Monday, May 25, 2009

parkinson's a designer disease

Among the many challenges of living with Parkinson’s is coming to terms with the unpredictable course it takes and the fear and uncertainty this creates. Although you can never be certain what lies ahead of you, your quality of life is determined by how you see the path you're on and how you manage your day-to-day situation.
Parkinson’s is known as a “designer disease” because the symptoms, rate of progression, and degree of disability vary greatly from person to person. What one person considers a major problem, perhaps because it negatively impacts their job performance, another sees as a minor inconvenience.
The anger, fear, helplessness, hopelessness, resentment, and depression created by living with a chronic disease can destroy careers, financial security, friendships, and marriages. As Parkinson’s progresses, it changes our roles in family, work and social situations, leaving an indelible mark on each of us, forever altering our sense of who we are. Some PWP never get past this, while others gain new strengths.
This is the opportunity to create the changes in your life that will bring meaning to every day and promote and sustain your physical and emotional well-being. It is up to you to make this happen.


On my own decade-long journey with Parkinson’s, I have discovered things about myself I never knew, done things I never dreamed of doing, forged friendships with people I would otherwise not have encountered, and met one of my celebrity heroes – former U.S. Attorney General Janet Reno.
Working on pdplan4life with my friend Jean Burns is the most rewarding venture I’ve ever undertaken. Your feedback has touched our lives as much as we have touched yours. It doesn’t get any better than that.

medicine mask the PD symptom not the treatment

UNDER SIEGE: Fighting Parkinson’s Disease
Diagnosed 7 years ago, aged 49, I qualify as a “young onset”
Parkinson’s patient. Patient? I’m anything but. I call myself a
“Parkinson’s combatant” instead. Parkinson’s Disease can strike much
earlier than it did in my case, of course, and the earlier it strikes, the
more you need to organize your defenses from the outset. My father’s
first cousin in Sweden had PD from his early twenties; recalling his
struggles (to the extent I was aware of them), I have some sense of
just how lucky I have been over the past 2 –3 decades.
Age aside, if you have PD, you’re in a fight – and let’s be honest about
this, your chances don’t look so good. What you have is a chronic,
degenerative neurological disease for which there is no cure, only
palliatives, i.e., drugs that address the symptoms, not the disease
itself. This means you can mask the symptoms – for a time. Sooner or
later, those drugs (especially carbidopa-levodopa) will begin to lose
their power, and your ability to lead something resembling a normal life
begins to disappear.
Sure, our doctors will tell you that this is the best time in history to have
PD. Implication: all the current research is bound to lead somewhere.
But I think there is nothing inevitable about it. If someone stumbles
into a cure, it will be like winning the lottery for all of us.
It’s like this: you are the Lord of the March. The castle is surrounded
by an invader. As you look out from your tallest tower, the serried
ranks of armed enemies and engines of war reach all the way to the
horizon. You’ve sent urgent messages to the King, asking him to send
the strongest force possible, but you have no idea whether the
message got through. Face it: chances are, you are on your own.
Still, if you adopt a sound strategy, you can hold out long enough to do
some valiant deeds—and have some fun while you are about it.
You may prefer another image: you’re a wrestler. You’ve been waiting
in the ring for a bit, but now your adversary is climbing over the ropes.
You look up and get a shock: he’s the most enormous sumo
contender you’ve ever seen.
Chevalier or wrestler, your problem is the same. How can you best
marshal your resources for this fight? First, you need to do an
inventory. There are two kinds of resources: internal and external.
Francis, Age 56
Diagnosed: 2002

Thursday, May 21, 2009

exercise

Exercise
Currently, exercise may be one of the most powerful tools at our disposal with which to fight PD and its degenerative nature. In addition to promoting overall physical and emotional health and well being, exercise tends to minimize some of the primary and secondary symptoms of the disease. Though exercise is not a cure, it can help people with PD maintain muscle tone and function, remain flexible, and improve overall mobility.While the precise role exercise plays in delaying the progression of the disease is still being researched, studies consistently report that those with PD who exercise regularly tend to do better than those who do not. When it comes to exercise, being younger has its advantages. Younger people are usually stronger and better able to maintain a regular exercise program over time. Many young people with PD have found that they are able to combine their exercise with grass roots fundraising efforts. From the well-known Walk-a-thons held across the country to the young men and women who have walked marathons to raise funds, finding sponsors who will cheer you on every step or mile can help you remain committed to an exercise plan.
Of course, marathons aren't for everyone! Choose the type of exercise that works for you. Whether you are walking around the block, riding a bicycle, swimming, or taking Pilates, tai chi, or yoga classes, any form of physical exercise that keeps you strong, increases your endurance, balance, or flexibility can help you manage your PD. Always check with your physician before you begin a new exercise program, and do your best to avoid injury by reviewing PD - Exercise & Safety Tips.

