HeroTeo - The Parkinson’s Fighter

massage and PD patient

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Dear Doctor,

Parkinson’s disease destroys dopamine-producing cells, therefore patients have dramatically low-levels of the neurotransmitter.
.
A simple massage can significantly improve the quality of life of Parkinson’s sufferers, say experts. Researchers at the University of Miami Touch Research Institute have found that massage helps patients’ to sleep as well as improving their ability to perform normal day-to-day activities.

Best regards

TEOKIMHOE

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Dr. Fernandez

Joined: 20 Jan 2007
Posts: 90

Posted: Mon Jul 30, 2007 5:53 pm Post subject:

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Thanks!
_________________
Hubert H. Fernandez

Tags: General by heroteo
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Posted: Sat Jul 28, 2007 3:31 am Post subject: Q: Massage and Parkinson disease

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Dear Doctor,

I wish to use this forum to share the benefits of Massage on PD patients.

Parkinson Disease destroys dopamine-producing cells therefore patients have dramatically low levels of neurotransmitter, massage normally increases dopamine level. Patients who receive massage increase quality of life, sleep well as well as improving their ability to perform normal day to day activities and decrease stress hormonal level in people with Parkinson disease.

Parkinson symptoms are reduced by massage therapy and progressive muscles exercise i.e progressive stiffness, rigidity of voluntary muscles.

TEOKIMHOE

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Kathrynne Holden, MS, RD

Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Sat Jul 28, 2007 8:31 am Post subject:

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Dear Teo,
Thank you for bringing up a very important consideration. Massage is very helpful to those with PD, for all the reasons you state, and I do encourage regular massage therapy if at all possible.
_________________
Best regards,
Kathrynne Holden, MS, RD
–

Tags: General by heroteo
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Posted: Sun Jul 15, 2007 1:26 am Post subject: Speech Difficulties in PD

Dear Doctor,

I understand about half of all people with PD are likely develop difficulty with speech. The speech changes that occur are due to inco-ordination and reduced activities of muscles that control the speech mechanism.

The main difficulties I have experience are:
Loss of volume, pitch, range and intonation in the voice.,
speech being either too fast or too slow
uncontrolled repetitions of sounds, words or phrases;
slurred speech;
difficulty initiating speech;
reduced facial expression and natural gesture; and
a harsh, breathy voice.

Is it related with Jaw tremor or trauma (the shock caused by unpleasant and upsetting experience )?

Is it related to tongue-tied/twister(difficulty to speak quickly) caused by neurological disorders?

Is it related with the drooling of saliva from the mouth ?

Best regards

TEOKIMHOE

Dear TEOKIMHOE,

Thank you for writing with these excellent questions. It is actually more than 50% of people with PD who have difficulty with speech and communication. The data tell us that it is actually closer to 85%. You are partially correct about the underlying causes of the speech problems. PD is caused by decreased dopamine in the central nervous system. The lack of dopamine also causes changes in control of the muscles that produce speech.

Typically, the motor speech changes are characterized by rigidity, weakness, difficulty in initiating movement, and difficulty making large movements. In addition, a critical component of the communication changes is the perception on the part of people with PD that they think they are speaking loud enough when, in fact, they are speaking at a low volume that also makes it difficult to understand them.

The result is that speech changes occur just like you described in your email: low volume, slurred speech, reduced intonation, alteration in rate, and changes in voice quality such as sounding breathy or harsh. These symptoms are caused by the PD. Sometimes people with try to compensate for these changes in ways that can make speech more difficult.

Unfortunately, the medications that can be so beneficial for limb symptoms have not been shown to have the same positive effect on speech and swallowing. However, there is a behavioral voice treatment that has been shown to help 80% of people with PD who complete the program. It is called LSVT. You can learn more about LSVT and find a certified clinician in your area by going to www.lsvt.org.

The last thing you mentioned is that you notice more drooling. There has been a lot of discussion about whether people with PD drool more or swallow less well. It seems the majority of the data point to the latter. People with PD swallow less frequently and with less strength and efficiency of muscle movement. One thing that can be done about this is to consciously tell yourself to swallow more frequently especially when in a social situation.

If you are already noticing signs of drooling there could be other changes in swallowing taking place. It would be a good idea to discuss this with your physician and seek an evaluation with a speech-language pathologist who has experience in evaluation and treatment of people with PD. Swallowing difficulties can potentially interfere with the ability to take pills and swallow safely and it is important to be vigilant.

I hope you will get treatment for your speech changes since communication is so important to quality of life.

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lmahler

Tags: General by heroteo
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Posted: Sat Jul 21, 2007 4:53 pm Post subject: Difficulties in PD speaker

Dear Doctor,

I understand about half of all people with PD are likely develop difficulty with speech. The speech changes that occur are due to inco-ordination and reduced activities of muscles that control the speech mechanism.

