HeroTeo - The Parkinson’s Fighter

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Anonymous
Posted: Tue Oct 30, 2007 2:02 am Post subject: Hypersalivation and Parkinson’s

There are 31% of Parkinson’s Patients have hypersalivation (excessive saliva) locked deep down in the throat that cause itching as they feel comfortable to cough and clear the throat all the times.

Besides the saliva drooling from the mouth that they feel uncomfortable as the excessive saliva is thick as a glue.

It is a chronic cough for Parkinson’s patients that causing them with insomnia also. This cough use to be at evening.

I am one of the sufferers. In order to ascertain whether it is a phlegm or saliva I have undergone Chest X Test and the result shown there is any phlegm in my chest.

Besides I have taken antihistamine (sedative) I also do CPOD test/ Pulmonary Function Test and the result there is no obstructive airway defict and no signficant response to bronchiectasis, normal lung volume and normal DLco.

I do not suffering from any breathing irregularity. Can you elaborate the above symptom in relation with Parkinson’s?

What are the best treatment besides my medication? My medication are : one dose of Atarax 25 gm for itching and two doses Ropect (Rotuss) for cough daily. I have little improvement of the above medications> Best regards TEOKIMHOE
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Dr. RodriguezJoined: 22 Jan 2007Posts: 92Location: Gainesville, Fl
Posted: Tue Oct 30, 2007 8:57 pm Post subject:

Swallowing is important to handle secretions, I recommend you assess your swallowing. Some people benefit from using guaifenesin to thin secretions, this is mostly anecdotal. There are some medications to decrease hyper salivation that can be tried._________________Ramon L Rodriguez, MD
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Tags: Medication by heroteo
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Further to my website I posted titled :Phlegm, Saliva,Cough and Parkinson’s Disease”, I have consulted a Pulmonoglist in Bumrungrad Hospital Bangkok to ascertain the causes of the phlegm deep in my throat and also to find out whether I am suffering from Chronic Pulmonary obstructive Disease (CPOD) as a result of Parkinson’s Disease.

After I have gone Pulmonary Function shown there are no obstructive airway defect,no significant response to bronchitis, normal lung volume and Normal Dulci; Inspired volume was less than 90% of best vital capacity.

I was told that the phlegm is actually thick saliva locked deep down in my throat.Due to my medication the saliva become thicker and stringier. The thick saliva locked down my throat that is itching and I feel the needs to cough and clear my throat all the times.

In fact excess saliva in the mouth which causes drooling, is one of the syndrome and feature of Parkinson’s . Studies shown that 70-80% pf people with Parkinson’s experience this problem.

In fact the condition is not due to excess production. On the contrary most people with Parkinson’s actually produce less saliva. The problem is that PD reduces the frequency of automatic swallowing, and this in turn allows saliva to accumulate within the mouth that causes saliva drooling when the mouth is opened. This is why PD have mask face (poker face)

In fact PD patients feel socially embarrassing for the above that are reluctant to go out in public.

Injection of toxin to reduce the saliva is one of the solution and it is effective for six months, Using atropine eye drops in the tongue once or two daily may help to alleviate the situation.

My medications for the treatments are: 2 doses of Prevacid 30 gm, 2 doses of Ropect (Rotuss) and one dose of Atarax 25mg daily

TEOKIMHOE

Tags: General, Medication by heroteo
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Anonymous
Posted: Mon Oct 29, 2007 10:25 am Post subject: Urination and Parkinson’s

I have experienced a lack control as far as urination is concern.

Firstly, when I am in the midst of urinating, I am unable to hold back or stop halfway through.

Secondly, when I feel the need to urinate I must go to the toilet immediately. I will not be able to hold back at all. I have seen Urologist and was told my PSA is normal though I have slight enlarged prostate gland.

My medication: 1 Capsule Detrusitol SR 4 mg and one dose Harnal 0.2mg taken after breakfast daily.

