Saliva and PD

Posted: Sat Jul 14, 2007 5:24 am Post subject: Saliva and PDPosted:週六2007年7月14日5:24分郵政主題:唾液和PD

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Dear Doctor,親愛的醫生,

As there are 70-80% PD patients have saliva drooling from the mouth.由於有70-80%的帕金森病患者有流涎唾液從嘴裡. I am one of them.我也是其中之一.

Kindly elaborate the cause of the saliva drooling from the mouth?請說明原因的唾沫口水從口?

What kind of treatment to stop it from drooling?什麼樣的治療,以阻止它垂涎?

As For me I have the saliva drooling after I have taken the requip 2mg three times a day.至於我,我的口水唾液後,我所採取的requip2mg/只每天三次.

Best regards問候

Teo Kim Hoe張志賢金鋤頭

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Dr. Fernandez費爾南德斯博士



Joined: 20 Jan 2007加入:2007年1月20日
Posts: 90職位:90

Posted: Sat Jul 14, 2007 8:03 am Post subject:Posted:週六2007年7月14日9:01分郵政主題:

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Drooling (or sialorrhea) is common in PD.流涎(口水)是常見的肢體. For the most part the cause is not increased saliva production but slowed reflex in automatically swallowing the natural saliva that accumulated in the mouth throughout the day.對大部份的原因是沒有增加唾液生產減緩,但反射自動吞嚥的唾液自然這樣積累的嘴整整一天.

You see, a person without PD does not even notice that saliva is constantly being produced (it is done so to lubricate the whole mouth for talking, eating, etc).你看!一個人沒有肢體甚至不公告,唾液不斷產生的影響(這是做注油整個嘴來說話,吃東西等). This is because after a certain volume is accumulated, this is automatically swallowed without even thinking about it.這是因為經過一定量的積累,這是自動吞下連思考. But in PD, this automatic swallowing is sometimes lost, thus the saliva pools and drools on the side of the mouth.但在PD,這種自動吞嚥有時會丟失,因此唾液池及嘴角站在一邊的嘴.

The best analogy I can give you is when you go to the dentist and you are told to keep you mouth wide open.最好的比喻,我可以給你的是,當你到牙醫,你告訴他們保持你的口是敞開的. You will notice that after some time, your saliva pools and the dentist either has a suction device or allows you to spit/gargle.你會發現,經過一段時間,你的唾液池及牙醫要么有吸塵裝置,或者允許你呸/含漱. You did not really have increased salivary production at the dentist's office, but you were not allowed to swallow, thus the pooling of saliva.你沒有真正增加唾液生產牙醫辦公室,但你不能吞食,因此,匯聚了唾沫.

The simplest strategy for this is to simply suck sugar-free (to prevent cavities) candy or chew sugar-free gum all day.最簡單的策略,因為這是簡單地吸吮無糖(防止蛀牙)糖果,或嚼無糖口香糖一整天. This will trigger your mouth to swallow.這將引發你的嘴吞下.

Sometimes, anticholinergic drugs are used to decrease salivary production (they cause dry mouth).有時,抗膽鹼藥物,是用來減少唾液生產(它們造成口乾). But that is not really addressing the problem since the issue is not increased salivary production.但那不是真正解決了問題,因為問題的關鍵不是增加唾液生產. It also has lots of side effects (cognitive slowing, blurred vision, urinary hesitancy, etc).它也有很多副作用(認知緩慢,視力模糊,尿液猶豫不決等).

The best therapy, in my opinion, is botulinum toxin injection of the parotid and submandibular gland.最好的治療,我認為這是肉毒桿菌毒素注射的腮腺和頜下腺. We have some reason to believe that Botox Type B is better than Type A for this indication.我們有理由相信,肉毒桿菌毒素B型比A型這種跡象. But either is generally okay.但無論是一般感冒.

Yours,萬事如意
__________________________________
Hubert H. Fernandez朱佩h.費爾南德斯

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Anonymous匿名






Posted: Sat Jul 14, 2007 9:40 am Post subject:Posted:週六2007年7月14日上午09點40分郵政主題:

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Dear Doctor,親愛的醫生,

I refer to the above I have the following for your advise:我指的是段,我有以下幾點建議您:

1 Is it the drooling or sialorrhea resulted by the jaw tremor?1,是它的口水還是口水造成的下顎顫抖?

2.2. Is it the neurological disorders associated with drooling of saliva?它是神經病變與口水唾液?

3.Is it an impact on lip, tongue, and jaw in PD speaker intellectuality and articulately?3.is它影響到嘴唇,舌頭,下巴鈀議長理智與加伊達?