The main difficulties I have experience are:
Loss of volume, pitch, range and intonation in the voice.,
speech being either too fast or too slow
uncontrolled repetitions of sounds, words or phrases;
slurred speech;
difficulty initiating speech;
reduced facial expression and natural gesture; and
a harsh, breathy voice

Speech difficulties can and do cause embarrassment and burden of career.

Best regards

TEOKIMHOE

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Dr. Rodriguez

Joined: 22 Jan 2007
Posts: 92
Location: Gainesville, Fl
Posted: Sun Jul 22, 2007 4:22 pm Post subject:

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You may benefit from an evaluation by a speech pathologist, using the Lee Silverman Voice Therapy or other as deemed necessary.
_________________
Ramon L Rodriguez

Tags: General by heroteo
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Psychiatric and Cognitive disorder in Parkinson’s disease Posted: Sat Jul 21, 2007 7:22 am
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Post subject: Psychiatric and Cognitive disorder in Parkinson’s disease

Dear Doctor,

I have known PD as an illness of the “body,mind soul”

Cognitive disorders are common in PD - anxiety, depression, uncertainties, emotional disturbances etc.

With the drastic improvement in the treatment of the movement problem in PD, I often find that the cognitive disorders are actually more difficult to treat than the movement problem.

Thanks

TEOKIMHOE

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Dr. Okun

Joined: 19 Jan 2007
Posts: 251
Location: University of Florida
Posted: Sat Jul 21, 2007 7:23 am Post subject:

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You are on target here. As PD progresses gait, speech and cognition in particular become a large challenge. We are focusing our research and development in these areas.
_________________
Michael S. Okun, M.D.

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Tags: General by heroteo
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Posted: Wed Jul 18, 2007 4:22 am Post subject: PD progression with times

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Dear Doctor,

My doctor Dr. Chew Nee Kong told me PD is a body,mind and soul diseases.

PD is very unique compared with all other nervous illnesses-
the patients have a lot of misunderstandings, emotional disturbances and uncertainties.The illness itself is highly technical especially medications. As such, inter-patient and doctor-patient communication is extremely relevant in managing this illness.

In this connection I was told by him that my body (movement,/agility’s) would aggravate with the times progression . No medicine would halt from it’s progression.

PD would come to every part of body movement due to neurological disorders. It is also to your non motor movement i.e. vision, speech, breathing, digestion, drooling of saliva, urinate , emotional disturbances and uncertainties.

TEOKIMHOE

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Dr. Fernandez

Joined: 20 Jan 2007
Posts: 90

Posted: Thu Jul 19, 2007 8:33 am Post subject:

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I agree.
_________________
Hubert H. Fernandez

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Posted: Sat Jul 14, 2007 5:24 am Post subject: Saliva and PDPosted:週六2007年7月14日5:24分郵政主題:唾液和PD

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Dear Doctor,親愛的醫生,

As there are 70-80% PD patients have saliva drooling from the mouth.由於有70-80%的帕金森病患者有流涎唾液從嘴裡. I am one of them.我也是其中之一.

Kindly elaborate the cause of the saliva drooling from the mouth?請說明原因的唾沫口水從口?

What kind of treatment to stop it from drooling?什麼樣的治療,以阻止它垂涎?

As For me I have the saliva drooling after I have taken the requip 2mg three times a day.至於我,我的口水唾液後,我所採取的requip2mg/只每天三次.

Best regards問候

Teo Kim Hoe張志賢金鋤頭

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Dr. Fernandez費爾南德斯博士

Joined: 20 Jan 2007加入:2007年1月20日
Posts: 90職位:90

Posted: Sat Jul 14, 2007 8:03 am Post subject:Posted:週六2007年7月14日9:01分郵政主題:

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Drooling (or sialorrhea) is common in PD.流涎(口水)是常見的肢體. For the most part the cause is not increased saliva production but slowed reflex in automatically swallowing the natural saliva that accumulated in the mouth throughout the day.對大部份的原因是沒有增加唾液生產減緩,但反射自動吞嚥的唾液自然這樣積累的嘴整整一天.

You see, a person without PD does not even notice that saliva is constantly being produced (it is done so to lubricate the whole mouth for talking, eating, etc).你看!一個人沒有肢體甚至不公告,唾液不斷產生的影響(這是做注油整個嘴來說話,吃東西等). This is because after a certain volume is accumulated, this is automatically swallowed without even thinking about it.這是因為經過一定量的積累,這是自動吞下連思考. But in PD, this automatic swallowing is sometimes lost, thus the saliva pools and drools on the side of the mouth.但在PD,這種自動吞嚥有時會丟失,因此唾液池及嘴角站在一邊的嘴.

