1. John got an excellent opportunity to speak to wounded veterans and their care takers along with about 50 other military personnel and civilians in Tampa Florida this summer. He spoke on the similarities of treatment with Parkinson’s and head trauma and how music therapy and specifically the playing of the Native American flute may help. Please enjoy the PowerPoint used in the speech

2. CARE COALITION RECOVERY PROGRAM, MENTOR TRAINING SESSION

3. MY NAME IS JOHN YONUSHONIS AND I HAVE PARKINSON’S

4. Intangibles of Music as Therapy I can not rotate my right hand over from palm to back I can not rotate my right hand over from palm to back My stamina and breath shortens with time My stamina and breath shortens with time I can not sequence my right thumb to my right finger but I can play the Native American Flute I can not sequence my right thumb to my right finger but I can play the Native American Flute

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

6. While there is no similarity in Parkinson’s and Traumatic Brain Injury in it’s occurrence, … While there is no similarity in Parkinson’s and Traumatic Brain Injury in it’s occurrence, … there is great similarity in the challenges of both. there is great similarity in the challenges of both. Our Goal is to Increase Quality of Life Through Alternative Therapy

7. To Help Reach Our Goal Of Improving The Life Of Service Men And Women Share my story on Parkinson’s and the Native American Flute Share my story on Parkinson’s and the Native American Flute Compare Parkinson’s to a general trauma and establish a connection in treatment Compare Parkinson’s to a general trauma and establish a connection in treatment Establish music therapy as a viable source of healing, learn its history Establish music therapy as a viable source of healing, learn its history The advantages of the Native American Flute in Trauma in healing The advantages of the Native American Flute in Trauma in healing

8. The Walk This is a story about a man’s walk in life with a flute that helped him overcome some of those physical and mental obstacles … This is a story about a man’s walk in life with a flute that helped him overcome some of those physical and mental obstacles … And a hope it may help many others with neurologic difficulties And a hope it may help many others with neurologic difficulties

9. Who Am I? I am not a Doctor and I am not a Music Therapist I am not a Doctor and I am not a Music Therapist I am a man with a chronic progressive neurological disease, that has no cure, who has experienced a change due to a music experience I am a man with a chronic progressive neurological disease, that has no cure, who has experienced a change due to a music experience I want to share that experience I want to share that experience

10. 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

11. When I Was Young I Read a Story

12. Promise To Myself After Diagnosis I would never be embarrassed by the disease I would never be embarrassed by the disease I would tell everyone so as to create awareness I would tell everyone so as to create awareness I would live every day to its fullest I would live every day to its fullest I would reach out to help others I would reach out to help others

13. Drooling Drooling Stiffness in right side Stiffness in right side Bradykinesea (slow) Bradykinesea (slow) Anxiety/Depression Anxiety/Depression Dystonia Dystonia Speech Difficulty Speech Difficulty Lack of tast and smell Lack of tast and smell Mycrographis (Can not write) Mycrographis (Can not write) Decreased facial expressions Decreased facial expressions What Do You Know About Me Now That You Know I Have Parkinson’s?

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

15. 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

16. My Story: Input From My Wife, Ann, At Taos Pueblo

17. Modern History James Parkinson James Parkinson Essay on the Shaking Palsy - 1817 Essay on the Shaking Palsy - 1817 Involuntary Tremulous Motion, with lessened muscular power, in part not in action and even when supported; with a propensity to bend the truck forwards, and to pass from a walking to a running pace; the senses and intellect being uninjured Involuntary Tremulous Motion, with lessened muscular power, in part not in action and even when supported; with a propensity to bend the truck forwards, and to pass from a walking to a running pace; the senses and intellect being uninjured Tretiakoff – 1919- discovered deficits in the SN Tretiakoff – 1919- discovered deficits in the SN Late 1950’s and 60’s – dopamine significance recognized Late 1950’s and 60’s – dopamine significance recognized

