Sunday, August 31, 2008

Parkinson's patients should use caution driving

Parkinson's Patients Should Use Caution Driving
by Taryn SimpsonLifestyle
Most people will agree that driving gives them a sense of independence. After all, people use driving to run errands such as grocery shopping, or to “get away from it all."
Driving in our culture is as natural as breathing and therefore, it is no wonder that losing the ability to drive has a huge impact on daily life. Older senior citizens will face this situation at some point in their lives. However, some people lose the ability to drive due to other reasons, like a disability.Parkinson’s disease afflicts people in their younger years as well as when they are senior citizens. Age is not necessarily the factor that causes problems with driving. In this case, Parkinson’s disease symptoms will be a deciding factor for being a safe driver or not.Think about it, there are times when Parkinson’s disease patients have difficulty with stiffness in their limbs, which may cause problems when they move their foot from the brake to the accelerator. Not to mention the difficulty of split-second decision making for patients who deal with cognitive problems. There is also the issue of “sleep attacks” that can occur suddenly in some patients. It goes without saying that this can be a very dangerous issue.So when should a Parkinson’s patient stop driving? The answer will vary for every patient. A good rule of thumb is if the patient’s symptoms are steadily becoming worse, it might be time to suggest a driving test at your local DMV. In any event, talk with your neurologist and bring a family member with you so that all questions can be addressed.Source:
Neurology Now, July/Aug 2008


Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Thu Sep 18, 2008 10:07 am Post subject:

Thanks for the post, we prefer to get the drivers test at a rehab center where in some cases they may be able to offer some help. It is important to have a low threshold to get checked!_________________Michael S. Okun, M.D.

Ten things you may not know about Parkinson's

Anonymous
Posted: Mon Sep 15, 2008 9:02 am Post subject: Ten things you may not know about parkinson's disease

Here are ten things you may not know about Parkinson’s disease: • It is a disease that occurs in the middle or late life. Its peak age of onset is in the 60s (range is 36 to 86 years). • More than one million individuals are afflicted by Parkinson disease in the United States of America. • Risk factors for developing Parkinson’s disease are a strong family history of the disease, male gender, head injury, exposure to pesticides, consumption of well water, and rural living. • Factors associated with decreased incidence of Parkinson’s disease are coffee drinking, smoking, use of nonsteroidal anti-inflammatory drugs, and estrogen replacement treatment in women who are postmenopausal. • Tremor (shakes) associated with Parkinson’s disease is most pronounced in the hands. It is most marked at rest and it is typically a ‘pill rolling’ of thumb over fingers. • A person with Parkinson’s disease may not have tremor; making diagnosis particularly difficult in such individuals. • There is never total paralysis; although this is implied by the name of the disease. It is common to find tremor, rigidity, bradykinesis (slowness), and loss of postural reflexes. • One-third of all persons affected will eventually develop intellectual deterioration (also known as dementia). • Despite the progressive nature of the disease, much can be achieved with good medical management, and sufferers may continue for years to live effective, happy lives in spite of this affliction. • An important part of any treatment program is the maintenance of optimum general health and planned exercise program, activity and rest. Formal exercises regulating posture and harmonizing this with mental strength can help mobility enormously- example Chinese qigong.

Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Thu Sep 18, 2008 10:10 am Post subject:

Thanks for the post. I removed the drug advertisement, as we are an information only board, Thanks again._________________Michael S. Okun, M.D.

Wednesday, August 13, 2008

Blood Clot and Medication

I have blood clot (T.I.A) recently.
My medications One dose Plavix Clopidognel 75mg and Zocor 20mg daily.
After my blood clot I am active in gym exercises and my agility and flexibility are increased. I take part weight lifting, Body combat, Box and Kick exercises and body pump daily
My questions are:
Any chances would I receive another stroke after receiving the Plavix treatment (thinning my blood clot)?
Should I slowdown my gym exercises to prevent another stroke?
Is it true once you had a stroke it would come again (major stroke) within tw0 -three years?
How would prevent another stroke by medication, lifestyle and diets?
I was told that once you received the Plavix/aspirin medication you have to stop taking them for one to two weeks before any surgeries therapies on you?