The best analogy I can give you is when you go to the dentist and you are told to keep you mouth wide open.最好的比喻,我可以給你的是,當你到牙醫,你告訴他們保持你的口是敞開的. You will notice that after some time, your saliva pools and the dentist either has a suction device or allows you to spit/gargle.你會發現,經過一段時間,你的唾液池及牙醫要么有吸塵裝置,或者允許你呸/含漱. You did not really have increased salivary production at the dentist’s office, but you were not allowed to swallow, thus the pooling of saliva.你沒有真正增加唾液生產牙醫辦公室,但你不能吞食,因此,匯聚了唾沫.

The simplest strategy for this is to simply suck sugar-free (to prevent cavities) candy or chew sugar-free gum all day.最簡單的策略,因為這是簡單地吸吮無糖(防止蛀牙)糖果,或嚼無糖口香糖一整天. This will trigger your mouth to swallow.這將引發你的嘴吞下.

Sometimes, anticholinergic drugs are used to decrease salivary production (they cause dry mouth).有時,抗膽鹼藥物,是用來減少唾液生產(它們造成口乾). But that is not really addressing the problem since the issue is not increased salivary production.但那不是真正解決了問題,因為問題的關鍵不是增加唾液生產. It also has lots of side effects (cognitive slowing, blurred vision, urinary hesitancy, etc).它也有很多副作用(認知緩慢,視力模糊,尿液猶豫不決等).

The best therapy, in my opinion, is botulinum toxin injection of the parotid and submandibular gland.最好的治療,我認為這是肉毒桿菌毒素注射的腮腺和頜下腺. We have some reason to believe that Botox Type B is better than Type A for this indication.我們有理由相信,肉毒桿菌毒素B型比A型這種跡象. But either is generally okay.但無論是一般感冒.

Yours,萬事如意
__________________________________
Hubert H. Fernandez朱佩h.費爾南德斯

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Anonymous匿名

Posted: Sat Jul 14, 2007 9:40 am Post subject:Posted:週六2007年7月14日上午09點40分郵政主題:

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Dear Doctor,親愛的醫生,

I refer to the above I have the following for your advise:我指的是段,我有以下幾點建議您:

1 Is it the drooling or sialorrhea resulted by the jaw tremor?1,是它的口水還是口水造成的下顎顫抖?

2.2. Is it the neurological disorders associated with drooling of saliva?它是神經病變與口水唾液?

3.Is it an impact on lip, tongue, and jaw in PD speaker intellectuality and articulately?3.is它影響到嘴唇,舌頭,下巴鈀議長理智與加伊達?

4.4. Is it reduced spontaneous swallowing?它是減少腹水吞下?

5 Are the above contribute to a poor quality of life and a career burden.?5以上的貢獻,為窮人的生活質量和事業的負擔.?

Best regards問候

TEOKIMHOEteokimhoe

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Dr. Fernandez費爾南德斯博士

Joined: 20 Jan 2007加入:2007年1月20日
Posts: 90職位:90

Posted: Sat Jul 14, 2007 10:51 pm Post subject:Posted:週六2007年7月14日10:51分郵政主題:

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Drooling is not a result of jaw tremor.流口水是不是因下顎顫抖.

If often has no/minimal impact on lip, tongue, jaw or speaking/articulation.如果常常沒有/影響微乎其微,嘴唇,舌頭,下巴或演講/articulation.

It is, as I mentioned, often a result of slowed or impaired natural/normal reflex to swallow the saliva regularly.但正如我所說,往往因放慢或受損自然/正常反射吞下唾液定期舉行.

Yes, if drooling is severe, it can affect quality of life.不錯,如果流口水是非常嚴重的,它可以影響生活質量.

Yours,萬事如意
__________________________________
Hubert H. Fernandez朱佩h.費爾南德斯

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Anonymous匿名

Posted: Sun Jul 15, 2007 12:24 am Post subject:張貼:孫2007年7月15日12:24分郵政主題:

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Dear Doctor,親愛的醫生,

I have a hypothesis about the saliva.我有一個假說,唾液. I sometimes suddenly feel a lot of saliva pooling in the front of my mouth.有時,我突然感到了不少口水匯集在門口把我的嘴. But it但
is only sometimes.只是有時候. True, I may not be swallowing it as well as once but I am *sure* it feels like a sudden surge of saliva being produced and as I have had parroted gland issues before I think I know what that feels like.不錯,我未必是它吞下以及一次,但我相信**感覺突然唾液出爐,而正如我曾腮腺問題之前,我想我知道是什麼感覺喜歡.

I was diagnosed with Sjogren’s Syndrome years ago.我被診斷患有乾燥綜合徵多年前. There was at times a very dry mouth and other times too much saliva as the parotid tried to make up for the deficit.有次在一個非常口乾,其他時間太多,因為唾液腮腺試圖使彌補赤字. Dry eyes also watering (as a reaction to the dryness), etc. You probably know this disease.眼睛乾澀也是澆水(作為一種反應乾燥)等,你大概知道這種病.

