Author
Message
Anonymous
Posted: Tue Oct 30, 2007 7:57 pm Post subject: Possible important discovery
Doctors: Interested in your thoughts as to whether this is as significant a breakthrough as it sounds like it could be. Thanks in advance! ------------------------------------------------------- ScienceDaily (Oct. 31, 2007) — Researchers at the Saint Louis University School of Medicine have discovered the key brain chemical that causes Parkinson's disease - a breakthrough finding that could pave the way for new, far more effective therapies to treat one of the most common and debilitating neurological disorders. Currently, the main approach for treating Parkinson's disease, which afflicts more than 1.5 million Americans, is to replace dopamine that's lost when the cells that produce it die off and cause the disorder. With this new research, however, scientists can better work toward 'neuroprotective' therapies - those that actually block dopamine cells from dying off in the first place. "We believe this work represents a very significant breakthrough in understanding the complicated chemical process that results in Parkinson's disease," said William J. Burke, M.D., Ph.D., professor of neurology at the Saint Louis University School of Medicine and the study's lead author. "For the first time, we've identified the chemical that triggers the events in the brain that cause this disorder," Burke added. "We believe these findings can be used to develop therapies that can actually stop or slow this process." Parkinson's disease occurs when some nerve cells in a part of the brain called the substantia nigra die or become impaired. Normally, these cells produce dopamine - a vital chemical that allows smooth, coordinated function of the body's muscles and movements. When about 80 percent of these dopamine-producing cells die or are damaged, the symptoms of Parkinson's disease begin to appear. These include tremors and shaking, slowness of movement, rigidity and stiffness, and difficulty with balance. Scientists have long known that a key protein called alpha-synuclein plays a role in the development of Parkinson's disease. Alpha-synuclein is found throughout the brain - but in some people, the protein clumps together. This causes the death of the dopamine-producing cells, which in turn causes Parkinson's to develop. The SLU researchers discovered that dopamine itself actually plays a role in destroying the cells that produce it. In the process that leads to Parkinson's disease, dopamine is converted into a highly toxic chemical called DOPAL. Using test-tube, cell-culture and animal models, the researchers found that it is DOPAL that causes alpha-synuclein protein in the brain to clump together, which in turn triggers the death of dopamine-producing cells and leads to Parkinson's. "This is very exciting," Burke said. "This is the first time that anyone has ever established that it is a naturally occurring byproduct of dopamine that causes alpha-synuclein to aggregate, or clump together. It's actually DOPAL that kicks this whole process off and results in Parkinson's disease." The research was supported by grants from the Missouri ADRDA Program, the Nestle Foundation, the St. Louis Veterans Administration Medical Center, the National Institutes of Health, the American Federation on Aging Research, the Alan A. and Edith L. Wolff Charitable Trust and the Blue Gator Foundation. The scientists' findings are published in an early online edition of the journal Acta Neuropathologica.
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Dr. RodriguezJoined: 22 Jan 2007Posts: 92Location: Gainesville, Fl
Posted: Tue Oct 30, 2007 8:53 pm Post subject:
This is very exciting, as DOPAL was suspected to be involved, but there was no clear evidence so far. Once this is replicated, it will be a fantastic target looking into ways to delay the progression of the disease (as you know, monoamine oxidase inhibitors are already available). I have not been able to read the manuscript yet, but will do ASAP and post impression._________________Ramon L Rodriguez, MD
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Wednesday, October 31, 2007
Tight outfits pose health risk for women
Tight outfits pose health risk for women
A seminar held by the Royal Thai College of Obstetricians and Gynaecologists Monday warned women against wearing underwear made from synthetic fabric because such material has poor ventilation when compared to cotton.
"Poor ventilation around women's private parts could lead to infections," said Dr Veeraphol Chandeeying of Prince of Songkhla University's Faculty of Medicine.
Veeraphol said common symptoms of infections such as leukorrhea include vaginal discharges of abnormal colour or with a foul smell.
Most women seeking treatment from gynaecologists were diagnosed with this type of infection, he said.
"One of the main causes is their underwear," he added.
Aside from choosing the right type of fabric, Veeraphol also emphasised that the underwear must be clean. After being washed, underwear should be left to dry in the sun, he said,
Dr Annop Jaisamran, of Chulalongkorn University's Faculty of Medicine, said infection could lead to inflammation.
"Although it is not life-threatening, it affects quality of life," he said.
He said some infections could also cause gonorrhoea. In the case of a prolonged viral infection, he said the risk of cancer also increased.
Annop said it was best for women to wash using clean water and to avoid tight pants or jeans.
"Avoid tight outfits or you risk getting a fungal infection. Choose underwear that will not cause irritation. With proper care, women won't need to visit a doctor about this problem," he said.
A seminar held by the Royal Thai College of Obstetricians and Gynaecologists Monday warned women against wearing underwear made from synthetic fabric because such material has poor ventilation when compared to cotton.
"Poor ventilation around women's private parts could lead to infections," said Dr Veeraphol Chandeeying of Prince of Songkhla University's Faculty of Medicine.
Veeraphol said common symptoms of infections such as leukorrhea include vaginal discharges of abnormal colour or with a foul smell.
Most women seeking treatment from gynaecologists were diagnosed with this type of infection, he said.
"One of the main causes is their underwear," he added.
Aside from choosing the right type of fabric, Veeraphol also emphasised that the underwear must be clean. After being washed, underwear should be left to dry in the sun, he said,
Dr Annop Jaisamran, of Chulalongkorn University's Faculty of Medicine, said infection could lead to inflammation.
"Although it is not life-threatening, it affects quality of life," he said.
He said some infections could also cause gonorrhoea. In the case of a prolonged viral infection, he said the risk of cancer also increased.
Annop said it was best for women to wash using clean water and to avoid tight pants or jeans.
"Avoid tight outfits or you risk getting a fungal infection. Choose underwear that will not cause irritation. With proper care, women won't need to visit a doctor about this problem," he said.
comment by Chai How
Hi Dr Chew,
That's great, I have gone through Mr Teo's blog, is really amazing, it is so informative.
I still keep a copy of all the articles that Dr Chew posted on mpda.org.my previously, so i think if we can combine all these articles together, I am sure we can come out a very informative website for PD patients.I am available for this weekend day time, just let know if we can meet up.
Thank you.
ChiaHow
That's great, I have gone through Mr Teo's blog, is really amazing, it is so informative.
I still keep a copy of all the articles that Dr Chew posted on mpda.org.my previously, so i think if we can combine all these articles together, I am sure we can come out a very informative website for PD patients.I am available for this weekend day time, just let know if we can meet up.
Thank you.
ChiaHow
Hypersalivation and Parkinson's
Author
Message
Anonymous
Posted: Tue Oct 30, 2007 2:02 am Post subject: Hypersalivation and Parkinson's
There are 31% of Parkinson's Patients have hypersalivation (excessive saliva) locked deep down in the throat that cause itching as they feel comfortable to cough and clear the throat all the times.
Besides the saliva drooling from the mouth that they feel uncomfortable as the excessive saliva is thick as a glue.
It is a chronic cough for Parkinson's patients that causing them with insomnia also. This cough use to be at evening.
I am one of the sufferers. In order to ascertain whether it is a phlegm or saliva I have undergone Chest X Test and the result shown there is any phlegm in my chest.
Besides I have taken antihistamine (sedative) I also do CPOD test/ Pulmonary Function Test and the result there is no obstructive airway defict and no signficant response to bronchiectasis, normal lung volume and normal DLco.
I do not suffering from any breathing irregularity. Can you elaborate the above symptom in relation with Parkinson's?
What are the best treatment besides my medication? My medication are : one dose of Atarax 25 gm for itching and two doses Ropect (Rotuss) for cough daily. I have little improvement of the above medications> Best regards TEOKIMHOE
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Dr. RodriguezJoined: 22 Jan 2007Posts: 92Location: Gainesville, Fl
Posted: Tue Oct 30, 2007 8:57 pm Post subject:
Swallowing is important to handle secretions, I recommend you assess your swallowing. Some people benefit from using guaifenesin to thin secretions, this is mostly anecdotal. There are some medications to decrease hyper salivation that can be tried._________________Ramon L Rodriguez, MD
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Message
Anonymous
Posted: Tue Oct 30, 2007 2:02 am Post subject: Hypersalivation and Parkinson's
There are 31% of Parkinson's Patients have hypersalivation (excessive saliva) locked deep down in the throat that cause itching as they feel comfortable to cough and clear the throat all the times.
Besides the saliva drooling from the mouth that they feel uncomfortable as the excessive saliva is thick as a glue.
It is a chronic cough for Parkinson's patients that causing them with insomnia also. This cough use to be at evening.
I am one of the sufferers. In order to ascertain whether it is a phlegm or saliva I have undergone Chest X Test and the result shown there is any phlegm in my chest.
Besides I have taken antihistamine (sedative) I also do CPOD test/ Pulmonary Function Test and the result there is no obstructive airway defict and no signficant response to bronchiectasis, normal lung volume and normal DLco.
I do not suffering from any breathing irregularity. Can you elaborate the above symptom in relation with Parkinson's?
What are the best treatment besides my medication? My medication are : one dose of Atarax 25 gm for itching and two doses Ropect (Rotuss) for cough daily. I have little improvement of the above medications> Best regards TEOKIMHOE
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Dr. RodriguezJoined: 22 Jan 2007Posts: 92Location: Gainesville, Fl
Posted: Tue Oct 30, 2007 8:57 pm Post subject:
Swallowing is important to handle secretions, I recommend you assess your swallowing. Some people benefit from using guaifenesin to thin secretions, this is mostly anecdotal. There are some medications to decrease hyper salivation that can be tried._________________Ramon L Rodriguez, MD
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Hypersalivation,Phlegm,Cough and Parkinson's Disease
Further to my website I posted titled :Phlegm, Saliva,Cough and Parkinson's Disease", I have consulted a Pulmonoglist in Bumrungrad Hospital Bangkok to ascertain the causes of the phlegm deep in my throat and also to find out whether I am suffering from Chronic Pulmonary obstructive Disease (CPOD) as a result of Parkinson's Disease.
After I have gone Pulmonary Function shown there are no obstructive airway defect,no significant response to bronchitis, normal lung volume and Normal Dulci; Inspired volume was less than 90% of best vital capacity.
I was told that the phlegm is actually thick saliva locked deep down in my throat.Due to my medication the saliva become thicker and stringier. The thick saliva locked down my throat that is itching and I feel the needs to cough and clear my throat all the times.
In fact excess saliva in the mouth which causes drooling, is one of the syndrome and feature of Parkinson's . Studies shown that 70-80% pf people with Parkinson's experience this problem.
In fact the condition is not due to excess production. On the contrary most people with Parkinson's actually produce less saliva. The problem is that PD reduces the frequency of automatic swallowing, and this in turn allows saliva to accumulate within the mouth that causes saliva drooling when the mouth is opened. This is why PD have mask face (poker face)
In fact PD patients feel socially embarrassing for the above that are reluctant to go out in public.
Injection of toxin to reduce the saliva is one of the solution and it is effective for six months, Using atropine eye drops in the tongue once or two daily may help to alleviate the situation.
My medications for the treatments are: 2 doses of Prevacid 30 gm, 2 doses of Ropect (Rotuss) and one dose of Atarax 25mg daily
TEOKIMHOE
After I have gone Pulmonary Function shown there are no obstructive airway defect,no significant response to bronchitis, normal lung volume and Normal Dulci; Inspired volume was less than 90% of best vital capacity.
I was told that the phlegm is actually thick saliva locked deep down in my throat.Due to my medication the saliva become thicker and stringier. The thick saliva locked down my throat that is itching and I feel the needs to cough and clear my throat all the times.
In fact excess saliva in the mouth which causes drooling, is one of the syndrome and feature of Parkinson's . Studies shown that 70-80% pf people with Parkinson's experience this problem.
In fact the condition is not due to excess production. On the contrary most people with Parkinson's actually produce less saliva. The problem is that PD reduces the frequency of automatic swallowing, and this in turn allows saliva to accumulate within the mouth that causes saliva drooling when the mouth is opened. This is why PD have mask face (poker face)
In fact PD patients feel socially embarrassing for the above that are reluctant to go out in public.