Tuesday, August 12, 2008

Difficulty falling into sleep?



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Anonymous
Posted: Thu Sep 11, 2008 8:01 pm Post subject: Difficulty falling into sleep?

Dear Doctor, We have difficulty falling into sleep? How to differentiate between normal difficulty sleeping and difficulty sleeping associated with Parkinson’s disease?

TEOKIMHOE
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Mon Sep 15, 2008 6:30 am Post subject:

This problem can indeed be challenging. We take a careful history and treat the sleep problem regardless of the PD status. Sometimes we even get a sleep study, and often we work on sleep habits._________________Michael S. Okun, M.D.

Why exercise are so important for Parkinson's

Daily exercise therapy is one of the best things that you can do for yourself to counteract the negative effects of Parkinson's disease & other neurological & muscular disorders. A lack of physical activity reduces the amount of oxygen to the brain, contributes to further cell damage, loss of cognitive skills and muscle control.
Exercise brings additional oxygen & glucose to the brain, both of which are crucial to brain function. The body responds by forming new capillaries to bring the additional blood to nerve cells and by boosting brain chemicals that protect neurons and strengthen new neuronal connections. Remarkable results have been achieved, over time, with daily mental & physical exercise therapy. Mental concentration on repetitive physical movements can provide benefits to our muscles as well as our mental ability to control them.
When nerve cells are deprived of stimuli they atrophy, suggesting that stimulation of the central nervous system by physical activity may retard the loss of nerve cells in the brain and elsewhere. Exercise has been shown to enhance blood flow to various parts of the brain as well as to increase the speed with which nerve messages travel through the brain.
In addition to the effects of Parkinson's, most people diagnosed with this disease are over the age of 50 and therefore are also experiencing the normal effects of aging.
However the good news is that we now know that most of the changes in our musculoskeletal system that were attributed to normal aging are in fact the result of inactivity and or insufficient physical exercise. The less physical activity and exercise we do the less capable we become.
According to the Mayo Clinic, "Exercise has important benefits for everyone regardless of age or physical condition... When your condition threatens to immobilize you, Exercise keeps you moving... to retain your mobility & function, use it or lose it".


As an exercise therapist for the Parkinson Assn. of S.W. Florida (a National Parkinson Foundation Center of Excellence), Susan Branco, a member of the National Council on Aging & the American Senior Fitness Association has seen first hand the positive results that her therapeutic exercise program has on participants in her classes.
Susan's program is now available on video or DVD, for use in the privacy of your home. If you or someone you know has Parkinson's disease, using this exercise program daily, can make a difference.
This seated exercise program was designed especially for people with Parkinson's Disease and other neurological or muscular disorders. An exercise program like this one should be a main component in your treatment plan. This tape offers stretching and strengthening routines that will help to minimize the negative effects that Parkinson's disease and other neurological and muscular disorders can have on your body. Using this tape regularly will help to improve overall flexibility and fitness level so that you can maintain a higher level of independence.

Source: Hope Digest- News and Reasearch



Meditation and Parkinson's Disease

2
Meditation and Parkinson's Disease
by Taryn SimpsonEmotional Impacts
Many holistic and some medical professionals are firm believers in meditation—especially if you have stress that needs to be released. Many people may think that learning to meditate is difficult. Actually, learning how to meditate is quite easy! There are several types of meditation to choose from such as:
Simple mediation
Walking meditation
Transcendental meditation
Mindfulness meditation
Movement meditation
As we all know, stress exacerbates Parkinson’s symptoms. In order to help alleviate symptoms, meditation is a very useful tool. For our purposes here, I will explain how to do “Simple Meditation.”Simple MeditationPlan to make meditation part of your daily routine. The best time to do meditation is first thing in the morning and then again in the evening. Set aside 10-20 minutes of time for each session.
Choose a comfortable, quiet place to meditate
Choose a time when you will be uninterrupted
Sit comfortably–you may want to try different positions
Close your eyes and try to relax
Pick a focus word or phrase that will initiate the beginning of your session (reciting a poem or a phrase that gives you peace and comfort, such as Om or “I am at peace”)
Take deep breaths–breathe in slowly and breathe out slowly.
Be aware of your body. Start at the top of your body and focus on relaxing your forehead, your mouth, tongue, neck, and shoulders, and so on until you reach your toes
Once you are completely relaxed, repeat an affirmation or focus word or phrase. Block all worries or free floating anxiety from your thoughts. Instead, use the focus phrase or word such as “I am at peace, I have energy,” or “I feel rejuvenated”
Once you have completed the meditation for 10-20 minutes, allow yourself to slowly open your eyes and start to move. You have just completed your first meditation exercise!Source:Holistic Online