4.4. Is it reduced spontaneous swallowing?它是減少腹水吞下?

5 Are the above contribute to a poor quality of life and a career burden.?5以上的貢獻,為窮人的生活質量和事業的負擔.?

Best regards問候

TEOKIMHOEteokimhoe

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Dr. Fernandez費爾南德斯博士



Joined: 20 Jan 2007加入:2007年1月20日
Posts: 90職位:90

Posted: Sat Jul 14, 2007 10:51 pm Post subject:Posted:週六2007年7月14日10:51分郵政主題:

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Drooling is not a result of jaw tremor.流口水是不是因下顎顫抖.

If often has no/minimal impact on lip, tongue, jaw or speaking/articulation.如果常常沒有/影響微乎其微,嘴唇,舌頭,下巴或演講/articulation.

It is, as I mentioned, often a result of slowed or impaired natural/normal reflex to swallow the saliva regularly.但正如我所說,往往因放慢或受損自然/正常反射吞下唾液定期舉行.

Yes, if drooling is severe, it can affect quality of life.不錯,如果流口水是非常嚴重的,它可以影響生活質量.

Yours,萬事如意
__________________________________
Hubert H. Fernandez朱佩h.費爾南德斯

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Anonymous匿名






Posted: Sun Jul 15, 2007 12:24 am Post subject:張貼:孫2007年7月15日12:24分郵政主題:

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Dear Doctor,親愛的醫生,

I have a hypothesis about the saliva.我有一個假說,唾液. I sometimes suddenly feel a lot of saliva pooling in the front of my mouth.有時,我突然感到了不少口水匯集在門口把我的嘴. But it但
is only sometimes.只是有時候. True, I may not be swallowing it as well as once but I am *sure* it feels like a sudden surge of saliva being produced and as I have had parroted gland issues before I think I know what that feels like.不錯,我未必是它吞下以及一次,但我相信**感覺突然唾液出爐,而正如我曾腮腺問題之前,我想我知道是什麼感覺喜歡.

I was diagnosed with Sjogren's Syndrome years ago.我被診斷患有乾燥綜合徵多年前. There was at times a very dry mouth and other times too much saliva as the parotid tried to make up for the deficit.有次在一個非常口乾,其他時間太多,因為唾液腮腺試圖使彌補赤字. Dry eyes also watering (as a reaction to the dryness), etc. You probably know this disease.眼睛乾澀也是澆水(作為一種反應乾燥)等,你大概知道這種病.

My point is that if one has this disease (Sjogren's) they don't recover the cells destroyed and theoretically the damage is done.我的意思是,如果你有這病(乾燥),他們不收回摧毀細胞,從理論上損害做到這一點. However, after a time all these secretions went back into balance for me.不過,經過一段時間,這些分泌物回去權衡了. I was then told that it was not "true" Sjogren's but that my symptoms were a result of a disturbed autonomic nervous system, specifically sympathetic, as a part of my Fibromyalgia.當時我說那不是"真實"格倫說,但我的症狀都造成了困擾植物神經系統,特別同情,並以此作為我國纖維肌痛.

I did a little research and lo, and behold, it seems very possible that this is true -- the sympathetic nervous system a little out of whack could cause too much saliva production in the same way it can cause some of the other commonly mentioned sympathetic nervous system issues.我作了一個小小的研究,螺,看吧,看來,極有可能這是一個事實--交感神經系統有點格格不入失衡可能導致太多的唾液生產一樣,它可以導致其他一些常提到的交感神經系統問題.

My point is that I have read that sympathetic nervous system dysfunction is commonly found in PD.我的意思是,我已看過,交感神經系統功能障礙是常見的並發症. I hypothesize a connection to the excess saliva.我猜測聯想的唾液過多. Every single book or article one reads says the same thing -- poor swallowing --I think mostly because it's not that important to researchers and one copies the others' remarks.每一本書或文章,一款是說,同樣的事情--窮人吞嚥--我想主要是因為它的不這一重要的研究者之一,拷貝他人的言論. But I am guessing if you asked a lot of patients they might say they feel surges of saliva (like when you are hungry and smell a hamburger!).但我猜測,如果你問了很多病人,他們可能會說,他們感到襲來的唾液(如當你餓了,聞到一個漢堡包!!).

