Parkinson's Disease

Parkinson's disease is a condition that affects control over your movements. It’s caused by a lack of dopamine, a chemical that helps nerve cells in your brain communicate with each other. When dopamine is missing from certain areas of the brain, the messages that tell your body how to move are lost or distorted. This can lead to symptoms such as shaking, stiffness, and slow movement. There’s no cure for Parkinson disease, but proper treatment can help ease symptoms and allow you to live a full, active life.

Dopamine is produced in a small area of the brain called the substantia nigra. For reasons that aren’t yet clear, the nerve cells in this region that make dopamine begin to die. This means less dopamine is available to help control your movements. When healthy, the substantia nigra makes enough dopamine to help control your body’s movements.

Parkinson's disease symptoms vary for each person. You may have many severe symptoms. Or you may have only a few mild ones. Your symptoms may involve only one side of your body. Or they may involve both sides of your body. Also, your symptoms may change over time. And you may have different symptoms at different stages. Your symptoms may also become more prominent as your disease progresses. Below are the most common:

• Shaking (resting tremor) - This can affect the hands, arms, and legs. Most often, the shaking is worse on one side of the body. It usually lessens when the arm or leg (limb) is used. Not everyone with Parkinson’s disease will have tremor.

• Slow movement (bradykinesia) - This can affect the whole body. People may walk with short, shuffling steps. They can also feel “frozen” and unable to move.

• Stiffness (rigidity) - This occurs when muscles don’t relax. It can cause muscle aches and stooped posture.

• Problems with balance - This can affect how well you stand and move. This can also increase your risk of falls.

Other symptoms of Parkinson’s disease include speaking too softly and in a monotone, writing that gets shaky and smaller across the page, and trouble swallowing. They also include constipation, oily skin, and changes in blood pressure. Memory loss and other problems with thinking can occur later in the disease progression. Bradykinesia—or slow movement—can cause problems with actions such as getting out of chairs and beds. Walking may be limited to short, shuffling steps. You may feel "frozen," or unable to move. Blinking, facial expressions, swinging of your arms when walking, and other "unconscious movements" are also slowed down. Some people may have problems with their urination and others may also feel depressed.

There is no single test for Parkinson’s disease. The diagnosis is based on your symptoms, health history, and a physical exam. You may also have tests to help rule out other problems. These may include blood tests to look for diseases that cause similar symptoms. They can also include brain-imaging tests, such as an MRI of the brain

Parkinsonism is the name for a group of brain conditions that all have symptoms similar to Parkinson’s disease. However, the causes of these symptoms are different. In some cases, Parkinson-type symptoms may result from strokes or head injury. They can also be caused by medicines or other diseases that affect the brain. In general, these conditions can’t be treated as well using the medicines that help people with Parkinson's disease.

Treating Parkinson’s Disease

Treatment for Parkinson’s disease has greatly improved over the years. Today, there are many treatments that can ease symptoms and improve your quality of life. These include medicines that help you control your movements. Staying active is also important. Surgery can help if there are complications or fluctuations with medical therapy.

Medicine

Medicines are the most important treatment for Parkinson’s disease. Most types replace missing dopamine, or imitate the way dopamine works in the brain. This helps you have better control over your movements. If needed, your doctor may also prescribe medicine for constipation, sleep problems, and other symptoms.

Activity and Exercise

Staying active is another vital part of treatment. Regular exercise helps keep your muscles strong and loose. It’s also crucial for overall health. If you’re already active, stick with your routine as much as you can. If you’re not active, now’s the time to start. Ask your doctor which activities are best for you. It also helps to do activities that engage your mind. These include hobbies, crafts, reading, and socializing with friends.

Surgery is not a cure. But it may be an option for people whose symptoms are no longer well controlled by medicine:

• Deep brain stimulation is the most common type of surgery. A thin wire is implanted in the part of the brain that controls movement. Electrical pulses are then sent through the wire. This can help improve symptoms more consistently than medication.

• Lesioning (pallidotomy and thalamotomy) destroys a small amount of tissue in a specific part of the brain. This can help you have better control over your movements by blocking activity in the brain that causes symptoms. However, deep brain stimulation is the type of surgery preferred in most situations.

Coping with Parkinson's disease can be frustrating because of its common symptoms—trembling, stiffness (often called rigidity), slow movements, and the loss of balance and coordination. A good deal of that frustration comes from the loss of control that you once had over your body. It can also be emotionally overwhelming to know that there is currently no cure for the disease.

Nonetheless, people have a number of tools to better manage the symptoms of Parkinson's disease and live a healthy, enjoyable life.

Eat smart

Eating a healthy, balanced diet and drinking plenty of water are important for everybody, but especially when you have Parkinson's disease. That's because people with Parkinson's are more likely to get bone fractures from falling, have constipation, or have trouble maintaining their weight. Staying hydrated and getting the best possible nutrition through fruits, vegetables, whole grains and protein can help counteract these effects.

Stay on top of your medicine

Medicines for Parkinson's disease have come a long way. Often a combination of drugs is successful in replacing the naturally occurring brain chemical dopamine that is in short supply when you have Parkinson's. Certain drugs improve only certain symptoms, and you'll want to work with your healthcare provider to find the best combination for you. Know that as the disease progresses, you may need to try other drugs and other combinations of drugs.

A treatment called deep brain stimulation, approved by the FDA, can provide additional relief for some people. It involves implanting a small electrical device in the brain that can ease Parkinson's symptoms and may decrease the need for certain medicines.

Talk with your healthcare provider about which of these options might be the right treatment approach for you.

Work with an occupational therapist

An occupational therapist is an important member of your treatment team. Working closely with this medical professional will help improve your quality of life. An occupational therapist will typically meet with you in your home, review your daily routine, and provide you with techniques and tools that will help you carry out your activities of daily living more effectively, even with the challenges presented by your illness.

Get daily living aids that can help you stay independent and safe

Among the tools that an occupational therapist might recommend are railings around your toilet and bathtub, a seat to use in the tub or shower, a pump soap dispenser instead of bar soap, an electric toothbrush and razor, a cordless phone that you can carry around with you, non-skid socks and Velcro-closure shoes, and an appropriate cane, walker, rollator or wheelchair to help you move around effectively.

Get a good night's sleep

Studies show that about 3 in 4 people with Parkinson's also have sleep problems, but it's crucial to your overall health to get a good night's sleep. Try strategies like creating a relaxing bedtime routine, going to bed at the same time every night, making your bedroom comfortable, dark and cool, and avoiding stimulants, such as caffeine, alcohol, exercise and even watching TV, right before bedtime. If you are still having sleep problems, ask your healthcare provider for a referral to a sleep specialist.

Take care of your mental health

About half of all people with Parkinson's deal with some sort of mood disturbance, such as depression or anxiety, at some point. These mood disorders will only further compound the problems of Parkinson's, so it's critical to get needed treatment, possibly medicine or counseling from a mental health professional.

Have an educated helper

Most people with Parkinson's disease need the help of one or more caregivers to get through the day. If you are a caregiver, one of the most important things you can do is educate yourself about Parkinson's disease, so that you can understand what your loved one is going through and how to best help them. Also, be involved by attending healthcare provider appointments and therapy sessions. Often, these professional health care providers will have tips and advice for the caregiver as well as the person living with the disease.