Monday, August 11, 2008

Am I Parkinson's Patient?

Posted: Fri Aug 08, 2008 8:11 am Post subject: Am I Parkinson's Patient?

Besides exercises medications are important for PD patients as it helps your body movement and flexibility as well as mobility. Consistenance, persistence, endurance and medication are the key for you to combat the disease. I am spending three hours daily to attend gym classes in the fitness centre from monday to saturday except sunday. I engage two trainers to align my body posture, stretching stiffness muscles, cardio and weights lifting as welll as box and kick exercises to train my endurance and balance two times a week. I spend nearly three years in the gym to combat the parkinson's diseases. I do not look like PD as told by my neurologlist and instructors as well as fitness members. I am driving to fitness centre daily.
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Mon Aug 11, 2008 6:02 am Post subject:

Exercise is like a drug in PD so you are making great choices. There is lots of research now that is beginning to support exercise as an important and potentially powerful treatment._________________Michael S. Okun, M.D.


Anonymous
Posted: Wed Aug 13, 2008 1:52 am Post subject: Is Parkinson's is not a bad disease?

From my experience, I have learnt that all Parkinson's patient is different from each other, in many aspects such as symptomatology, rate of disease progression and response to treatment. Managing my Parkinson's patients has been made easier by respecting the differences between each Parkinson's patients - there are no "two Parkinson's patients who are identical". One day, a man came to my clinic and asked me why his 62-year-old wife, who suffered from Parkinson's, could hardly walk despite having the illness for only four years. "I read an article in the newspaper which described how an elderly Parkinson's patient, who had been having the illness for twelve years, was doing some rather strenous exercises in a gym. How come my wife can't do even 5% of this exercise?" he commented. As I have treated his wife for about six years, I could easily understand why she behaved so differently from the other "super-fit" Parkinson's patient. His wife suffered from severe anxiety and depression, while her Parkinson's was actually quite mild. In other words, what "crippled" her was her mood disorder, and not the Parkinson's. Almost all the time, she would just lie on the bed or sit on a chair. Whenever her husband tried to help her to stand up, she would complain of dizziness and feeling like falling down. In addition, she had numerous other symptoms such as blurring of vision, numbness of hands, palpitation, etc (which were the symptoms of anxiety). Her social life was almost zero - she stayed at home all the time and even refused to follow her children to the restaurant. Thus, an important factor that contributes to the varying response to treatment is co-existing psychiatric disorders. Most Parkinson's patients have anxiety or depression or both, in varying degrees, which I think are partly due to difficulty in accepting their illness (i.e. Parkinson's). Some Parkinson's patients are devastated by Parkinson's while others are crippled by the psychiatric disorders (anxiety / depression). Unfortunately, psychiatric disorders in PD are very often neglected by both the patients and doctors. Mr Teo is fortunate that he does not have any psychiatric disorder. In fact, he has a very unusually "outgoing" personality, which most Parkinson's patients do not have. Mr. Teo is an optimistic person who has accepted his Parkinson's, and he always tries his best to cope with his illness. It is this "optimistic" personality that has made him so different from other Parkinson's patients. Dr Chew Nee Kong, Kuala Lumpur.
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Sun Aug 17, 2008 12:09 am Post subject:

Thanks for the wonderful comment._________________Michael S. Okun, M.D.

