How Is Parkinsons Disease Treated
There is no cure for Parkinsons disease. However, medications and other treatments can help relieve some of your symptoms. Exercise can help your Parkinsons symptoms significantly. In addition, physical therapy, occupational therapy and speech-language therapy can help with walking and balance problems, eating and swallowing challenges and speech problems. Surgery is an option for some patients.
Do What You Can While You Can
I have had Parkinsons disease for nearly 20 years. My wife is a teacher, so we travel every summer when she is not working. Since my diagnosis, I have been to China, Nepal, Prague, Paris and many other places. The Parkinsons comes along, too, so our trips require more planning than they used to and we involve my care team. We factor in daily naps and take it slow. My balance isnt as good as it used to be and too much walking wears me out so we bring a collapsible wheelchair along or make sure one is available. I also use a cane. I dont know how many more places we will get to visit as my disease continues to progress, but we have made some wonderful memories that we wouldnt have if we had let my Parkinsons dictate every aspect of our lives. Nicholas, diagnosed at 52, still traveling at 72
Many people with Parkinsons disease are not allowing the condition to take over their lives. Despite the everyday setbacks they face, they are still creating fulfilling lives for themselves by redirecting their attention to people and activities that bring them joy. You can do the same. Try building a few hobbies into your routine that will give you a break from dwelling on the disease. Find some activities that help you forget about Parkinsons for a while. That may be painting, writing, gardening, or reading to your grandchildren.
Who Is At Risk Of Developing Parkinson’s Disease
While the exact cause of Parkinson’s disease is unknown, certain factors can spike your risk of developing the brain disorder.
- Genes: Researchers have found that specific genetic mutations can cause Parkinson’s disease. However, these are uncommon except in rare cases with many family members who had/have Parkinson’s disease.
- Age: Like most health issues, age can play a major role in the risk of Parkinson’s disease. Young adults are at low risk, while middle-aged and older people are at higher risk of the disease. People usually develop the disease around the age of 60 or older.
- Gender: Researchers have found that men are more likely to suffer from a brain disorder, as compared to women.
- Environment: Exposure to pesticides, herbicides and other chemical toxins in the environment can spike your risk of the disorder.
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Tips For Better Sleep
- Keep a regular sleep schedule go to bed at the same time and get up at the same time.
- Choose your bedtime based on when you want to get up. Plan to spend seven to eight hours a night in bed.
- Make a bedtime routine for example, snack, bath, tooth-brushing, toileting and follow it every evening.
- Spend time outdoors and exercise every day, in the morning if possible. Avoid exercise after 8:00 p.m.
- If you cant get outdoors, consider light therapy sitting or working near a light therapy box, available at drug stores and department stores.
- If you nap, try to do so at the same time every day, for no more than an hour, and not after 3:00 p.m.
- Sleep in a cool dark place and use the bed only for sleeping and sexual activity.
- Do not read or watch television in bed.
- Use satin sheets and pajamas to make moving in bed easier.
- Minimize drinking liquids for three hours before bedtime to avoid frequent nighttime urination.
- Go to the bathroom immediately before retiring.
- Place a commode next to the bed, to minimize the effort, and light to get up during the night.
- Avoid:
- Alcohol, caffeine and other stimulants such as nicotine
- Heavy late-night meals
- Heavy exercise within six hours of bedtime
- Thoughts or discussions before bedtime about topics that cause anxiety, anger or frustration
- Clock watching
- Screen time television, phones, tablets one or two hours before bed.
Stooping Or Hunched Posture
People who have Parkinsons disease may notice changes in their posture due to other symptoms of the disease, such as muscle rigidity.
People naturally stand so that their weight is evenly distributed over their feet. However, people who have Parkinsons disease may start bending forward, making them appear hunched or stooped over.
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What Are The Symptoms Of Parkinsons Disease
Symptoms of Parkinsons disease and the rate of decline vary widely from person to person. The most common symptoms include:
Other symptoms include:
- Speech/vocal changes: Speech may be quick, become slurred or be soft in tone. You may hesitate before speaking. The pitch of your voice may become unchanged .
- Handwriting changes: You handwriting may become smaller and more difficult to read.
- Depression and anxiety.
- Sleeping disturbances including disrupted sleep, acting out your dreams, and restless leg syndrome.
- Pain, lack of interest , fatigue, change in weight, vision changes.
- Low blood pressure.
R = Rem Sleep Behavior Disorder
REM Sleep Behavior Disorder is a problem related to dreams.
When a person without Parkinsons disease sleeps, the body is paralyzed. Thus, he/she cannot move or act out their dreams. This is a normal process.
When Parkinsons patients sleep, this does not happen. So, they may act out their dreams.
Parkinsons patients may start talking when sleeping. They may walk or run while sleeping, and sometimes thrash wildly.
These movements can be violent. They can hurt the patient or the person sleeping beside them.