My point is that if one has this disease (Sjogren’s) they don’t recover the cells destroyed and theoretically the damage is done.我的意思是,如果你有這病(乾燥),他們不收回摧毀細胞,從理論上損害做到這一點. However, after a time all these secretions went back into balance for me.不過,經過一段時間,這些分泌物回去權衡了. I was then told that it was not “true” Sjogren’s but that my symptoms were a result of a disturbed autonomic nervous system, specifically sympathetic, as a part of my Fibromyalgia.當時我說那不是”真實”格倫說,但我的症狀都造成了困擾植物神經系統,特別同情,並以此作為我國纖維肌痛.

I did a little research and lo, and behold, it seems very possible that this is true — the sympathetic nervous system a little out of whack could cause too much saliva production in the same way it can cause some of the other commonly mentioned sympathetic nervous system issues.我作了一個小小的研究,螺,看吧,看來,極有可能這是一個事實–交感神經系統有點格格不入失衡可能導致太多的唾液生產一樣,它可以導致其他一些常提到的交感神經系統問題.

My point is that I have read that sympathetic nervous system dysfunction is commonly found in PD.我的意思是,我已看過,交感神經系統功能障礙是常見的並發症. I hypothesize a connection to the excess saliva.我猜測聯想的唾液過多. Every single book or article one reads says the same thing — poor swallowing –I think mostly because it’s not that important to researchers and one copies the others’ remarks.每一本書或文章,一款是說,同樣的事情–窮人吞嚥–我想主要是因為它的不這一重要的研究者之一,拷貝他人的言論. But I am guessing if you asked a lot of patients they might say they feel surges of saliva (like when you are hungry and smell a hamburger!).但我猜測,如果你問了很多病人,他們可能會說,他們感到襲來的唾液(如當你餓了,聞到一個漢堡包!!).

Since you doctors are always very sympathetic to the quality of life issues the excess saliva and drooling can cause I thought I would mention it.因為你的醫生總是非常同情的生活質量問題過多唾液和口水可造成我以為我會提到它. Also, it could explain good results from the borax rather than a bone dry miserable mouth because the borax would be inhibiting the *excess* saliva.另外,它可以解釋好成績,從肉毒而非骨幹口苦,因為肉毒會抑制過剩**唾液.

Well, not that you asked my views .好,而不是你問我的意見. .. .but there you have it!.但你有!

Best wishes.良好的祝愿.

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Dr. Fernandez費爾南德斯博士

Joined: 20 Jan 2007加入:2007年1月20日
Posts: 90職位:90

Posted: Sun Jul 15, 2007 7:57 am Post subject:張貼:孫2007年7月15日上午07點57分郵政主題:

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Your views are always welcome.你的意見都是歡迎的.

But we do care about drooling and research is being done on the field.但我們關心的口水和研究,正在做有關的領域.

We now offer botox for this, which was not offered even 5 years ago!我們現在所提供的肉毒毒素,這也是無法提供,甚至5年前!

Yours,萬事如意
__________________________________
Hubert H. Fernandez朱佩h.費爾南德斯

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Anonymous匿名

Posted: Mon Jul 16, 2007 5:40 am Post subject: Saliva and PDPosted:週一2007年7月16日上午05點40分郵政主題:唾液和PD

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Dear Doctor,”親愛的醫生,”

I am given to take Benzhexol HCL 2mg for my drooling of saliva i.e. 1 tablet 3 times a day.能給我以鹽酸苯2mg/只對我的口水唾液,即1片,每日3次.

i am told that BTX is expensive and has to be given every three months as it is effective for three months only.告訴我的BTX非常昂貴,而且也可以獲得每三個月,因為它是有效的只用三個月.

As for anti depression I am given to take 2 tablets of Seroquel 25mg and 1/2 tablet of Rivotril 0,5mg at night.至於抗抑鬱能給我以2粒思瑞康93.4%,93.3%和1/2片rivotril0,5毫克時夜. I stop taking Zyprexa Zydis as it worsen the PD patient.我停止服用用藥zydis因為關愛帕金森病人.

Kindly advise善意提醒

TEOKIMHOEteokimhoe

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Anonymous匿名

Posted: Mon Jul 16, 2007 3:17 pm Post subject:Posted:週一2007年7月16日下午03點17分郵政主題:

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Dr. F –六博士–

I hope you read my remark acknowledging that you DO care.我希望你看過我的話承認你的照顧. I wasn’t sure from what you said.我不知道你剛才說的. You guys (people) are so你的男孩(人)等
compassionate.富於同情心. It’s just heartening to know you are out there.這只是欣慰地知道你在那裡.

Best wishes.良好的祝愿.