Older adults and Medication

Older adults who experience dizziness, constipation, upset stomach, sleep changes, diarrhea, incontinence, blurred vision, mood changes, a rash or other symptoms after taking a drug should call their doctors. The following suggestions may also help:
Tell your doctor about all the drugs you take. If you have several doctors, make sure they all know what the others are prescribing, and ask one doctor (such as an internist or general practitioner) to coordinate your drugs.
Keep track of side effects. New symptoms may not be from old age but from the drug you're taking.
Learn about your drugs. Find out as much as you can by asking questions and reading the package inserts. Both your doctor and pharmacist should alert you to possible interactions between drugs, how to take any drug properly, and whether there's a less expensive generic drug available.
Have your doctor review your drugs. If you take a number of drugs, take them all with you on a doctor's visit.
Ask the doctor, "When can I stop taking this drug?" and, "How do we know this drug is still working?"
Ask a pharmacist what foods to take with each drug. Some drugs are better absorbed with certain foods, and some drugs shouldn't be taken with certain foods.
Follow directions. Read the label every time you take the medication to prevent mistakes, and be sure you understand the timing and dosage prescribed.
Don't forget to take your medicines. Use a memory aid to help you -- a calendar, pill box, or your own system. Whatever works for you is best.

What to Ask the Doctor

Before you leave your doctor's office with a new prescription, make sure you fully understand how to take the drug correctly. Your pharmacist can also provide valuable information about how to take your medicines and how to cope with side effects. Ask the following questions:

What is the dosing schedule and how do I take it?
What should I do if I forget a dose?
What side effects should I expect?
How long will I be on this drug?
How should I store this drug?
Should I take this on an empty stomach or with food? Is it safe to drink alcohol with this drug?

Source: WebMD

Sunday, August 10, 2008

T.I.A (Blood Clot ) and medication

Recently I have a Blood Clot and been given:
1 Plavix Clopidogrel 75 mg and 1 Zocor to thinning my blood and lowering my cholesterol daily.
Is Plavix effective to prevent a major stroke as there are 75- 100% chances to have within 2 -5 years?
My PD medications are: 4 mg Requip, 1 Jumex 5mg, 3 Sinemet CR , 3 Serc 16 mg, 3 Motilium 10 mg and 1 Seroquel 25 mg daily
I have my blood test on antioxidant and vitamin & mineral profile and taking vitamin supplements.
I am also doing hormone therapies treatment.
I am taking them for the past of three years and going well before I have a T.I.A
Recently I have a dizziness and my blood pressure is normal between 125-140/70-75. I am driving daily.
Is it the sideeffect of the Plavix/aspirin as it contains acid?
Your advise will be appreciated'
TEOKIMHOE

Box and Kick Exercise

It is a good exercise for Parkinson Patient.
I am taking this Box and Kick Exercises (Thai Boxing) for two and half years in my fitness centre besides body combat. I engage a trainer to guide me two times a week and each training last for a hour.
It is advisable to engage a trainer as PD patients would find difficulty to do box and kick exercises as it involves your body balance and mobility. You need endurance and flexibility whilst doing Box and Kick exercise.
I have a T.I.A stroke recently.
There are 75- 100 % chances to have another major stroke within 2 to 5 years.
Kindly advise me should I avoid this strenuous exercise ?
TEOKIMHOE

Breathing and Parkinson's Patient

I understand there are so far few articles touch on subject on Breathing with PD patients.There are many types of breathing in which the rhythm, rate or characterise abnormal.. Breathing is the alternation of active inhalation of air into the lungs through the mouth or nose with the passive exhalation of the air. As PD patients have stiffness muscles and slowdown movement some PD have reduction in nasal airflow with Breathing. They have cyclical variation in the rate, which becomes slower until breathing stops for several seconds before speeding up to a peak and then slowing again.It occurs whether sensitivity of the respiratory centres in the brain is impaired .Therefore most PD die on pneum0nia disease
TEOKIMHOE

Five things new patients should know?