Injection of toxin to reduce the saliva is one of the solution and it is effective for six months, Using atropine eye drops in the tongue once or two daily may help to alleviate the situation.
My medications for the treatments are: 2 doses of Prevacid 30 gm, 2 doses of Ropect (Rotuss) and one dose of Atarax 25mg daily
TEOKIMHOE
Tuesday, October 30, 2007
Urination and Parkinson's
Author
Message
Anonymous
Posted: Mon Oct 29, 2007 10:25 am Post subject: Urination and Parkinson's
I have experienced a lack control as far as urination is concern.
Firstly, when I am in the midst of urinating, I am unable to hold back or stop halfway through.
Secondly, when I feel the need to urinate I must go to the toilet immediately. I will not be able to hold back at all. I have seen Urologist and was told my PSA is normal though I have slight enlarged prostate gland.
My medication: 1 Capsule Detrusitol SR 4 mg and one dose Harnal 0.2mg taken after breakfast daily.
Kindly clarify whether the above is it related to Parkinson's Disease? If it is please explain why and how this affects my problem of urination? Is it ageing process? Combination cause of enlarged Prostate gland and Parkinson's?
Thanks TEOKIMHOE
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Dr. RodriguezJoined: 22 Jan 2007Posts: 92Location: Gainesville, Fl
Posted: Mon Oct 29, 2007 11:42 am Post subject:
I do not believe is a result of the PD and is more likely a result of enlargement of the prostate, quite common in men over 50y/o._________________Ramon L Rodriguez, MD
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In fact there are 27-29% of PD have bladder and urinary difficulties.
Unlike bowel dysfunction which becomes motor feature at the early stage of PD urinary and bladder dyfunction with PD becomes evident at later stages of Parkinson's.
The primary function of the bladder is twofold- to store urine and then to empty the urine when it is convenient and socially acceptable to do so.
The most common urinary symptoms experienced by people with PD
are first the need to urinate extremely frequently and difficulty in delaying urination once the need perceived , creating a sense of urinary urgency.
Therefore urinary problem is a feature amongst PD and they should not hesitate to bring these problems to the doctor and seek for treatment.
TEOKIMHOE
Message
Anonymous
Posted: Mon Oct 29, 2007 10:25 am Post subject: Urination and Parkinson's
I have experienced a lack control as far as urination is concern.
Firstly, when I am in the midst of urinating, I am unable to hold back or stop halfway through.
Secondly, when I feel the need to urinate I must go to the toilet immediately. I will not be able to hold back at all. I have seen Urologist and was told my PSA is normal though I have slight enlarged prostate gland.
My medication: 1 Capsule Detrusitol SR 4 mg and one dose Harnal 0.2mg taken after breakfast daily.
Kindly clarify whether the above is it related to Parkinson's Disease? If it is please explain why and how this affects my problem of urination? Is it ageing process? Combination cause of enlarged Prostate gland and Parkinson's?
Thanks TEOKIMHOE
Back to top
Dr. RodriguezJoined: 22 Jan 2007Posts: 92Location: Gainesville, Fl
Posted: Mon Oct 29, 2007 11:42 am Post subject:
I do not believe is a result of the PD and is more likely a result of enlargement of the prostate, quite common in men over 50y/o._________________Ramon L Rodriguez, MD
Back to top
In fact there are 27-29% of PD have bladder and urinary difficulties.
Unlike bowel dysfunction which becomes motor feature at the early stage of PD urinary and bladder dyfunction with PD becomes evident at later stages of Parkinson's.
The primary function of the bladder is twofold- to store urine and then to empty the urine when it is convenient and socially acceptable to do so.
The most common urinary symptoms experienced by people with PD
are first the need to urinate extremely frequently and difficulty in delaying urination once the need perceived , creating a sense of urinary urgency.
Therefore urinary problem is a feature amongst PD and they should not hesitate to bring these problems to the doctor and seek for treatment.
TEOKIMHOE
Wednesday, October 24, 2007
Bloating and Parkinson Patient
Author
Message
Anonymous
Posted: Mon Aug 13, 2007 2:44 am Post subject: Q: Bloating and Parkinson Patient
Bloating is a very common gastrointestinal condition that million of people around the world suffer from each and everyday. Chances are that there is really nothing wrong with you if you find that your are experiencing bloating and there is no need to be alarmed. However it is different with the Parkinson patient. Besides eating food that may not particularly agree with your system , having constipation. There are Parkinson medications or vitamins that have been shown to cause bloating. Treatments for bloating depending on how bad your symptoms are. TEO KIM HOE
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Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Mon Aug 13, 2007 7:06 am Post subject:
Dear Teo, Thanks for your post, it's a good reminder that bloating can be caused by a number of conditions, and it's important to talk with your doctor. The PD medications known as agonists, such as Requip and Mirapex, can cause bloating. Also, gastroparesis (slowed stomach emptying) can cause excess stomach acid, which, mixed with food, creates gas and bloating in the stomach. I encourage all folks to talk with your doctor if this occurs._________________Best regards, Kathrynne Holden, MS, RD -- For a Parkinson Tip of the Day visit: http://www.nutritionucanlivewith.com/
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Anonymous
Posted: Sat Oct 20, 2007 3:52 am Post subject: Bloating and Parkinson Patient
Dear Dr. Kathrynne Holden, I am glad that you are my respected doctor. You are working hard for the awareness of Parkinson's patients. Lord bless you. In view of the above articles I am recently diagnosed that I have reflux acid. It causes saliva drooling from my mouth and excessive phlegm deep in my throat. I have poor cough occasionally when I lie down at bed. My phlegm is thin as a glue. I do not have COPD (Chronic obstructive pulmonary disease} as told by my Pulmonary specialist. As what you have mentioned the Parkinson's medication known as agonists, such as Requip can cause bloating,saliva and phlegm deep in the throat that irritated with cough when one rests at bed. I could not sleep at night and taking "Ativan "and it wear off in 3- 4 hours thus no relief from early morning awakening. I have consulted Lung Specialist for the treatment and am taking two doses of Prevacid 30 mg before food daily. As for my insomnia 2 doses of Ativan before bed time. In this connection should I cutdown the taking of Requip from 12 mg to 8 mg and substitute with one extra of Sinemet from two doses to three doses daily? Sinemet is the wonder drug. My doctor Dr. Chew agrees with the changes. However I am worry does the changes affecting my physically agility at the Gym? In this connection kindly advise me on how to get away or substitute the taking "Ativan" for insomnia as it has sideeffect if I regular use over time and increase significant risks in the elderly like me. It could develop over-sedation, confusion and balance impairment increasing the risk of falls. Kindly advise me TEOKIMHOE
Anonymous
Posted: Tue Oct 23, 2007 12:38 am Post subject: Bloating and Parkinson Patient
Dear Mr Teo Dopamine agonists such as Requip do not cause your symptoms of bloating, phlegm etc. You should continue the Requip at the same dose (12 mg per day). Dr Chew
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Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Tue Oct 23, 2007 10:23 am Post subject:
Dear Teo, Acid reflux is not uncommon among those with PD. It may be a result of slowed stomach emptying (gastroparesis), which occurs when PD slows the movement of the muscles of the stomach, so that food remains in the stomach for an abnormally long time. The food, mixed with stomach acid, creates gas, which pushes the acid contents upward into the throat, creating acid reflux. This can cause persistent coughing, as you note. However, to the best of my knowledge the drooling of saliva is a different matter, not related to the reflux, nor to the Requip. This may occur due to “hypersalivation” as a result of PD; but more often, it occurs because one forgets to swallow as often as needed. Phlegm and Mucus is not at all uncommon among folks with PD. Here are a couple of suggestions; one or the other has worked for most people: 1) Alkalol: Medications, breathing through the mouth, sleeping with the mouth open, using medications that cause dry mouth, and other conditions can sometimes lead to a buildup of sticky mucous that's difficult to swallow. If so, ask your dentist whether it might be helpful to try swishing the mouth, or gargling, with a mouthwash called Alkalol. Alkalol is a mucous solvent; ingredients include thymol, eucalyptol, menthol, camphor, benzoin, potassium alum, potassium chlorate, sodium, bicarbonate, sodium chloride, and oils of sweet birch, spearmint, pine, and cinnamon, plus 2/100 of 1% alcohol. It is commonly used as a mouthwash, nasal spray, and gargle, to cut mucous. People with sleep apnea, singers with throat irritation, and others use Alkalol, but it's fine as a daily mouthwash also. Alkalol is available at most U.S. drugstores; if your dentist agrees it might be useful, ask the pharmacist to point it out. If they don't carry it, the pharmacist can order it: The Alkalol Company Taunton, Massachusetts 02780-0952 or, online by the case (I have no personal experience with the following company, and do not endorse it, nor receive payment from it): Case of 12: $33.58 http://www.medichest.com/alkalolliquidcaseof1.html For an article that describes various ways of irrigating, as well as use of Alkalol and other solutions, please see: http://www.allergybuyersclub.com/faqs/faq-sinusitis.shtml --- A forum friend comments: Sips of pineapple juice (not pineapple drink or juice with sugar, just plain juice or papaya (the fruit) will help relieve the throat of mucous and excess saliva. Another forum friend's comment: I have used Alkolol for about six weeks now and find it very helpful. I bought a salt water nasal spray bottle and emptied it and filled it with straight Alkolol for sinuses. I only use it a couple times a week as needed. For gargling I find it takes a tiny swig out of the bottle. Just a little bit cuts through all the dry mouth and throat build up. Its great and inexpensive. 2) The combination of fenugreek and thyme has helped a number of people who have problems with drooling or excess mucus. It can be obtained in capsule form at many health food stores. Regarding medication changes, I cannot assist you, as this is outside my scope of practice as a dietitian._________________Best regards, Kathrynne Holden, MS, RD -- For a Parkinson Tip of the Day visit: http://www.nutritionucanlivewith.com/
Anonymous
Posted: Wed Oct 24, 2007 5:05 am Post subject: Bloating and Parkinson Patient
Dear Mr Teo Take three tablets of Ativan at night. Two tablets may not be sufficient for you. Don't worry about sleeping pills - they are safe. Most of my PD patients are on sleeping pills because insomnia is common in PD. Dr Chew
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Message
Anonymous
Posted: Mon Aug 13, 2007 2:44 am Post subject: Q: Bloating and Parkinson Patient
Bloating is a very common gastrointestinal condition that million of people around the world suffer from each and everyday. Chances are that there is really nothing wrong with you if you find that your are experiencing bloating and there is no need to be alarmed. However it is different with the Parkinson patient. Besides eating food that may not particularly agree with your system , having constipation. There are Parkinson medications or vitamins that have been shown to cause bloating. Treatments for bloating depending on how bad your symptoms are. TEO KIM HOE
Back to top
Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Mon Aug 13, 2007 7:06 am Post subject:
Dear Teo, Thanks for your post, it's a good reminder that bloating can be caused by a number of conditions, and it's important to talk with your doctor. The PD medications known as agonists, such as Requip and Mirapex, can cause bloating. Also, gastroparesis (slowed stomach emptying) can cause excess stomach acid, which, mixed with food, creates gas and bloating in the stomach. I encourage all folks to talk with your doctor if this occurs._________________Best regards, Kathrynne Holden, MS, RD -- For a Parkinson Tip of the Day visit: http://www.nutritionucanlivewith.com/
Back to top
Anonymous
Posted: Sat Oct 20, 2007 3:52 am Post subject: Bloating and Parkinson Patient
Dear Dr. Kathrynne Holden, I am glad that you are my respected doctor. You are working hard for the awareness of Parkinson's patients. Lord bless you. In view of the above articles I am recently diagnosed that I have reflux acid. It causes saliva drooling from my mouth and excessive phlegm deep in my throat. I have poor cough occasionally when I lie down at bed. My phlegm is thin as a glue. I do not have COPD (Chronic obstructive pulmonary disease} as told by my Pulmonary specialist. As what you have mentioned the Parkinson's medication known as agonists, such as Requip can cause bloating,saliva and phlegm deep in the throat that irritated with cough when one rests at bed. I could not sleep at night and taking "Ativan "and it wear off in 3- 4 hours thus no relief from early morning awakening. I have consulted Lung Specialist for the treatment and am taking two doses of Prevacid 30 mg before food daily. As for my insomnia 2 doses of Ativan before bed time. In this connection should I cutdown the taking of Requip from 12 mg to 8 mg and substitute with one extra of Sinemet from two doses to three doses daily? Sinemet is the wonder drug. My doctor Dr. Chew agrees with the changes. However I am worry does the changes affecting my physically agility at the Gym? In this connection kindly advise me on how to get away or substitute the taking "Ativan" for insomnia as it has sideeffect if I regular use over time and increase significant risks in the elderly like me. It could develop over-sedation, confusion and balance impairment increasing the risk of falls. Kindly advise me TEOKIMHOE
