As a degenerative disease, Parkinsons wears down your motor skills over time, leaving you bedridden towards the end of its lifecycle. You have to make sure you treat your symptoms or else lose independent ambulation after an average of eight years and be bedridden after ten years. Luckily, with the increased amount of attention the disease receives, it has become difficult to find individuals suffering from Parkinsons disease that aren’t receiving treatment. People plagued with the disease have a lot of options for treatment. The ideal option depends on the current state of the patient’s conditions. Patients who are further along in the disease’s lifecycle are limited in what they can do to stop the progression of the disease.

For the past 30 years, the most common treatment has been Levodopa. This drug increases patient’s amount of dopamine, but it has its fair share of side effects. There’s no treatment that will immediately address the symptoms of Parkinsons disease. Some of the treatments take a bit of the sting off of the symptoms of the disease; however, nothing will stop its inevitable progression. The treatment that works for a particular patient is subjective. Work with your doctor to try one treatment or a series of treatments to see what works. If you start to experience side effects, speak up. You shouldn’t have to deal with side effects on top of everything else that comes with the disease.

You should invest in a quality medical alert bracelet the moment you receive your diagnosis. If you experience any episodes in your disease and you’re away from people who know how to help you, you will want strangers and medical professionals to know what disease you have so they can treat it properly. Your medical bracelet can be a simple metal bracelet that indicates you have Parkinsons disease or something a little more elaborate. It doesn’t have to be a fancy fashion accessory. It just has to get the message across that you have Parkinsons disease. Sometimes you can get away with not having to pay for your bracelet, depending on what insurance you have.

A diagnosis of Parkinsons disease is no longer a gloomy scenario. Treatments exist that will prolong your lifespan and improve your quality of life. With the awareness that’s coming to the disease through the efforts of Michael J. Fox and others, the future looks bright. New treatments will come out in the future. The possibility of doctors finding a cure increases with every dollar that’s invested and hour that’s spent trying to find it. Don’t worry about the dire implications that come with the disease. People are out there who are more than willing to support you and find the right solution for you.

Here is the simple truth. People recover from Parkinson’s when they hold the belief that recovery is possible. Those who believe their health can improve do improve. They take responsibility for their own health and well being and commit to a program that gives their body the support it needs to heal.

Consciously or unconsciously many persons with Parkinson’s hold the opposite belief. They are convinced they have a “disease” and are resigned to the fact their health is destined to deteriorate over time.

Perhaps the deterioration will be slow, but deterioration at any pace is unavoidable. They are convinced that their body is broken and needs to be fixed by someone else or by a magical drug in order for them to get well.

Thousands of research articles exist that evaluate the effectiveness of one treatment or another on the symptoms of persons with Parkinson’s. The bulk of this research evaluates the effectiveness of one drug or another. The underlying thesis of this literature converges on the same proposition. The health of persons with Parkinson’s decline on average 3-4% each year.

Virtually every published source of information on Parkinson’s states that it is a progressive disease. Progressive means that once an individual is diagnosed with the condition, they are destined to get worse, year after year.

Government publications say that Parkinson’s is progressive. Most web sites with a focus on Parkinson’s say this. Many health care providers believe Parkinson’s is degenerative.

I also believe the condition is progressive, but the meaning I have in mind has a very different spin. Progressive in my book of definitions means that anyone with Parkinson’s can get progressively better.

When I examine studies that track people on drug therapies for Parkinson’s, there is an interesting finding that is consistent across studies. Ten percent of people with Parkinson’s on average do not get worse over time. Deterioration thus does not happen for 10% of the people with Parkinson’s symptoms.

People do recover from Parkinson’s. People do feel better when they begin to take care of their bodies. The body is a miracle that can always heal itself when given the proper support.

Even if you are enthusiastic and optimistic about getting well today, most people with Parkinsons eventually revert back to the belief that Parkinson’s is a progressively degenerative disease. Since this belief is held by many people, it is easy to fall back into the black hole of hopelessness.

