Living Well With Parkinson’s
While medication and DBS surgery are the most effective treatments for PD, individuals often choose to delay these treatments because of their adverse side effects. Until a therapy is developed that can halt the progression of PD, there is a significant need for strategies that provide symptom relief without causing negative side effects.
Diet, Exercise, and Stress Reduction
Findings from several studies suggest that exercise has the potential to provide relief from certain PD symptoms. Anecdotally, people with Parkinsons disease who exercise typically do better. However, many questions remain. Among them is whether exercise provides a conditioning effect by strengthening muscles and improving flexibility or whether it has a direct effect on the brain.
In an NINDS-funded trial comparing the benefits of tai chi, resistance training, and stretching, tai chi was found to reduce balance impairments in people with mild-to-moderate PD. People in the tai chi group also experienced significantly fewer falls and greater improvements in their functional capacity.
Technologies that Improve Quality of Life
How Do I Prevent Falls From Common Hazards
- Floors: Remove all loose wires, cords, and throw rugs. Minimize clutter. Make sure rugs are anchored and smooth. Keep furniture in its usual place.
- Bathroom: Install grab bars and non-skid tape in the tub or shower. Use non-skid bath mats on the floor or install wall-to-wall carpeting.
- Lighting: Make sure halls, stairways, and entrances are well-lit. Install a night light in your bathroom or hallway and staircase. Turn lights on if you get up in the middle of the night. Make sure lamps or light switches are within reach of the bed if you have to get up during the night.
- Kitchen: Install non-skid rubber mats near the sink and stove. Clean spills immediately.
- Stairs: Make sure treads, rails, and rugs are secure. Install a rail on both sides of the stairs. If stairs are a threat, it might be helpful to arrange most of your activities on the lower level to reduce the number of times you must climb the stairs.
- Entrances and doorways: Install metal handles on the walls adjacent to the doorknobs of all doors to make it more secure as you travel through the doorway.
Historical Aspects Of Viruses And Parkinsonism
It is remarkable that a relationship between the presence of antibodies to coronaviruses that cause the common cold, coronavirus OC43 and 229E, in the cerebrospinal fluid and Parkinsons disease was reported nearly twenty years prior to the current pandemic by Stanley Fahn and colleagues. Prior coronaviruses have been occasionally reported to exhibit neurological manifestations and CSF invasion, including in children,.
Table 1 Mechanisms involved in the pathogenesis of viral-induced parkinsonism.
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The 5 Stages Of Parkinsons Disease
Getting older is underrated by most. Its a joyful experience to sit back, relax and watch the people in your life grow up, have kids of their own and flourish. Age can be a beautiful thing, even as our bodies begin to slow down. We spoke with David Shprecher, DO, movement disorders director at Banner Sun Health Research Institute about a well-known illness which afflicts as many as 2% of people older than 65, Parkinsons Disease.
Incidence Of Parkinsons Disease
Its estimated that approximately four people per 1,000 in Australia have Parkinsons disease, with the incidence increasing to one in 100 over the age of 60. In Australia, there are approximately 80,000 people living with Parkinsons disease, with one in five of these people being diagnosed before the age of 50. In Victoria, more than 2,225 people are newly diagnosed with Parkinsons every year.
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Parkinsons Goes Prime Time: Five Things To Know About Parkinsons Disease
Michael J. Fox is back in the spotlight this fall in a new sitcom The Michael J. Fox Show and spreading awareness about Parkinsons disease, a condition both he and his TV character have in common. Fox has been an outspoken advocate for Parkinsons disease research and awareness since disclosing his condition to the public in 1998.
Parkinsons disease is a progressive nervous system disorder that affects movement and may cause shaking, muscle stiffness, slowing of movement, impaired balance or other symptoms. Mayo Clinic movement disorders specialist, Anhar Hassan, M.D., says it impacts about 1 in 200 people. What Michael J. Fox is doing to spread awareness on Parkinsons from fundraising to education to playing a TV character with the disease is very commendable. Parkinsons disease touches the lives of many people. Education is vital. says Dr. Hassan.
