Saturday, July 5, 2008

Illness but not Parkinson's

As PD is " not going disease' i.e. a slow progression and is different from other disease i.e a self -limited sickness or injury that temporarily impact their lives as inconvenience or comfort

I think your brother's problem is difficulty accepting his illness rather than apathy. One of the most challenging problems that any neurologist faces is patient's difficulty in accepting illness. As a result, these patients do not really accept the doctor's advise, e.g. medication schedule (poor compliance). I treated a man with Young-Onset PD (onset of symptoms before the age of 40) recently. He was just 38 years old, and at such age it is just natural for him to have difficulty accepting his PD. When I treated him with Pramipexole, he insisted that he had felt slower and weaker despite the medication. And he said, "since I am not getting better with Parkinson's medications, it means that I have another illlness and NOT PD" - which was his way of denying that he has PD. At one stage, he even stopped his medications as he did not believe he had PD. He even questioned my diagnosis of PD. It took me a long time to convince him to start taking Pramipexole again. Recently, I heard from his sister that he had continued taking Pramipexole - he had finallly accepted his illness. Difficulty in accepting PD is largely due to ignorance and fear. I think it helps patients to accept their PD if we tell them that they can continue to have a relatively good quality of life as the treatment of PD has drastically improved over the past decade (due to new medications and brain surgery). Dr Chew Nee Kong, Kuala Lumpur


Posted: Sun Jul 06, 2008 7:31 pm Post subject:

While that is possible, it is also possible that the patient is suffering from apathy. 20-30% of PD patients are apathetic

Yours,_________________Hubert H. Fernandez

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