Patients with Parkinson’s disease and their family members often have many questions. Below we answer a few of the more common questions you may have about this disease and its treatment.
Q: What are the signs of Parkinson’s disease?
A: Parkinson’s disease—originally called the “shaking palsy”—is diagnosed based on the presence of one or more of the primary symptoms, which can easily be remembered by the acronym TRAP: tremor, rigidity, akinesia/bradykinesia and postural instability.
- Tremor: In the disease’s early stages, about 70 percent of patients experience a slight tremor on one side of the body, usually in the hand or foot (although sometimes in the jaw or face). This tremor has a characteristic appearance. It takes the form of a rhythmic back-and-forth motion at a rate of four to six beats per second. It’s most obvious when a person is under stress.
- Rigidity: Most PD sufferers experience muscle inflexibility or stiffness, caused by the disruption in the normal movement of muscles that stretch when in motion and relax when at rest. In Parkinson’s patients, an affected limb’s muscle tone cannot relax, which leads to a decreased range of motion. This rigidity can also cause pain and cramping.
- Akinesia/Bradykinesia: This is the loss of spontaneous automatic movement (akinesia) or a slowdown in movement (bradykinesia). Either condition can make daily activities very difficult. Over time, Parkinson’s disease can reduce the patient’s ability to initiate voluntary movements such as buttoning a shirt, taking a shower, or combing his or her hair. While walking, the patient’s steps may be short and shuffling.
- Postural Instability: Parkinson’s patients often suffer from impaired balance, which may lead to falls. Individuals with postural instability may not be able to steady themselves if bumped. Some develop a condition called retropulsion, a dangerous tendency to swing backward. PD patients may also develop a stooped posture, in which the head is bowed and the shoulders droop.
There are other symptoms that may accompany Parkinson’s disease—some are minor, others are more complex. These include: depression, emotional changes, swallowing problems, speech changes, urinary problems, constipation, skin problems, edema, dementia or cognitive problems, a drop in blood pressure while standing up (called orthostatic hypotension), muscle cramps, dystonia, pain, fatigue, sexual dysfunction, drooling and an inability to initiate movement.
The good news is, many PD symptoms can be treated with medication and therapy.
Q: Who gets Parkinson’s disease?
A: It is estimated that about one out of every 100 people age 60 and older, and one out of every 250 people age 40 and older, have Parkinson’s, although getting a precise count is difficult. The disease affects men and women more or less equally, and does not discriminate by race or socioeconomic status. The average age of onset is 60.
Q: How is Parkinson’s disease diagnosed?
A: There are no specific tests that can diagnose Parkinson’s disease. In fact, diagnosis is often delayed because the symptoms are mistaken for another condition or misread as the normal signs of aging. A Parkinson’s diagnosis can only be made by a neurologist following a neurological exam. The diagnosis relies on clinical information provided by the patient and the findings from the neurological exam.
Q: What is the treatment for Parkinson’s?
A: Unfortunately, there is no cure for Parkinson’s disease. Parkinson’s is a very individualized disease; each person will experience it differently, and will require his or her own unique treatment plan. The goal of treatment is to reduce symptoms and allow the patient to function normally. There are several medications that can manage PD symptoms. The most common is called Levodopa-carbidopa. It is very effective at reducing the tremors and other PD symptoms during the disease’s early stages, allowing most PD patients to extend the period of time in which they can lead relatively normal, productive lives. The choice of medication often depends on the side effects the patient experiences, as well as his or her ability to tolerate the medication.
There is also a surgical option. Deep brain stimulation (DBS) has become the standard for treatment. It uses electrodes surgically implanted into part of the brain; the electrodes are connected by a wire under the skin to a pulse generator, which is implanted in the chest beneath the collarbone. The pulse generator and electrodes painlessly stimulate the brain and can help stop many PD symptoms.
Q: What other treatments are helpful for individuals with Parkinson’s disease?
A: There are a number of complementary and supportive treatments that can help. These include physical therapy, occupational therapy and speech therapy, which are used to address issues related to gait, balance, rigidity and voice disorders.
Diet and exercise are also important. A high-fiber diet along with plenty of fluids can help patients deal with constipation. Patients taking Levodopa-carbidopa may also need to avoid a high-protein diet, which can interfere with the medication’s effectiveness. There is also ongoing research into whether the supplement Coenzyme Q10 can help slow the progression of Parkinson’s disease.
Exercise, meanwhile, helps PD patients improve their mobility and flexibility. Therapy and muscle-strengthening skills are often used to reduce rigidity and improve the patient’s range of motion. Exercises for PD can include walking, gardening, exercise machines and even Tai Chi.
Q: What other services are available to PD patients or their family members?
A: At the Florida Hospital Parkinson’s Outreach Center, we offer several area support groups which allow people battling this disease to learn from each other and share news and experiences. Some support groups also offer exercise classes and music therapy. The Outreach Center also has information on Parkinson’s disease, and can link you to information referral services and supportive counseling services. Give us a call today at (407) 303-5295 or email us at firstname.lastname@example.org.
Read the Florida Hospital Parkinson’s Outreach Center’s newsletter, which is full of great information about managing the disease.
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For patients battling PD, Social Security Disability can be a lifesaver. You can download a Social Security Disability application here.
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If you have an appointment with the Florida Hospital Parkinson’s Outreach Center, there’s some information we need to best serve you. Please download this form, which will help you prepare for your appointment.
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Get the most out of your medical appointment, including organizing materials and what questions to ask your physician with this information.
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