Anonymous
Posted: Tue Oct 23, 2007 12:38 am Post subject: Bloating and Parkinson Patient
Dear Mr Teo Dopamine agonists such as Requip do not cause your symptoms of bloating, phlegm etc. You should continue the Requip at the same dose (12 mg per day). Dr Chew
Back to top
Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Tue Oct 23, 2007 10:23 am Post subject:
Dear Teo, Acid reflux is not uncommon among those with PD. It may be a result of slowed stomach emptying (gastroparesis), which occurs when PD slows the movement of the muscles of the stomach, so that food remains in the stomach for an abnormally long time. The food, mixed with stomach acid, creates gas, which pushes the acid contents upward into the throat, creating acid reflux. This can cause persistent coughing, as you note. However, to the best of my knowledge the drooling of saliva is a different matter, not related to the reflux, nor to the Requip. This may occur due to “hypersalivation” as a result of PD; but more often, it occurs because one forgets to swallow as often as needed. Phlegm and Mucus is not at all uncommon among folks with PD. Here are a couple of suggestions; one or the other has worked for most people: 1) Alkalol: Medications, breathing through the mouth, sleeping with the mouth open, using medications that cause dry mouth, and other conditions can sometimes lead to a buildup of sticky mucous that's difficult to swallow. If so, ask your dentist whether it might be helpful to try swishing the mouth, or gargling, with a mouthwash called Alkalol. Alkalol is a mucous solvent; ingredients include thymol, eucalyptol, menthol, camphor, benzoin, potassium alum, potassium chlorate, sodium, bicarbonate, sodium chloride, and oils of sweet birch, spearmint, pine, and cinnamon, plus 2/100 of 1% alcohol. It is commonly used as a mouthwash, nasal spray, and gargle, to cut mucous. People with sleep apnea, singers with throat irritation, and others use Alkalol, but it's fine as a daily mouthwash also. Alkalol is available at most U.S. drugstores; if your dentist agrees it might be useful, ask the pharmacist to point it out. If they don't carry it, the pharmacist can order it: The Alkalol Company Taunton, Massachusetts 02780-0952 or, online by the case (I have no personal experience with the following company, and do not endorse it, nor receive payment from it): Case of 12: $33.58 http://www.medichest.com/alkalolliquidcaseof1.html For an article that describes various ways of irrigating, as well as use of Alkalol and other solutions, please see: http://www.allergybuyersclub.com/faqs/faq-sinusitis.shtml --- A forum friend comments: Sips of pineapple juice (not pineapple drink or juice with sugar, just plain juice or papaya (the fruit) will help relieve the throat of mucous and excess saliva. Another forum friend's comment: I have used Alkolol for about six weeks now and find it very helpful. I bought a salt water nasal spray bottle and emptied it and filled it with straight Alkolol for sinuses. I only use it a couple times a week as needed. For gargling I find it takes a tiny swig out of the bottle. Just a little bit cuts through all the dry mouth and throat build up. Its great and inexpensive. 2) The combination of fenugreek and thyme has helped a number of people who have problems with drooling or excess mucus. It can be obtained in capsule form at many health food stores. Regarding medication changes, I cannot assist you, as this is outside my scope of practice as a dietitian._________________Best regards, Kathrynne Holden, MS, RD -- For a Parkinson Tip of the Day visit: http://www.nutritionucanlivewith.com/
Anonymous
Posted: Wed Oct 24, 2007 5:05 am Post subject: Bloating and Parkinson Patient
Dear Mr Teo Take three tablets of Ativan at night. Two tablets may not be sufficient for you. Don't worry about sleeping pills - they are safe. Most of my PD patients are on sleeping pills because insomnia is common in PD. Dr Chew
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Test rates driving ability in Parkinson's patients
Author
Message
Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Tue Oct 23, 2007 10:44 am Post subject: News: Test rates driving ability in Parkinson's patients
Dear Friends, the following may be of interest. Best, Kathrynne ======================================================== Test rates driving ability in Parkinson's patients Wed Oct 17, 2007 9:51pm BST http://uk.reuters.com/article/healthNews/idUKTON77500520071017 By Michelle Rizzo NEW YORK (Reuters Health) - A short screening test, developed by a Belgian team, which measures four clinical variables can accurately predict the fitness of patients with Parkinson's disease to drive, according to findings published in the current issue of the journal Neurology. "Physicians often rely on a medical history and an interview with the patient and the next of kin regarding driving problems," lead author Dr. Hannes Devos noted in comment to Reuters Health. However, "physicians often overestimate the driving skills of their patients." Devos of Catholic University in Leuven and colleagues developed a brief, efficient screening system to help physicians assess the fitness of Parkinson's disease patients to drive a car. Eighty individuals, including 40 with Parkinson's disease and 40 healthy subjects matched to the patients for age and other variables, were assessed using a driving simulator, a driving history survey, and the Clinical Dementia Rating scale. In addition, the Parkinson's patients underwent a screening test and an evaluation designed by the Belgian Road Safety Institute. This included visual, intellectual and on-road testing. The combination of assessments that included disease duration, sensitivity to contrasts, Clinical Dementia Rating, and the motor part of the Unified Parkinson's Disease Rating Scale provided the best screening test to predict fitness to drive. Overall, 36 (90 percent) patients with Parkinson's disease were correctly classified as pass or fail using this screening method. "When the result on the formula is positive, the patient can continue to drive without further restrictions," Devos explained. When the patient fails, he may be allowed to drive with restrictions or be considered unfit to drive, he said. "Further assessment at an official driving assessment center then seems to be the right course of action." Parkinson's disease "is often regarded as a disease that mainly affects motor functions, while visual and cognitive functions are often disregarded," Devos noted. "Nonetheless, problems with attention, visuospatial organization, planning and judgment, and contrast sensitivity are also seen in Parkinson's disease." "It is my opinion that the driving performance of Parkinson's disease patients is often overestimated and that they should be evaluated on a more regular basis," Devos concluded. SOURCE: Neurology October 2, 2007. http://uk.reuters.com/article/healthNews/idUKTON77500520071017_________________Best regards, Kathrynne Holden, MS, RD -- For a Parkinson Tip of the Day visit: http://www.nutritionucanlivewith.com/
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Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Tue Oct 23, 2007 10:44 am Post subject: News: Test rates driving ability in Parkinson's patients
Dear Friends, the following may be of interest. Best, Kathrynne ======================================================== Test rates driving ability in Parkinson's patients Wed Oct 17, 2007 9:51pm BST http://uk.reuters.com/article/healthNews/idUKTON77500520071017 By Michelle Rizzo NEW YORK (Reuters Health) - A short screening test, developed by a Belgian team, which measures four clinical variables can accurately predict the fitness of patients with Parkinson's disease to drive, according to findings published in the current issue of the journal Neurology. "Physicians often rely on a medical history and an interview with the patient and the next of kin regarding driving problems," lead author Dr. Hannes Devos noted in comment to Reuters Health. However, "physicians often overestimate the driving skills of their patients." Devos of Catholic University in Leuven and colleagues developed a brief, efficient screening system to help physicians assess the fitness of Parkinson's disease patients to drive a car. Eighty individuals, including 40 with Parkinson's disease and 40 healthy subjects matched to the patients for age and other variables, were assessed using a driving simulator, a driving history survey, and the Clinical Dementia Rating scale. In addition, the Parkinson's patients underwent a screening test and an evaluation designed by the Belgian Road Safety Institute. This included visual, intellectual and on-road testing. The combination of assessments that included disease duration, sensitivity to contrasts, Clinical Dementia Rating, and the motor part of the Unified Parkinson's Disease Rating Scale provided the best screening test to predict fitness to drive. Overall, 36 (90 percent) patients with Parkinson's disease were correctly classified as pass or fail using this screening method. "When the result on the formula is positive, the patient can continue to drive without further restrictions," Devos explained. When the patient fails, he may be allowed to drive with restrictions or be considered unfit to drive, he said. "Further assessment at an official driving assessment center then seems to be the right course of action." Parkinson's disease "is often regarded as a disease that mainly affects motor functions, while visual and cognitive functions are often disregarded," Devos noted. "Nonetheless, problems with attention, visuospatial organization, planning and judgment, and contrast sensitivity are also seen in Parkinson's disease." "It is my opinion that the driving performance of Parkinson's disease patients is often overestimated and that they should be evaluated on a more regular basis," Devos concluded. SOURCE: Neurology October 2, 2007. http://uk.reuters.com/article/healthNews/idUKTON77500520071017_________________Best regards, Kathrynne Holden, MS, RD -- For a Parkinson Tip of the Day visit: http://www.nutritionucanlivewith.com/
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Medication for Phelgm, Saliva, Cough and PD
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Message
Anonymous
Posted: Mon Aug 13, 2007 2:44 am Post subject: Q: Bloating and Parkinson Patient
Bloating is a very common gastrointestinal condition that million of people around the world suffer from each and everyday. Chances are that there is really nothing wrong with you if you find that your are experiencing bloating and there is no need to be alarmed. However it is different with the Parkinson patient. Besides eating food that may not particularly agree with your system , having constipation. There are Parkinson medications or vitamins that have been shown to cause bloating. Treatments for bloating depending on how bad your symptoms are. TEO KIM HOE
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Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Mon Aug 13, 2007 7:06 am Post subject:
Dear Teo, Thanks for your post, it's a good reminder that bloating can be caused by a number of conditions, and it's important to talk with your doctor. The PD medications known as agonists, such as Requip and Mirapex, can cause bloating. Also, gastroparesis (slowed stomach emptying) can cause excess stomach acid, which, mixed with food, creates gas and bloating in the stomach. I encourage all folks to talk with your doctor if this occurs._________________Best regards, Kathrynne Holden, MS, RD -- For a Parkinson Tip of the Day visit: http://www.nutritionucanlivewith.com/
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Anonymous
Posted: Sat Oct 20, 2007 3:52 am Post subject: Bloating and Parkinson Patient
Dear Dr. Kathrynne Holden, I am glad that you are my respected doctor. You are working hard for the awareness of Parkinson's patients. Lord bless you. In view of the above articles I am recently diagnoised that I have reflux acid. It causes saliva drooling from my mouth and excessive phlegm deep in my throat. I have poor cough occassionlly when I lie down at bed. My phlegm is thin as a glue. I do not have COPD (Chronic obstructive pulmonary disease} as told by Pulumonoglist.
As what you have mentioned the Parkinson's medication known as agonists, such as Requip can cause bloating,saliva and phlegm deep in the throat that irritated with cough when one rests at bed. I could not sleep at night and taking "Ativan "and it wear off in 3- 4 hours thus no relief from early morning awakening.
In this respect my Pulumonoglist prescribed me two doses of Prevacid 30 mg taken before the food daily.
As for my insomnia 2 doses of Ativan taken before the bed time.
In this connection should I cutdown the taking of Requip from 12 mg to 8 mg and substitute with one extra of Sinemet from two doses to three doses daily?
Sinemet is the wonder drug. My doctor Dr. Chew agrees with the changes.
However I am worry does the changes affecting my physically agility at the Gym?