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Dr. Rodriguez羅德里格斯博士

Joined: 22 Jan 2007加入:2007年1月22日
Posts: 92職位:92
Location: Gainesville, Fl位置:斯維爾,外語
Posted: Mon Jul 16, 2007 4:20 pm Post subject:Posted:週一2007年7月16日4:20分郵政主題:

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Teo:張志賢:

The Benzhexol is fine, but be aware that it may cause confusion or mental slowness in some patients.苯的是好的,但要知道這可能會引起混淆或智力遲鈍在一些病人. If it is not causing any problem to you, you can stay on it.如果是不會造成任何問題,你便可以留在這.

This is why Botulinum toxin is an option, because avoids this type of side effects, quite common in some PD patients.這就是為什麼肉毒桿菌毒素是一種選擇,因為可避免這種副作用相當普遍,在一些PD患者.

As for your depression, I prefer medications like SSRi’s (serotonin reuptake inhibitors) like Lexapro or Zoloft before trying the Seroquel.至於你的抑鬱症,我寧願服用類及SSRI(血清素再吸收抑製劑)lexapro象或舍曲之前嘗試的思瑞康. I am fine with the Rivotril.我的罰款與rivotril. The Seroquel is especially helpful in depressed patient with some psychotic symptoms.思瑞康的,尤其是幫助抑鬱症患者有精神病症狀.

Hope this helps.希望這有助於.
__________________________________
Ramon L Rodriguez, MDL號拉蒙羅德里格斯,海事

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一

Tags: General by heroteo
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Posted: Sun Jul 15, 2007 1:26 am Post subject: Speech Difficulties in

Dear Doctor,

I understand about half of all people with PD are likely develop difficulty with speech. The speech changes that occur are due to inco-ordination and reduced activities of muscles that control the speech mechanism.

The main difficulties I have experience are:
Loss of volume, pitch, range and intonation in the voice.,
speech being either too fast or too slow
uncontrolled repetitions of sounds, words or phrases;
slurred speech;
difficulty initiating speech;
reduced facial expression and natural gesture; and
a harsh, breathy voice.

Is it related with Jaw tremor or trauma (the shock caused by unpleasant and upsetting experience )?

Is it related to tongue-tied/twister(difficulty to speak quickly) caused by neurological disorders?

Is it related with the drooling of saliva from the mouth ?

Best regards

TEOKIMHOE

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Kathrynne Holden, MS, RD

Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Wed Jul 18, 2007 7:04 am Post subject:

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Dear Teo,
Once again, your questions are very good, and relevant. However, this is outside my scope of practice as a dietitian. NPF has an excellent forum, however, that addresses speech concerns. Please go back to “Discussion Corner,” and scroll down to “Talk To A Speech Clinician.” Post your question there for an answer by experts in the field.
_________________
Best regards,
Kathrynne Holden, MS, RD
–

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Posted: Thu Jul 05, 2007 6:17 am Post subject: Emotional disorders and Parkinson Disease

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Dear Doctor,

I refer to my articles.

I had seen the Psychiatrist for our matrimonial relationship in the past and the more I complaint the heave medication would be given as I was a trouble maker in order to calm down my emotional disorders and it was not a successful treatment.

In order to communicate amongst each other in connection with our matrimonial relationship is it advisable to consult Psychology Centre?

Kindly advise.

TEO KIM HOE

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Dr. Fernandez

Joined: 20 Jan 2007
Posts: 90

Posted: Thu Jul 05, 2007 4:15 pm Post subject:

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Definitely. Pharmacotherapy (provided by a psychiatrist) plus psychotherapy (provided by a psychologist), is better than either approach alone.

Yours,
_________________
Hubert H. Fernandez

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Anonymous

Posted: Sat Jul 07, 2007 10:12 pm Post subject: Emotional disorders and Parkinson Disease

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Dear Doctor,

I have seen the doctor of psychologist and was told to do the text on Urinary Metabolic Profile and Kryptopyroles and were part of nutritional diagnostic testing for mood disorder.

Do you believe they are related with the emotional disorders?

Are they effective to reflect the nutritional level that caused the emotional disorder?

At present I am taking anti depression drugs i.e. 1l2 tablet Zyprexa Zydis 10 mg, one Luvox 50mg,1/2 of Rivotril 0.5 mg and one Lexapio 10mg at bed time.

would I cutdown the medication as they are too repetition?

Are they safe of taking antidepression and the effect of sexuality?

Kindly elaborate

TEOKIMHOE

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Dr. Fernandez

Joined: 20 Jan 2007
Posts: 90

Posted: Sun Jul 08, 2007 7:17 am Post subject:

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Sorry, I do not know about the relationship of urinary metabolic profiles and kryptopyroles and depression. It is not something I routinely do, nor do I know if our psychologists/psychiatrists here do that.