Guess what? This belief is not true.

The truth is that recovery is possible. Relief from symptoms happens. People have done it. People are doing it.

Of course it is difficult to sustain a belief that differs from what knowledgeable authorities say is true. When a bad day creeps up on you, the normal reaction is to say to yourself :

“Oh, right. The evidence is staring me in the face. I am feeling worse today than yesterday. This means I am getting worse, just as ‘they’ said would happen.”

We feel good some days and lousy other days. Note that I say “we.” By “we” I mean everyone – people who are healthy and those who are not. The difference is that people who are healthy say to themselves:

“I will be better soon.”

People with Parkinson’s say to themselves

“Oh God. Here it is.”

The recovery process involves good days and bad days that come in strange and unpredictable patterns. When the body makes adjustments in its journey to return to a state of balance the aftermath can sometimes be pain and discomfort.

Our research shows that as symptoms improve, people report slightly more pain in the short run. Why is this so? They are paying closer attention to the messages their bodies are sending them.

Ever had an entire day of being virtually symptom free? It is so wonderful when this happens. Then, a bad day comes out of nowhere.

Symptoms smack you in the face. It is challenge to get out of bed. Brushing your teeth is more difficult than yesterday.

On a bad day it is tough to dispute the belief that you are deteriorating. After all, you feel lousy. Those who love you probably hold the same belief that most other people hold. What is this belief? Your ill health today means you are deteriorating.

The path to recovery is not a gentle slope in an upward direction. Our observation from working with clients with Parkinson’s reveals that recovery zigzags all over the place.

Recovery is difficult to track for this reason, especially when you happen to be the one who is experiencing the unpleasant symptoms.

The last ditch hope is always for a quick fix. A miracle would be nice. Surely there is a supplement, a drug or some therapy that will cure Parkinson’s? Isn’t a cure just around the corner?

Wouldn’t it be wonderful if a cure were just around the corner? Waiting for a cure is just a lame excuse for not giving your body what it needs to recover.

The problem in a nutshell is this. If you believe you are getting worse, you will get worse. If you sustain the belief that you are in recovery, you will recover.

The belief in recovery will be absorbed by each and every cell in your body.

Your cells will exude hope.

Hope is infectious.

Hope heals.

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General Characteristics of Parkinson’s Disease

Parkinson’s disease, sometimes referred to as “shaking palsy,” affects approximately half a million people in the United States. It is a disorder that results from the degeneration of certain brain cells, and its most characteristic feature is defective message transmission from the brain to various portions of the body. This results in uncontrollable movement, which may be manifested as tremor, muscular rigidity or sluggishness.

Causes and Types of Parkinsonism

The most common form of the disease is called idiopathic parkinsonism and has no known cause. It has no known hereditary component, nor is it contagious. Parkinsonism affects women and men in equal proportions.

There is also drug-induced parkinsonism, which is caused mostly by drugs to treat severe mental illness. This form of parkinsonism is usually reversed when the drug is discontinued or its dosage decreased. Parkinsonism also may be caused by disorders such as encephalitis and hardening of the arteries (arteriosclerosis), or following certain brain injuries, including those caused by a stroke.

Mechanism of Parkinsonism

Parkinsonism is believed to be related to the substantia nigra (black substance) of the nerve cells, which produce and store a chemical substance called dopamine–one of several neurotransmitters. (A neurotransmitter relays messages from the brain across a small open space–or synapse–at the junction of the nerves.) Parkinson’s disease apparently interferes with dopamine storage and/or production, which causes disturbances in nerve message transmission. This, in turn, leads to shaking or other defective motor responses. In addition to dopamine depletion, parkinsonism also seems to involve an excess of cholinergic activity. Treatment, therefore, entails either increasing the concentration of dopamine or decreasing the concentration of acetylcholine, another neurotransmitter that causes symptoms of Parkinson’s disease when dopamine levels are reduced. Both treatments are often used.