In this connection kindly advise me on how to get away or substitute the taking "Ativan" for insomnia as it has sideeffect if I regular use over time and increase significant risks in the elderly like me. It could develop over-sedation, confusion and balance impairment increasing the risk of falls. Kindly advise me TEOKIMHOE
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Anonymous
Posted: Tue Oct 23, 2007 12:38 am Post subject: Bloating and Parkinson's Patient
Dear Mr Teo Dopamine agonists such as Requip do not cause your symptoms of bloating, phlegm etc. You should continue the Requip at the same dose (12 mg per day). Dr Chew
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Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Tue Oct 23, 2007 10:23 am Post subject:
Dear Teo, Acid reflux is not uncommon among those with PD. It may be a result of slowed stomach emptying (gastroparesis), which occurs when PD slows the movement of the muscles of the stomach, so that food remains in the stomach for an abnormally long time. The food, mixed with stomach acid, creates gas, which pushes the acid contents upward into the throat, creating acid reflux. This can cause persistent coughing, as you note. However, to the best of my knowledge the drooling of saliva is a different matter, not related to the reflux, nor to the Requip. This may occur due to “hypersalivation” as a result of PD; but more often, it occurs because one forgets to swallow as often as needed. Phlegm and Mucus is not at all uncommon among folks with PD. Here are a couple of suggestions; one or the other has worked for most people: 1) Alkalol: Medications, breathing through the mouth, sleeping with the mouth open, using medications that cause dry mouth, and other conditions can sometimes lead to a buildup of sticky mucous that's difficult to swallow. If so, ask your dentist whether it might be helpful to try swishing the mouth, or gargling, with a mouthwash called Alkalol. Alkalol is a mucous solvent; ingredients include thymol, eucalyptol, menthol, camphor, benzoin, potassium alum, potassium chlorate, sodium, bicarbonate, sodium chloride, and oils of sweet birch, spearmint, pine, and cinnamon, plus 2/100 of 1% alcohol. It is commonly used as a mouthwash, nasal spray, and gargle, to cut mucous. People with sleep apnea, singers with throat irritation, and others use Alkalol, but it's fine as a daily mouthwash also. Alkalol is available at most U.S. drugstores; if your dentist agrees it might be useful, ask the pharmacist to point it out. If they don't carry it, the pharmacist can order it: The Alkalol Company Taunton, Massachusetts 02780-0952 or, online by the case (I have no personal experience with the following company, and do not endorse it, nor receive payment from it): Case of 12: $33.58 http://www.medichest.com/alkalolliquidcaseof1.html For an article that describes various ways of irrigating, as well as use of Alkalol and other solutions, please see: http://www.allergybuyersclub.com/faqs/faq-sinusitis.shtml --- A forum friend comments: Sips of pineapple juice (not pineapple drink or juice with sugar, just plain juice or papaya (the fruit) will help relieve the throat of mucous and excess saliva. Another forum friend's comment: I have used Alkolol for about six weeks now and find it very helpful. I bought a salt water nasal spray bottle and emptied it and filled it with straight Alkolol for sinuses. I only use it a couple times a week as needed. For gargling I find it takes a tiny swig out of the bottle. Just a little bit cuts through all the dry mouth and throat build up. Its great and inexpensive. 2) The combination of fenugreek and thyme has helped a number of people who have problems with drooling or excess mucus. It can be obtained in capsule form at many health food stores. Regarding medication changes, I cannot assist you, as this is outside my scope of practice as a dietitian._________________Best regards, Kathrynne Holden, MS, RD -- For a Parkinson Tip of the Day visit: http://www.nutritionucanlivewith.com/
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Message
Anonymous
Posted: Mon Aug 13, 2007 2:44 am Post subject: Q: Bloating and Parkinson Patient
Bloating is a very common gastrointestinal condition that million of people around the world suffer from each and everyday. Chances are that there is really nothing wrong with you if you find that your are experiencing bloating and there is no need to be alarmed. However it is different with the Parkinson patient. Besides eating food that may not particularly agree with your system , having constipation. There are Parkinson medications or vitamins that have been shown to cause bloating. Treatments for bloating depending on how bad your symptoms are. TEO KIM HOE
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Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Mon Aug 13, 2007 7:06 am Post subject:
Dear Teo, Thanks for your post, it's a good reminder that bloating can be caused by a number of conditions, and it's important to talk with your doctor. The PD medications known as agonists, such as Requip and Mirapex, can cause bloating. Also, gastroparesis (slowed stomach emptying) can cause excess stomach acid, which, mixed with food, creates gas and bloating in the stomach. I encourage all folks to talk with your doctor if this occurs._________________Best regards, Kathrynne Holden, MS, RD -- For a Parkinson Tip of the Day visit: http://www.nutritionucanlivewith.com/
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Anonymous
Posted: Sat Oct 20, 2007 3:52 am Post subject: Bloating and Parkinson Patient
Dear Dr. Kathrynne Holden, I am glad that you are my respected doctor. You are working hard for the awareness of Parkinson's patients. Lord bless you. In view of the above articles I am recently diagnoised that I have reflux acid. It causes saliva drooling from my mouth and excessive phlegm deep in my throat. I have poor cough occassionlly when I lie down at bed. My phlegm is thin as a glue. I do not have COPD (Chronic obstructive pulmonary disease} as told by Pulumonoglist.
As what you have mentioned the Parkinson's medication known as agonists, such as Requip can cause bloating,saliva and phlegm deep in the throat that irritated with cough when one rests at bed. I could not sleep at night and taking "Ativan "and it wear off in 3- 4 hours thus no relief from early morning awakening.
In this respect my Pulumonoglist prescribed me two doses of Prevacid 30 mg taken before the food daily.
As for my insomnia 2 doses of Ativan taken before the bed time.
In this connection should I cutdown the taking of Requip from 12 mg to 8 mg and substitute with one extra of Sinemet from two doses to three doses daily?
Sinemet is the wonder drug. My doctor Dr. Chew agrees with the changes.
However I am worry does the changes affecting my physically agility at the Gym?
In this connection kindly advise me on how to get away or substitute the taking "Ativan" for insomnia as it has sideeffect if I regular use over time and increase significant risks in the elderly like me. It could develop over-sedation, confusion and balance impairment increasing the risk of falls. Kindly advise me TEOKIMHOE
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Anonymous
Posted: Tue Oct 23, 2007 12:38 am Post subject: Bloating and Parkinson's Patient
Dear Mr Teo Dopamine agonists such as Requip do not cause your symptoms of bloating, phlegm etc. You should continue the Requip at the same dose (12 mg per day). Dr Chew
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Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Tue Oct 23, 2007 10:23 am Post subject:
Dear Teo, Acid reflux is not uncommon among those with PD. It may be a result of slowed stomach emptying (gastroparesis), which occurs when PD slows the movement of the muscles of the stomach, so that food remains in the stomach for an abnormally long time. The food, mixed with stomach acid, creates gas, which pushes the acid contents upward into the throat, creating acid reflux. This can cause persistent coughing, as you note. However, to the best of my knowledge the drooling of saliva is a different matter, not related to the reflux, nor to the Requip. This may occur due to “hypersalivation” as a result of PD; but more often, it occurs because one forgets to swallow as often as needed. Phlegm and Mucus is not at all uncommon among folks with PD. Here are a couple of suggestions; one or the other has worked for most people: 1) Alkalol: Medications, breathing through the mouth, sleeping with the mouth open, using medications that cause dry mouth, and other conditions can sometimes lead to a buildup of sticky mucous that's difficult to swallow. If so, ask your dentist whether it might be helpful to try swishing the mouth, or gargling, with a mouthwash called Alkalol. Alkalol is a mucous solvent; ingredients include thymol, eucalyptol, menthol, camphor, benzoin, potassium alum, potassium chlorate, sodium, bicarbonate, sodium chloride, and oils of sweet birch, spearmint, pine, and cinnamon, plus 2/100 of 1% alcohol. It is commonly used as a mouthwash, nasal spray, and gargle, to cut mucous. People with sleep apnea, singers with throat irritation, and others use Alkalol, but it's fine as a daily mouthwash also. Alkalol is available at most U.S. drugstores; if your dentist agrees it might be useful, ask the pharmacist to point it out. If they don't carry it, the pharmacist can order it: The Alkalol Company Taunton, Massachusetts 02780-0952 or, online by the case (I have no personal experience with the following company, and do not endorse it, nor receive payment from it): Case of 12: $33.58 http://www.medichest.com/alkalolliquidcaseof1.html For an article that describes various ways of irrigating, as well as use of Alkalol and other solutions, please see: http://www.allergybuyersclub.com/faqs/faq-sinusitis.shtml --- A forum friend comments: Sips of pineapple juice (not pineapple drink or juice with sugar, just plain juice or papaya (the fruit) will help relieve the throat of mucous and excess saliva. Another forum friend's comment: I have used Alkolol for about six weeks now and find it very helpful. I bought a salt water nasal spray bottle and emptied it and filled it with straight Alkolol for sinuses. I only use it a couple times a week as needed. For gargling I find it takes a tiny swig out of the bottle. Just a little bit cuts through all the dry mouth and throat build up. Its great and inexpensive. 2) The combination of fenugreek and thyme has helped a number of people who have problems with drooling or excess mucus. It can be obtained in capsule form at many health food stores. Regarding medication changes, I cannot assist you, as this is outside my scope of practice as a dietitian._________________Best regards, Kathrynne Holden, MS, RD -- For a Parkinson Tip of the Day visit: http://www.nutritionucanlivewith.com/
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Lack of Sleep may lead to Irrational behaviour
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Message
Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Tue Oct 23, 2007 10:29 am Post subject: News: Lack Of Sleep May Lead To Irrational Behavior
Dear Friends, the following may be of interest. Best, Kathrynne ======================================================== Sleep Deprivation Stirs Up Emotions Study Explains Why Lack Of Sleep May Lead To Irrational Behavior http://www.cbsnews.com/stories/2007/10/22/health/webmd/main3392528.shtml Oct. 22, 2007 (AP) (WebMD) Sleep deprivation may make it harder to keep your emotions in check. A new study shows that sleep deprivation is linked to a disconnect in the part of the brain responsible for keeping emotions under control, adding to the already long list of negative effects of lack of sleep on health. Researchers say the results are the first to explain on a scientific level how lack of sleep may lead to emotionally irrational behavior. "It's almost as though, without sleep, the brain had reverted back to more primitive patterns of activity, in that it was unable to put emotional experiences into context and produce controlled, appropriate responses," says researcher Matthew Walker, director of the University of California, Berkeley's Sleep and Neuroimaging Laboratory, in a news release. "You can see it in the reaction of a military combatant soldier dealing with a civilian, a tired mother to a meddlesome toddler, the medical resident to a pushy patient. It's these everyday scenarios that tell us people don't get enough sleep," says Walker. Lack of Sleep Affects Emotions In the study, published in Current Biology, researchers examined the effects of lack of sleep on 26 healthy adults. Half were assigned to a sleep deprivation group and were kept awake for 35 hours, and the other half slept normally. The participants' brains were then scanned using functional magnetic resonance imaging (fMRI) while they looked at 100 different images, ranging from emotionally neutral to negative, such as mutilated bodies and other gory images. The results showed that the sleep-deprived group had a much bigger reaction to the emotionally charged images. The brain scans showed that the amygdala, the area of the brain critical to processing emotions, appeared to overreact to the gory images in the sleep-deprived group compared with the normal activity found in the normal-sleep group. "The size of the increase truly surprised us," says Walker. "The emotional centers of the brain were over 60 percent more reactive under conditions of sleep deprivation than in subjects who had obtained a normal night of sleep. "Sleep appears to restore our emotional brain circuits, and in doing so prepares us for the next day's challenges and social interactions," says Walker. (What are you like when you go without sleep? Tell us about it on WebMD's Sleep Disorders: Michael Breus, PhD, ABSM, message board.) By Jennifer Warner Reviewed by Louise Chang ©2007 WebMD, Inc. All rights reserved. http://www.cbsnews.com/stories/2007/10/22/health/webmd/main3392528.shtml_________________Best regards, Kathrynne Holden, MS, RD -- For a Parkinson Tip of the Day visit: http://www.nutritionucanlivewith.com/
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Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Tue Oct 23, 2007 10:29 am Post subject: News: Lack Of Sleep May Lead To Irrational Behavior
Dear Friends, the following may be of interest. Best, Kathrynne ======================================================== Sleep Deprivation Stirs Up Emotions Study Explains Why Lack Of Sleep May Lead To Irrational Behavior http://www.cbsnews.com/stories/2007/10/22/health/webmd/main3392528.shtml Oct. 22, 2007 (AP) (WebMD) Sleep deprivation may make it harder to keep your emotions in check. A new study shows that sleep deprivation is linked to a disconnect in the part of the brain responsible for keeping emotions under control, adding to the already long list of negative effects of lack of sleep on health. Researchers say the results are the first to explain on a scientific level how lack of sleep may lead to emotionally irrational behavior. "It's almost as though, without sleep, the brain had reverted back to more primitive patterns of activity, in that it was unable to put emotional experiences into context and produce controlled, appropriate responses," says researcher Matthew Walker, director of the University of California, Berkeley's Sleep and Neuroimaging Laboratory, in a news release. "You can see it in the reaction of a military combatant soldier dealing with a civilian, a tired mother to a meddlesome toddler, the medical resident to a pushy patient. It's these everyday scenarios that tell us people don't get enough sleep," says Walker. Lack of Sleep Affects Emotions In the study, published in Current Biology, researchers examined the effects of lack of sleep on 26 healthy adults. Half were assigned to a sleep deprivation group and were kept awake for 35 hours, and the other half slept normally. The participants' brains were then scanned using functional magnetic resonance imaging (fMRI) while they looked at 100 different images, ranging from emotionally neutral to negative, such as mutilated bodies and other gory images. The results showed that the sleep-deprived group had a much bigger reaction to the emotionally charged images. The brain scans showed that the amygdala, the area of the brain critical to processing emotions, appeared to overreact to the gory images in the sleep-deprived group compared with the normal activity found in the normal-sleep group. "The size of the increase truly surprised us," says Walker. "The emotional centers of the brain were over 60 percent more reactive under conditions of sleep deprivation than in subjects who had obtained a normal night of sleep. "Sleep appears to restore our emotional brain circuits, and in doing so prepares us for the next day's challenges and social interactions," says Walker. (What are you like when you go without sleep? Tell us about it on WebMD's Sleep Disorders: Michael Breus, PhD, ABSM, message board.) By Jennifer Warner Reviewed by Louise Chang ©2007 WebMD, Inc. All rights reserved. http://www.cbsnews.com/stories/2007/10/22/health/webmd/main3392528.shtml_________________Best regards, Kathrynne Holden, MS, RD -- For a Parkinson Tip of the Day visit: http://www.nutritionucanlivewith.com/
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Misdiagnosing disease Parkinson's Patients
Posted: Tue Oct 23, 2007 5:55 am Post subject: Misdiagnosing disease
The Star Monday, 23/04/2007
Misdiagnosing disease Parkinson's patients being sent to psychiatrics instead PETALING JAYA:
Some Parkinson's Disease (PD) patients have been misdiagnosed as suffering from depression and were referred to psychiatrics, said a neurologist.
