HeroTeo - The Parkinson’s Fighter

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Since being diagnosed with Parkinson’s two years ago at age 60, I have experienced muscle stiffness in my legs, back and neck and overall weakness. Is this caused by the disease? Is weight lifting the best therapy?

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A:

Muscle weakness is not usually seen as part of Parkinson’s disease but can be the result of decreased activity due to the different symptoms of Parkinson’s disease. And yes, muscle stiffness is one of the primary signs of PD. Thus, an adjustment to your antiparkinson medication regimen may be needed to help relieve this concern.

Of course, overall stiffness can also be due to a lack of exercise. Regular exercises which target all the muscles of the body are essential in helping to keep these muscles healthy and mobile. Weight lifting is good exercise IF it is a form of exercise you enjoy and thus will perform on a regular basis (minimum of 3 times per week; daily is better). Full range-of-motion exercises are more important than strength exercises in Parkinson’s disease

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Q:

Are there any diet recommendations that are proven to be effective to decrease symptoms? I have heard about a low-protein diet and then read about the high-protein diet being helpful. Please advise. (anonymous)

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A:

There is no scientific proof that any specific diet can decrease the severity of PD symptoms. However, it is known that meals high in protein can block the absorption of Sinemet in some patients so that an individual dose might not be as effective as when taken on an empty stomach. The most useful strategy would be to take the dose of Sinemet a half hour prior to eating a meal or 45 minutes after finishing.

That said, there are other issues with regard to diet and the PD patient. As a side effect of some of the antiparkinson medications and because of the slowness of muscles seen in PD (including the muscles used to process and eliminate foods), constipation is a fairly common problem. A diet designed with these problems in mind can be very helpful (in addition to daily exercise!). Weight loss is another problem that is fairly common in the PD population. This can be due to swallowing difficulties which can be seen in the later stages of PD in some patients, or even slowness of movement of food through the throat. By this I mean that more advanced patients may eat more slowly, and before they are able to eat their fill, the food is cold and unappetizing. Smaller, more frequent meals or re-heating portions may help with this problem. Some persons with PD can also experience a reduced sense of taste or smell which can have an impact on a person’s appetite. For such individuals, foods that are more flavorful may be more tempting.

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Does Parkinson’s disease cause confusion and hallucinations even when off all medications? (anonymous)

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Some patients can experience mental confusion as part of Parkinson’s disease or as side effects of the medications. If hallucinations occur without taking any medications, then the diagnosis may not be Parkinson’s disease, but perhaps one of the Parkinson-plus syndromes. Or, there may be an additional problem, separate from Parkinson’s disease, causing the hallucinations. This question should be raised with the neurologist taking care of the person in question

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I would like to know what to expect in the end stages of PD. Is unresponsiveness a common problem? (GG)

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The first thing to be determined is if this state of “unresponsiveness” is voluntary (for example, the patient is depressed and chooses not to respond), or involuntary (an example of this might be the patient’s symptoms are so significant that even blinking or otherwise showing they understand might be difficult or impossible). Other concurrent health concerns (known or as yet undiagnosed) may need to be considered as well.

The final stage of Parkinson’s (Stage 5) is characterized by the patient being bed- or wheelchair-bound for most, if not all the day, and requiring assistance for all the basic activities of daily living. How long a patient might remain in this “stage” is impossible to predict as much can depend on the care provided, on other concurrent health issues and even the patient’s own will to live.

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Can you please explain the stages of Parkinson’s disease? I need to know what to expect as the disease progresses so that I can be prepared for it. (CH)

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A:

The “staging” of Parkinson’s disease (PD) is not based on symptoms seen but rather on the level of limitations the person with PD is experiencing. For example, Stage 1 is defined as minor involvement on only one side of the body with no limitations in daily activities. Stage 5 is defined as sigificant limitations, bed or wheelchair-bound and requiring assistance with all daily activities.

There are many symptoms that can be seen as part of Parkinson’s, but not every person with this diagnosis is going to experience every one or any symptom in a particular order. And because everyone’s activities of daily life can differ greatly, a symptom such as tremor that might limit or bother one person may not interfere in someone else’s life which doesn’t require a steady hand.