There are five things new patients should know by Dr. Wagner:-
1. Parkinson’s disease is certainly treatable and most new patients respond very nicely to medication.
2.A person with Parkinson’s disesae has the same life expectancy as a normal person.
3.New patients usually go through a “honeymoon period” where treatment will control symptoms so well that you won’t even notice the effects of the disease. As the disease progresses, symptoms may be more noticeable.
4.Once you are diagnosed, start making accommodations for yourself, particularly at home. People with PD have a tendency to fall frequently so avoid situations where falls may occur.
5.Don’t be shy about asking your neurologist questions; don’t rely on the Internet for accuracy
TEOKIMHOE


Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Mon Aug 11, 2008 8:06 am Post subject:

Thanks for the wonderful comments._________________Michael S. Okun, M.D.

Anxiety

Posted: Fri Aug 08, 2008 8:03 am Post subject: Anxiety?

More people with parkinson's disease suffer from anxiety than depression.

I am with Requip 4 mg / 4 mg / 2 mg, Sinemet one / half / half and Selegiline 5 mg bd. My blood pressure is no longer low. In fact it has gone up to 150 / 80 in the late evening. In the evening, I also feel tired and tense. I know that my Parkinson's is well controlled, but I am often worried about the possibility of recurrence of TIA. I can fall asleep easily with Lorazepam 1.5 mg at night, but often wakes up early (4 am). After that, I can't fall asleep anymore. Kindly advise.
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Dr. FernandezJoined: 20 Jan 2007Posts: 90
Posted: Sat Aug 09, 2008 4:51 pm Post subject:

Hi, Difficulty maintaing sleep at night is very common in PD. The reasons for this are varied. Most often it is because of low levels of medication such that the patient feels uncomfortable therby waking up often. Sometimes, it is because of too much naping during the day, depression, anxiety, etc. Low blood pressure when sleeping is not usually a concern because you are lying flat which brings blood supply to the brain. So, the first thing I would suggest is to talk to your doctor to discuss the possibility of simply making your requip 4 mg three times per day. If this does not help, you can see if adding a sinemet CR at night might help. If not, then you need to look at other causes of sleep fragmentation. Perhaps even consider a sleep study (termed polysomnography). Or change your sleeping pill to another brand. Yours,_________________Hubert H. Fernandez
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Tuesday, August 5, 2008

End of Dose Wearing off (EODWO)?

End-of-Dose Wearing Off (EODWO)

As PD is " not going disease' i.e. a slow progression and is different from other disease i.e a self -limited sickness or injury that temporarily impact their lives as inconvenience or comfort.


Patients with Parkinson's disease (PD) who are taking levodopa therapy – the most widely-used may experience the effects of their medication "wearing off" sooner than their health care providers realize.

Wearing off refer the worsening of a parkinson’s disease symptom as its use inability to control parkinson's symptoms over time. It lasts for shorter periods, causing symptoms to re-emerge before the next dose. This phenomenon is known as "wearing off." '

There are almost 50 percent of PD patients receiving levodopa therapy begin to notice that their medication lasts for shorter periods, causing symptoms to re-emerge before the next dose within two to three years.

"Wearing off" is associated with the re-emergence of motor symptoms (e.g. tremor and problems with balance), non-motor symptoms (e.g. anxiety, fatigue, mood changes, and restlessness), and autonomic nervous system dysfunction (e.g. sweating and hypersalivation).

"To date, the frequency of end-of-dose 'wearing off' in a general neurology practice is unknown, and no specific tools exist to aid clinical diagnoses of its signs and symptoms," said Dr. Hauser.

As parkinson’s disease is a movement disorder attention has focussed on problems with movement. However there are symptom are not related with movement they are classified as non-motor symptoms. Some non motor symptoms may interpret as part normal course of disease. However they are bothersome than motor symptoms. Non-motor symptoms can include changes in thoughts and feelings, sensations and sense of well-being and changes in autonomic nervous system functions


Dr. FernandezJoined: 20 Jan 2007Posts: 90
Posted: Sat Aug 09, 2008 4:43 pm Post subject:

thanks!_________________Hubert H. Fernandez

Monday, August 4, 2008

Is Parkinson's the end of the life?

