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Parkinson’s 101

About a million people in the U.S. are living with Parkinson’s disease—that’s more than everyone who has multiple sclerosis, Lou Gehrig’s disease, and muscular dystrophy combined. Roughly 60,000 people are diagnosed each year. According to the Parkinson’s Foundation research, about 24,000 North Carolinians have it.

When you hear Parkinson’s Disease (PD) your first thoughts are probably about people who shake or shuffle. You think of famous people who had or have it, like Muhammad Ali, Michael J. Fox, Neil Diamond, Billy Graham, Rev. Jesse Jackson, Janet Reno, Linda Ronstadt, and Alan Alda. And, unless you have PD or know someone who has it, that’s probably all you know.

What is Parkinson’s Disease?

Parkinson’s disease is a long-term degenerative disorder of the central nervous system that mainly affects the motor system. No, not your car. Your motor system is made up of all the nerves in your body that allow you to move. Basically, PD happens when the nerve cells that control movement die or are impaired.

An English surgeon and political activist, Dr. James Parkinson, discovered what he called Shaking Palsy, in 1817. Sixty years later the condition became known as Parkinson’s disease.

Parkinson’s Disease Symptoms

The early symptoms can show up gradually, and you may not even think about them as symptoms. Maybe you notice your handwriting has gotten smaller, or you have trouble smelling certain foods (like bananas, licorice, or pickles), or you have a softer voice or sound hoarse. Fatigue, constipation, and trouble sleeping can also be symptoms. These things individually probably aren’t symptoms of PD, especially if they go away, but if you experience some of them for longer periods of time they could be.

More common early symptoms are tremors, rigid muscles, slowness of movement, and difficulty walking. The “Parkinson’s shuffle” describes the very short, shuffling steps a person with advancing PD takes. It’s difficult for people with PD to start moving from a still position or stand from a sitting position. Conversely, once they start a movement, it’s difficult for them to stop suddenly. People with PD also lack facial expressions; they have a blank, fixed look, like a mask. Very advanced patients with PD can develop depression and even difficulty with memory.

Causes, Diagnoses, Treatments

There’s not a blood or lab test or procedure to diagnose Parkinson’s disease, which can make it difficult early on. Doctors rely on your known symptoms and other diagnostic tests to confirm the diagnosis and usually refer you to a neurologist. This is why talking to your doctor about all your symptoms is so important.

While there is considerable research being done to learn more about PD, there is no cure. The most common causes are long-term exposure to pesticides and herbicides, repetitive head trauma (boxing, football, multiple concussions), and genetics (about 10-15% of diagnoses). Men are 1.5 times more likely to have Parkinson’s than women (note the list of famous people above). Most people with PD develop the disease around the age of 60; only about 5-10% have early-onset PD (before the age of 50) and that is often inherited.

PD treatment varies from person to person, depending on your symptoms and their severity. There are several helpful medications to control the symptoms. These medications increase dopamine levels in the brain, control nonmotor symptoms, and affect other brain chemicals in the body. There’s also a surgical procedure to implant a neurostimulator device into the brain for people who don’t respond well to the medications.

Aside from medications, people with Parkinson’s can benefit from therapy (physical, occupational, and speech), exercise (to strengthen muscles and improve balance), and a nutritious diet.

 

Dr. Beth Hodges, MD is a family practice and palliative care/hospice physician in Asheboro, N.C., as well as a part-time medical director for HealthTeam Advantage.


6 Tips for Living with PD

(From the Michael J. Fox Foundation)

  1. Exercise Regularly (check with your doctor before starting a new exercise routine).
  2. Eat a healthy, balanced diet.
  3. Learn about Parkinson’s.
  4. Build a support system (family, friends, others with PD).
  5. Find a movement disorder specialist (a neurologist with additional training in PD).
  6. Get involved in the Parkinson’s community.

7 Takeaways

(From the Parkinson’s Foundation)

  1. There are non-movement symptoms—apathy, depression, constipation, sleep disorders, loss of sense of smell, and cognitive impairment.
  2. PD symptoms and treatment vary from person to person—there is no one right way.
  3. Many doctors recommend the Mediterranean diet. It helps reduce blood pressure and cardiovascular disease.
  4. Proper dental care is especially important if you have PD.
  5. Men are 1.5 times more likely to get PD than women.
  6. Having PD does not put you at a higher risk of getting COVID-19, but recovery is harder if you get it.
  7. Exercise can slow the decline of your quality of life and help manage your symptoms (especially flexibility exercise, aerobic activity, and resistance or strength exercises).

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