Journalists: Sound bites with Dr. Hassan are in the downloads. To interview Dr. Hassan or another Mayo Clinic Parkinsons expert about the disease contact Nick Hanson at or call 507-284-5005.
Diagnosis And Management Of Parkinsons Disease
There are no diagnostic tests for Parkinsons. X-rays, scans and blood tests may be used to rule out other conditions. For this reason, getting a diagnosis of Parkinsons may take some time.
No two people with Parkinsons disease will have exactly the same symptoms or treatment. Your doctor or neurologist can help you decide which treatments to use.
People can manage their Parkinsons disease symptoms through:
- seeing a Doctor who specialises in Parkinsons
- medication
- multidisciplinary therapy provided for example, by nurses, allied health professionals and counsellors
- deep brain stimulation surgery .
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Drug Therapy And Research
If the disease progresses beyond minor symptoms, drug treatment may be indicated. Drug therapy for Parkinsonâs typically provides relief for 10â15 years or more. The most commonly prescribed medication is L-dopa , and this helps replenish some of the depleted dopamine in the brain. Sinemet, a combination of levodopa and carbidopa, is the drug most doctors use to treat Parkinsonâs disease. Recent clinical studies have suggested, in the younger person, the class of drugs called âdopamine agonistsâ should be used prior to levodopa-carpidopa except in patients with cognitive problems or hallucinations. In those older than 75, dopamine agonists should be used cautiously because of an added risk of hallucinations.
Other drugs are also used, and new drugs are continually being tested. It is common for multiple drugs to be prescribed because many of them work well together to control symptoms and reduce side effects. Contrary to past beliefs, starting Sinemet in newly diagnosed people does not lead to early symptoms of dyskinesia . Current knowledge is that the disease progression causes dyskinesias, not a âresistanceâ to the drug.
Quality of life studies show that early treatment with dopaminergic medications improves daily functioning, prevents falls, and improves a personâs sense of well-being.
Who Gets Parkinsons Disease
Parkinsonâs disease, documented in 1817 by physician James Parkinson, is the second most common neurodegenerative disease after Alzheimerâs disease. Estimates regarding the number of people in the United States with Parkinsonâs range from 500,000 to 1,500,000, with 50,000 to 60,000 new cases reported annually. No objective test for Parkinsonâs disease exists, so the misdiagnosis rate can be high, especially when a professional who doesnât regularly work with the disease makes the diagnosis.
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What Is Parkinsons Disease
Parkinsons disease is a nervous system disease that affects your ability to control movement. The disease usually starts out slowly and worsens over time. If you have Parkinsons disease, you may shake, have muscle stiffness, and have trouble walking and maintaining your balance and coordination. As the disease worsens, you may have trouble talking, sleeping, have mental and memory problems, experience behavioral changes and have other symptoms.
Q: I Received The Covid
A: The vaccine is certainly able to cause short term side effects of fatigue, aches and even fever. There isnt extensive data yet on how it affects PD symptoms, just anecdotal data. For some people, PD symptoms are worse in the short term. This does not mean that your PD has progressed, and I would expect that you will return to your previous baseline in the next few days. I would talk with your neurologist about your worsened tremor as well.
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What Are The Symptoms Of Covid
Common symptoms of COVID-19 begin two to 14 days after exposure. They include fever, tiredness, and dry cough. Other symptoms include loss of taste or smell, nasal congestion, sore throat, muscle and joint pain, chills, vomiting, nausea, and diarrhea.
Most of these symptoms are usually mild, and about 80% of people who get the virus will typically recover without needing any special treatment.
However, it is estimated that about 15% become seriously ill and develop breathing difficulties, and 5% become critically ill and require intensive care. Symptoms of serious COVID-19 include shortness of breath, loss of appetite, and pain or pressure in the chest.
People over the age of 60 and those with underlying medical conditions such as diabetes, heart and lung issues, cancer, and high blood pressure are most at risk of becoming seriously ill.