Kindly clarify whether the above is it related to Parkinson’s Disease? If it is please explain why and how this affects my problem of urination? Is it ageing process? Combination cause of enlarged Prostate gland and Parkinson’s?

Thanks TEOKIMHOE
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Dr. RodriguezJoined: 22 Jan 2007Posts: 92Location: Gainesville, Fl
Posted: Mon Oct 29, 2007 11:42 am Post subject:

I do not believe is a result of the PD and is more likely a result of enlargement of the prostate, quite common in men over 50y/o._________________Ramon L Rodriguez, MD
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In fact there are 27-29% of PD have bladder and urinary difficulties.

Unlike bowel dysfunction which becomes motor feature at the early stage of PD urinary and bladder dyfunction with PD becomes evident at later stages of Parkinson’s.

The primary function of the bladder is twofold- to store urine and then to empty the urine when it is convenient and socially acceptable to do so.

The most common urinary symptoms experienced by people with PD
are first the need to urinate extremely frequently and difficulty in delaying urination once the need perceived , creating a sense of urinary urgency.

Therefore urinary problem is a feature amongst PD and they should not hesitate to bring these problems to the doctor and seek for treatment.

TEOKIMHOE

Tags: Medication by heroteo
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Anonymous
Posted: Tue Oct 23, 2007 5:55 am Post subject: Misdiagnosing disease

The Star Monday, 23/04/2007 Misdiagnosing disease Parkinson’s patients being sent to psychiatrics instead PETALING JAYA: Some Parkinson’s Disease (PD) patients have been misdiagnosed as suffering from depression and were referred to psychiatrics, said a neurologist. “We have to teach the public that the moment they have tremors, they have to think about PD.” “Patients suffering from depression may have slower movements but not tremors,” said Dr Chew Nee Kong at the Red Tulip campaign of World Parkinson’s Disease Day recently. He said some also has been sent to heart specialists because of their difficulty in breathing and to bone specialists because they had body aches. “As a result of the non-specific nature of the disease, coupled with the lack of specialists and public awareness, diagnosis can be a challenge and delayed,” he said. Symptoms of PD include the slowing down in speech and body movements, softening of voices and lacking in facial expression resembling ageing process. “Patients tend to think of these as a natural process and do not seek treatment,” said Dr Chew. PD is the result of lack of dopamine, a biochemical substance that is needed for body movement. Patients lack energy, have uncontrollable trembling of hands, sometimes of the head and jaw, and body stiffness. “With newer medication and brain surgery, patients do not have to suffer anymore. PD patients can now lead normal lives for 15 to 20 years,” he said. “In 95% of PD cases, the cause was unknown while the other 5% were due to inherited genes or chemical substance in the environment,” he said.
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Anonymous
Posted: Mon Aug 13, 2007 2:44 am Post subject: Q: Bloating and Parkinson Patient

Bloating is a very common gastrointestinal condition that million of people around the world suffer from each and everyday. Chances are that there is really nothing wrong with you if you find that your are experiencing bloating and there is no need to be alarmed. However it is different with the Parkinson patient. Besides eating food that may not particularly agree with your system , having constipation. There are Parkinson medications or vitamins that have been shown to cause bloating. Treatments for bloating depending on how bad your symptoms are. TEO KIM HOE
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Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Mon Aug 13, 2007 7:06 am Post subject:

Dear Teo, Thanks for your post, it’s a good reminder that bloating can be caused by a number of conditions, and it’s important to talk with your doctor. The PD medications known as agonists, such as Requip and Mirapex, can cause bloating. Also, gastroparesis (slowed stomach emptying) can cause excess stomach acid, which, mixed with food, creates gas and bloating in the stomach. I encourage all folks to talk with your doctor if this occurs._________________Best regards, Kathrynne Holden, MS, RD — For a Parkinson Tip of the Day visit: http://www.nutritionucanlivewith.com/
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Anonymous
Posted: Sat Oct 20, 2007 3:52 am Post subject: Bloating and Parkinson Patient