What I can tell you in your current medication is that I am concerned you are on zyprexa. It is an antipsychotic drug (usually for hallucinations, but occasionally used for other indications), but this clearly worsens PD. I would get off the drug if I were you. The only 2 antipsychotic drugs that PD patients can safely take are quetiapine and clozapine. All ther rest may worsen PD.

Yours,
_________________
Hubert H. Fernandez

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Anonymous

Posted: Mon Jul 16, 2007 4:24 am Post subject: Emotional disorders and Parkinson Disease

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Dear Doctor,

Thank you for the advices.

My doctor stops me from taking antidepression drugs i.e. 1l2 tablet Zyprexa Zydis 10 mg, one Luvox 50mg,1/2 of Rivotril 0.5 mg and one Lexapio 10mg at bed time.

My doctor replaces them with Seroquel 25mg two tablets and 1/2 of Rivotril 0.5mg at night.

My medications for PD i.e. one sinemet 25/100 two times
with one requip 4mg three times per day.

I am given one Benzhexol HCL 2mg three tablets per day for
treatment of drooling of Saliva.

I was told it is expensive to have BTX treatment for salivary drooling and potential side effects of BTX. It is effective for three months.

Kindly advise

TEOKIMHOE

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Dr. Okun

Joined: 19 Jan 2007
Posts: 251
Location: University of Florida
Posted: Tue Jul 17, 2007 12:35 pm Post subject:

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Botox can be effective for drooling, but is expensive and does need to be repeated every 3-4 months.
_________________
Michael S. Okun, M.D.

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Posted: Sat Jul 14, 2007 5:24 am Post subject: Saliva and PDPosted:周六2007年7月14日5:24分邮政主题:唾液和PD

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Dear Doctor,亲爱的医生,

As there are 70-80% PD patients have saliva drooling from the mouth.由于有70-80%的帕金森病患者有流涎唾液从嘴里. I am one of them.我也是其中之一.

Kindly elaborate the cause of the saliva drooling from the mouth?请说明原因的唾沫口水从口?

What kind of treatment to stop it from drooling?什么样的治疗,以阻止它垂涎?

As For me I have the saliva drooling after I have taken the requip 2mg three times a day.至于我,我的口水唾液后,我所采取的requip2mg/只每天三次.

Best regards问候

Teo Kim Hoe张志贤金锄头

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Dr. Fernandez费尔南德斯博士

Joined: 20 Jan 2007加入:2007年1月20日
Posts: 90职位:90

Posted: Sat Jul 14, 2007 8:03 am Post subject:Posted:周六2007年7月14日9:01分邮政主题:

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Drooling (or sialorrhea) is common in PD.流涎(口水)是常见的肢体. For the most part the cause is not increased saliva production but slowed reflex in automatically swallowing the natural saliva that accumulated in the mouth throughout the day.对大部份的原因是没有增加唾液生产减缓,但反射自动吞咽的唾液自然这样积累的嘴整整一天.

You see, a person without PD does not even notice that saliva is constantly being produced (it is done so to lubricate the whole mouth for talking, eating, etc).你看!一个人没有肢体甚至不公告,唾液不断产生的影响(这是做注油整个嘴来说话,吃东西等). This is because after a certain volume is accumulated, this is automatically swallowed without even thinking about it.这是因为经过一定量的积累,这是自动吞下连思考. But in PD, this automatic swallowing is sometimes lost, thus the salive pools and drools on the side of the mouth.但在PD,这种自动吞咽有时会丢失,因此唾液池及嘴角站在一边的嘴.

The best analogy I can give you is when you go to the dentist and you are told to keep you mouth wide open.最好的比喻,我可以给你的是,当你到牙医,你告诉他们保持你的口是敞开的. You will notice that after some time, your saliva pools and the dentist either has a suction device or allows you to spit/gargle.你会发现,经过一段时间,你的唾液池及牙医要么有吸尘装置,或者允许你呸/含漱. You did not really have increased salivary production at the dentist’s office, but you were not allowed to swallow, thus the pooling of saliva.你没有真正增加唾液生产牙医办公室,但你不能吞食,因此,汇聚了唾沫.

The simplest strategy for this is to simply suck sugar-free (to prevent cavities) candy or chew sugar-free gum all day.最简单的策略,因为这是简单地吸吮无糖(防止蛀牙)糖果,或嚼无糖口香糖一整天. This will trigger your mouth to swallow.这将引发你的嘴吞下.

Sometimes, anticholinergic drugs are used to decrease salivary production (they cause dry mouth).有时,抗胆碱药物,是用来减少唾液生产(它们造成口干). But that is not really addressing the problem since the issue is not increased salivary production.但那不是真正解决了问题,因为问题的关键不是增加唾液生产. It also has lots of side effects (cognitive slowing, blurred vision, urinary hesitancy, etc).它也有很多副作用(认知缓慢,视力模糊,尿液犹豫不决等).