Tuesday, May 19, 2009

frequently asked questions




Frequently Asked Questions
How is a neurologist different than a brain surgeon? Do I need to have both?
How can you tell the difference between a simple headache and a headache caused by a brain tumor or a stroke?
Is there a way to tell while you are young that you are at risk for getting Alzheimer''s disease?
Are all brain tumors caused by cancer?
What is Parkinson''s disease?
What causes Parkinson''s disease?
Currently, what are the most effective treatments available for Parkinson''s disease?

How is a neurologist different than a brain surgeon? Do I need to have both?
A neurologist is a physician who has received special training in the diagnosis and medical treatment of diseases of the nervous system. Neurologists do not do brain surgery.
Neurosurgeons are physicians who have been specially trained to do surgery on nerves, the brain and the spinal cord.
Persons who believe they may have a neurologic condition are usually referred to a neurologist first to diagnose their condition. If it is a condition for which neurosurgery is appropriate, the patient would then be referred to a neurosurgeon. However, there are many different types of neurologic conditions, and not all of them require surgery to treat. Should you require surgery after seeing a neurologist, the Maxine Dunitz Neurosurgical Institute has an international reputation for its results in neurosurgery.
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How can you tell the difference between a simple headache and a headache caused by a brain tumor or a stroke?
Headaches are among the most common medical complaints. Some people have them often, while others hardly ever have them. Both chronic and recurring headaches may be painful and distressing but rarely reflect a serious medical condition. However, a change in the pattern or nature of headaches - for instance, from rare to frequent or from mild to severe - could signal a serious problem and calls for prompt medical attention.
Headaches can have a variety of causes, including muscle tension, eyestrain or problems with the nose, throat, teeth and ears. Usually a doctor can determine the cause of a headache from the patient's medical history and a physical examination. A variety of tests can be used to detect illness that may be causing the headache, including:
Blood tests that can identify an underlying illness
A spinal tap, in which a small amount of fluid is taken from the spine and checked for infection or bleeding
Scanning techniques, such as computed tomography (CT) or magnetic resonance imaging (MRI), which are used when a brain tumor, stroke or other problem is suspected Only rarely are chronic headaches caused by brain tumors, brain injuries or lack of oxygen to the brain.
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Is there a way to tell while you are young that you are at risk for getting Alzheimer's disease?
With an expected 360,000 new cases of Alzheimer's in the United States each year and a rapidly growing elderly population, the National Institutes of Health have made Alzheimer's an urgent research priority. While impressive progress has been made in researching the causes of Alzheimer's and potential genetic factors influencing the disease, there currently is no way to predict whether or not a person will get Alzheimer's when they are older.
Researchers have identified four genes associated with Alzheimer's and suspect that many more may influence the disease. One type of the disease, familial Alzheimer's disease (FAD) appears to be inherited. Only about 5% of all Alzheimer's cases are FAD. This condition occurs before the age of 65. Researchers have identified three genetic mutations that are associated with FAD.
Sporadic Alzheimer's, which can occur either before or after age 65, has no clear hereditary pattern. However researchers have indications that genetic factors may also be involved with this category of Alzheimer's. So far, however, there are no sure ways to identify whether or not a person will get Alzheimer's.
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Are all brain tumors caused by cancer?
No, a brain tumor can either be benign (noncancerous) or cancerous. A tumor is a mass or growth of abnormal cells.
Brain tumors are usually classified as either primary or secondary. Primary brain tumors are ones that start in the brain and can be either benign or malignant. About 17,000 Americans a year are diagnosed with these fairly rare tumors. Secondary brain tumors, which are malignant, result from cancer that started elsewhere in the body and spread to the brain. These tumors are more common, affecting some 90,000 Americans a year.
Benign tumors are usually slow growing, easier to remove and less likely to recur compared to malignant ones. However, in a few cases, even a benign tumor can cause serious problems or be life threatening, depending where in the brain it is. Malignant brain tumors can grow rapidly and crowd or destroy nearby brain tissue.
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What is Parkinson's disease?
Diagnosed in 50,000 Americans every year, Parkinson's disease is a degenerative disorder of the central nervous system. Parkinson's disease affects nerve cells (neurons) in the part of the brain that controls muscle movement, leading to symptoms, such as trembling, rigidity, difficulty walking and problems with balance and coordination. In about five to 10 percent of cases, Parkinson's disease begins before age 50. For most people, the first symptoms develop after age 50, and the likelihood of developing Parkinson's disease continues to increase with age.
Parkinson's disease is progressive, meaning the symptoms become worse over time. Although the disease may eventually be disabling, signs and symptoms usually develop gradually, and most people have many years of productive living after a diagnosis.
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What causes Parkinson's disease?
Since Parkinson's disease was first described nearly 200 years ago, researchers have been intensely studying the causes of this complex disorder. Parkinson's disease develops when certain nerve cells in a part of the brain called the substantia nigra are damaged or destroyed. Normally, these cells release dopamine - a chemical that transmits signals between the substantia nigra and another part of the brain, the corpus striatum. These signals cause your muscles to make smooth, controlled movements. Everyone loses some dopamine-producing neurons as they age, but people with Parkinson's disease lose at least 60 percent of neurons in the substantia nigra.
Currently, scientists believe Parkinson's disease may result from a combination of genetic and environmental factors, including:
Genetic factors. Research has revealed that people who have a parent, a sibling or a child who has or had Parkinson's disease are three times more likely to develop the disease themselves. If you have two such relatives with Parkinson's disease, your risk can increase as much as 10 times.
Exposure to herbicides and pesticides can raise your risk of developing Parkinson's disease three times, but so far, no one has been able to connect a specific herbicide or pesticide to the disease.
Medications. Drugs, such as haloperidol (Haldol) and chlorpromazine (Thorazine), which are prescribed for certain psychiatric disorders, and drugs used to treat nausea, such as metoclopramide (Reglan) and prochlorperazine (Compazine) can increase your risk of developing Parkinson's disease. The epilepsy drug valproate (Depacon) also may cause some of the features of parkinsonism. In fact, this drug is notorious for producing tremors, although these tremors are a little different from those seen in Parkinson's disease.
Toxins. Exposure to manganese dust, the chemical MPTP - a byproduct of heroin production - among other toxins, can lead to parkinsonism. Scientists first became aware of MPTP-induced parkinsonism in the 1980s when heroin addicts using a street drug contaminated with MPTP developed all the symptoms of Parkinson's disease. Still, toxin-related cases are extremely rare.
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Currently, what are the most effective treatments available for Parkinson's disease?
Recognizing the signs and symptoms of Parkinson's disease and seeking early diagnosis are essential to beginning appropriate treatment and managing symptoms for as long as possible. Unlike other serious neurologic diseases, such as Lou Gehrig's and Huntington's disease, Parkinson's disease is treatable. For a long time, the drug L-dopa was used to treat Parkinson's. Today newer drugs, including dopamine agonist medications, are also used - either alone or in combination with L-dopa.
Experiments with surgically transplanted stem cells, fetal nerve cells or genetically engineered cells to replace lost or damaged neurons are also being done. Deep brain stimulation (DBS) is another form of surgical therapy for Parkinson's disease that has had encouraging results. It involves implanting a brain stimulator, similar to a heart pacemaker, in an area of the brain called the thalamus. It has been used for the past decade to treat parkinsonian tremor, and researchers believe that implanting this device in a part of the brain called the subthalamic nucleus may help treat other aspects of the disease as well.
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common question about parkinson's