Dear Dr. Kathrynne Holden, I am glad that you are my respected doctor. You are working hard for the awareness of Parkinson’s patients. Lord bless you. In view of the above articles I am recently diagnosed that I have reflux acid. It causes saliva drooling from my mouth and excessive phlegm deep in my throat. I have poor cough occasionally when I lie down at bed. My phlegm is thin as a glue. I do not have COPD (Chronic obstructive pulmonary disease} as told by my Pulmonary specialist. As what you have mentioned the Parkinson’s medication known as agonists, such as Requip can cause bloating,saliva and phlegm deep in the throat that irritated with cough when one rests at bed. I could not sleep at night and taking “Ativan “and it wear off in 3- 4 hours thus no relief from early morning awakening. I have consulted Lung Specialist for the treatment and am taking two doses of Prevacid 30 mg before food daily. As for my insomnia 2 doses of Ativan before bed time. In this connection should I cutdown the taking of Requip from 12 mg to 8 mg and substitute with one extra of Sinemet from two doses to three doses daily? Sinemet is the wonder drug. My doctor Dr. Chew agrees with the changes. However I am worry does the changes affecting my physically agility at the Gym? In this connection kindly advise me on how to get away or substitute the taking “Ativan” for insomnia as it has sideeffect if I regular use over time and increase significant risks in the elderly like me. It could develop over-sedation, confusion and balance impairment increasing the risk of falls. Kindly advise me TEOKIMHOE

Anonymous
Posted: Tue Oct 23, 2007 12:38 am Post subject: Bloating and Parkinson Patient

Dear Mr Teo Dopamine agonists such as Requip do not cause your symptoms of bloating, phlegm etc. You should continue the Requip at the same dose (12 mg per day). Dr Chew
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Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Tue Oct 23, 2007 10:23 am Post subject:

Dear Teo, Acid reflux is not uncommon among those with PD. It may be a result of slowed stomach emptying (gastroparesis), which occurs when PD slows the movement of the muscles of the stomach, so that food remains in the stomach for an abnormally long time. The food, mixed with stomach acid, creates gas, which pushes the acid contents upward into the throat, creating acid reflux. This can cause persistent coughing, as you note. However, to the best of my knowledge the drooling of saliva is a different matter, not related to the reflux, nor to the Requip. This may occur due to “hypersalivation” as a result of PD; but more often, it occurs because one forgets to swallow as often as needed. Phlegm and Mucus is not at all uncommon among folks with PD. Here are a couple of suggestions; one or the other has worked for most people: 1) Alkalol: Medications, breathing through the mouth, sleeping with the mouth open, using medications that cause dry mouth, and other conditions can sometimes lead to a buildup of sticky mucous that’s difficult to swallow. If so, ask your dentist whether it might be helpful to try swishing the mouth, or gargling, with a mouthwash called Alkalol. Alkalol is a mucous solvent; ingredients include thymol, eucalyptol, menthol, camphor, benzoin, potassium alum, potassium chlorate, sodium, bicarbonate, sodium chloride, and oils of sweet birch, spearmint, pine, and cinnamon, plus 2/100 of 1% alcohol. It is commonly used as a mouthwash, nasal spray, and gargle, to cut mucous. People with sleep apnea, singers with throat irritation, and others use Alkalol, but it’s fine as a daily mouthwash also. Alkalol is available at most U.S. drugstores; if your dentist agrees it might be useful, ask the pharmacist to point it out. If they don’t carry it, the pharmacist can order it: The Alkalol Company Taunton, Massachusetts 02780-0952 or, online by the case (I have no personal experience with the following company, and do not endorse it, nor receive payment from it): Case of 12: $33.58 http://www.medichest.com/alkalolliquidcaseof1.html For an article that describes various ways of irrigating, as well as use of Alkalol and other solutions, please see: http://www.allergybuyersclub.com/faqs/faq-sinusitis.shtml — A forum friend comments: Sips of pineapple juice (not pineapple drink or juice with sugar, just plain juice or papaya (the fruit) will help relieve the throat of mucous and excess saliva. Another forum friend’s comment: I have used Alkolol for about six weeks now and find it very helpful. I bought a salt water nasal spray bottle and emptied it and filled it with straight Alkolol for sinuses. I only use it a couple times a week as needed. For gargling I find it takes a tiny swig out of the bottle. Just a little bit cuts through all the dry mouth and throat build up. Its great and inexpensive. 2) The combination of fenugreek and thyme has helped a number of people who have problems with drooling or excess mucus. It can be obtained in capsule form at many health food stores. Regarding medication changes, I cannot assist you, as this is outside my scope of practice as a dietitian._________________Best regards, Kathrynne Holden, MS, RD — For a Parkinson Tip of the Day visit: http://www.nutritionucanlivewith.com/