The best therapy, in my opinion, is botulinum toxin injection of the parotid and submandibular gland.最好的治疗,我认为这是肉毒杆菌毒素注射的腮腺和颌下腺. We have some reason to believe that Botox Type B is better than Type A for this indication.我们有理由相信,肉毒杆菌毒素B型比A型这种迹象. But either is generally okay.但无论是一般感冒.

Yours,万事如意
__________________________________
Hubert H. Fernandez朱佩h.费尔南德斯

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Anonymous匿名

Posted: Sat Jul 14, 2007 9:40 am Post subject:Posted:周六2007年7月14日上午09点40分邮政主题:

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Dear Doctor,亲爱的医生,

I refer to the above I have the following for your advise:我指的是段,我有以下几点建议您:

1 Is it the drooling or sialorrhea resulted by the jaw tremor?1,是它的口水还是口水造成的下颚颤抖?

2.2. Is it the neurological disorders associated with drooling of saliva?它是神经病变与口水唾液?

3.Is it an impact on lip, tongue, and jaw in PD speaker intellectuality and articulately?3.is它影响到嘴唇,舌头,下巴钯议长理智与加伊达?

4.4. Is it reduced spontaneous swallowing?它是减少腹水吞下?

5 Are the above contribute to a poor quality of life and a career burden.?5以上的贡献,为穷人的生活质量和事业的负担.?

Best regards问候

TEOKIMHOEteokimhoe

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Dr. Fernandez费尔南德斯博士

Joined: 20 Jan 2007加入:2007年1月20日
Posts: 90职位:90

Posted: Sat Jul 14, 2007 10:51 pm Post subject:Posted:周六2007年7月14日10:51分邮政主题:

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Drooling is not a result of jaw tremor.流口水是不是因下颚颤抖.

If often has no/minimal impact on lip, tongue, jaw or speaking/articulation.如果常常没有/影响微乎其微,嘴唇,舌头,下巴或演讲/articulation.

It is, as I mentioned, often a result of slowed or impaired natural/normal reflex to swallow the saliva regularly.但正如我所说,往往因放慢或受损自然/正常反射吞下唾液定期举行.

Yes, if drooling is severe, it can affect quality of life.不错,如果流口水是非常严重的,它可以影响生活质量.

Yours,万事如意
__________________________________
Hubert H. Fernandez朱佩h.费尔南德斯

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Anonymous匿名

Posted: Sun Jul 15, 2007 12:24 am Post subject:张贴:孙2007年7月15日12:24分邮政主题:

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Dear Doctor,亲爱的医生,

I have a hypothesis about the saliva.我有一个假说,唾液. I sometimes suddenly feel a lot of saliva pooling in the front of my mouth.有时,我突然感到了不少口水汇集在门口把我的嘴. But it但
is only sometimes.只是有时候. True, I may not be swallowing it as well as once but I am *sure* it feels like a sudden surge of saliva being produced and as I have had parotid gland issues before I think I know what that feels like.不错,我未必是它吞下以及一次,但我相信**感觉突然唾液出炉,而正如我曾腮腺问题之前,我想我知道是什么感觉喜欢.

I was diagnosed with Sjogren’s Syndrome years ago.我被诊断患有干燥综合征多年前. There was at times a very dry mouth and other times too much saliva as the parotid tried to make up for the deficit.有次在一个非常口干,其他时间太多,因为唾液腮腺试图使弥补赤字. Dry eyes also watering (as a reaction to the dryness), etc. You probably know this disease.眼睛干涩也是浇水(作为一种反应干燥)等,你大概知道这种病.

My point is that if one has this disease (Sjogren’s) they don’t recover the cells destroyed and theoretically the damage is done.我的意思是,如果你有这病(干燥),他们不收回摧毁细胞,从理论上损害做到这一点. However, after a time all these secretions went back into balance for me.不过,经过一段时间,这些分泌物回去权衡了. I was then told that it was not “true” Sjogren’s but that my symptoms were a result of a disturbed autonomic nervous system, specifically sympathetic, as a part of my Fibromyalgia.当时我说那不是”真实”格伦说,但我的症状都造成了困扰植物神经系统,特别同情,并以此作为我国纤维肌痛.

I did a little research and lo, and behold, it seems very possible that this is true — the sympathetic nervous system a little out of whack could cause too much saliva production in the same way it can cause some of the other commonly mentioned sympathetic nervous system issues.我作了一个小小的研究,螺,看吧,看来,极有可能这是一个事实–交感神经系统有点格格不入失衡可能导致太多的唾液生产一样,它可以导致其他一些常提到的交感神经系统问题.