This problem of moving while dreaming is called REM Sleep Behavior Disorder .
You can read more about sleep problems with Parkinsons here: .
Also, here is a good website explaining RBD in greater detail.
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Less Common Premotor Symptoms
The CARD symptoms are the most common early symptoms of Parkinsons disease.
However, some patients may have other early symptoms as well.
They are important to know. These symptoms may be dismissed as vague or strange at first.
| 5 less common pre-motor symptoms |
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Prescription Medications To Treat Parkinsons
Most movement symptoms are due to a lack of dopamine. Therefore, drugs prescribed to treat PD are dopaminergic they either replenish dopamine or mimic its effects on the brain. The most common is called levodopa. The body converts this medication into dopamine to help control movement symptoms.
Make sure your doctor knows all medications you take including over-the-counter and supplements. This helps reduce the risk of drug interactions, a common issue for Parkinsons patients.
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Early Signs Of Parkinsons
The nerve damage that leads to Parkinsons disease occurs as a protein called alpha-synuclein builds up around the nerves. These same protein clumps develop in other areas of your brain before they reach the area that causes the primary Parkinsons symptoms. As a result, you can develop early signs such as:
Depression And Anxiety Are Also Early Warning Signs Of Parkinson’s How So
A: Like the other symptoms discussed here, late-onset depression and anxiety are nonmotor prodromal manifestations of the condition. It’s not that everyone who is depressed will get Parkinson’s, and the numbers are lower than they are for symptoms like anosmia and REM behavior disorder. But the link is important to explore, and we are doing more research on it all the time.
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What Lifestyle Changes Can I Make To Ease Parkinsons Symptoms
Exercise: Exercise helps improve muscle strength, balance, coordination, flexibility, and tremor. It is also strongly believed to improve memory, thinking and reduce the risk of falls and decrease anxiety and depression. One study in persons with Parkinsons disease showed that 2.5 hours of exercise per week resulted in improved ability to move and a slower decline in quality of life compared to those who didnt exercise or didnt start until later in the course of their disease. Some exercises to consider include strengthening or resistance training, stretching exercises or aerobics . All types of exercise are helpful.
Eat a healthy, balanced diet: This is not only good for your general health but can ease some of the non-movement related symptoms of Parkinsons, such as constipation. Eating foods high in fiber in particular can relieve constipation. The Mediterranean diet is one example of a healthy diet.
Preventing falls and maintaining balance: Falls are a frequent complication of Parkinson’s. While you can do many things to reduce your risk of falling, the two most important are: 1) to work with your doctor to ensure that your treatments whether medicines or deep brain stimulation are optimal and 2) to consult with a physical therapist who can assess your walking and balance. The physical therapist is the expert when it comes to recommending assistive devices or exercise to improve safety and preventing falls.
What Causes Parkinsons Disease
Parkinsons disease occurs when nerve cells in an area of the brain called the substantia nigra become impaired or die. These cells normally produce dopamine, a chemical that helps the cells of the brain communicate . When these nerve cells become impaired or die, they produce less dopamine. Dopamine is especially important for the operation of another area of the brain called the basal ganglia. This area of the brain is responsible for organizing the brains commands for body movement. The loss of dopamine causes the movement symptoms seen in people with Parkinsons disease.
People with Parkinsons disease also lose another neurotransmitter called norepinephrine. This chemical is needed for proper functioning of the sympathetic nervous system. This system controls some of the bodys autonomic functions such as digestion, heart rate, blood pressure and breathing. Loss of norepinephrine causes some of the non-movement-related symptoms of Parkinsons disease.
Scientists arent sure what causes the neurons that produce these neurotransmitter chemicals to die.
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Know The Early Signs Which Occur Long Before Tremors
Parkinsons disease is well-known for causing tremors and other muscle-related problems. Whats not commonly known, however, is that muscle symptoms arent always the first signs of Parkinsons disease.
It takes an experienced neurologist like William Shankle, MD at Shankle Clinic to determine if your early signs may signal the onset of Parkinsons. The only way to know if you should come to see us for a neurological assessment is by learning the signs that occur long before tremors.
What Are The Different Stages Of Parkinsons Disease
Each person with Parkinsons disease experiences symptoms in in their own unique way. Not everyone experiences all symptoms of Parkinsons disease. You may not experience symptoms in the same order as others. Some people may have mild symptoms others may have intense symptoms. How quickly symptoms worsen also varies from individual to individual and is difficult to impossible to predict at the outset.
In general, the disease progresses from early stage to mid-stage to mid-late-stage to advanced stage. This is what typically occurs during each of these stages:
Early stage
Early symptoms of Parkinsons disease are usually mild and typically occur slowly and do not interfere with daily activities. Sometimes early symptoms are not easy to detect or you may think early symptoms are simply normal signs of aging. You may have fatigue or a general sense of uneasiness. You may feel a slight tremor or have difficulty standing.