18. Who Gets PD? 1 in 100 over 60 years of age 1 in 100 over 60 years of age Average age of onset 60 years of age Average age of onset 60 years of age 15% diagnosed before 50 years of age 15% diagnosed before 50 years of age Slightly more men than women Slightly more men than women

19. What is Parkinson’s Disease? Chronic progressive neurological disorder Chronic progressive neurological disorder Certain brain cells or neurons in the substantia nigra (SN) die or are impaired Certain brain cells or neurons in the substantia nigra (SN) die or are impaired Those neurons produce dopamine Those neurons produce dopamine Responsible for coordinated movement and balance Responsible for coordinated movement and balance

20. Our Brain Circuits formed by living cells called neurons Circuits formed by living cells called neurons 50 billion neurons 50 billion neurons On average 10,000 ends to each neuron On average 10,000 ends to each neuron 1/2 transmitters 1/2 transmitters 1/2 receptors 1/2 receptors

21. Our Brain Neurons not directly connected to one another Neurons not directly connected to one another Tiny gap between the transmitter end of one cell and the receptor end of another cell Tiny gap between the transmitter end of one cell and the receptor end of another cell Gap is called a synapse Gap is called a synapse

22. Our Brain - Messages Neurons act as a communication network by using chemicals called neurotransmitters Neurons act as a communication network by using chemicals called neurotransmitters Carry the message across synapses from one neuron to another Carry the message across synapses from one neuron to another Allow nervous system to communicate with muscles and translate thought into motion Allow nervous system to communicate with muscles and translate thought into motion

23. Movement Normally we don’t think about how it is possible for our bodies to move Normally we don’t think about how it is possible for our bodies to move It just happens when we want it to! It just happens when we want it to!

24. Dopamine Helps transmit messages from the SN to the striatum Helps transmit messages from the SN to the striatum Initiates movement Initiates movement Controls movement and balance Controls movement and balance Makes sure: Makes sure: Muscles work smoothly, Muscles work smoothly, Under control and Under control and Without extra or unwanted movements Without extra or unwanted movements

25. Loss of Dopamine SN degenerate  SN degenerate  decreased dopamine  decreased dopamine  lack of regulation of movement control centers in the brain  lack of regulation of movement control 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 70- 80% dopamine loss Cardinal signs become apparent at 70- 80% dopamine loss

26. Other Signs of PD Small handwriting Small handwriting Changes in posture – stooped and lack of arm swing Changes in posture – stooped and lack of arm swing Decreased facial expression Decreased facial expression Speech changes Speech changes Difficulty swallowing and drooling Difficulty swallowing and drooling Depression/anxiety Depression/anxiety Pain Pain Sleep disturbances Sleep disturbances Constipation Constipation Urinary frequency Urinary frequency Sexual dysfunction Sexual dysfunction Low blood pressure Low blood pressure Fatigue/loss of energy Fatigue/loss of energy Changes in mental function over time Changes in mental function over time

27. TBI Long Term TBI can also cause epilepsy and increase the risk for conditions such as Alzheimer’s disease, Parkinson’s disease, and other brain disorders that become more prevalent with age. TBI can also cause epilepsy and increase the risk for conditions such as Alzheimer’s disease, Parkinson’s disease, and other brain disorders that become more prevalent with age. About 75% of TBIs that occur each year are concussions About 75% of TBIs that occur each year are concussions

28. Remember A brain that engages in music is changed by engaging in music

29. Advantages Of Native Flute Relaxation Relaxation Coordination Coordination Breathing Exercise Breathing Exercise Social Stimulation Social Stimulation Fun Fun Portable Portable Focus on now…Today Focus on now…Today

30. 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

31. Tony In Cameron The Flute And His Father

32. The Profession of Music Therapy Began after WW I & II Began after WW I & II Musicians went to Veterans Hospitals Musicians went to Veterans Hospitals Positive patients physical & emotional response Positive patients physical & emotional response First formal degree program in Music Therapy began in 1950 in the U.S. First formal degree program in Music Therapy began in 1950 in the U.S. NIH/NLM US Army, Fitzsimons

33. MUSIC THERAPY Music therapy is defined as Music therapy is defined as “the systematic application of music by the music therapist “the systematic application of music by the music therapist to bring about helpful changes to bring about helpful changes in the emotional or physical health of the client.” in the emotional or physical health of the client.” and and

34. 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.

