Parkinsons And The Common Cough
Parkinsons is a neurodegenerative disease which damages the sufferers brain progressively over a number of years. With up to an estimated 10 million people with the condition worldwide, could new trials using a drug found in cough medicine hold hope for patients with this cruel condition?
As stated above, Parkinsons is a neurodegenerative disease, meaning it damages the sufferers brain over time. It is caused by a loss of nerve cells in the substantia nigra , which leads to a reduction in dopamine in the brain. Dopamine is vital to the regulation of the movement of the body a reduction in dopamine is responsible for many of the symptoms of Parkinsons disease. The three main symptoms include involuntary shaking , slow movement, and stiff or inflexible muscles. Exactly what causes the loss of nerve cells is unclear but most experts think it is a combination of genetic and environmental factors. Parkinsons is the second most common aged-related, neurodegenerative disease after Alzheimers, with your risk of suffering increasing from 41 in 100,000 in your 40s, to 1,900 in 100,000 by your 80s, and men are 1.5 times more likely to develop it that women. Current treatments try to enhance the quality of life for the sufferer through physio- and occupational therapies, medication, and occasionally brain surgery.
Exercises For Restoring Health Breathing
There are various suggested types of exercise which can help gradually shift the equilibrium point of CO2 intolerance back to healthy states. However, all of these emphasize nose breathing over mouth breathing , and diaphragmatic breathing over chest breathing. This represents an immediate roadblock for people with PD, for whom mouth breathing is likely to have become so ingrained that it feels like the nose is permanently stuffed up, and who have diaphragms which are so frozen that it cannot voluntarily be flexed. However, it is possible to open the nose in the majority cases through some simple exercises. Robert Litman in the above video demonstrates this, and below is another video of Patrick McKeown on the topic. See also my article on how I restored nose breathing with the help of a red light anti-allergy device. It is also possible to restore access to diaphragmatic breathing, as I covered in another article, which explains how I used Block Therapy to achieve this.
Once nasal and diaphragmatic breathing is made possible there are a few different types of breathing exercises one try for restoring CO2 tolerance to more normal levels. It is important to note that these exercises are not necessarily targeted at immediate regulation of the Nervous System, unlike breathing methods designed for in-the-moment relaxation or mobilization, but are aimed at long term retraining of breathing patterns in order to restore healthy oxygenation levels to the brain and muscles.
Surgery And Deep Brain Stimulation
Deep brain stimulation is a treatment for Parkinsonâs disease that uses an implantable pacemaker-like device to deliver electrical pulses to parts of the brain involved in movement. The DBS system consists of leads precisely inserted into a specific brain target, the neurostimulator implanted in the chest, and extension wires that connect the leads to the neurostimulator. Though implantation of the system requires a neurosurgical procedure, the treatment itself consists of long-term electrical stimulation. Advantages of DBS include its ability to reduce the high doses of medications , its adjustability , and its reversibility DBS was approved by the Food and Drug Administration as a treatment for PD in 2002 and according to Medtronic , more than 80,000 patients have undergone DBS surgery worldwide.
Typical candidates are those who have motor fluctuations or periods of âoffâ time with troublesome symptoms alternating with periods of âonâ time with good symptom control, and also with possible periods of excessive movement .
Not all patients with Parkinsonâs disease are good candidates for treatment with DBS. Approximately 10â20% of patients considered for possible treatment with DBS include those:
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Staying Safe At Home With Parkinsons
Simple changes around the home can make it easier for you to function well while dealing with Parkinson’s symptoms. Pituch notes that healthcare providers can help you come up with a detailed plan for living safely and independently at home.
Discuss specific strategies with your Parkinson’s medical team to design a safer living space. Occupational therapists can suggest ways to create an environment that’s friendly to those with Parkinson’s this type of therapist looks at things like furniture placement, handrails, extensions on toilets, and floor coverings to determine where possible hazards lie.
Trouble Moving Or Walking
Do you feel stiff in your body, arms or legs? Have others noticed that your arms dont swing like they used to when you walk? Sometimes stiffness goes away as you move. If it does not, it can be a sign of Parkinson’s disease. An early sign might be stiffness or pain in your shoulder or hips. People sometimes say their feet seem stuck to the floor.
What is normal?If you have injured your arm or shoulder, you may not be able to use it as well until it is healed, or another illness like arthritis might cause the same symptom.
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How Do I Know If I Have A Speech Or Voice Problem
- My voice makes it difficult for people to hear me.
- People have difficulty understanding me in a noisy room.
- My voice issues limit my personal and social life.
- I feel left out of conversations because of my voice.
- My voice problem causes me to lose income.