http://www.youngparkinsons.org/educationMainAbout.php?PHPSESSID=371f45c3d5577cd872be1be55e378ad7#commonQuestions

Parkinson’s Cases Set To Double



Discussion Corner Forum Index -> Ask about Nutrition
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Kathrynne Holden, MS, RDJoined: 22 Jan 2007Posts: 94Location: www.nutritionucanlivewith.com
Posted: Wed May 13, 2009 7:39 am Post subject: News: Parkinson’s Cases Set To Double

. Dear Friends, the following may be of interest. Best, Kathrynne ======================================================== Parkinson’s Cases Set To Double WEBWIRE – Tuesday, May 12, 2009 http://www.webwire.com/ViewPressRel.asp?aId=94847 (Springfield, GA)—While the number of people diagnosed with Parkinson’s disease worldwide is already thought to be more than four million, a new study says that the world’s largest nations are set to see a doubling of that number within twenty-five years. According to a study published by the journal Neurology, countries like China, India and the United states have allocated relatively few resources to chronic diseases such as Parkinson’s, focusing instead on communicative illnesses such as HIV. In addition, world populations are growing older, meaning more people are living long enough to develop diseases like Parkinson’s. “It’s so important that the world’s leaders realize how devastating Parkinson’s is,” says author and Parkinson’s advocate Kay Mixson Jenkins. “Certainly many diseases are challenging, but the degenerative diseases present a major burden to every aspect of a country’s medical infrastructure.” Ms. Jenkins’ book, Who Is Pee Dee? Explaining Parkinson’s Disease to a Child, is the story of Colt, a young boy whose mother has been diagnosed with Parkinson’s. It is set to go international, and Ms. Jenkins says she hopes the book will make more people aware of the devastating effect the disease can have on families. “It affects a person’s ability to do even the simplest things,” says Ms. Jenkins. “Even tying shoes or going for groceries can become a nightmare.” That nightmare could cost developing nations as much as $550 billion in national income over the next ten years, according to the study. In Who Is Pee Dee?, Ms. Jenkins explains how some of these new Parkinson’s patients might be affected through various characters including: • Mask, a stuffed bear that represents the way the disease can wear people down and rob them of their affectionate personalities. • Pee Dee, a stuffed bear that explains the disease to the story’s main character, Colt, • Colt, who believes his mother doesn’t love him because she is often too tired to play. • The adults around Colt’s mother, who are upset and unsure of what to do. “This disease affects everyone in a family,” says Ms. Jenkins. “When one person has PD, everyone around them does too in some ways.” For more information, contact the author directly via kmj@ParkinsonsInThePark.org. http://www.webwire.com/ViewPressRel.asp?aId=94847 ._________________Best regards, Kathrynne Holden, MS, RD -- For a Parkinson Tip of the Day =

How is sleep affected in PD?

