By Susan Varbedian Lucken, R.N., B.S.N.
What do Michael J. Fox, Alan Alda, Neil Diamond, Linda Ronstadt, Mu-hammad Ali and Janet Reno all have in common? If you guessed Parkin-son’s disease, you would be correct.
Parkinson’s disease is a progressive nervous system disorder that affects movement. Symptoms start gradually, sometime starting with a barely no-ticeable tremor in just one hand. Tremors are common, but the disorder also commonly causes stiffness or slowness of movement.
In the early stages of Parkinson’s disease, your face may show little or no expression. Your arms may not swing when you walk. Your speech may become soft and slurred. Parkinson’s disease symptoms worsen as your condition progresses over time.
Although Parkinson’s disease can’t be cured, medications might signifi-cantly improve your symptoms. Occasionally surgery may be indicated to regulate certain regions of your brain and improve your symptoms.
Parkinson’s disease signs and symptoms can be different for everyone. Early signs may be mild and go unnoticed. Symptoms often begin on one side of your body and usually remain worse on that side, even after symptoms begin to affect both sides. Signs and symptoms may include:
- Tremor. A tremor, or shaking usually begins in a limb, often your hand or fingers. You may rub your thumb and forefinger back and forth, known as pill-rolling tremor. Your hand may tremor when it’s at rest.
- Slowed movement. Over time, Parkinson’s disease may slow your movement, making simple tasks difficult and time-consuming . Your steps may become shorter when you walk. You may have trouble get-ting out of a chair. You may drag your feet as you try to walk.
- Rigid muscles. Muscle stiffness may occur in any part of your body. That can be painful and limit your range of motion.
- Impaired posture and balance. Your posture may become stooped or you may have balance problems.
- Loss of automatic movements. You may have decreased ability to perform movements such as blinking, smiling or swinging your arms while walking.
- Speech changes. You may speak softly, quickly or slur or hesitate before talking. Your speech could also become monotone.
- Writing changes. You may have difficulty writing and your writing may appear small.
In Parkinson’s disease, certain nerve cells ( neurons ) in the brain gradu-ally break down or die. Many of these symptoms are due to a loss of neu-rons that produce a chemical messenger called dopamine. When dopa-mine levels decrease, it causes abnormal brain activity, leading to symp-toms of Parkinson’s disease.
The cause of Parkinson’s disease is unknown, but several factors appear to play a role, including:
- Your genes. Researchers have identified specific genetic mutations that can cause Parkinson’s.
- Environmental triggers. Exposure to certain toxins or environmental factors may increase the risk of later Parkinson’s, but the risk is rela-tively small.
- Age. The risk of Parkinson’s increases with age. It ordinarily begins in middle or late life. People usually develop the disease around 60 or older, but Michael J. Fox is a good example of a person getting it at a rather young age.
- Heredity. Having a close relative with Parkinson’s disease increases the chances that you’ll develop the disease. However, your risks are still small unless you have many relatives in your family with Parkin-son’s.
- Gender. Men are more likely than women to develop Parkinson’s.
- Exposure to toxins. Ongoing exposure to herbicides and pesticides may significantly increase your risk.
- Thinking difficulties. You may experience dementia and thinking difficul-ties in the later stages of the disease.
- Depression and emotional changes such as fear, anxiety or loss of mo-tivation.
- Swallowing problems. Saliva may accumulate in your mouth due to slowed swallowing, leading to drooling.
- Sleep problems and sleep disorders. These can include waking up fre-quently during the night, waking up early or falling asleep during the day.
- Bladder problems such as inability to control urine or having difficulty urinating.
- Constipation due to a slower digestive tract.
You may also experience:
- Blood pressure changes such as dizziness and lightheadedness when you stand.
- Smell dysfunction. You may have difficulty identifying certain odors.
- Fatigue or pain
- Sexual dysfunction. Decrease in sexual desire or performance.
No specific tests exist to diagnose Parkinson’s disease . A Neurologist will diagnose Parkinson’s based on your medical history, a review of your signs and symptoms, and a complete neurological and physical exam. Blood tests and certain types of imaging can rule out other conditions that may be causing your symptoms, but imaging tests aren’t particularly helpful for diagnosing Parkinson’s.
In addition to your exam, your doctor may give you a medication such as Sinemet which is a Parkinson’s medication. If you show significant im-provement with this medication, it will often confirm your diagnosis of Parkinson’s.
Parkinson’s disease can’t be cured, but medications can help control your symptoms, often dramatically. Your doctor may also suggest aerobic exercise, physical therapy, stretching and speech therapy.
There are several different types of medications that may help you man-age problems with walking, movement and tremor. These medications increase or substitute for dopamine. People with Parkinson’s have low brain dopamine concentrations. However, dopamine can’t be given di-rectly, as it can’t enter your brain. Levodopa is the most effective Parkin-son’s medication. It’s a natural chemical that passes into your brain and is converted to dopamine. It is combined with carbidopa which protects levodopa from early conversion to dopamine outside your brain. This lessens side effects such as nausea.
Surgical procedures such as insertion of deep brain stimulators can also be used but most often in people with advanced Parkinson’s who have unstable medication responses.
You should see your doctor if you have any of the symptoms associated with Parkinson’s – not only to diagnose your condition but also to rule out other causes for your symptoms. Parkinson’s can be profoundly frustrat-ing as walking, talking and even eating become more difficult and time consuming. Depression is also common and your doctor can prescribe antidepressants if necessary. You may also consider Parkinson’s support groups which your doctor can discuss with you as well.
If you’ve received a diagnosis of Parkinson’s disease, you’ll need to work closely with your doctor to find a treatment plan that offers you the great-est relief for symptoms with the fewest side effects. Certain lifestyle changes may help make living with Parkinson’s easier.
A Note from the Parish Health Ministry
Over the past three years, the Parish Health Ministry has been committed to helping you take care of your body, a gift from God. Each month, I have shared important information to help educate and inform you through Heart-to-Heart, and I have been moved by how many of you have told me how helpful this ministry has been for you. As we consider ways to continue to serve our parish’s health and well-being, we have decided to take a hiatus from Heart-to-Heart. Please feel free to give us your feedback and let us know how we can continue to help your mind, body and spirit.
Thank you for your support!