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ABOUT PARKINSON'S DISEASE

How is movement affected?

Parkinson's Disease (PD) is considered a movement disorder. It primarily affects persons over the age of 60 and is more common among men than women. However, some persons develop PD much earlier, in their 40's and 50's. Many persons with PD develop shaking or trembling (tremor) usually in one hand. The tremor may start and stop, often as a reaction to some kind of stress or worry. Walking almost always becomes slower, and more difficult. Some persons with Parkinson's Disease start walking normally, but then their steps become too small and too fast. They lose their walking rhythm, which can cause them to fall. Sitting down, standing up, turning over in bed, reaching for a cup of coffee, may take real effort. The face muscles may lose movement too, and thus the face of a person with PD may lack expression.

The source of movement problems in PD is a breakdown of nerve cells deep in the brain. These cells stop producing a natural brain chemical called dopamine. One important role of dopamine is to send information to parts of the brain that control movement.

Other symptoms of Parkinson's Disease

Sometimes PD does not start with movement problems and a specialist is needed to recognize the early symptoms. Depression is often an early symptom. Unexplained stiffness and pain may develop; for instance, in one shoulder. Over time PD patients may experience sleep disturbances, constipation, fatigue, anxiety, memory loss, soft, unclear speech and blurry vision. Some researchers think not all of these symptoms are related to a loss of dopamine in the brain, but their source is still not well understood. Click here for a one minute test to evaluate if you or someone you know may have symptoms that could be signs of Parkinson's Disease.

Causes of Parkinson's Disease

Scientists now believe that in a very small number of cases a Parkinson gene plays a role in the development of Parkinson's Disease. Some researchers think that PD results from an interaction between genetics and enviromental toxins, such as DDT and lead paint. This is only a hypothesis. Despite considerable progress in research, the cause of PD is unknown.

Forms of Treatment

Medication

A variety of drugs work to replace lost dopamine or create conditions that allow dopamine to be more efficient. These drugs calm shaking or tremor and allow easier movement. Over time the effectiveness of these drugs may decline and they may produce side effects. Persons with PD react in individual ways to medication. Physicians who specialize in PD work with a patient to decide when medication should be prescribed, which medications will best control symptoms; ways to avoid (or minimize) side effects, and the right dosage of medicine.

Lifestyle and Attitude

The best way for anyone to remain healthy is to stay active, mentally and physically. For someone with PD it is especially important to remain as physically active as possible. Any kind of movement is good: walking, swimming, yoga, dancing of any kind, especially to music, gardening, doing the housework. Because of movement difficulties and balance problems, someone with PD should pay particular attention to exercising safely and in a safe envronment. Keeping the mind fit involves activity too: reading, puzzles, organizing papers, learning anything new, playing a game, thinking about a problem and different ways to solve it. One way to keep mentally fit is through work. Physicians often encourage patients with PD to continue working. Equally important are social activities such as seeing friends on a regular basis, going to church, staying active in the family and community. An active lifestyle, together with appropriate care from a physician experienced in treating Parkinson's Disease, makes living with Parkinson's Disease much easier.

Physicians Who Treat Parkinson's Disease

PD is treated by many kinds of physicians including internists, family physicians, gerontologists, doctors of osteopathy, general neurologists and neurologists who specialize in movement disorders such as PD. Specialists in movement disorders have more training and are likely to have more experience in treating PD than other physicians. A specialist is familiar with the wide variety of PD symptoms beyond movement difficulties, the range of medications available, their side effects, dosages, and how they interact with other kinds of medications.

A highly trained specialist however, is not always available near the home of a person with PD. A general neurologist who has many patients with PD can be an excellent choice. Even neurologists who do not see exclusively or mostly persons with PD can offer needed care.

Many persons with PD make an appointment with a movement disorder specialist, even if the office is far away, for consultation from time to time, while remaining with a local physician whom they know and trust for ongoing care.

One of the important things to look for in any physician is someone who listens and takes time to discuss concerns.

Ways to Find a Physician for PD diagnosis and Care

A trusted internist or family practitioner is a good place to start. An excellent source of information is a PD support group in your area. A support group most likely is a place to learn about physicians from the experience of other persons with PD. Another excellent source of information is the National Parkinson Foundation (800 327 4545). On the internet, go to www.nationalparkinsonfoundation.org. Choose "Find Resources," and then click on "Physicians." Put your zip code in the blank. A list of physicians in your area will be provided. Also at the NPF site, you may want to click on "Ask the Doctor," and sign up for this service. NPF's "Ask the Doctor" is a first rate source of answers to questions about Parkinson's Disease. This resource is used by families across the country that are affected by PD, as well as by physicians and other health care specialists. "Ask the Doctor" daily posts questions and answers sent in, and sends these via email to anyone who has registered. All questions are answered within a matter of days.

The Role of Patients and Families in PD Care...

...is as important as the physician's role. Learning about Parkinson's and remaining active is important. Discussing concerns and asking questions during a doctor's visit is important. Adapting life at home to fit the needs of the person with PD as well as those of the rest of the family is important. Group effort may well benefit the PD patient with better care, less stress, and a sense of control.

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If you would like more detailed information about PD, click on Parkinson Links for a list of other informative sites. There are many good sources of information about PD on the web. Please email BPG if you find sites you think we should add to our list.