Anonymous
Posted: Sun Aug 03, 2008 1:40 am Post subject: Is Parkinson's the end of the life?

As PD not a disease by itself but rather a syndrome therefore parkinson is not the end of life. It is not the illness and not a"going away" disease. It progresses with time. Therefore we need the knowledge of the disease, a power on how to counter the disease to slowdown from its progression. Medication and exercises are important to activate your mobility and align your movements. Discipline yourself on your physical activities help you to have a quality of life. Diets and supplements are helpful for body maintance too. TEOKIMHOE
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Mon Aug 04, 2008 6:17 am Post subject:

Thanks for the comment._________________Michael S. Okun, M.D.

Parkinson's is not the End
by Staff Condition Overview
It’s there if we want it, but we must reach for it. Fulfillment is not far and is entirely accessible. A diagnosis of Parkinson’s disease is not a sentence of something terrible, if we accept it as we accept without question the consequences of ageing! We must move ahead into that part of our future within our control by:
Identifying our unused talents and skills.
Applying them.
How do we identify our latent abilities? Easy! Make a list, a long list, of goals in which you have an interest (what would you really like to do or be?), and one or two will stand out as being the most appealing because you plan to work on them first. It can get exciting! Every one of us has hidden abilities we have not yet used, as I discovered. Until I was a year or so into Parkinson’s, I had not realized I was able to write well. Now I have authored quite a few books. I discovered yet another hidden talent in writing children’s books. My new full-time avocation is keeping me busy and constantly presents new goals.
Just as Satisfied With Life Now As I Was Before Parkinson's Hit!
I wish to add the very important fact that I quit driving years ago— before I did something bad. This keeps me at home most of the time. My lovely bride of 37 years works full time, but that’s OK. I have plenty to look forward to, every day, as I count my blessings. Life is good.

An surge of interest of Parkinson's

Anonymous
Posted: Sun Aug 03, 2008 9:06 am Post subject: New interest in an old disease

Dear Doctor,

Parkinson is an old disease since eighteen century.

Suddenly there is an surge of interest and publicity as there are recently more young Parkinson's patients.

Exercises suddenly a hot topic to be discussed to slowdown the PD disease. TEOKIMHOE
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Mon Aug 04, 2008 6:15 am Post subject:

Thanks for the comment. PD has been around a long time... Shakespeare....why dost though quiver man?_________________Michael S. Okun, M.D.

Lifestyle of PD and the family

Anonymous
Posted: Sun Aug 03, 2008 1:49 am Post subject: Lifestyle of PD and the family

Lifestlye of PD and the family

As PD is not a going on disease the nature of PD disease and the rate of progression, varies differently from one to other. They have to learn how to overcome difficulties i.e. lifestyle that it takes longer or concentration to accomplish a task once considered automatic. There are emotional, psychological, financial, family relationsip and social life for them to learn how to cope up. "Why me" anxiety, fear, helplessness and loss of control if are not managable made worsen by PD disease.These are normal reactions amongst the PD patients. Teo Kim Hoe
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Mon Aug 04, 2008 6:14 am Post subject:

Thanks for the comments._________________Michael S. Okun, M.D.

Sunday, August 3, 2008

Is Parkinson's not a so bad disease and is easy to control?

Anonymous
Posted: Thu Jul 31, 2008 3:45 am Post subject: Is Parkinson's is not a so bad disease and easy to control?

Dear Doctor,

I was diagnosed as a Parkinson's patient in the year of 2005. Besides medications I do exercises in the gym daily. I spend two hours in the gym and I have two personnel trainers who help me to strenghten my physical mobility and body flexibilities. I do yoga,body combat,pump, Box and kick exercise and cardio training. I am normal and don't look like anything is wrong actually had been told by my doctor, physical trainers and members of my family. Though it is expensive to battle. Is Parkinson's not a bad disease and is so easy to control?