Q: How Does The Delta Variant Affect Someone With Pd
A: We do not have any specific data yet on how the Delta variant affects people with PD.
The COVID-19 virus, like all viruses, is able to mutate and create variants of itself. Many variants of COVID-19 have been identified around the world. Only a few of these variants have been of concern to public health however, because they have a characteristic that makes the virus either more easily transmissible or more likely to cause significant disease. The Delta variant is currently the variant of concern and has been shown to be more easily transmitted from person to person than prior variants of COVID.
The vaccines approved in the US do offer protection against the Delta variant, but not to the extent that was seen in the original trials. That means that fully vaccinated people are more likely to get infected with the Delta variant of COVID-19 than other variants. However, the major goal of the vaccines is to prevent severe illness, hospitalization, and death from COVID-19 and all the approved vaccines are approximately 90% effective in preventing these consequences of infection. Therefore, vaccination remains extremely valuable.
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Q: My Husband Has Pd With Moderate Symptoms Normally He Is Independent With All His Activities Although He Walks Slowly One Day His Symptoms Worsened Dramatically And He Was Not Able To Walk I Took Him To The Er Where He Tested Positive For Covid
A: In general, people with PD and other brain illnesses often have 1) worsening of their PD symptoms in the face of inter-current illnesses such as COVID-19, and 2) have a slower recovery to their baseline once they have recovered from the inter-current illness. It sounds like both of these have happened to your husband. However, with proper rehab and some perseverance, there is hope that he will slowly return to his baseline.
Q: Are There Any Studies Of The Long
A: A recent study examined post-COVID symptoms in a small number of PD patients. Among the symptoms that persisted after COVID infection included worsening of motor function, increased levodopa daily dose requirements, fatigue, cognitive disturbances, and sleep disturbances. More research will need to be done to corroborate and expand on these findings.
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What Treatments Are Available
Many Parkinson’s patients enjoy an active lifestyle and a normal life expectancy. Maintaining a healthy lifestyle by eating a balanced diet and staying physically active contributes to overall health and well-being. Parkinson’s disease can be managed with self-care, medication, and surgery.
Self careExercise is as important as medication in the treatment of PD. It helps maintain flexibility and improves balance and range of motion. Patients may want to join a support group and continue enjoyable activities to improve their quality of life. Equally important is the health and well being of the family and caregivers who are also coping with PD. For additional pointers, see Coping With Parkinsons Disease.
These are some practical tips patients can use:
Medications There are several types of medications used to manage Parkinson’s. These medications may be used alone or in combination with each other, depending if your symptoms are mild or advanced.
After a time on medication, patients may notice that each dose wears off before the next dose can be taken or erratic fluctuations in dose effect . Anti-Parkinsons drugs can cause dyskinesia, which are involuntary jerking or swaying movements that typically occur at peak dosage and are caused by an overload of dopamine medication. Sometimes dyskinesia can be more troublesome than the Parkinsons symptoms.
How Do Symptoms Progress
The most common symptoms of Parkinson’s are tremor, rigidity and slowness of movement.
Not everyone with Parkinson’s experiences the same combination of symptoms they vary from person to person.
Also, how Parkinson’s affects someone can change from day to day, and even from hour to hour. Symptoms that may be noticeable one day may not be a problem the next.
Many of the symptoms can be treated or managed with medication and therapies.
Many people with Parkinson’s lead active and fulfilling lives. An important part of coping with Parkinson’s is understanding how it affects you and how to work around it.
It may not always be easy to maintain a positive outlook, especially immediately after diagnosis. But we can give you help and support.
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Lyme Disease Transmission: Can It Spread From Person To Person
Excerpted from Healthline:
Can you catch Lyme disease from someone else? The short answer is no. Theres no direct evidence that Lyme disease is contagious. The exception is pregnant women, who can transmit it to their fetus.
Lyme disease is a systemic infection caused by spirochete bacteria transmitted by black-legged deer ticks. The corkscrew-shaped bacteria, Borrelia burgdorferi, are similar to the spirochete bacteria that cause syphilis.