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Dr. FernandezJoined: 20 Jan 2007Posts: 90
Posted: Mon May 18, 2009 8:34 am Post subject: How is sleep affected in PD?

Parkinson’s patients frequently complain of insomnia and other sleep disturbances. Sleep disorders affect up to 98% of patients at some point during their disease (Thorpy and Adler 2005). Sleep disorders are perhaps the most common non-motor problem in Parkinson’s disease, and one of the few non-motor symptoms that was initially described by James Parkinson in his original essay on The Shaking Palsy. The causes of sleep disturbances in Parkinson’s disease are often varied. They may arise as a primary manifestation of Parkinson’s disease or may be a result of medications, motor disturbances (such as difficulty turning in bed), pain, nocturia (meaning, frequent urination at night), cognitive problems, hallucinations, depression and/or anxiety. Parkinson’s disease patients may also be at higher risk for other common causes of sleep disturbances including restless legs syndrome, sleep apnea, periodic leg movements of sleep, and rapid eye movement (REM) behavior disorder. How do you bring up these sleep problems with your doctor? Given the number of conditions which can interfere with sleep, a complete history is essential to managing your sleep problems. It is important to determine if you are having difficulty with sleep initiation or sleep maintenance as these may have different causes. Other important points to address include changes of your Parkinson’s disease symptoms during sleeping and waking hours, and history of thinking problems (including hallucinations), motor disturbances (such as motor fluctuations and dyskinesias), abnormal behaviors (vocalizations during sleep, nightmares, dream enactment, leg movements) and urinary problems at night (Kluger and Fernandez 2008). Your spouse or caregiver can also help describe your sleep, particularly if you snore or have lots of movements during your sleep that you may not recall during an appointment. Sometimes, when your doctor discusses appropriate sleep hygiene with you, this issue may also lead to a discussion of a bad sleep habit related that could be associated with your sleep difficulties. A sleep diary, reflecting the hours of sleep and timing of medication dosages is helpful. When the specific cause of your sleep problem cannot be determined, an overnight sleep study (called polysomnography) may be particularly useful in determining a diagnosis and directing treatment. Yours,_________________Hubert H. Fernandez
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Thursday, May 14, 2009

depression , anxiety and insomina by Dr.Chew

As I had mentioned earlier, you have been more affected by the non-motor symptoms (insomnia, depression, anxiety) than the motor symptoms of Parkinson's. Overall, your motor symptoms are well controlled by a combination of effective medications, good exercise program and optimistic attitude.In fact, with the effective treatment for motor symptoms of Parkinson's (e.g. medications, brain surgery), I find that managing the non-motor symptoms is much more challenging. Depression and anxiety are very common in Parkinson's. Most of my patients are on sedative agents and anti-depressants. When I have difficulty managing these problems, I do refer these patients to the psychiatrists. Another common non-motor symptoms is insomnia. Most of my Parkinson's patients are on sleeping pills. I am quite liberal in prescribing sleeping pills for Parkinson's patients because I believe that good quality sleep is important in helping the body to rest and maintaining optimal level of physical activity. Apart from sleeping pills, we should also investigate the underlying causes of insomnia e.g. suboptimal control of motor symptoms at night, coexisting depression and anxiety, etc. As in your case, the following cocktail has help you to have a good quality of sleep;Stilnox (10 mg) 1/2 tablet - helps you to fall asleep quickly (within 15 minutes) and maintains sleep for at least 6 hours.Xanax (0.5 mg) 1/2 tablet - anti-anxiety medication which also helps you to fall asleep.Lexapro (10 mg) 1/2 tablet - anti-depressant and anti-anxiety medication. Seroquel (25 mg) 1/2 tablet - even though it is not approved by the FDA, this medication has been used to treat insomnia due to its sedative effect.Hope you will continue to do well with your medications.Dr Chew Nee Kong, Kuala Lumpur.