"We have to teach the public that the moment they have tremors, they have to think about PD." "Patients suffering from depression may have slower movements but not tremors," said Dr Chew Nee Kong at the Red Tulip campaign of World Parkinson's Disease Day recently. He said some also has been sent to heart specialists because of their difficulty in breathing and to bone specialists because they had body aches. "As a result of the non-specific nature of the disease, coupled with the lack of specialists and public awareness, diagnosis can be a challenge and delayed," he said. Symptoms of PD include the slowing down in speech and body movements, softening of voices and lacking in facial expression resembling ageing process. "Patients tend to think of these as a natural process and do not seek treatment," said Dr Chew.
PD is the result of lack of dopamine, a biochemical substance that is needed for body movement. Patients lack energy, have uncontrollable trembling of hands, sometimes of the head and jaw, and body stiffness. "With newer medication and brain surgery, patients do not have to suffer anymore. PD patients can now lead normal lives for 15 to 20 years," he said. "In 95% of PD cases, the cause was unknown while the other 5% were due to inherited genes or chemical substance in the environment," he said.
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The Star Monday, 23/04/2007
Misdiagnosing disease Parkinson's patients being sent to psychiatrics instead PETALING JAYA:
Some Parkinson's Disease (PD) patients have been misdiagnosed as suffering from depression and were referred to psychiatrics, said a neurologist.
"We have to teach the public that the moment they have tremors, they have to think about PD." "Patients suffering from depression may have slower movements but not tremors," said Dr Chew Nee Kong at the Red Tulip campaign of World Parkinson's Disease Day recently. He said some also has been sent to heart specialists because of their difficulty in breathing and to bone specialists because they had body aches. "As a result of the non-specific nature of the disease, coupled with the lack of specialists and public awareness, diagnosis can be a challenge and delayed," he said. Symptoms of PD include the slowing down in speech and body movements, softening of voices and lacking in facial expression resembling ageing process. "Patients tend to think of these as a natural process and do not seek treatment," said Dr Chew.
PD is the result of lack of dopamine, a biochemical substance that is needed for body movement. Patients lack energy, have uncontrollable trembling of hands, sometimes of the head and jaw, and body stiffness. "With newer medication and brain surgery, patients do not have to suffer anymore. PD patients can now lead normal lives for 15 to 20 years," he said. "In 95% of PD cases, the cause was unknown while the other 5% were due to inherited genes or chemical substance in the environment," he said.
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Tuesday, October 23, 2007
Phlegm and Cough :Parkinson's
Author
Message
Anonymous
Posted: Fri Oct 19, 2007 10:48 am Post subject: Phlegm and cough:Parkinson's
Further to the above article there are 15% Parkinson's patients starting the levodopa thereapy report the above diseases. Is it the cause of the disease (excessive phlegm deep in the throat and saliva) the sideffect of the levodopa therapy? Is it the cause of the level of levodopa wearing off? What are the treatment i.e reducing or adjusting levodopa dose times or otherwise? What's about anti acid dose? Is it the cause of "heartburn" complaints aggravated by the Parkinson's progression with times? TEOKIMHOE
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Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Tue Oct 23, 2007 10:03 am Post subject:
Dear Teo, Excessive phlegm among people with PD can have a number of different causes. - Some of the PD medications (particularly selegeline) can cause dry mouth and thickened phlegm - Some people tend to breathe through the mouth, rather than the nose, thus drying and thickening mucus and phlegm - Often, people drink too little water and other fluids, leading to mild dehydration. This, too, can lead to drying of the tissues of the mouth and throat, and thickened phlegm. I have not heard that PD itself, nor antacids, can cause this phlegm. However, acid reflux can cause damage to the throat, leading to coughing. But this is a different matter than the phlegm. Yes, heartburn can get worse over time, and this you must discuss with your physician, who will choose the best solution for your particular needs. It may be that something as simple as chewing Tums (calcium carbonate) will help; in more extreme cases, prescription medication may be needed._________________Best regards, Kathrynne Holden, MS, RD -- For a Parkinson Tip of the Day visit: http://www.nutritionucanlivewith.com/
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Message
Anonymous
Posted: Fri Oct 19, 2007 10:48 am Post subject: Phlegm and cough:Parkinson's
Further to the above article there are 15% Parkinson's patients starting the levodopa thereapy report the above diseases. Is it the cause of the disease (excessive phlegm deep in the throat and saliva) the sideffect of the levodopa therapy? Is it the cause of the level of levodopa wearing off? What are the treatment i.e reducing or adjusting levodopa dose times or otherwise? What's about anti acid dose? Is it the cause of "heartburn" complaints aggravated by the Parkinson's progression with times? TEOKIMHOE
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Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Tue Oct 23, 2007 10:03 am Post subject:
Dear Teo, Excessive phlegm among people with PD can have a number of different causes. - Some of the PD medications (particularly selegeline) can cause dry mouth and thickened phlegm - Some people tend to breathe through the mouth, rather than the nose, thus drying and thickening mucus and phlegm - Often, people drink too little water and other fluids, leading to mild dehydration. This, too, can lead to drying of the tissues of the mouth and throat, and thickened phlegm. I have not heard that PD itself, nor antacids, can cause this phlegm. However, acid reflux can cause damage to the throat, leading to coughing. But this is a different matter than the phlegm. Yes, heartburn can get worse over time, and this you must discuss with your physician, who will choose the best solution for your particular needs. It may be that something as simple as chewing Tums (calcium carbonate) will help; in more extreme cases, prescription medication may be needed._________________Best regards, Kathrynne Holden, MS, RD -- For a Parkinson Tip of the Day visit: http://www.nutritionucanlivewith.com/
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Nutrients,lavodopa,protein and I
Author
Message
Anonymous
Posted: Sat Oct 20, 2007 6:39 pm Post subject: Nutrition,Levodopa and I
Dear Dr.Kathrynne Holden, As a Dietitian could you tell us " Nutrition "is helpful for those with Parkinson's. Why is it related with Parkinson's health? What are the Nutrition could help Parkinson's health i.e slow gastrointestinal tract, constipation, bloating, phlegm, saliva drooling ,swallowing, nausea, insomnia, and appetite loss. All sickness as mentioned are the one side effects or risks taking levodapa for Parkinson's treatment. Why Parkinson's patient are at increased risk for malnutrition, most of them are weight loss, insomnia and low blood pressure? What are they related with nutrition-related diseases? Kindly advise me what is optimal nutrition for people with Parkinson's and the need to maintain nutrition level. Is it yearly blood test your vitamin level and exercises? Why a combination of levodopa( treating Parkinson's) and protein cause problems with our body's absorption? How to avoid them? What is the optimal time to take lavodapa to reduce the conflict with Protein? Kindly brief them. TEOKIMHOE
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Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Tue Oct 23, 2007 10:10 am Post subject:
Dear Teo, Good nutrition is important for everyone, but there are specific concerns with PD. Many people get less exercise, thus the muscles begin to shrink, and bone loss occurs. People are also more apt to experience falling as PD progresses, and with weaker muscles and thinner bones, they are less able to prevent falls, and more likely to break bones when they do fall. Constipation occurs more frequently with PD, and is best managed by including plenty of fiber and fluids in the daily diet, along with as much exercise as is possible. There are many other concerns, and I recommend you email the National Parkinson Foundation for a copy of “Nutrition Matters.” Go to: http://www.parkinson.org/ Click "Publications" Here, you'll find the free series of excellent booklets. I recommend them all; but for your purposes, "Nutrition Matters" should answer your questions. There is a form available for you to order as many as you need; or you can telephone, if you prefer._________________Best regards, Kathrynne Holden, MS, RD -- For a Parkinson Tip of the Day visit: http://www.nutritionucanlivewith.com/
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Anonymous
Posted: Sat Oct 20, 2007 6:39 pm Post subject: Nutrition,Levodopa and I
Dear Dr.Kathrynne Holden, As a Dietitian could you tell us " Nutrition "is helpful for those with Parkinson's. Why is it related with Parkinson's health? What are the Nutrition could help Parkinson's health i.e slow gastrointestinal tract, constipation, bloating, phlegm, saliva drooling ,swallowing, nausea, insomnia, and appetite loss. All sickness as mentioned are the one side effects or risks taking levodapa for Parkinson's treatment. Why Parkinson's patient are at increased risk for malnutrition, most of them are weight loss, insomnia and low blood pressure? What are they related with nutrition-related diseases? Kindly advise me what is optimal nutrition for people with Parkinson's and the need to maintain nutrition level. Is it yearly blood test your vitamin level and exercises? Why a combination of levodopa( treating Parkinson's) and protein cause problems with our body's absorption? How to avoid them? What is the optimal time to take lavodapa to reduce the conflict with Protein? Kindly brief them. TEOKIMHOE
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Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Tue Oct 23, 2007 10:10 am Post subject:
Dear Teo, Good nutrition is important for everyone, but there are specific concerns with PD. Many people get less exercise, thus the muscles begin to shrink, and bone loss occurs. People are also more apt to experience falling as PD progresses, and with weaker muscles and thinner bones, they are less able to prevent falls, and more likely to break bones when they do fall. Constipation occurs more frequently with PD, and is best managed by including plenty of fiber and fluids in the daily diet, along with as much exercise as is possible. There are many other concerns, and I recommend you email the National Parkinson Foundation for a copy of “Nutrition Matters.” Go to: http://www.parkinson.org/ Click "Publications" Here, you'll find the free series of excellent booklets. I recommend them all; but for your purposes, "Nutrition Matters" should answer your questions. There is a form available for you to order as many as you need; or you can telephone, if you prefer._________________Best regards, Kathrynne Holden, MS, RD -- For a Parkinson Tip of the Day visit: http://www.nutritionucanlivewith.com/
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Saliva and Phlegm with Parkinson's
Author
Message
Anonymous
Posted: Fri Oct 19, 2007 8:34 pm Post subject: Saliva and phlegm with Parkinson's
I have poor cough occasionally especially at bed. I have seen Lung Specialist and my lung is clear. I was told I have reflex acid. Besides my saliva drooling from my mouth I have thin phlegm deep in my throat'. It is white and looking like glue. Is it the side effect of medication ? At present I am taking requip 12 mg and Sinemet 20/100 2 doses per day. Is it overdose ,"mean " wearing off , optimize or reducing the doses? I am taking 2 doses of Pravacid 30 mg daily to thinner the phlegm deep in my mouth. I find difficulty with my speech as saliva drooling from my mouth. Kindly enlighten me TEOKIMHOE
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Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Tue Oct 23, 2007 10:04 am Post subject:
Dear Teo, Please see my previous message, which should answer your questions._________________Best regards, Kathrynne Holden, MS, RD -- For a Parkinson Tip of the Day visit: http://www.nutritionucanlivewith.com/
Message
Anonymous
Posted: Fri Oct 19, 2007 8:34 pm Post subject: Saliva and phlegm with Parkinson's
I have poor cough occasionally especially at bed. I have seen Lung Specialist and my lung is clear. I was told I have reflex acid. Besides my saliva drooling from my mouth I have thin phlegm deep in my throat'. It is white and looking like glue. Is it the side effect of medication ? At present I am taking requip 12 mg and Sinemet 20/100 2 doses per day. Is it overdose ,"mean " wearing off , optimize or reducing the doses? I am taking 2 doses of Pravacid 30 mg daily to thinner the phlegm deep in my mouth. I find difficulty with my speech as saliva drooling from my mouth. Kindly enlighten me TEOKIMHOE
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Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Tue Oct 23, 2007 10:04 am Post subject:
Dear Teo, Please see my previous message, which should answer your questions._________________Best regards, Kathrynne Holden, MS, RD -- For a Parkinson Tip of the Day visit: http://www.nutritionucanlivewith.com/
Doctor's write up-Dr. NK.Chew
Introduction to Parkinson's Disease (PD) Dr Chew Nee Kong Consultant Neurologist Pantai Cheras Medical Centre Kuala Lumpur. 8th October 2007. Email: nkchew33@hotmail.com What is PD? PD is a progressive, nervous disorder characterized by a deficiency of dopamine, a biochemical substance in the brain that is important for coordination of body movement. PD is named after Dr James Parkinson, a British general physician who wrote the first comprehensive report on this illness in 1817. What is the cause of PD? PD is a mysterious illness - to date the cause of PD is generally unknown. There is also no cure yet. As such the symptoms of PD deteriorate with time despite medications. Despite this, the available treatment (medications and brain surgery) are effective in improving the quality of life of PD patients. What are the symptoms of PD? The commonest symptoms are tremor (uncontrollable trembling of hands), slowness of movement and body stiffness. These symptoms result in difficulty in getting out of a chair, starting to walk, writing and turning over in bed. However, it is important to note that the symptoms of PD start very slowly and can be so subtle that sometimes patients themselves do not realize they have the disease until at least several years after its onset. Occasionally, the observant spouses and immediate family members are the first ones who notice the early symptoms. Quite often, it is the slowness of movement rather than tremor that brings a patient to see a doctor. This is because tremor by itself is usually not as disabling as slowness of movement especially in carrying out basic daily activities such as bathing, walking and eating. Who are at risk for getting PD? PD does not spare any race or ethnic group - it is seen in any country in this world. PD can affect any age group but it is most common in elderly people. It is known to affect even children and teenagers (hereditary parkinsonism) but this is very rare. Age is an important risk factor for PD, with the incidence rising with age. Thus, PD is generally an illness of elderly people. However, a small percentage of PD patients are relatively young. A study which was carried out at University Malaya Medical Centre, Kuala Lumpur (1998) on 153 PD patients showed that the onset of symptoms was at age 20-45 in 20.9% of patients (one patient had onset of symptoms at age 24). How is PD diagnosed? This is carried out based on typical history and bed-side examination. A good response to medications further support the diagnosis of PD. Brain scans and blood tests are generally not necessary. What are the treatment options for PD? During the early to moderate stage of PD (first 10-15 years), most patients are on medications alone. However, as the physical disability of PD patients become more severe with time, after 10-15 years of illness, many PD patients have difficulty carrying out daily activities despite taking maximal medications. At the advanced stage of PD (after 10-15 years), brain surgery is effective in relieving the main symptoms of PD such as slowness of movement and tremor. Currently, surgical treatment is available in Malaysia. Supportive treatment involves counseling, dietary advice, physiotherapy (exercise) and rehabilitation (social and occupational therapy while specific treatment employs drugs and brain surgery. Conclusions Even though there is no cure for PD, it is important to recognize the existence of PD because the rapid improvement in the treatment has resulted in much better quality of life. PD patients should not be made to suffer as they used to be. There are so many new and effective medications for PD. With the increase in the proportion of elderly people in the society, there will be more and more PD patients in the near future.
Parkinson's Disease Discussion Corner All of you are welcomed to join Mr Teo Kim Hoe, a Parkinson's patient, in discussing any issue or problems regarding Parkinson's Disease. Share your experiences and knowledge so that all Parkinsons patients will have a better life.
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Dr. RodriguezJoined: 22 Jan 2007Posts: 92Location: Gainesville, Fl
Posted: Mon Oct 22, 2007 3:39 pm Post subject:
Thanks for your comments Mr. Teo. Good luck!_________________Ramon L Rodriguez, MD
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Sunday, October 21, 2007
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Phlegm and Cough :Parkinson's
Posted: Fri Oct 19, 2007 8:52 am Post subject: Phlegm and cough:Parkinson's
Dear Doctor,
Recently I have excessive phlegm deep in my throat that irritated me with cough especially when I lie down at bed.
I have seen ENT and pulumonologist for treatment.
Kindly enlighten me the causes of the diseases. I have saliva too.
Is it caused me phlegm deep in my throat?
Best regards
TEOKIMHOE
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Sun Oct 21, 2007 8:11 am Post subject:
If you have PD, then it is best to: 1- see a neurologist for medication optimization; and potentially botox if too much saliva 2- see a speech language pathologist for a swallowing study 3- potentially see an allergist or a pulmonologist
You will need to work out the cause and then decide on best treatment._________________Michael S. Okun, M.D.
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Dear Doctor,
Recently I have excessive phlegm deep in my throat that irritated me with cough especially when I lie down at bed.
I have seen ENT and pulumonologist for treatment.
Kindly enlighten me the causes of the diseases. I have saliva too.
Is it caused me phlegm deep in my throat?
Best regards
TEOKIMHOE
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Sun Oct 21, 2007 8:11 am Post subject:
If you have PD, then it is best to: 1- see a neurologist for medication optimization; and potentially botox if too much saliva 2- see a speech language pathologist for a swallowing study 3- potentially see an allergist or a pulmonologist
You will need to work out the cause and then decide on best treatment._________________Michael S. Okun, M.D.
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Successful ageing
Successful Ageing
Dr. Rajbans SinghConsultant GeriatricianPantai Medical Centre
As we age we start worring about the effects of old age. The question uppermost in our minds is what we can do to delay the ageing process.10 Tips To Successful Ageing1. The Mind - Keeping the mind active is very important. Persons who have a goal and purpose in life and have a positive outlook live longer.2. Socialise - Persons who are sociable and are closer to family and friends live longer.3. Nutrition - Experience from Okinawa and the Mediterranean show that diets high in fruits, vegetables, fish, legumes, nuts and soy and low consumption of high glycaemic index foods is the best anti-ageing tool.4. Exercise - The best buy in public health. Aerobic exercise with strengthening and flexibility exercises, done regularly can delay the ravages of ageing. No matter what your age is now start an exercise programme immediately.5. Stress - Knowing how to handle stress is paramount to healthy ageing. The right attitude to stress is important. Sometimes taking up exercises like yoga and Qigong can help.6. Sleep - Good sleeping habits are important and when someone has sufficient rest, the hormones that promote anti-ageing are released at night.7. Stay slim - People who are overweight and obese have shorter life spans and are more disease prone than those who maintain their ideal body weight.8. Avoid toxins and pollutants - Stop smoking. Avoid alcohol.9. Manage free radicals - Free radical damage causes ageing. Check your free radicals and add a ACE supplement if needed.10. Take a personal responsibility to look after your health. The choice of good health lies in our hands.Live long, live well...
Dr. Rajbans SinghConsultant GeriatricianPantai Medical Centre
As we age we start worring about the effects of old age. The question uppermost in our minds is what we can do to delay the ageing process.10 Tips To Successful Ageing1. The Mind - Keeping the mind active is very important. Persons who have a goal and purpose in life and have a positive outlook live longer.2. Socialise - Persons who are sociable and are closer to family and friends live longer.3. Nutrition - Experience from Okinawa and the Mediterranean show that diets high in fruits, vegetables, fish, legumes, nuts and soy and low consumption of high glycaemic index foods is the best anti-ageing tool.4. Exercise - The best buy in public health. Aerobic exercise with strengthening and flexibility exercises, done regularly can delay the ravages of ageing. No matter what your age is now start an exercise programme immediately.5. Stress - Knowing how to handle stress is paramount to healthy ageing. The right attitude to stress is important. Sometimes taking up exercises like yoga and Qigong can help.6. Sleep - Good sleeping habits are important and when someone has sufficient rest, the hormones that promote anti-ageing are released at night.7. Stay slim - People who are overweight and obese have shorter life spans and are more disease prone than those who maintain their ideal body weight.8. Avoid toxins and pollutants - Stop smoking. Avoid alcohol.9. Manage free radicals - Free radical damage causes ageing. Check your free radicals and add a ACE supplement if needed.10. Take a personal responsibility to look after your health. The choice of good health lies in our hands.Live long, live well...
New warning about hearing loss for impotence drugs
New warnings about hearing loss for impotence drug users Drugs concerned are Viagra, Cialis, and Levitra, used by millions of men. -->
Fri, Oct 19, 2007Reuters
WASHINGTON, Oct 18 (Reuters) - US regulators on Thursday added new warnings about the potential risk of sudden hearing loss to best-selling impotence drugs Viagra, Cialis, and Levitra, used by millions of men.
The US Food and Drug Administration said a published report of a man taking Pfizer Inc's Viagra, who suffered from sudden hearing loss, prompted it to explore a possible association.
A further review of the FDA's side effect data found 29 cases of sudden hearing loss with a relationship to the three drugs.
In one-third of the cases the hearing loss was temporary, the agency said, the remaining cases were described as ongoing at the time of the report or the outcome was not described.
Eli Lilly sells Cialis and GlaxoSmithKline Plc sells Levitra. Pfizer's Revatio, a version of Viagra used for a lung condition, will also carry a new warning.
Erectile dysfunction drugs are a huge business, with Pfizer reporting Viagra sales of US$450 million in its most recent quarter. The drugmakers are all cooperating with the FDA and defended the safety of their drugs.
The new label warnings follow a 2005 label change noting cases of sudden vision loss in some patients.
Reports of serious side effects to the FDA's safety data-base are widely viewed as representing only a fraction of actual problems with drugs and medical devices.
Drugmakers Pfizer and Lilly both said their data did not show any causal relationship between hearing loss and the drugs. The FDA said no causal link has been established.