Symptoms of Parkinson’s Disease

Parkinson’s disease usually starts very gradually. Early symptoms, which may go unnoticed for years, include stiffness of the hands, fatigue or weakness, depression and a slight limp or changes in posture. The symptoms increase and eventually may develop into full-blown parkinsonism, exhibiting muscular rigidity, tremor and slowness of movement. Other symptoms vary from patient to patient and may include soft, monotonous or slow speech, difficulty in swallowing, trouble in walking, shuffling, a change in bowel habits, slow urination, excessive sweating or drooling. Symptoms often are limited to one side of the body. Diagnosis is sometimes assisted by analysis of the patient’s handwriting, which may show evidence of tremor, is typically small and tends to decrease in size with the passage of time.

Treatment of Parkinson’s Disease

A short while ago, a diagnosis of parkinsonism was a lifelong condemnation. But parkinsonism has become a very treatable condition, and many patients are able to function normally for many years.

Since the cause of the disease is still unknown, therapy is aimed at relieving symptoms. Treatment usually consists of drug therapy, physical therapy and the use of devices (such as a typewriter, instead of writing by hand, or a speech amplifier) that permit patients to lead productive lives. Treatment does involve trial and error, and both doctor and patient must persevere in an attempt to find the best individual combination of drugs and dosages. Drug treatment usually entails supplying the brain with the missing neurotransmitter, dopamine. These drugs are called dopamine precursors. Some patients react best when the excessive acetylcholine is inhibited through the use of anti-cholinergic drugs.

Exercises

Exercises are usually prescribed by the doctor, who may refer the patient to a physical therapist.

• Patients who stoop are taught to line up their spine against a wall or door jamb several times each day.
• Patients who shuffle are taught to raise their feet over books which are placed at regular intervals along the floor.
• Patients who have trouble getting out of chairs are taught to stand up by leaning forward 45 degrees and pushing up with their hands.
• Patients who have trouble speaking may benefit from reading aloud.

General physical condition is also important, and patients are encouraged to develop general exercise routines for home practice.

General Tips

• Good, comfortable shoes and a cane, if the patient is unsteady, will make walking easier.
• Patients who have trouble getting out of chairs should avoid deep, upholstered furniture. A chair whose back legs are two inches higher than the front legs may prove helpful.
• Handbars and rails in the bathroom and/or a raised toilet seat will assist disabled victims.

Summing Up 

Parkinsonism is a serious but treatable disease. As with most chronic illness, patients may be depressed, anxious and fearful. Parkinson’s disease patients and their families may contact a voluntary health agency for support and information.

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Parkinson’s disease is the second most common neurodegenerative disease, with Alzheimer’s disease being the first. Approximately 1 million people in the United States are affected by Parkinson’s disease. Fifty thousand new cases are diagnosed annually. It is an age related disorder with a population incidence of 1-2% in the 60-70 year old age group, going up to 3% in those over 80. Early recognition of symptoms of PD and starting treatment soon afterwards is critical in maintaining the longest quality of life in these patients. Starting treatment early in Parkinson patients may significantly improve long-term outcomes, maintaining patient independence. Early, appropriate therapy can also lessen the need for assisted care and admissions to nursing homes. Disability from Parkinson’s disease can also be slowed down and limited to a degree.

Diagnosis of Parkinson Disease

Parkinson’s is a clinical diagnosis. There is no lab test, CT scan or MRI to make the diagnosis. To make a proper diagnosis of PD a qualified physician needs to do a detailed history and physical exam. There are 4 main clinical hallmarks in Parkinson’s: 1) Bradykinesia or slowness of movement, 2) Postural imbalance, gait unsteadiness; 3) Rigidity or feeling of lead-like stiffness; 4) Tremor at rest. To make the accurate diagnosis of Parkinson’s disease, one must have 3 of 4 of the hallmarks of this disorder. It should be noted that one-third of all PD patients do not have tremor. The converse is true: Not everything that shakes is Parkinson’s disease. Parkinson’s is a constellation of symptoms, a syndrome which requires that a physician be familiar with the clinical presentation of this disease. Parkinson patients have a characteristic blank facial expression, the Parkinson facies.