Therefore, I would rather encourage you to learn about Parkinson’s disease itself to understand what symptoms are possible to be seen and what therapies are available to help limit the severity of these symptoms should they be experienced. I would encourage you to learn about exercise and dietary considerations and coping strategies for different symptoms that may arise. Know what’s possible AND that there are things that can be done so IF such problems arise, you can recognize them and are prepared to tackle them.

We can help as we offer a wide variety of printed materials which cover most all aspects of Parkinson’s (re-visit our website at www.pdf.org); we have four counselors available to help via our toll-free HelpLine (800)457-6676. We have resources to other organizations, agencies, foundations, etc. which, should the need arise, we are happy to share.

Let us know how we can help.

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What are the initial symptoms of Parkinson’s disease? Can the symptoms be confused with those of other diseases? (anonymous)

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A:

The “initial” symptoms seen in PD patients can vary greatly from patient to patient. While one may originally complain of changes in handwriting,
another will first notice changes in his golf swing or her ability to
run, stop and turn easily when playing tennis. One may notice a tremor in
his hand while another will be bothered by his inability to smile easily.
Yet another may notice some stiffness in an extremity that they may relate
to arthritis while another may first experience some balance problems.
Others may experience changes in their voice quality. The list goes on.
And, each of these problems can be related to other difficulties. This is
why a consultation with a doctor (usually a neurologist who specializes in the diagnosis and symptomatic treatment of movement disorders) is often necessary to arrive at a correct diagnosis. This is also why many patients initially receive an incorrect diagnosis from their general practitioner or internist.

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Can PD be diagnosed by blood test; for example, testing for levels of dopamine. And has any new drug with fewer side affects come out for
treatment? (anonymous)

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A:

Blood tests are only helpful in ruling out another possible cause of
tremors. Unfortunately, a blood test cannot determine the levels of
dopamine in the substantia nigra - the area of the brain in PD where
dopamine is deficient.

With regard to drugs used to treat the symptoms of PD having fewer side
effects, the newer drugs tend to be “more specific.” By this I mean that as new drugs are developed, scientists are becoming more able to pinpoint their target areas more specifically. For example, the newer agonist drugs, Mirapex and ReQuip, are “more specific” than the older agonists Parlodel and Permax. Thus, fewer side effects are seen as a result.

However, one must remember that any drug powerful enough to provide benefit
is also powerful enough to induce side effects. Thus, a physician
knowledgeable about the uses of these drugs is most helpful in limiting the
side effects seen.

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In the early stages, is PD commonly mistaken for some other disease or syndrome? (JM)

A:

In the early stages of the disorder and/or under the care of a less-experienced physician, yes, the symptoms of PD can be mistaken as other health problems or other health concerns can be mistaken as Parkinson’s. If there is any question about a diagnosis, a second opinion should be sought - preferably with a neurologist who has a subspecialty in movement disorders (the category in neurology under which PD and other similar disorders fall).

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How close are scientists to finding a cure for Parkinson’s disease? And what more will it take to find a cure?

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A few years ago, many scientists were so optimistic about progresses being made that they were then suggesting we could have a cure within five to seven years. Unfortunately, this was based on the rate of discoveries of past scientific advances and this has turned out not to be a truly accurate way to predict the future. Thus, now more than seven years later, we still have no cure.

But, this is not to say that scientists have not continued to advance our knowledge of the brain, of Parkinson’s disease and how it affects the brain, and these same scientists continue to develop new ways to study PD and to limit the symptoms. But a cure is still beyond our means

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I would like to know if doctors are getting any closer to finding a cure for Parkinson’s disease? And would you happen to know how much longer it might be ’til we do?

A:

Until we actually have a proven cure, it is hard to estimate just how close scientists may be to developing one. Some more optimistic scientists have suggested we could see a cure for PD within the next five years though most of my advisers do feel this is too optimistic. Much will depend on the money available to support ongoing research and the sad fact is that all granting institutions receive more worthwhile grant requests than we are able to fund. Thus, the key to finding a cure for Parkinson’s disease is going to be in finding more ways to support the work being proposed by highly reputable scientists all over the world.

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