Piano Practice and Bradykinesia

With Parkinson’s Disease, one of the defining symptoms is bradykinesia. What’s that? Yeah, I asked the same thing. Bradykinesia is a slowness of movement that isn’t necessarily explainable with other known effects of PD but is definitely there.

Piano practice is one place where bradykinesia shows up for Michelle. It affects agility in vocal and instrumental play. After tremor, this was the first symptom Michelle noticed: She could no longer strum fast-paced rhythm guitar patterns at full tempo for more than a couple measures before her battery ran out. Since the symptoms started in 2021, she has had to adjust how she plays.

The good news is medication can lessen many of PD’s symptoms. Levodopa has restored much of the mobility that PD stole, but musical agility is still a struggle.

Since all songs need to be practiced at slowly before gradually speeding up, Michelle is able to tackle many pieces with her music. She’s been able to practice and feed her soul with her beloved music. However, at some point she would love to regain the ability to play quickly.

In typical Michelle style, she’s working out the kinks in her musical ability like everything else, with a methodical approach and taking data. She noticed Sunday, Nov 5, that she had trouble doing anything. She wanted to speed up a few short Bergmüller pieces to allegro, but after playing ten or twenty minutes, she crashed.

She tried to get on the exercise bike, because she’s learned it triggers dopamine production and that helps, but it was impossible to rotate her feet faster than they wanted to rotate. Period. So she sat there biking at a super slow speed for an hour in front of the TV until bedtime.

Monday was worse. While there was a girl’s trip and a time change happened on Sunday, she only lasted five minutes for practice. She’s working to understand she has a time limit on playing.

In her notes, musical agility requires more dopamine. Michelle is also determined, so of course she brought out the camera to see how her practice worked on Tuesday. The camera times out, so she started and stopped it after each run of an individual piece or passage.

Below are the videos where Michelle can play at some speed, and then when her battery ran out. After bradykinesia kicks in, she rests with her puppies.

This is a timeline from Tuesday, Nov 7:
8:00 am – morning Levodopa*
10:00ish am – 60 min on stationary bike
11:30 am – late morning Levodopa*
11:33 am – started practicing piano
12:08 pm – video 1 of 2 (the bottom one below)
12:11 pm – video 2 of 2 (the top one below)
1:30 – can move again

*carbidopa/levodopa 25/100 x 2 both times

A Return to Singing

If you didn’t know, Michelle was diagnosed with Type 1 Diabetes and Parkinson’s Disease in 2022. With those diagnoses she was able to get proper treatment and medication for both diseases. The year before was extremely difficult. Here is part of her struggle in her words, along with a glimpse into her recovery.

2021 was a difficult year. I lost 75 pounds without trying and spent most of the year binging on Netflix shows. I couldn’t even play games. I just stared at the TV. All. Year. Don’t get me wrong; I got the work done that needed to be done, but it was the bare minimum.

That’s the year I lost my voice.


I lost the other instruments, too: piano, guitar, violin, drums. But I could still play slow songs, and piano was decent since the PD only affected my right side at first. My left hand picked up the burden. But I couldn’t sing.

I have a great support network, so I didn’t wallow in depression. But now that I’m medicated for both diseases and have regained maybe 90% of the mobility I lost in ’21, I’m working hard to get all the instruments back, including my beloved voice, which I didn’t realize was such a dear friend. Frankly, I’m pissed at PD for taking it away from me.

Quick side note: the doctors and all the literature blame the PD, and it’s well established that PD impacts the voice. But it was the T1D that stole my energy: my cells weren’t getting any fuel. That surely contributed to barely using my voice for a year.

Either way, the ENT shoved a camera up my nose and proclaimed: vocal fold atrophy.

So I saw a speech therapist for about six weeks, and I’ve been working hard to get my voice back. It’s so slow going that I decided to document the journey, maybe just to convince myself the progress is worth it. I took some earlier videos, but I need to dig through them to build the history.

26 Oct 2023

Great work, Michelle! Keep singing. We’re going to join in on the next verse.