Since you doctors are always very sympathetic to the quality of life issues the excess saliva and drooling can cause I thought I would mention it.因為你的醫生總是非常同情的生活質量問題過多唾液和口水可造成我以為我會提到它. Also, it could explain good results from the borax rather than a bone dry miserable mouth because the borax would be inhibiting the *excess* saliva.另外,它可以解釋好成績,從肉毒而非骨幹口苦,因為肉毒會抑制過剩**唾液.

Well, not that you asked my views .好,而不是你問我的意見. .. .but there you have it!.但你有!

Best wishes.良好的祝愿.

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Dr. Fernandez費爾南德斯博士



Joined: 20 Jan 2007加入:2007年1月20日
Posts: 90職位:90

Posted: Sun Jul 15, 2007 7:57 am Post subject:張貼:孫2007年7月15日上午07點57分郵政主題:

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Your views are always welcome.你的意見都是歡迎的.

But we do care about drooling and research is being done on the field.但我們關心的口水和研究,正在做有關的領域.

We now offer botox for this, which was not offered even 5 years ago!我們現在所提供的肉毒毒素,這也是無法提供,甚至5年前!

Yours,萬事如意
__________________________________
Hubert H. Fernandez朱佩h.費爾南德斯

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Anonymous匿名






Posted: Mon Jul 16, 2007 5:40 am Post subject: Saliva and PDPosted:週一2007年7月16日上午05點40分郵政主題:唾液和PD

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Dear Doctor,''親愛的醫生,''

I am given to take Benzhexol HCL 2mg for my drooling of saliva i.e. 1 tablet 3 times a day.能給我以鹽酸苯2mg/只對我的口水唾液,即1片,每日3次.

i am told that BTX is expensive and has to be given every three months as it is effective for three months only.告訴我的BTX非常昂貴,而且也可以獲得每三個月,因為它是有效的只用三個月.

As for anti depression I am given to take 2 tablets of Seroquel 25mg and 1/2 tablet of Rivotril 0,5mg at night.至於抗抑鬱能給我以2粒思瑞康93.4%,93.3%和1/2片rivotril0,5毫克時夜. I stop taking Zyprexa Zydis as it worsen the PD patient.我停止服用用藥zydis因為關愛帕金森病人.

Kindly advise善意提醒

TEOKIMHOEteokimhoe

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Anonymous匿名






Posted: Mon Jul 16, 2007 3:17 pm Post subject:Posted:週一2007年7月16日下午03點17分郵政主題:

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Dr. F --六博士--

I hope you read my remark acknowledging that you DO care.我希望你看過我的話承認你的照顧. I wasn't sure from what you said.我不知道你剛才說的. You guys (people) are so你的男孩(人)等
compassionate.富於同情心. It's just heartening to know you are out there.這只是欣慰地知道你在那裡.

Best wishes.良好的祝愿.

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Dr. Rodriguez羅德里格斯博士



Joined: 22 Jan 2007加入:2007年1月22日
Posts: 92職位:92
Location: Gainesville, Fl位置:斯維爾,外語
Posted: Mon Jul 16, 2007 4:20 pm Post subject:Posted:週一2007年7月16日4:20分郵政主題:

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Teo:張志賢:

The Benzhexol is fine, but be aware that it may cause confusion or mental slowness in some patients.苯的是好的,但要知道這可能會引起混淆或智力遲鈍在一些病人. If it is not causing any problem to you, you can stay on it.如果是不會造成任何問題,你便可以留在這.

This is why Botulinum toxin is an option, because avoids this type of side effects, quite common in some PD patients.這就是為什麼肉毒桿菌毒素是一種選擇,因為可避免這種副作用相當普遍,在一些PD患者.

As for your depression, I prefer medications like SSRi's (serotonin reuptake inhibitors) like Lexapro or Zoloft before trying the Seroquel.至於你的抑鬱症,我寧願服用類及SSRI(血清素再吸收抑製劑)lexapro象或舍曲之前嘗試的思瑞康. I am fine with the Rivotril.我的罰款與rivotril. The Seroquel is especially helpful in depressed patient with some psychotic symptoms.思瑞康的,尤其是幫助抑鬱症患者有精神病症狀.

Hope this helps.希望這有助於.
__________________________________
Ramon L Rodriguez, MDL號拉蒙羅德里格斯,海事

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