35. Active Music Making and Music Therapy Services: An Early Intervention and Readjustment Program Among Returning 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

36. WHY IS MUSIC USEFUL PROMOTES WELLNESS PROMOTES WELLNESS ALEVIATES PAIN ALEVIATES PAIN MANAGE STRESS MANAGE STRESS OUTLET TO EXPRESS FEELINGS OUTLET TO EXPRESS FEELINGS IMPROVE COMMUNICATION IMPROVE COMMUNICATION IMPROVE PHYSICAL COORDINATION IMPROVE PHYSICAL COORDINATION FORCES FOCUS ON TODAY FORCES FOCUS ON TODAY

37. How music promotes the relaxation effect Biochemical theory Biochemical theory states that music is a sensory stimulus that is processed though the sense of heaing. states that music is a sensory stimulus that is processed though the sense of heaing. Sound vibrations are chemically changed into nervous impulses that Sound vibrations are chemically changed into nervous impulses that activate either the sympathetic or activate either the sympathetic or parasympathetic nervous system parasympathetic nervous system

38. How music promotes the relaxation effect Metaphysical theory suggests Metaphysical theory suggests that music is divine in nature. that music is divine in nature.

39. Music Therapy the “ability to experience an altered state of the “ability to experience an altered state of physical arousal and subsequent mood physical arousal and subsequent mood by processing a progression of musical notes of by processing a progression of musical notes of varying tone, varying tone, rhythm, and rhythm, and instrumentation instrumentation for a pleasing effect.” for a pleasing effect.”

40. THE FLUTE Increased mental health with necessity to focus Increased mental health with necessity to focus Increased dexterity with playing motion Increased dexterity with playing motion Increased breathing capacity Increased breathing capacity Allowed me to share something of beauty with those around me Allowed me to share something of beauty with those around me

41. LUNCH WITH MUHAMMAD ALI BECAUSE OF MUSIC THERAPY

42. AA

43. Text of speech for next slide: 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

44. A

45. PLAY ANYTIME I GET A CHANCE AND TELL MY STORY TO EVERYONE

46. 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

47. EXPERIENCES BLESSING SONG KLAGETOH KLAGETOH

48. EXPERIENCES BECAUSE OF MUSIC THERAPY EXPERIENCES BECAUSE OF MUSIC THERAPY KLAGETOH HOGAN KLAGETOH HOGAN

49. TRAINING PERSONAL GROUP AND INDIVIDUAL TRAINING BY MYSELF AND VIA CD PERSONAL GROUP AND INDIVIDUAL TRAINING BY MYSELF AND VIA CD CUSTOMIZED FLUTE MAKING IE, LOSS OF LIMB CUSTOMIZED FLUTE MAKING IE, LOSS OF LIMB UPDATED PROGRAMS FOR LEARNING VIA WEB AND CD UPDATED PROGRAMS FOR LEARNING VIA WEB AND CD MILITARY FLUTE CIRCLES OR JOIN THE LOCAL CHAPTERS MILITARY FLUTE CIRCLES OR JOIN THE LOCAL CHAPTERS

50. A SPECIAL THANK YOU TO ALL THAT HAVE SERVED THIS GREAT COUNTRY TO ALL THAT HAVE SERVED THIS GREAT COUNTRY

51. www.FFPNR.org Foundation for Parkinson’s and Neurological Research Mission: A world without Parkinson’s