TeoKimHoe
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Dr. FernandezJoined: 20 Jan 2007Posts: 90
Posted: Sat Aug 02, 2008 3:34 pm Post subject:

Thanks, Tim. PD affects people differently. For some people, the symptoms are very mild, they don't even realize they have PD. Yet for others, they are devastated by the ilness.

Fortunately, for those with significant illness, we now have better drugs to help patients.

There are a few more factors that play a role into this:

1. presence of co-morbidities. PD patients who are affected by the illness who are otherwise healthy will tolerate the disease much better than those who also have heart disease, diabetes, high blood pressure, etc.

2. interaction with doctors. Pd patients and families who have a good relationship with their doctors have better adjustments of their medications.

3. caregiver support. PD patients who have good family and social support do better than those who do not.

4. Patient's outlook and attitude. Like any other illness, patients with a great attitude go a long way than those who do not.

Yours,_________________Hubert H. Fernandez

From my experience, I have learnt that all Parkinson's patient is different from each other, in many aspects such as symptomatology, rate of disease progression and response to treatment. Managing my Parkinson's patients has been made easier by respecting the differences between each Parkinson's patients - there are no "two Parkinson's patients who are identical". One day, a man came to my clinic and asked me why his 62-year-old wife, who suffered from Parkinson's, could hardly walk despite having the illness for only four years. "I read an article in the newspaper which described how an elderly Parkinson's patient, who had been having the illness for twelve years, was doing some rather strenous exercises in a gym. How come my wife can't do even 5% of this exercise?" he commented. As I have treated his wife for about six years, I could easily understand why she behaved so differently from the other "super-fit" Parkinson's patient. His wife suffered from severe anxiety and depression, while her Parkinson's was actually quite mild. In other words, what "crippled" her was her mood disorder, and not the Parkinson's. Almost all the time, she would just lie on the bed or sit on a chair. Whenever her husband tried to help her to stand up, she would complain of dizziness and feeling like falling down. In addition, she had numerous other symptoms such as blurring of vision, numbness of hands, palpitation, etc (which were the symptoms of anxiety). Her social life was almost zero - she stayed at home all the time and even refused to follow her children to the restaurant. Thus, an important factor that contributes to the varying response to treatment is co-existing psychiatric disorders. Most Parkinson's patients have anxiety or depression or both, in varying degrees, which I think are partly due to difficulty in accepting their illness (i.e. Parkinson's). Some Parkinson's patients are devastated by Parkinson's while others are crippled by the psychiatric disorders (anxiety / depression). Unfortunately, psychiatric disorders in PD are very often neglected by both the patients and doctors. Mr Teo is fortunate that he does not have any psychiatric disorder. In fact, he has a very unusually "outgoing" personality, which most Parkinson's patients do not have. Mr. Teo is an optimistic person who has accepted his Parkinson's, and he always tries his best to cope with his illness. It is this "optimistic" personality that has made him so different from other Parkinson's patients. Dr Chew Nee Kong, Kuala Lumpur.
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Parkinson's Is "Not Such a Bad Disease?"
by Patricia LightnerEmotional Impacts
Diane, a woman with Parkinson’s, recently explained an unfortunate experience.
I actually had a doctor tell me: "Parkinson's is not such a bad disease. It’s so easy to control. Look at you; you don't look like anything is wrong," I didn't even respect the comment by an answer. I was so mad.He doesn’t see me when I'm at the end of a dose, or my meds are not working, or he doesn't realize many reasons why it’s very difficult to live with. It’s a very expensive disease and a battle.
People with Parkinson's interact with people who do not have all the information about the disease or medical research.Keep in mind that these are opportunities for you to share some of your experiences and develop some understanding. Who knows? You may convince someone to be an advocate for Parkinson's disease and the science that could render a cure.


Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Tue Sep 23, 2008 9:22 am Post subject:

Thanks for the wonderful note!_________________Michael S. Okun, M.D.