mobility and strength: between people with stroke and mobility

You have brought up a very good point. In Parkinson's, the muscle power is normal. It is the speed of movement which is affected - Parkinson's patients are slow. Therefore many Parkinson's patients can lift up heavy objects (despite being slow). And in your case, I saw how powerful your punches were when you were doing boxing exercise at the California Gym today. Parkinson's is one of the many brain diseases which affects the basal ganglia, a part in the brain which coordinates body movement.In contrast, stroke patients have reduced muscle power (paralysis) which prevents them from using the affected limbs to lift up heavy objects. In stroke, the affected part of the brain is the pyramidal system, which is different from the basal ganglia. Whether it is Parkinson's or stroke, the body movement is affected, albeit in different ways. The human brain is a very complicated and unique body organ. Dr Chew Nee Kong, Kuala Lumpur

Tuesday, May 12, 2009

Worrying: Medication or disease progression? Forum

Joined: 03 Mar 2007Posts: 136Location: Malaysia
Posted: Mon May 11, 2009 7:58 pm Post subject: Worrying: medication or disease progression?>

As parkinson's patients have to worry the medication of sideeffects on them and the progression of the disease, some patients do not take the medication regulary and accordingly to instruction by doctor, some total denial of the disease by avioding to medication. Some feel anxiety on the progression of the disease by taking medication. This is the non motor symptoms of parkinson's disease. Are you worrying of the sideeeffect of medication or anxiety on the progression of the disease?_________________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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bernard shawJoined: 19 Aug 2008Posts: 281Location: Austria Late UK
Posted: Tue May 12, 2009 5:15 am Post subject: Bern.

I have Parkinson's for the last twenty five years. I do not worry about taking my medicines. My only worry is that the Sinamet will not cut in on time. Then I know my only solution is to go back to bed and wait for the next tablets session. Bern_________________If your face wants to smile, Let it. If it doesn't, Make it.

http://www.patientslikeme.com/forum/show/44254


StargazerJoined: 26 Dec 2007Posts: 139Location: Eastern Washington
Posted: Tue May 12, 2009 5:45 pm Post subject:

Hi Teo and Bern, especially the early morning doses. I take my early morning dose and then go back to bed set the alarm for an hour later and they have kicked in. Now there are a couple of things that can interfere, constipation, not feeling well or actually being sick and good old stress. I most often have a bout with one thing or the other at least once a week. Even at that Bern we are pretty well grounded but our age does that for us we or at least I have developed an attitude. A lady Dr. once told me something is going to get us one way or the other. My thought was not if I can help it........but no point to worry. Have a great week Teo & Bern Deeann

Monday, May 11, 2009

Requesting for your Views on Observations

Anonymous
Posted: Wed Apr 29, 2009 8:35 pm Post subject: Requesting for your Views on Observations

Dear Doctor I would like to share the following experiences with you :- Firstly, I notice that I get overly "excited" about many issues, some of them quite trivial. When I am faced with any issues, I get upset very quickly, losing my temper in the process. I also feel very sensitive to many issues that can be quite normal for everybody. And when I have such feelings, I get the urge to be very tensed up and I fel the need to air my views repeatedly, which can go on for days, until the issue is settled in my mind. I feel his tremendous pressure within myself to let my views out. In the event that I keep it in, I will get very moody and unsatisfied. I will lose my temper unnecessarily and scold the ones surrounding me. I noticed that my children, particularly my son, and some of my daughters, carry this thread in their behaviour. They can be quite unreasonable and have the tendency to explode in the face of the most trivial of issues. I also recollect that my mother exhibit similar behaviour. Is this a symptom of Parkinson's Disease, particularly in my case. Or could "genetic" cause be an answer here, in the sense that my behaviour is inherited from my family members. Secondly, I notice that being a PD patient, my shoulder and neck muscles are stiff, thereby impeding the motions of my arms. I have difficulty in swinging my arms while walking, which is quite natural for people who are not suffering from PD. The swinging of the arm is actually to counterbalance the movement of walking. In order to compensate for the lack of movements in my arms, I notice that I stoop with my chest and head forward to balance myself while walking, and also to force some movements into my arms. I notice that a lot of other PD sufferers are walking in a "stoop" manner as well. I would like your input and comments on my observations on the above. Teo Kim Hoo
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Tue May 05, 2009 7:52 pm Post subject:

The stoop and the walk are common in PD and I suggest physical therapy and a regular exercise routine. For the irritability/anger/moodiness I would suggest an evaluation by a psychiatrist as this could be PD related non-motor symptoms, but also could be bipolar or other psychiatric disorder. There are many treatment options so you should seek a diagnosis._________________Michael S. Okun, M.D.
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Anonymous
Posted: Wed May 06, 2009 4:55 pm Post subject:

Regarding the stooped posture you recommend physical therapy. Does therapy reverse this posture or, if not, what purpose does it serve?
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Dr. FernandezJoined: 20 Jan 2007Posts: 90
Posted: Sun May 10, 2009 7:18 pm Post subject:

It may or may not reverse the stooped posture (this is one of the most difficult symptoms to treat in PD). But PT could prevent further decline, could make your truncal muscles stronger, and help with balance even if the posture remains stooped. Yours,_________________Hubert H. Fernandez
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Dear Mr TeoDr Okun has already answered your question. Anxiety disorder and depression can be inherited, just like your Parkinson's. As you have mentioned earlier, you had already been diagnosed to have depression since you were in your 20's. In your case, what happened was that the pre-existing depression and anxiety disorder were aggravated when you started having the motor symptoms of Parkinson's (about ten years ago). In fact, you are currently more disabled by your non-motor symptoms (depression and anxiety disorder) than the motor symptoms of Parkinson's. This is why I am inclined to advise you to continue taking Lexapro as long as possible. Dr Chew Nee Kong, Kuala Lumpur

Thursday, May 7, 2009

Is Anxiety Genetic Inheritance or PD Symptom?

Posted: Sun May 03, 2009 6:00 am Post subject: Is Anxiety Genetic Inheritance or PD Symptom?

Dear Doctor I notice that I have been suffering from feelings of anxiety and impulsiveness for the pass few years, and this feelings have been particularly strong after I had been diagnosed as having Parkinson's Disease (PD). I overeact even to the most trivial of things, and I would lose my temper and take it out on my family members. I tend to get very sensitive over every tiny issue that crosses my mind. I get depressed and I have the feeling/urge to express myself over and over again on the issues I have problem with. This results in me repeating the same issues over and over again until my "urge" dies down. Furthermore, when I have this "urge"to express myself, I tend to get very emotional and impulsive, whereby I feel the need to immediately do the things to rectify the situation. I will feel very unsatisfied and unfulfilled if things does not go my way. I noticed that my children, particularly my son and one of my daughters, suffer from anxiety as well, and he/she can be pretty impulsive too. Is my feelings of anxiety/impulsiveness a result of PD? If so, please enlighten me on the causes associated with it. Since my son, who is only 36 years old, exhibit the symptoms of anxiety, can it be passed on genetically? For your information, I remember my mother has the same behaviour too.
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Tue May 05, 2009 7:57 pm Post subject:

There can definitely be genetic anxiety disorders and other psychiatric disorders like depression or bipolar disease that run in families. This is usually unrelated to PD. Depression, impulsiveness, moodiness, anger, etc. can all be seen as manifestations of PD._________________Michael S. Okun, M.D.

Wednesday, May 6, 2009

Suspected Causes Of Irritable Bowel Syndrome - IBSBy David Hiller
Irritable bowel syndrome, commonly referred to as IBS, is believed to be caused by the dysfunction of the muscles that control the gastrointestinal tract. It is also said that these muscle dysfunctions could be caused by the nerves which control the related organs of this tract.
The nervous control of the gastrointestinal tract is extremely complex. A system of nerves runs the full length of the gastrointestinal tract from the esophagus to the anus in the muscular walls of the organs. These nerves communicate with the nerves traveling to and from the spinal cord. Nerves within the spinal cord travel to and from the brain. Therefore, abnormal function of the nervous system in IBS may occur in a gastrointestinal muscular organ, the spinal cord, or the brain. The nervous system controlling the gastrointestinal organs, as with most other organs, contains sensory and motor nerves. Theses nerves continuously sense what is happening within the organs and relay this information to nerves in the organ's wall. From there, information can be relayed to the spinal cord and brain. This information is received and processed in the organ's wall, the spinal cord, or the brain. Then, based on this sensory input and the way the input is processed, responses are sent to the organ over the motor nerves. The most common motor responses in the intestine are contraction or relaxation of the muscle of the organ and secretion of fluid and/or mucus into the organ.
Abnormal function of the nerves of the gastrointestinal organs, theoretically, may occur in the organ, spinal cord, or brain. Moreover, the abnormalities might occur in the sensory nerves, the motor nerves, or at processing centers in the intestine, the spinal cord, or brain. Some research argues that the cause of functional diseases is abnormalities in the function of the sensory nerves. For example, normal activities, such as stretching of the small intestine by food, may give rise to abnormal sensory signals that are sent to the spinal cord and brain, where they are perceived as pain.
Still other research claims that the cause of functional diseases is abnormalities in the function of the motor nerves. For example, abnormal commands through the motor nerves can produce painful contractions of the muscles. Still others argue that abnormally functioning processing centers are responsible for functional diseases since they misinterpret normal sensations or send abnormal commands to the organ. In fact, some functional diseases may be due to sensory dysfunction, motor dysfunction, or both sensory and motor dysfunction. Still others may be due to abnormalities within the processing centers.
One area that is receiving a great deal of scientific attention is the potential role of gas produced by intestinal bacteria in patients with IBS. Studies have demonstrated that patients with IBS produce larger amounts of gas than individuals without IBS, and the gas may be retained longer in the small intestine. Among patients with IBS, abdominal size increases over the day, reaching a maximum in the evening and returning to normal by the following morning. In individuals without IBS, there is no increase in abdominal size during the day.
There is a great deal of controversy over the role that poor digestion and/or absorption of dietary sugars may play in aggravating the symptoms of IBS. Poor digestion of lactose is very common as is poor absorption of fructose, and other sweeteners commonly found in processed foods. Poor digestion or absorption of these sugars could aggravate the symptoms of IBS since unabsorbed sugars often increase the formation of gas.
Although these abnormalities in production and transport of gas could give rise to some of the symptoms of IBS, much more work will need to be done before the role of intestinal gas in IBS is clear.
Dietary fat in healthy individuals causes food as well as gas to move slowly through the stomach and small intestine. Some patients with IBS may even respond to dietary fat in an exaggerated fashion with greater slowing. Therefore, dietary fat could also aggravate the symptoms of IBS.
Article Source: http://EzineArticles.com/?expert=David_Hiller