Pfizer vice president for medical affairs, Dr. Ponni Subbiah, said hearing loss was included in Viagra's adverse events section of its label upon its 1998 FDA approval. It occurred in less than 2 percent of patients in clinical trials, which she said was statistically comparable to those in a placebo group.
About 30 million men have taken Viagra since its approval in 1998 as the first widely-used drug for erectile dysfunction, according to Pfizer.
Lilly spokeswoman Keri McGrath said a recent Lilly review found about 1.1 incidents of sudden hearing loss per million Cialis patients, which she said was lower than the incident rate in the general population. Nearly 12 million men have been prescribed the drug, the company said.
Schering-Plough Corp. and GlaxoSmithKline co-market Levitra in the United States, while Germany's Bayer AG sold the drug originally.
Schering-Plough spokesman Lee Davies said the company would comply with the FDA's request and said all the hearing loss cases were temporary.
About 4,000 new cases of sudden hearing loss occur in the United States annually, according to the National Institute on Deafness and Other Communication Disorders. It typically occurs in one ear, and symptoms include ringing in the ear and dizziness.
The condition resolves itself in some cases, but in 15 percent of cases, it gets worse over time, according to the institute.
Fri, Oct 19, 2007Reuters
WASHINGTON, Oct 18 (Reuters) - US regulators on Thursday added new warnings about the potential risk of sudden hearing loss to best-selling impotence drugs Viagra, Cialis, and Levitra, used by millions of men.
The US Food and Drug Administration said a published report of a man taking Pfizer Inc's Viagra, who suffered from sudden hearing loss, prompted it to explore a possible association.
A further review of the FDA's side effect data found 29 cases of sudden hearing loss with a relationship to the three drugs.
In one-third of the cases the hearing loss was temporary, the agency said, the remaining cases were described as ongoing at the time of the report or the outcome was not described.
Eli Lilly sells Cialis and GlaxoSmithKline Plc sells Levitra. Pfizer's Revatio, a version of Viagra used for a lung condition, will also carry a new warning.
Erectile dysfunction drugs are a huge business, with Pfizer reporting Viagra sales of US$450 million in its most recent quarter. The drugmakers are all cooperating with the FDA and defended the safety of their drugs.
The new label warnings follow a 2005 label change noting cases of sudden vision loss in some patients.
Reports of serious side effects to the FDA's safety data-base are widely viewed as representing only a fraction of actual problems with drugs and medical devices.
Drugmakers Pfizer and Lilly both said their data did not show any causal relationship between hearing loss and the drugs. The FDA said no causal link has been established.
Pfizer vice president for medical affairs, Dr. Ponni Subbiah, said hearing loss was included in Viagra's adverse events section of its label upon its 1998 FDA approval. It occurred in less than 2 percent of patients in clinical trials, which she said was statistically comparable to those in a placebo group.
About 30 million men have taken Viagra since its approval in 1998 as the first widely-used drug for erectile dysfunction, according to Pfizer.
Lilly spokeswoman Keri McGrath said a recent Lilly review found about 1.1 incidents of sudden hearing loss per million Cialis patients, which she said was lower than the incident rate in the general population. Nearly 12 million men have been prescribed the drug, the company said.
Schering-Plough Corp. and GlaxoSmithKline co-market Levitra in the United States, while Germany's Bayer AG sold the drug originally.
Schering-Plough spokesman Lee Davies said the company would comply with the FDA's request and said all the hearing loss cases were temporary.
About 4,000 new cases of sudden hearing loss occur in the United States annually, according to the National Institute on Deafness and Other Communication Disorders. It typically occurs in one ear, and symptoms include ringing in the ear and dizziness.
The condition resolves itself in some cases, but in 15 percent of cases, it gets worse over time, according to the institute.
More Sports doctors needed?
More sports doctors needed as sporting interest grows in S'pore
(Oct 15) SPORTS School student Clement Lim, 14, feared his hopes of becoming a top swimmer were dashed - he had a shoulder injury that was not getting better.
He had seen a general practitioner and had undergone physiotherapy, but it still hurt to lift his arm.
One friend had to stop swimming because of injury. He recalled: 'I was worried.'
His father took him to sports doctor and world-class athlete Ben Tan, who saw the problem - common among swimmers - at once: part of his muscle was caught between his shoulder blade and arm bone.
Dr Tan reduced the swelling with medicine and ultrasound waves. He also taught him strengthening exercises.
A few months later, Clement won four golds at the Asia Age Group meet in Jakarta.
As sports takes on a higher profile, professional athletes and serious amateurs will need the support of sports specialists who can get them back on their feet and back to serious training much faster.
This is critical to the performance of professionals.
And with more Singaporeans taking to exercising and sports, such as running in marathons, sports-related injuries are set to rise.
Demand is so high that the Sports Clinic at Changi General Hospital has turned away people as it is already operating at capacity.
Specialists are also needed to sniff out doping at international meets. Said Dr Tan: 'Singapore needs qualified sports doctors to go along with its players at international events.
(Oct 15) SPORTS School student Clement Lim, 14, feared his hopes of becoming a top swimmer were dashed - he had a shoulder injury that was not getting better.
He had seen a general practitioner and had undergone physiotherapy, but it still hurt to lift his arm.
One friend had to stop swimming because of injury. He recalled: 'I was worried.'
His father took him to sports doctor and world-class athlete Ben Tan, who saw the problem - common among swimmers - at once: part of his muscle was caught between his shoulder blade and arm bone.
Dr Tan reduced the swelling with medicine and ultrasound waves. He also taught him strengthening exercises.
A few months later, Clement won four golds at the Asia Age Group meet in Jakarta.
As sports takes on a higher profile, professional athletes and serious amateurs will need the support of sports specialists who can get them back on their feet and back to serious training much faster.
This is critical to the performance of professionals.
And with more Singaporeans taking to exercising and sports, such as running in marathons, sports-related injuries are set to rise.
Demand is so high that the Sports Clinic at Changi General Hospital has turned away people as it is already operating at capacity.
Specialists are also needed to sniff out doping at international meets. Said Dr Tan: 'Singapore needs qualified sports doctors to go along with its players at international events.
Put Specialists and GP under One Roof?
TODAY, the provision of chronic care is divided between specialists in their specialist clinics and general practitioners in their private clinics or polyclinics.
The best way to treat the growing group of patients with chronic ailments is a holistic approach - specialist care when needed, GP or polyclinic care at other times, and even care by nurse practitioners in between for patients whose conditions are stable.
Such 'right-siting' of care has been the buzzword in health-care circles here for some years. Giving the proper level of care - and no more than that - is the best way to keep health-care costs down.
In theory, everyone agrees with this. In practice, it is more difficult to implement.
Part of the problem is that patients do not want to move down the expertise ladder once they are being treated by a specialist.
This is partly due to the belief that specialists give better care. But specialists are the first to admit that not all patients need the level of care they give.
Many sick people whose conditions are not severe, or are stable, can be treated by their family or polyclinic doctor. But public-sector specialists complain that they have a hard time discharging patients who refuse to leave their care - especially subsidised patients, who fear that once they are discharged from the Specialist Outpatient Clinic (SOC), they might have difficulty getting back in as subsidised patients should their condition deteriorate.
Add to that the very modest consultation fee of $20-$25 for subsidised patients seeing a specialist. This is close to what a private GP would charge. While polyclinics cost less, at $8 per visit, and half that for the elderly, the difference may not be too significant today.
Furthermore, patients, especially elderly ones who are more prone to chronic illnesses, are creatures of habit. Those who have been going to an SOC will want to keep doing so.
The solution appears obvious. Instead of moving patients from polyclinics to SOCs and back to polyclinics, why not have both specialists and family doctors operating from the same place?
Instead of keeping SOCs hospital-based, where the cost of space is high, why not move them out?
Similarly, polyclinics - originally meant to treat the poorest 20 per cent of the population for acute illness - are seeing increasing numbers of chronic acute patients.
Chronic-care centres housing both specialists and polyclinic doctors would solve several problems at the same time.
It would leave the polyclinics free to deal with acute illness and thus get rid of the long queues seen today.
Subsidised patients no longer need to decide whether to stick to a specialist or return to the polyclinic.
They go to this centre, get a quick check from the triage nurse who then gives them an appointment with either a general doctor or a specialist, according to the patient's need at the time of visit.
This way, fewer specialists will be needed to care for a larger pool of patients.
Even better yet, train more nurse practitioners who can see patients on alternate visits. Some polyclinics are already doing this. This practice should be extended to bring specialists into the loop as well.
Moving SOCs out of hospitals will have another benefit. It frees up expensive hospital space for inpatient care. Instead of expanding existing hospitals, build these chronic-care centres in large housing estates.
Specialists who have inpatients could spend half a day at the hospital and the other half at the chronic-care centre. Should the patient need to be hospitalised, he would be treated by the same specialist.
For patients, having a chronic-care centre that treats various ailments such as diabetes, hypertension and heart problems means going to just one place for all their needs.
The patient's files would be shared by all the doctors he sees at the centre, so they would know what other medicines he is taking.
This way, a patient who needs specialist care for a short period need not have to get a referral from a polyclinic doctor, then make an extra trip to a hospital to see the specialists. It can all be done during that one visit.
The pharmacy would also be able to double check to ensure that he is not given any medicine that would react adversely with something else he is taking.
Peripheral health-care services, such as podiatric care for diabetics, rehabilitation centres for recovering stroke patients or a gym for heart patients to get back into shape, could all be housed in the same place.
As the population ages, the number of people with chronic ailments will go up. If Singapore continues with its current pigeon-hole system, health care will remain fragmented.
Bringing the various services under one roof will give patients holistic care and free specialists to look after those who really need their level of expertise. It should also help to keep a cap on rising health-care costs.
salma@sph.com.sg
The best way to treat the growing group of patients with chronic ailments is a holistic approach - specialist care when needed, GP or polyclinic care at other times, and even care by nurse practitioners in between for patients whose conditions are stable.
Such 'right-siting' of care has been the buzzword in health-care circles here for some years. Giving the proper level of care - and no more than that - is the best way to keep health-care costs down.
In theory, everyone agrees with this. In practice, it is more difficult to implement.
Part of the problem is that patients do not want to move down the expertise ladder once they are being treated by a specialist.
This is partly due to the belief that specialists give better care. But specialists are the first to admit that not all patients need the level of care they give.
Many sick people whose conditions are not severe, or are stable, can be treated by their family or polyclinic doctor. But public-sector specialists complain that they have a hard time discharging patients who refuse to leave their care - especially subsidised patients, who fear that once they are discharged from the Specialist Outpatient Clinic (SOC), they might have difficulty getting back in as subsidised patients should their condition deteriorate.
Add to that the very modest consultation fee of $20-$25 for subsidised patients seeing a specialist. This is close to what a private GP would charge. While polyclinics cost less, at $8 per visit, and half that for the elderly, the difference may not be too significant today.
Furthermore, patients, especially elderly ones who are more prone to chronic illnesses, are creatures of habit. Those who have been going to an SOC will want to keep doing so.
The solution appears obvious. Instead of moving patients from polyclinics to SOCs and back to polyclinics, why not have both specialists and family doctors operating from the same place?
Instead of keeping SOCs hospital-based, where the cost of space is high, why not move them out?
Similarly, polyclinics - originally meant to treat the poorest 20 per cent of the population for acute illness - are seeing increasing numbers of chronic acute patients.
Chronic-care centres housing both specialists and polyclinic doctors would solve several problems at the same time.
It would leave the polyclinics free to deal with acute illness and thus get rid of the long queues seen today.
Subsidised patients no longer need to decide whether to stick to a specialist or return to the polyclinic.
They go to this centre, get a quick check from the triage nurse who then gives them an appointment with either a general doctor or a specialist, according to the patient's need at the time of visit.
This way, fewer specialists will be needed to care for a larger pool of patients.
Even better yet, train more nurse practitioners who can see patients on alternate visits. Some polyclinics are already doing this. This practice should be extended to bring specialists into the loop as well.