- I have to strain to produce voice.
- My voice clarity is unpredictable.
- My voice problem upsets me.
- My voice makes me feel handicapped.
- People ask, “What’s wrong with your voice?”
What Is Parkinsons Disease
Parkinsonâs disease is a progressive, neurological disease that mainly affects movement but can also affect cognition. Parkinsonâs disease results from the destruction of nerve cells in a part of the brain called the basal ganglia.
Different parts of the brain work together by sending signals to each other to coordinate all of our thoughts, movements, emotions, and senses. When we want to move, a signal is sent from the basal ganglia to the thalamus and then to the cerebral cortex, all different parts of the brain. Nerve cells in the brain communicate by using chemicals. A chemical called dopamine is produced in a group of cells called the substantia nigra and is essential for normal movement. When the cells die, they can no longer produce and send dopamine, so the signal to move doesnât get communicated. By the time a person starts to experience motor symptoms of Parkinsonâs, theyâve already lost approximately 50% of their dopamine producing cells. People may experience non-motor symptoms from loss of other neurotransmitters up to ten years before motor symptoms are noticed.
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Increased Feelings Of Anxiety Or Depression
Anxiety and depression have been linked to Parkinsons. In addition to movement problems, the disease can also have an impact on your mental health. Its possible that changes in your emotional well-being can be a sign of changing physical health as well.
If you are more anxious than usual, have lost interest in things, or feel a sense of hopelessness, talk to your doctor.
Two Areas In Which Parkinsons Disease May Bring About Death
PD patients are at an increased risk of falling and bad falls can lead to death. This usually occurs as a complication of a fall that requires hospitalization, particularly if it involves surgery. While most people do not fracture their hips when they fall, some do, and hip surgery, while routine, is still major surgery. It carries the risk of infection, delirium related to pain medications and anesthesia, heart failure, pneumonia, blood clots in the legs that then go to the lungs, and general weakness from immobility. Hip fractures are probably the main cause for death for those who fall, but people can fracture other bones and require surgery. They may fracture their ribs, which leads to reduced coughing, because of the pain, and an increased risk of lung infections . It is surprisingly uncommon for Parkinsons Disease patients to die from brain injuries related to falls, but it still may occur.
PD patients also may develop pneumonias completely unrelated to difficulties with swallowing, just like their non-PD friends and relatives.
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Medication Not Working The Way It Used To
In the early stages, taking medicine works well to get rid of symptoms. But as Parkinsons progresses, your medication works for shorter periods of time, and symptoms return more easily. Your doctor will need to change your prescription.
Dr. Valerie Rundle-Gonzalez, a Texas-based neurologist, says to pay attention to how long your medicine takes to kick in and when it stops working. She says you should feel like symptoms significantly improve or are almost gone while on medication.
Changes In Sleeping Patterns
As Parkinsons progresses, you can also develop problems with sleep patterns. These may not happen in the early stages, but can be noticeable later. You might wake up often in the middle of the night or sleep more during the day than you do at night.
Another common sleep disturbance for people with Parkinsons is rapid eye movement sleep behavior disorder. This is when you start acting out your dreams in your sleep, such as verbally and physically, which can get uncomfortable if someone is sharing your bed. Dr. Rundle-Gonzalez says many times a bed partner will be the one to notice sleep problems.
REM sleep behavior disorder can also happen in people who dont have Parkinsons. However, if this isnt something youve dealt with before, its likely related to your disease. There are medications your doctor can prescribe to help you sleep comfortably through the night.
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Apda In Your Community
This article was written at the request of a Parkinsons patient who wanted to know how patients die from PD.
Most patients die with Parkinsons Disease and not from it. The illnesses that kill most people are the same as those that kill people with PD. These are heart conditions, stroke and cancer. As we age we become increasingly aware that more than one bad thing can happen to our bodies.
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Tips For People With Parkinsons Who Want To Take Over The Counter Medications During Flu Season
People with PD often tell us that when they get sick with cold and flu-like symptoms, their pharmacist and healthcare professionals warn them to stay away from the medication aisle of the pharmacy. They are told that any over-the-counter medication has the potential to worsen Parkinsons symptoms. Unfortunately, many people interpret this potential worsening as a recommendation to never use these medications.
Also contributing to this issue is a series of reports that medications such as anticholinergics may cause acute confusion and even contribute to long-term cognitive changes. It is important to keep in mind when selecting a cough or flu medication that the intent is not to treat long-term issues.
This flu season we wanted to provide the PD community with some tips to help you navigate Parkinsons while simultaneously addressing cold and flu symptoms:
In 2014, Kim Painter wrote a great article in the USA Today to help individuals and families stay safe in the cold and flu aisle.