General observation

Posted: Wed Apr 29, 2009 8:35 pm Post subject: Requesting for your Views on Observations

Dear Doctor I would like to share the following experiences with you :- Firstly, I notice that I get overly "excited" about many issues, some of them quite trivial. When I am faced with any issues, I get upset very quickly, losing my temper in the process. I also feel very sensitive to many issues that can be quite normal for everybody. And when I have such feelings, I get the urge to be very tensed up and I fel the need to air my views repeatedly, which can go on for days, until the issue is settled in my mind. I feel his tremendous pressure within myself to let my views out. In the event that I keep it in, I will get very moody and unsatisfied. I will lose my temper unnecessarily and scold the ones surrounding me. I noticed that my children, particularly my son, and some of my daughters, carry this thread in their behaviour. They can be quite unreasonable and have the tendency to explode in the face of the most trivial of issues. I also recollect that my mother exhibit similar behaviour. Is this a symptom of Parkinson's Disease, particularly in my case. Or could "genetic" cause be an answer here, in the sense that my behaviour is inherited from my family members. Secondly, I notice that being a PD patient, my shoulder and neck muscles are stiff, thereby impeding the motions of my arms. I have difficulty in swinging my arms while walking, which is quite natural for people who are not suffering from PD. The swinging of the arm is actually to counterbalance the movement of walking. In order to compensate for the lack of movements in my arms, I notice that I stoop with my chest and head forward to balance myself while walking, and also to force some movements into my arms. I notice that a lot of other PD sufferers are walking in a "stoop" manner as well. I would like your input and comments on my observations on the above. Teo Kim Hoo
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Tue May 05, 2009 7:52 pm Post subject:

The stoop and the walk are common in PD and I suggest physical therapy and a regular exercise routine. For the irritability/anger/moodiness I would suggest an evaluation by a psychiatrist as this could be PD related non-motor symptoms, but also could be bipolar or other psychiatric disorder. There are many treatment options so you should seek a diagnosis._________________Michael S. Okun, M.D.

stroke and parkinson's

Posted: Mon Apr 27, 2009 8:17 am Post subject: mobility and strength

Please elaborate Why people with stroke could move their body faster than the parkinson's patients during exercise but they lack of strength than the latter? Thank
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Tue May 05, 2009 7:50 pm Post subject:

The statement is actually not accurate. The speed of movements in Parkinson and in stroke are highly variable from patient to patient and it is probably not a fair comparison. Hope that helps._________________Michael S. Okun, M.D.

Genetic and parkinson's

Posted: Sun May 03, 2009 6:00 am Post subject: Is Anxiety Genetic Inheritance or PD Symptom?

Dear Doctor I notice that I have been suffering from feelings of anxiety and impulsiveness for the pass few years, and this feelings have been particularly strong after I had been diagnosed as having Parkinson's Disease (PD). I overeact even to the most trivial of things, and I would lose my temper and take it out on my family members. I tend to get very sensitive over every tiny issue that crosses my mind. I get depressed and I have the feeling/urge to express myself over and over again on the issues I have problem with. This results in me repeating the same issues over and over again until my "urge" dies down. Furthermore, when I have this "urge"to express myself, I tend to get very emotional and impulsive, whereby I feel the need to immediately do the things to rectify the situation. I will feel very unsatisfied and unfulfilled if things does not go my way. I noticed that my children, particularly my son and one of my daughters, suffer from anxiety as well, and he/she can be pretty impulsive too. Is my feelings of anxiety/impulsiveness a result of PD? If so, please enlighten me on the causes associated with it. Since my son, who is only 36 years old, exhibit the symptoms of anxiety, can it be passed on genetically? For your information, I remember my mother has the same behaviour too.
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Tue May 05, 2009 7:57 pm Post subject:

There can definitely be genetic anxiety disorders and other psychiatric disorders like depression or bipolar disease that run in families. This is usually unrelated to PD. Depression, impulsiveness, moodiness, anger, etc. can all be seen as manifestations of PD._________________Michael S. Okun, M.D.


