE THE FLUTE

Increased mental health with Increased mental health with necessity to focusnecessity to focus

Increased dexterity with playing Increased dexterity with playing motionmotion

Increased breathing capacityIncreased breathing capacityAllowed me to share something of Allowed me to share something of

beauty with those around me beauty with those around me

LUNCH WITH MUHAMMAD ALI LUNCH WITH MUHAMMAD ALI BECAUSE OF MUSIC THERAPYBECAUSE OF MUSIC THERAPY

AAAA

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The flute has allowed me to give back in a way that I would never be able to without it I would not have met Muhammad Ali and played at his luncheon, I also gifted to him a flute as his Parkinson’s is advancing rapidly in these packets I have a book written by his daughter Rasheda and written from the perspective of a child looking at there grand father who has Parkinson’s

AA

PPLAY ANYTIME I GET A CHANCE LAY ANYTIME I GET A CHANCE AND TELL MY STORY TO AND TELL MY STORY TO

EVERYONEEVERYONE

Text of speech for next slide:

I would like to share another story, this one goes down in the “you just do not know where this will take you.” Ann and I volunteered to help rebuild a basketball court on the Navajo reservation, a town called Klagetoh and at St. Anne’s mission. I have become a regular, being 45 miles from Window Rock, Arizona and 69 miles from Gallup the music is welcome. I learned another value to the flute, a Navajo family came into the mission and asked brother John to give a blessing to the daughter, he asked me to play a blessing song, I spoke briefly with the Grandmother and as I remember what she said, the low notes are sending a message up to our deity and the high notes are the answer so we prayed together through the flute I do that a lot now in my quiet times

EXPERIENCESEXPERIENCESBLESSING SONGBLESSING SONG

KLAGETOHKLAGETOH

EXPERIENCES BECAUSE OF EXPERIENCES BECAUSE OF MUSIC THERAPYMUSIC THERAPY

KLAGETOH HOGANKLAGETOH HOGAN

TRAININGTRAINING

PERSONAL GROUP AND INDIVIDUAL PERSONAL GROUP AND INDIVIDUAL TRAINING BY MYSELF AND VIA CDTRAINING BY MYSELF AND VIA CD

CUSTOMIZED FLUTE MAKING IE, CUSTOMIZED FLUTE MAKING IE, LOSS OF LIMBLOSS OF LIMB

UPDATED PROGRAMS FOR LEARNING UPDATED PROGRAMS FOR LEARNING VIA WEB AND CDVIA WEB AND CD

MILITARY FLUTE CIRCLES OR JOIN MILITARY FLUTE CIRCLES OR JOIN THE LOCAL CHAPTERSTHE LOCAL CHAPTERS

A SPECIAL THANK YOU A SPECIAL THANK YOU

TO ALL THAT HAVE SERVED THIS TO ALL THAT HAVE SERVED THIS GREAT COUNTRYGREAT COUNTRY

www.FFPNR.orgwww.FFPNR.org

Foundation for Parkinson’s and Foundation for Parkinson’s and

Neurological Research Neurological Research

Mission:Mission:

A world without A world without Parkinson’sParkinson’s