My point is that I have read that sympathetic nervous system dysfunction is commonly found in PD.我的意思是,我已看过,交感神经系统功能障碍是常见的并发症. I hypothesize a connection to the excess saliva.我猜测联想的唾液过多. Every single book or article one reads says the same thing — poor swallowing –I think mostly because it’s not that important to researchers and one copies the others’ remarks.每一本书或文章,一款是说,同样的事情–穷人吞咽–我想主要是因为它的不这一重要的研究者之一,拷贝他人的言论. But I am guessing if you asked a lot of patients they might say they feel surges of saliva (like when you are hungry and smell a hamburger!).但我猜测,如果你问了很多病人,他们可能会说,他们感到袭来的唾液(如当你饿了,闻到一个汉堡包!!).

Since you doctors are always very sympathetic to the quality of life issues the excess saliva and drooling can cause I thought I would mention it.因为你的医生总是非常同情的生活质量问题过多唾液和口水可造成我以为我会提到它. Also, it could explain good results from the bot ox rather than a bone dry miserable mouth because the botox would be inhibiting the *excess* saliva.另外,它可以解释好成绩,从肉毒而非骨干口苦,因为肉毒会抑制过剩**唾液.

Well, not that you asked my views .好,而不是你问我的意见. .. .but there you have it!.但你有!

Best wishes.良好的祝愿.

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Dr. Fernandez费尔南德斯博士

Joined: 20 Jan 2007加入:2007年1月20日
Posts: 90职位:90

Posted: Sun Jul 15, 2007 7:57 am Post subject:张贴:孙2007年7月15日上午07点57分邮政主题:

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Your views are always welcome.你的意见都是欢迎的.

But we do care about drooling and research is being done on the field.但我们关心的口水和研究,正在做有关的领域.

We now offer botox for this, which was not offered even 5 years ago!我们现在所提供的肉毒毒素,这也是无法提供,甚至5年前!

Yours,万事如意
__________________________________
Hubert H. Fernandez朱佩h.费尔南德斯

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Anonymous匿名

Posted: Mon Jul 16, 2007 5:40 am Post subject: Saliva and PDPosted:周一2007年7月16日上午05点40分邮政主题:唾液和PD

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Dear Doctor,”亲爱的医生,”

I am given to take Benzhexol HCL 2mg for my drooling of saliva i.e. 1 tablet 3 times a day.能给我以盐酸苯2mg/只对我的口水唾液,即1片,每日3次.

i am told that BTX is expensive and has to be given every three months as it is effective for three months only.告诉我的BTX非常昂贵,而且也可以获得每三个月,因为它是有效的只用三个月.

As for antidepression I am given to take 2 tablets of Seroquel 25mg and 1/2 tablet of Rivotril 0,5mg at night.至于抗抑郁能给我以2粒思瑞康93.4%,93.3%和1/2片rivotril0,5毫克时夜. I stop taking Zyprexa Zydis as it worsen the PD patient.我停止服用用药zydis因为关爱帕金森病人.

Kindly advise善意提醒

TEOKIMHOE

Posted: Mon Jul 16, 2007 3:17 pm Post subject:Posted:周一2007年7月16日下午03点17分邮政主题:

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Dr. F –六博士–

I hope you read my remark acknowledging that you DO care.我希望你看过我的话承认你的照顾. I wasn’t sure from what you said.我不知道你刚才说的. You guys (people) are so你的男孩(人)等
compassionate.富于同情心. It’s just heartening to know you are out there.这只是欣慰地知道你在那里.

Best wishes.良好的祝愿.

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Dr. Rodriguez罗德里格斯博士

Joined: 22 Jan 2007加入:2007年1月22日
Posts: 92职位:92
Location: Gainesville, Fl位置:斯维尔,外语
Posted: Mon Jul 16, 2007 4:20 pm Post subject:Posted:周一2007年7月16日4:20分邮政主题:

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Teo:张志贤:

The Benzhexol is fine, but be aware that it may cause confusion or mental slowness in some patients.苯的是好的,但要知道这可能会引起混淆或智力迟钝在一些病人. If it is not causing any problem to you, you can stay on it.如果是不会造成任何问题,你便可以留在这.

This is why Botulinum toxin is an option, because avoids this type of side effects, quite common in some PD patients.这就是为什么肉毒杆菌毒素是一种选择,因为可避免这种副作用相当普遍,在一些PD患者.

As for your depression, I prefer medications like SSRi’s (serotonin reuptake inhibitors) like Lexapro or Zoloft before trying the Seroquel.至于你的抑郁症,我宁愿服用类及SSRI(血清素再吸收抑制剂)lexapro象或舍曲之前尝试的思瑞康. I am fine with the Rivotril.我的罚款与rivotril. The Seroquel is especially helpful in depressed patient with some psychotic symptoms.思瑞康的,尤其是帮助抑郁症患者有精神病症状.

Hope this helps.希望这有助于.
__________________________________
Ramon L Rodriguez, MDL号拉蒙罗德里格斯,海事

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