Treatment of Parkinson Disease

With early diagnosis of Parkinson’s, treatment should be started with either Azilect preferably or selegiline. Both are in the group of medications that slow down the breakdown of the brain transmitter, dopamine. The dopamine producing cells in the brain slowly die off in Parkinson’s disease. Early studies with Azilect suggest that this medication may slow down the progression and alter the course of Parkinson’s disease. While no clear studies for selegiline are ongoing, this drug is in the same class of medication as Azilect and is available in generic form. Patients should stay on one or the other drug for the duration of their life, as long as they are tolerating either medication. Coffee consumption or taking caffeine tablets can help combat excessive daytime drowsiness, which may seen throughout the course of this disease..

As Parkinson’s disease symptoms progress other therapy is required. With rigidity or slowness of movement, starting amantadine may be of benefit. In patients who have predominately tremor, Artane can be of benefit. Some patients may need both. Parkinson’s disease is a slowly progressive illness, usually running its course over 15-20 years. It is not a fatal disease itself. When tremor or bradykinesia worsen, the dopamine agonists should be the next line of drugs considered. Mirapex and Requip are drugs in this category. These drugs can help significantly reduce the symptoms of PD and allow patients to have improved functionality and carrying out activities of daily living. It is not unusual to stay on these medications for months to years before needing to add the ace card in treatment of Parkinson’s disease – Sinemet (levodopa-carbidopa). Sinemet is the gold standard in the treatment of PD. It works by increasing brain dopamine levels. This should be the last drug started however, as it has a clinical usefulness for 3-5 years before other complications from using it start. Complications from using Sinemet are directly related to daily amount taken and length of time of levodopa therapy. Motor complications of long-term Sinemet use include freezing episodes, off time and dyskinesias – involuntary flailing of head, shoulders and arms.

Ways to decrease motor complications of Sinemet include delay using this medication until no other medication works, keep the daily dose as low as possible and use drugs that boost the effect of Sinemet. Azilect or selegiline can help in this regard. Comtan is another medication that only works when taken with Sinemet to boost the brain dopamine levels. Any combination of these can help keep the daily dosage of Sinemet to the lowest possible effective dose.

Non-Pharmacological Treatment of Parkinson Patients

Parkinson patients need to stay physically and medically active. Playing cards, doing crossword puzzles, doing jig-saw puzzles or other mental activities help support good brain function. Watching television or surfing the Internet should be limited as these activities promote cognitive deterioration. Physical activity is critical. Move it or lose it is a cliché that is so true in PD. Clearly PD patients who lead a vegetative lifestyle have accelerated physical disability. Exercise in any form is beneficial in quality of life in Parkinson patients. Walking, swimming, pool exercise, gardening or any other regular physical activity that keeps the patient moving benefits them. Working out at the gym or riding a stationary bike are good ways to get safe exercise. Obviously a healthy diet and drinking plenty of fluids is beneficial in overall health maintenance. Gait imbalance and falling are always a big concern in Parkinson population. quad canes or roller walkers are the preferred method of gait stabilization. Falling must be prevented, requiring diligence on the part of the patient and their caregivers.

Parkinson Disease Summary

Parkinson’s disease is a common neurodegenerative disease in the United States. With early diagnosis and treatment of PD, patents can lead a continued productive, active lifestyle – minimizing the debilitating effects of this chronic illness. Quality of life can be dramatically improved with patient education and ongoing counseling. Continuing to lead an active lifestyle, exercising, engaging in mentally challenging activities and proper diet all lead to better outcomes and improved day-to-day functioning. If you or someone you know has symptoms suggestive of Parkinson’s disease, go see a neurologist to get a full evaluation and early treatment for the best long-term outcome and quality of life.

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