Often, a family member or friend notices some of the subtle signs before you do. They may notice things like body stiffness or lack of normal movement slow or small handwriting, lack of expression in your face, or difficulty getting out of a chair.
Mid stage
Mid-late stage
Standing and walking are becoming more difficult and may require assistance with a walker. You may need full time help to continue to live at home.
Advanced stage
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Other Typical Symptoms Of Parkinson’s
Tremor is an uncontrollable movement that affects a part of the body. A Parkinsons tremor typically starts in the hand before spreading to affect the rest of the arm, or down to the foot on the same side of the body.
There is no cure for a tremor, but there are ways to manage the symptom with support from a specialist or Parkinsons nurse.
Slowness of movement also known as bradykinesia may mean that it takes someone with Parkinson’s longer to do things. For example, they might struggle with coordination, walking may become more like a shuffle or walking speed may slow down.
Everyday tasks, such as paying for items at a check-out or walking to a bus stop, might take longer to do.
Parkinsons causes stiff muscles, inflexibility and cramps. This can make certain tasks such as writing, doing up buttons or tying shoe laces, hard to do. Rigidity can stop muscles from stretching and relaxing. It can be particularly noticeable, for example, if you struggle to turn over or get in and out of bed.
Symptoms and the rate at which they develop will vary from person to person. The most important thing to do if youre worried you have Parkinsons is to speak to your GP.
Accept What You Can No Longer Do
Over time, it may seem as though you are losing your independence because you can no longer do all the things you once did. As these losses occur, you will probably go through the five stages of grief identified by Dr. Elisabeth Kübler-Ross. They include denial, anger, bargaining, depression and acceptance. Being aware of the issue or loss to which you are reacting will help you to move from one stage to another more easily.
No matter what your symptoms are, motor or non-motor symptoms, dont let Parkinsons beat you!
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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 .
Early Signs Of Parkinsons Disease
In its earliest stages, Parkinsons disease can be difficult to identify. Most early signs can be easy to mistake for a separate disease or disorder or may be ignored altogether. Sudden tremors, while you are at rest remain the most characteristic early sign of the disease, but some other early symptoms include:
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Who Is Affected By Tremor
About 70% of people with Parkinsons experience a tremor at some point in the disease. Tremor appears to be slightly less common in younger people with PD, though it is still one of the most troublesome symptoms. People with resting tremor usually have a more slowly progressing course of illness than people without tremor.
Your Symptoms Are Unique To You
Article written by Jackie Hunt Christensen.
Since that life-altering moment you received your diagnosis, you probably have learned about the symptoms of Parkinsons disease and your treatment options. But what you should also know is that your Parkinsons and how you deal with it are as unique as you are.
For some people embracing new activities that refocus their attention away from troubling symptoms and onto things that are intrinsically satisfying can help. The key, she says, is to find ways to bring joy and happiness into your life every day.
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How Many People Have Parkinsons Disease
Worldwide, there are more than 10 million Parkinsons patients and the Parkinsons Foundation predicts nearly 1 million Americans will have PD by 2020. Each year, the U.S. sees around 60,000 new diagnoses. Age and gender are the greatest risk factors. Around 96 percent of patients are over the age of 50 and men are around 1.5 times more likely to have PD.
What Is Rem Behavior Disorder And How Is It Connected To Parkinson’s
A: REM behavior disorder is different than other sleep problems, like insomnia. People who have it may jerk or kick it’s as though they are acting out their dreams. In a similar pattern to anosmia, people with idiopathic REM sleep behavior disorder have at least a 50 percent chance of eventually developing Parkinson’s disease.
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The First Motor Symptoms Of Parkinsons Disease
When people ask what are the early signs and symptoms of PD? the answer they are typically expecting is one that involves motor symptoms. Early motor symptoms of PD can be a subtle rest tremor of one of the arms or hands . A rest tremor is one that occurs when the limb is completely at rest. If the tremor occurs when the limb is suspended against gravity or actively moving, this may still be a sign of PD, but may also be a sign of essential tremor.
The initial motor symptom of PD may be a sense of stiffness in one limb, sometimes interpreted as an orthopedic problem . This sense of stiffness may be noted when a person is trying to get on his/her coat for example. A person may also experience a sense of slowness of one hand or a subtle decrease in dexterity of one hand. For example, it may be hard to manipulate a credit card out of a wallet or perform a fast, repetitive motor task such as whisking an egg. A person may notice that one arm does not swing when he/she walks or that one arm is noticeably less active than the other when performing tasks. Another motor sign may be a stoop with walking or a slowing down of walking. A family member may notice that the person blinks infrequently or has less expression in his/her face and voice.
These motor symptoms may be very subtle. Bottom line if you are concerned that you may have an early motor or non-motor symptom of Parkinsons disease, make an appointment with a neurologist for a neurologic exam to discuss your concerns.