Anonymous
Posted: Wed Oct 24, 2007 5:05 am Post subject: Bloating and Parkinson Patient

Dear Mr Teo Take three tablets of Ativan at night. Two tablets may not be sufficient for you. Don’t worry about sleeping pills - they are safe. Most of my PD patients are on sleeping pills because insomnia is common in PD. Dr Chew
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Tags: Medication by heroteo
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Anonymous
Posted: Mon Aug 13, 2007 2:44 am Post subject: Q: Bloating and Parkinson Patient

Bloating is a very common gastrointestinal condition that million of people around the world suffer from each and everyday. Chances are that there is really nothing wrong with you if you find that your are experiencing bloating and there is no need to be alarmed. However it is different with the Parkinson patient. Besides eating food that may not particularly agree with your system , having constipation. There are Parkinson medications or vitamins that have been shown to cause bloating. Treatments for bloating depending on how bad your symptoms are. TEO KIM HOE
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Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Mon Aug 13, 2007 7:06 am Post subject:

Dear Teo, Thanks for your post, it’s a good reminder that bloating can be caused by a number of conditions, and it’s important to talk with your doctor. The PD medications known as agonists, such as Requip and Mirapex, can cause bloating. Also, gastroparesis (slowed stomach emptying) can cause excess stomach acid, which, mixed with food, creates gas and bloating in the stomach. I encourage all folks to talk with your doctor if this occurs._________________Best regards, Kathrynne Holden, MS, RD — For a Parkinson Tip of the Day visit: http://www.nutritionucanlivewith.com/
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Anonymous
Posted: Sat Oct 20, 2007 3:52 am Post subject: Bloating and Parkinson Patient

Dear Dr. Kathrynne Holden, I am glad that you are my respected doctor. You are working hard for the awareness of Parkinson’s patients. Lord bless you. In view of the above articles I am recently diagnoised that I have reflux acid. It causes saliva drooling from my mouth and excessive phlegm deep in my throat. I have poor cough occassionlly when I lie down at bed. My phlegm is thin as a glue. I do not have COPD (Chronic obstructive pulmonary disease} as told by Pulumonoglist.

As what you have mentioned the Parkinson’s medication known as agonists, such as Requip can cause bloating,saliva and phlegm deep in the throat that irritated with cough when one rests at bed. I could not sleep at night and taking “Ativan “and it wear off in 3- 4 hours thus no relief from early morning awakening.

In this respect my Pulumonoglist prescribed me two doses of Prevacid 30 mg taken before the food daily.

As for my insomnia 2 doses of Ativan taken before the bed time.

In this connection should I cutdown the taking of Requip from 12 mg to 8 mg and substitute with one extra of Sinemet from two doses to three doses daily?

Sinemet is the wonder drug. My doctor Dr. Chew agrees with the changes.

However I am worry does the changes affecting my physically agility at the Gym?