Here are some of Kims tips:
- Treat only symptoms you have and be wary of multi-symptom products.
- Know your dose and dont overdose.
- Know your health risks .
- Don’t double up and accidentally take two medicines with similar ingredients.
- Consider trying alternatives .
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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Cough Syrup Drug Being Trialled As Parkinsons Treatment
14 February 2020
After finding that a drug found in cough syrups may have use as a treatment for Parkinsons disease, UCL researchers have received funding for the next stage in clinical trials.
Ambroxol, a medication originally designed to clear phlegm and ease coughing for people with respiratory diseases such as bronchitis, is being tested to see if it can slow down the progression of Parkinsons disease by keeping cells healthier for longer.
A research team led by Professor Tony Schapira reported in January that ambroxol was safe and well-tolerated in 17 study participants with Parkinsons disease.
According to the findings published in JAMA Neurology, the drug also effectively crossed the blood-brain barrier and increased levels of the glucocerebrosidase protein in the participants brain cells. This protein allows cells to remove waste more effectively, a function which evidence suggests is deficient in some people with Parkinsons. Increasing levels of the protein may have the potential to keep cells healthier for longer and, therefore, slow Parkinsons progression.
By increasing levels of GCase, ambroxol allows cells to remove waste, which would ideally keep cells healthier for longer and could slow down the progression of Parkinsons, explained Professor Schapira.
The iLCT committee had prioritised ambroxol in 2014.
Related Diagnosis: Lewy Body Dementia
Current research is helping to differentiate dementia related conditions in relationship to Parkinsonâs disease. Doctorâs use a 12-month arbitrary rule to aid in diagnosis. When dementia is present before or within 1 year of Parkinsonâs motor symptoms developing, an individual is diagnosed with DLB. Those who have an existing diagnosis of Parkinsonâs for more than a year, and later develop dementia, are diagnosed with PDD.
In the simplest terms, Lewy bodies are abnormal clumps of proteins that develop in nerve cells. Cholinesterase inhibitors, medications originally developed for Alzheimerâs disease, are the standard treatment today for cognitive DLB and PDD symptoms. Early diagnosis is important, as DLB patients may respond differently than Alzheimerâs disease patients to certain drug, behavioral, and dementia care treatments.
This challenging, multi-system disorder involving movement, cognition, behavior, sleep, and autonomic function requires a comprehensive treatment approach to maximize the quality of life for both the care recipient and their caregiver. It is very important to pay attention to symptoms of dementia and to search for an expert clinician who can diagnose the condition accurately.
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Origins Of Breathing Disorders
The book by Leon Chaitow and co-authors cited above explains how breathing disorders are intrinsically linked to chronic stress and anxiety. The shallow, fast chest breathing through the mouth is a hallmark of the body preparing itself for the exertion of flight or fight due to a stress response. While this adaptive in acute stress situations, when stress is chronic and the body is spending a lot of time in fight or flight, the associated pattern of breathing becomes habitual, and eventually the system gets stuck in the new equilibrium of the CO2 intolerant state. However, the vicious circle work both ways, because overbreathing itself puts the body into a stress response state and feeds anxiety. A very good tutorial about the two way links between anxiety and breathing patterns is given by Robert Litman in the video below.
It is not surprising therefore that people with PD can present with disordered breathing associated with chronic stress and anxiety, since there are very significant overlaps between the other symptoms of chronic stress and those of Parkinsons Diseases, and ingrained fight or flight behaviours are common to the pre-diagnosis background histories of people with PD. Conversely, it is important to note that techniques which have been developed to treat breathing disorders should also help to decrease the symptoms of PD, including reduction of anxiety and increasing resilience to stress.
How Can I Make Chewing And Swallowing Easier
The way you sit, the foods you eat, and how you eat can affect your ability to swallow. To use your posture to make chewing and swallowing easier, you can:
- Sit upright at a 90-degree angle.
- Tilt your head slightly forward.
- Stay seated or standing for 15-20 minutes after you eat a meal.
When you eat:
If you don’t make enough saliva:
- Drink plenty of fluids.
- Every once in a while, suck on ice pops, ice chips, lemon ice, or lemon-flavored water to add to your saliva. That’ll help you swallow more often.
If chewing is difficult or tiring:
- Cut back on or stop eating foods you have to chew, and eat more soft things.
- Puree your food in a blender.
- If thin liquids make you cough, thicken them with a liquid thickener. You can also use thicker liquids instead of thin ones, like nectars instead of juices and cream soups instead of plain broths.
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