Lyme disease can become debilitating for some people and life-threatening if it isnt treated.
The Centers for Disease Control and Prevention Trusted Source estimates that 300,000 people in the United States are diagnosed with Lyme each year. But many cases may go unreported. Other studies suggest that the incidence of Lyme may be as high as 1 million cases per year.
Diagnosis is challenging because Lyme symptoms mimic those of many other diseases.
A tick requires a blood meal at each stage of its life as larvae, nymphs, and adults. Ticks normally feed on animals, ground-feeding birds, or reptiles. Humans are a secondary blood source.tick
Most bites to humans are from tick nymphs, which are the size of poppy seeds. Its hard to spot them, even on open skin. The prime seasons for human tick bites are late spring and summer.
Depending on the ticks bacterial virulence, you could be infected with Lyme within 24 hoursTrusted Source of the tick bite.
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Support For People With Parkinsons Disease
Early access to a multidisciplinary support team is important. These teams may include doctors, physiotherapists, occupational therapists, speech therapists, dietitians, social workers and specialist nurses. Members of the team assess the person with Parkinsons disease and identify potential difficulties and possible solutions.There are a limited number of multidisciplinary teams in Victoria that specialise in Parkinsons disease management. But generalist teams are becoming more aware of how to help people with Parkinsons disease.
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What Should Sick Individuals Do
If symptoms are present or a COVID-19 diagnosis is confirmed, the following steps should be taken to prevent the spread of infection:
- Stay at home, preferably in a separate room not shared with others, and isolate yourself, with the exception of getting medical care.
- Avoid public areas and public transport.
- Wear a mask if you have to be around people.
- Limit contact with pets and animals.
- Avoid sharing personal items.
- Cover coughs and sneezes with tissues and dispose of them properly.
- Sanitize hands regularly.
What Medications Are Used To Treat Parkinsons Disease
Medications are the main treatment method for patients with Parkinsons disease. Your doctor will work closely with you to develop a treatment plan best suited for you based on the severity of your disease at the time of diagnosis, side effects of the drug class and success or failure of symptom control of the medications you try.
Medications combat Parkinsons disease by:
- Helping nerve cells in the brain make dopamine.
- Mimicking the effects of dopamine in the brain.
- Blocking an enzyme that breaks down dopamine in the brain.
- Reducing some specific symptoms of Parkinsons disease.
Levodopa: Levodopa is a main treatment for the slowness of movement, tremor, and stiffness symptoms of Parkinsons disease. Nerve cells use levodopa to make dopamine, which replenishes the low amount found in the brain of persons with Parkinsons disease. Levodopa is usually taken with carbidopa to allow more levodopa to reach the brain and to prevent or reduce the nausea and vomiting, low blood pressure and other side effects of levodopa. Sinemet® is available in an immediate release formula and a long-acting, controlled release formula. Rytary® is a newer version of levodopa/carbidopa that is a longer-acting capsule. The newest addition is Inbrija®, which is inhaled levodopa. It is used by people already taking regular carbidopa/levodopa for when they have off episodes .
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Medications For People With Parkinsons Disease
Symptoms of Parkinsons disease result from the progressive degeneration of nerve cells in the brain and other organs such as the gut, which produce a neurotransmitter called dopamine. This causes a deficiency in the availability of dopamine, which is necessary for smooth and controlled movements. Medication therapy focuses on maximising the availability of dopamine in the brain. Medication regimes are individually tailored to your specific need. Parkinsons medications fit into one of the following broad categories:
- levodopa dopamine replacement therapy
- dopamine agonists mimic the action of dopamine
- COMT inhibitors used along with levodopa. This medication blocks an enzyme known as COMT to prevent levodopa breaking down in the intestine, allowing more of it to reach the brain
- anticholinergics block the effect of another brain chemical to rebalance its levels with dopamine
- amantadine has anticholinergic properties and improves dopamine transmission
- MAO type B inhibitors prevent the metabolism of dopamine within the brain.