In this connection kindly advise me on how to get away or substitute the taking “Ativan” for insomnia as it has sideeffect if I regular use over time and increase significant risks in the elderly like me. It could develop over-sedation, confusion and balance impairment increasing the risk of falls. Kindly advise me TEOKIMHOE
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Anonymous
Posted: Tue Oct 23, 2007 12:38 am Post subject: Bloating and Parkinson’s Patient

Dear Mr Teo Dopamine agonists such as Requip do not cause your symptoms of bloating, phlegm etc. You should continue the Requip at the same dose (12 mg per day). Dr Chew
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Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Tue Oct 23, 2007 10:23 am Post subject:

Dear Teo, Acid reflux is not uncommon among those with PD. It may be a result of slowed stomach emptying (gastroparesis), which occurs when PD slows the movement of the muscles of the stomach, so that food remains in the stomach for an abnormally long time. The food, mixed with stomach acid, creates gas, which pushes the acid contents upward into the throat, creating acid reflux. This can cause persistent coughing, as you note. However, to the best of my knowledge the drooling of saliva is a different matter, not related to the reflux, nor to the Requip. This may occur due to “hypersalivation” as a result of PD; but more often, it occurs because one forgets to swallow as often as needed. Phlegm and Mucus is not at all uncommon among folks with PD. Here are a couple of suggestions; one or the other has worked for most people: 1) Alkalol: Medications, breathing through the mouth, sleeping with the mouth open, using medications that cause dry mouth, and other conditions can sometimes lead to a buildup of sticky mucous that’s difficult to swallow. If so, ask your dentist whether it might be helpful to try swishing the mouth, or gargling, with a mouthwash called Alkalol. Alkalol is a mucous solvent; ingredients include thymol, eucalyptol, menthol, camphor, benzoin, potassium alum, potassium chlorate, sodium, bicarbonate, sodium chloride, and oils of sweet birch, spearmint, pine, and cinnamon, plus 2/100 of 1% alcohol. It is commonly used as a mouthwash, nasal spray, and gargle, to cut mucous. People with sleep apnea, singers with throat irritation, and others use Alkalol, but it’s fine as a daily mouthwash also. Alkalol is available at most U.S. drugstores; if your dentist agrees it might be useful, ask the pharmacist to point it out. If they don’t carry it, the pharmacist can order it: The Alkalol Company Taunton, Massachusetts 02780-0952 or, online by the case (I have no personal experience with the following company, and do not endorse it, nor receive payment from it): Case of 12: $33.58 http://www.medichest.com/alkalolliquidcaseof1.html For an article that describes various ways of irrigating, as well as use of Alkalol and other solutions, please see: http://www.allergybuyersclub.com/faqs/faq-sinusitis.shtml — A forum friend comments: Sips of pineapple juice (not pineapple drink or juice with sugar, just plain juice or papaya (the fruit) will help relieve the throat of mucous and excess saliva. Another forum friend’s comment: I have used Alkolol for about six weeks now and find it very helpful. I bought a salt water nasal spray bottle and emptied it and filled it with straight Alkolol for sinuses. I only use it a couple times a week as needed. For gargling I find it takes a tiny swig out of the bottle. Just a little bit cuts through all the dry mouth and throat build up. Its great and inexpensive. 2) The combination of fenugreek and thyme has helped a number of people who have problems with drooling or excess mucus. It can be obtained in capsule form at many health food stores. Regarding medication changes, I cannot assist you, as this is outside my scope of practice as a dietitian._________________Best regards, Kathrynne Holden, MS, RD — For a Parkinson Tip of the Day visit: http://www.nutritionucanlivewith.com/
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Tags: Medication by heroteo
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Anonymous
Posted: Fri Oct 19, 2007 10:48 am Post subject: Phlegm and cough:Parkinson’s

Further to the above article there are 15% Parkinson’s patients starting the levodopa thereapy report the above diseases. Is it the cause of the disease (excessive phlegm deep in the throat and saliva) the sideffect of the levodopa therapy? Is it the cause of the level of levodopa wearing off? What are the treatment i.e reducing or adjusting levodopa dose times or otherwise? What’s about anti acid dose? Is it the cause of “heartburn” complaints aggravated by the Parkinson’s progression with times? TEOKIMHOE
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Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Tue Oct 23, 2007 10:03 am Post subject:

Dear Teo, Excessive phlegm among people with PD can have a number of different causes. - Some of the PD medications (particularly selegeline) can cause dry mouth and thickened phlegm - Some people tend to breathe through the mouth, rather than the nose, thus drying and thickening mucus and phlegm - Often, people drink too little water and other fluids, leading to mild dehydration. This, too, can lead to drying of the tissues of the mouth and throat, and thickened phlegm. I have not heard that PD itself, nor antacids, can cause this phlegm. However, acid reflux can cause damage to the throat, leading to coughing. But this is a different matter than the phlegm. Yes, heartburn can get worse over time, and this you must discuss with your physician, who will choose the best solution for your particular needs. It may be that something as simple as chewing Tums (calcium carbonate) will help; in more extreme cases, prescription medication may be needed._________________Best regards, Kathrynne Holden, MS, RD — For a Parkinson Tip of the Day visit: http://www.nutritionucanlivewith.com/
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Tags: General, Medication by heroteo
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Anonymous
Posted: Sat Oct 20, 2007 6:39 pm Post subject: Nutrition,Levodopa and I

Dear Dr.Kathrynne Holden, As a Dietitian could you tell us ” Nutrition “is helpful for those with Parkinson’s. Why is it related with Parkinson’s health? What are the Nutrition could help Parkinson’s health i.e slow gastrointestinal tract, constipation, bloating, phlegm, saliva drooling ,swallowing, nausea, insomnia, and appetite loss. All sickness as mentioned are the one side effects or risks taking levodapa for Parkinson’s treatment. Why Parkinson’s patient are at increased risk for malnutrition, most of them are weight loss, insomnia and low blood pressure? What are they related with nutrition-related diseases? Kindly advise me what is optimal nutrition for people with Parkinson’s and the need to maintain nutrition level. Is it yearly blood test your vitamin level and exercises? Why a combination of levodopa( treating Parkinson’s) and protein cause problems with our body’s absorption? How to avoid them? What is the optimal time to take lavodapa to reduce the conflict with Protein? Kindly brief them. TEOKIMHOE
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Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Tue Oct 23, 2007 10:10 am Post subject:

Dear Teo, Good nutrition is important for everyone, but there are specific concerns with PD. Many people get less exercise, thus the muscles begin to shrink, and bone loss occurs. People are also more apt to experience falling as PD progresses, and with weaker muscles and thinner bones, they are less able to prevent falls, and more likely to break bones when they do fall. Constipation occurs more frequently with PD, and is best managed by including plenty of fiber and fluids in the daily diet, along with as much exercise as is possible. There are many other concerns, and I recommend you email the National Parkinson Foundation for a copy of “Nutrition Matters.” Go to: http://www.parkinson.org/ Click “Publications” Here, you’ll find the free series of excellent booklets. I recommend them all; but for your purposes, “Nutrition Matters” should answer your questions. There is a form available for you to order as many as you need; or you can telephone, if you prefer._________________Best regards, Kathrynne Holden, MS, RD — For a Parkinson Tip of the Day visit: http://www.nutritionucanlivewith.com/
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Tags: General, Nutrients by heroteo
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Anonymous
Posted: Fri Oct 19, 2007 8:34 pm Post subject: Saliva and phlegm with Parkinson’s

I have poor cough occasionally especially at bed. I have seen Lung Specialist and my lung is clear. I was told I have reflex acid. Besides my saliva drooling from my mouth I have thin phlegm deep in my throat’. It is white and looking like glue. Is it the side effect of medication ? At present I am taking requip 12 mg and Sinemet 20/100 2 doses per day. Is it overdose ,”mean ” wearing off , optimize or reducing the doses? I am taking 2 doses of Pravacid 30 mg daily to thinner the phlegm deep in my mouth. I find difficulty with my speech as saliva drooling from my mouth. Kindly enlighten me TEOKIMHOE
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Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Tue Oct 23, 2007 10:04 am Post subject:

Dear Teo, Please see my previous message, which should answer your questions._________________Best regards, Kathrynne Holden, MS, RD — For a Parkinson Tip of the Day visit: http://www.nutritionucanlivewith.com/

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Introduction to Parkinson’s Disease (PD) Dr Chew Nee Kong Consultant Neurologist Pantai Cheras Medical Centre Kuala Lumpur. 8th October 2007. Email: nkchew33@hotmail.com What is PD? PD is a progressive, nervous disorder characterized by a deficiency of dopamine, a biochemical substance in the brain that is important for coordination of body movement. PD is named after Dr James Parkinson, a British general physician who wrote the first comprehensive report on this illness in 1817. What is the cause of PD? PD is a mysterious illness - to date the cause of PD is generally unknown. There is also no cure yet. As such the symptoms of PD deteriorate with time despite medications. Despite this, the available treatment (medications and brain surgery) are effective in improving the quality of life of PD patients. What are the symptoms of PD? The commonest symptoms are tremor (uncontrollable trembling of hands), slowness of movement and body stiffness. These symptoms result in difficulty in getting out of a chair, starting to walk, writing and turning over in bed. However, it is important to note that the symptoms of PD start very slowly and can be so subtle that sometimes patients themselves do not realize they have the disease until at least several years after its onset. Occasionally, the observant spouses and immediate family members are the first ones who notice the early symptoms. Quite often, it is the slowness of movement rather than tremor that brings a patient to see a doctor. This is because tremor by itself is usually not as disabling as slowness of movement especially in carrying out basic daily activities such as bathing, walking and eating. Who are at risk for getting PD? PD does not spare any race or ethnic group - it is seen in any country in this world. PD can affect any age group but it is most common in elderly people. It is known to affect even children and teenagers (hereditary parkinsonism) but this is very rare. Age is an important risk factor for PD, with the incidence rising with age. Thus, PD is generally an illness of elderly people. However, a small percentage of PD patients are relatively young. A study which was carried out at University Malaya Medical Centre, Kuala Lumpur (1998) on 153 PD patients showed that the onset of symptoms was at age 20-45 in 20.9% of patients (one patient had onset of symptoms at age 24). How is PD diagnosed? This is carried out based on typical history and bed-side examination. A good response to medications further support the diagnosis of PD. Brain scans and blood tests are generally not necessary. What are the treatment options for PD? During the early to moderate stage of PD (first 10-15 years), most patients are on medications alone. However, as the physical disability of PD patients become more severe with time, after 10-15 years of illness, many PD patients have difficulty carrying out daily activities despite taking maximal medications. At the advanced stage of PD (after 10-15 years), brain surgery is effective in relieving the main symptoms of PD such as slowness of movement and tremor. Currently, surgical treatment is available in Malaysia. Supportive treatment involves counseling, dietary advice, physiotherapy (exercise) and rehabilitation (social and occupational therapy while specific treatment employs drugs and brain surgery. Conclusions Even though there is no cure for PD, it is important to recognize the existence of PD because the rapid improvement in the treatment has resulted in much better quality of life. PD patients should not be made to suffer as they used to be. There are so many new and effective medications for PD. With the increase in the proportion of elderly people in the society, there will be more and more PD patients in the near future.

Parkinson’s Disease Discussion Corner All of you are welcomed to join Mr Teo Kim Hoe, a Parkinson’s patient, in discussing any issue or problems regarding Parkinson’s Disease. Share your experiences and knowledge so that all Parkinsons patients will have a better life.
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Dr. RodriguezJoined: 22 Jan 2007Posts: 92Location: Gainesville, Fl
Posted: Mon Oct 22, 2007 3:39 pm Post subject:

Thanks for your comments Mr. Teo. Good luck!_________________Ramon L Rodriguez, MD
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