Moving SOCs out of hospitals will have another benefit. It frees up expensive hospital space for inpatient care. Instead of expanding existing hospitals, build these chronic-care centres in large housing estates.
Specialists who have inpatients could spend half a day at the hospital and the other half at the chronic-care centre. Should the patient need to be hospitalised, he would be treated by the same specialist.
For patients, having a chronic-care centre that treats various ailments such as diabetes, hypertension and heart problems means going to just one place for all their needs.
The patient's files would be shared by all the doctors he sees at the centre, so they would know what other medicines he is taking.
This way, a patient who needs specialist care for a short period need not have to get a referral from a polyclinic doctor, then make an extra trip to a hospital to see the specialists. It can all be done during that one visit.
The pharmacy would also be able to double check to ensure that he is not given any medicine that would react adversely with something else he is taking.
Peripheral health-care services, such as podiatric care for diabetics, rehabilitation centres for recovering stroke patients or a gym for heart patients to get back into shape, could all be housed in the same place.
As the population ages, the number of people with chronic ailments will go up. If Singapore continues with its current pigeon-hole system, health care will remain fragmented.
Bringing the various services under one roof will give patients holistic care and free specialists to look after those who really need their level of expertise. It should also help to keep a cap on rising health-care costs.
salma@sph.com.sg
Nutrients,lavodopa,protein and I
Dear Dr.Kathrynne Holden,
As a Dietitian could you tell us " Nutrition "is helpful for those with Parkinson's.
Why is it related with Parkinson's health?
What are the Nutrition could help Parkinson's health i.e slow gastrointestinal tract, constipation, bloating, phelgm, salivia drooling ,swallowing, nausea, insomnia, and appetite loss.
All sickness as mentioned are the one sideeffects or risks taking levodopa for parkinson's treatment.
Why are Parkinson's patient at increased risk for malnutrition, most of them are weight loss, insomnia, low blood pressure,slow movement,depression and constipation?
What are they related with nutrition-related diseases?
Malnutrition increased the risk for bone facture and loss of immune system that protect us from the risks of infestion.
Kindly advise me what is optimal nutrition for people with Parkinson's and the need to maintain nutrition level. What's about taking nutritional supplements i.e vitamin and mineral?
Is it yearly blood test your vitamin level helpful for nutrition?
Why's combination of levodopa( treating parkinson's) and protein
cause problems with our body's absorption? Therefore we have reflex acid, phlegm deep in the throat and drooling saliva from the mouth
What are the medication to be treated?
What is the optimal time to take lavodapa to minimize the body absortption with Protein ?
Kindly brief them.
TEOKIMHOE
As a Dietitian could you tell us " Nutrition "is helpful for those with Parkinson's.
Why is it related with Parkinson's health?
What are the Nutrition could help Parkinson's health i.e slow gastrointestinal tract, constipation, bloating, phelgm, salivia drooling ,swallowing, nausea, insomnia, and appetite loss.
All sickness as mentioned are the one sideeffects or risks taking levodopa for parkinson's treatment.
Why are Parkinson's patient at increased risk for malnutrition, most of them are weight loss, insomnia, low blood pressure,slow movement,depression and constipation?
What are they related with nutrition-related diseases?
Malnutrition increased the risk for bone facture and loss of immune system that protect us from the risks of infestion.
Kindly advise me what is optimal nutrition for people with Parkinson's and the need to maintain nutrition level. What's about taking nutritional supplements i.e vitamin and mineral?
Is it yearly blood test your vitamin level helpful for nutrition?
Why's combination of levodopa( treating parkinson's) and protein
cause problems with our body's absorption? Therefore we have reflex acid, phlegm deep in the throat and drooling saliva from the mouth
What are the medication to be treated?
What is the optimal time to take lavodapa to minimize the body absortption with Protein ?
Kindly brief them.
TEOKIMHOE
Saturday, October 20, 2007
Dis:Phlegm,Saliva,Cough , Insomnia:and I
Dear Dr. Kathrynne Holden,
I am glad that you are my respected doctor.
You are working hard for the awareness of Parkinson's patients..
In view of the above articles I am recently diagnosed that I have reflux acid. It causes saliva drooling from my mouth and excessive phlegm deep in my throat.
I have poor cough occasionally when I lie down at bed. My phlegm is thin as a glue. I do not have COPD (Chronic obstructive pulmonary disease} as told by my Pulmonary specialist.
As what you have mentioned the Parkinson's medication known as agonises, such as Requip can cause bloating,saliva and phlegm deep in the throat that irritated with cough occasionally when one rests at bed.
I could not sleep at night and taking "Ativan "and it wear off in 3- 4 hours thus no relief from my early morning awakening.
I have consulted Lung Specialist for the treatment and am taking two doses of Prevacid 30 mg before food daily. As for my insomnia 2 doses of Ativan taking before bed time.
In this connection should I cut down the taking of Requip from 12 mg to 8 mg and substitute with one extra of Sinemet from two doses to three doses daily?
Sinemet is the wonder drug and is or one of the dopamine agonist doses late in the day are probably most beneficial preventing resumption of sleep in the middle of night due to the long duration of action of these compound.
However I am worry does the changes affecting my physically agility at the Gym?
In this connection kindly advise me on how to get away or substitute the taking "Ativan" for insomnia as it has side effect for regular users and could increase significant risks in the elderly like me.
It could develop over-sedation, confusion and balance impairment increasing the risk of falls.
Kindly advise me.
TEOKIMHOE
I am glad that you are my respected doctor.
You are working hard for the awareness of Parkinson's patients..
In view of the above articles I am recently diagnosed that I have reflux acid. It causes saliva drooling from my mouth and excessive phlegm deep in my throat.
I have poor cough occasionally when I lie down at bed. My phlegm is thin as a glue. I do not have COPD (Chronic obstructive pulmonary disease} as told by my Pulmonary specialist.
As what you have mentioned the Parkinson's medication known as agonises, such as Requip can cause bloating,saliva and phlegm deep in the throat that irritated with cough occasionally when one rests at bed.
I could not sleep at night and taking "Ativan "and it wear off in 3- 4 hours thus no relief from my early morning awakening.
I have consulted Lung Specialist for the treatment and am taking two doses of Prevacid 30 mg before food daily. As for my insomnia 2 doses of Ativan taking before bed time.
In this connection should I cut down the taking of Requip from 12 mg to 8 mg and substitute with one extra of Sinemet from two doses to three doses daily?
Sinemet is the wonder drug and is or one of the dopamine agonist doses late in the day are probably most beneficial preventing resumption of sleep in the middle of night due to the long duration of action of these compound.
However I am worry does the changes affecting my physically agility at the Gym?
In this connection kindly advise me on how to get away or substitute the taking "Ativan" for insomnia as it has side effect for regular users and could increase significant risks in the elderly like me.
It could develop over-sedation, confusion and balance impairment increasing the risk of falls.
Kindly advise me.
TEOKIMHOE
Friday, October 19, 2007
Parkinson's progression with times? by Dr.N.K.Chew
Posted: Thu Oct 18, 2007 3:14 am Post subject: Parkinson's progression survival with times
For an incurable illness such as PD, it is certainly hoped that there should be at least a way to slow down the progression of illness, i.e. the rate of brain cell loss. Unfortunately, so far, no medication has been unequivocably proven to be able to slow down the progression of PD. The good news is that dopamine agonists (Pramipexole, Ropinirole) have been shown to have potential neuroprotective effect - the ability to slow down the rate of brain cell loss. Experimental studies have shown that dopamine agonists can protect nerve cells from the damage caused by poison. The ability of dopamine agonists to protect the brain cells (if it is true) can help Parkinson's patients to have additional several years of relatively good quality of life, and without motor complications (the involuntary movement). Despite this, I still think that there is a potential neuroprotective property of dopamine agonists. I still prefer to use dopamine agonists as the first-line medications for my PD patients. I am happy that Pramipexole and Ropinirole have recently arrived in Malaysia, and I am already prescribing them to my patients. Dr Chew Nee Kong, Kuala Lumpur, Malaysia.
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Dr. RodriguezJoined: 22 Jan 2007Posts: 92Location: Gainesville, Fl
Posted: Thu Oct 18, 2007 12:19 pm Post subject:
Thanks for your comments, especially for those patients from Malaysia. Just as a comment, especially for our US members, the role of dopamine agonists as neuroprotective agents is currently under investigation and there is no current indication at this time for this medications as a neuroprotective agent. However the comment from Dr. Kong is very much appreciated and we are crossing our fingers that the results of the studies will be positive._________________Ramon L Rodriguez, MD
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For an incurable illness such as PD, it is certainly hoped that there should be at least a way to slow down the progression of illness, i.e. the rate of brain cell loss. Unfortunately, so far, no medication has been unequivocably proven to be able to slow down the progression of PD. The good news is that dopamine agonists (Pramipexole, Ropinirole) have been shown to have potential neuroprotective effect - the ability to slow down the rate of brain cell loss. Experimental studies have shown that dopamine agonists can protect nerve cells from the damage caused by poison. The ability of dopamine agonists to protect the brain cells (if it is true) can help Parkinson's patients to have additional several years of relatively good quality of life, and without motor complications (the involuntary movement). Despite this, I still think that there is a potential neuroprotective property of dopamine agonists. I still prefer to use dopamine agonists as the first-line medications for my PD patients. I am happy that Pramipexole and Ropinirole have recently arrived in Malaysia, and I am already prescribing them to my patients. Dr Chew Nee Kong, Kuala Lumpur, Malaysia.
Back to top
Dr. RodriguezJoined: 22 Jan 2007Posts: 92Location: Gainesville, Fl
Posted: Thu Oct 18, 2007 12:19 pm Post subject:
Thanks for your comments, especially for those patients from Malaysia. Just as a comment, especially for our US members, the role of dopamine agonists as neuroprotective agents is currently under investigation and there is no current indication at this time for this medications as a neuroprotective agent. However the comment from Dr. Kong is very much appreciated and we are crossing our fingers that the results of the studies will be positive._________________Ramon L Rodriguez, MD
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Shoes and Balance
Posted: Thu Oct 18, 2007 5:51 am Post subject: Shoes and Balance
So far I do not see any article for the above subject in your Discussion Corner Forum.
What are the shoes are suitable for Parikinson's patients?
As for the shoes I suggest putting on "MBT" it helps you walk upright and swing your arm whilst go jogging.
The benefits are as follows: 1. Improve posture and Giat. 2. Activates neglected muscles 3.Tones and shape the body. 4. Can help with back,hip, leg and foot problems. 5.Reduce stress and knees and hip joint I am sure there are shoes besides MBT suitable for Parkinson's patient. However it is individual. Best regards God bless TEOKIMHOE
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So far I do not see any article for the above subject in your Discussion Corner Forum.
What are the shoes are suitable for Parikinson's patients?
As for the shoes I suggest putting on "MBT" it helps you walk upright and swing your arm whilst go jogging.
The benefits are as follows: 1. Improve posture and Giat. 2. Activates neglected muscles 3.Tones and shape the body. 4. Can help with back,hip, leg and foot problems. 5.Reduce stress and knees and hip joint I am sure there are shoes besides MBT suitable for Parkinson's patient. However it is individual. Best regards God bless TEOKIMHOE
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Wednesday, October 17, 2007
Shoes and Balance?
Posted: Tue Oct 16, 2007 4:25 am Post subject: Hi
I have Parkinson's for two years.
I am taking my medication i.e 12 mg Requip per day for the past of six months and it increases my agility's doing my physical exercises at gym.
I do yoga, body combat, pump and spinning in class for hourly. I do not have difficulties as you have mention. Anyway it is individual.
As for the shoes I suggest putting on "MBT" it helps you walk upright and swing your arm whilst go jogging.
TEOKIMHOE_________________to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
I have Parkinson's for two years.
I am taking my medication i.e 12 mg Requip per day for the past of six months and it increases my agility's doing my physical exercises at gym.
I do yoga, body combat, pump and spinning in class for hourly. I do not have difficulties as you have mention. Anyway it is individual.
As for the shoes I suggest putting on "MBT" it helps you walk upright and swing your arm whilst go jogging.
TEOKIMHOE_________________to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
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