Everyone has thoughts or a song that gets "stuck" in our mind. Perfectly normal!Stress can make it worse.Many very very successful people have obsessive personalities; dotting every i and crossing every T makes for great accountants, attorneys, surgeons, etc....Obsessive personality and obsessive compulsive disorder are both hereditary!Maybe talk to your doctor, the way you describe your urge, and the need to see it through, could be perfectly normal (just annoying) or medications like dopamine agonists or brain chemistry could have pushed it towards obsessive/compulsive thoughts or behaviors (interferes with the quality of your life).Anyone on a dopamine agonist needs to consult with their doctor immediately if they experience an increase in compulsive behavior! (A small or even cute obession could quickly become a huge problem; gambling, sex, spending, etc) And yes, heriditary does make you a bit more vulnerable to the medication caused compulsions.If you are not using an agonist, you might ask yourself if the thoughts interfere with your enjoyment of life, your relationships, or your functioning....many people are helped by cognitive behavior therapy, by behavior modification, by medication, or by changing a medication that causes compulsions
Source: PatientslikeMe

http://www.patientslikeme.com/forum/show/43636?post_id=591955#591955

Tuesday, May 5, 2009

Apathy vs depression

Posted: Tue Feb 24, 2009 9:29 am Post subject: Apathy vs depression

The symptoms of Apathy : indifference, unconcern, lifelessness, uninterested, dullness, listless, uninquisitiveness, lack of emotions or feeling,etc Symptoms of depression: sadness, poor appetite, sleep disturbances, fatigue, feelings of guilt, self-criticism and worthlessness Apathy and depression are different emotional disorders. It is hard to deal people with apathy rather depression. There are so far no medication available for people with apathy. However people with depression started apathy if it is not treated._________________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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wheelersceJoined: 02 Mar 2007Posts: 743Location: MI
Posted: Tue Feb 24, 2009 4:53 pm Post subject:

I've heard the doctors say how hard it is to treat apathy, but for me two things helped. 1) stop taking Amantadine. 2) start taking Prozac. I know antidepressants aren't supposed to help with apathy, but after taking them for a very short time I went from not wanting to do anything at all (and believing nothing would ever seem fun again) to a reasonable sense of satisfaction with daily life. Antidepressants are worth a try. I never thought I'd be such a pill-pusher! sw

Sunday, May 3, 2009

stooped posture

Being a person suffering from Parkinson's Disease (PD), I notice other PD patients, including myself, suffer from a stooped posture, particularly while walking. I would like to share with you my experience in the causation of the posture suffered by most, if not all PD sufferers.
I notice that my muscles surrounding my shoulders right down to my arms, are generally very stiff. Because of the stiffness in the said muscles, I have difficulty in swinging my arms when I walk. The swinging of the arms on opposite sides of your limbs, i.e. you swing your right hand when you walk with your left foot and vice versa, during walking gives us the counterbalance required to maintain a correct posture while walking. Due to the lack of arm motion due to the stiffness of the muscles in the shoulder region, the body will naturally be off balance. To compensate for the lack of balance, I find myself exagerating the arm swinging movement, in that I need to push hard with my shoulder to swing the hands forward and backward. This in turn lead to the muscles in the shoulders and upper back to tense up. This result in the body having to stoop forward to maintain the balance of the body during walking.
I would be grateful for your input and comments on this.

Genetic and parkinson's- PatientslikeMe forum

I notice that I have been suffering from feelings of anxiety and impulsiveness for the pass few years, and this feelings have been particularly strong after I had been diagnosed as having Parkinson's Disease (PD). I overeact even to the most trivial of things, and I would lose my temper and take it out on my family members. I tend to get very sensitive over every tiny issue that crosses my mind. I get depressed and I have the feeling/urge to express myself over and over again on the issues I have problem with. This results in me repeating the same issues over and over again until my "urge" dies down. Furthermore, when I have this "urge"to express myself, I tend to get very emotional and impulsive, whereby I feel the need to immediately do the things to rectify the situation. I will feel very unsatisfied and unfulfilled if things does not go my way. I noticed that my children, particularly my son and one of my daughters, suffer from anxiety as well, and he/she can be pretty impulsive too. Is my feelings of anxiety/impulsiveness a result of PD? If so, please enlighten me on the causes associated with it. Since my son, who is only 36 years old, exhibit the symptoms of anxiety, can it be passed on genetically? For your information, I remember my mother has the same behaviour too.

Everyone has thoughts or a song that gets "stuck" in our mind. Perfectly normal!
Stress can make it worse.
Many very very successful people have obsessive personalities; dotting every i and crossing every T makes for great accountants, attorneys, surgeons, etc....Obsessive personality and obsessive compulsive disorder are both hereditary!
Maybe talk to your doctor, the way you describe your urge, and the need to see it through, could be perfectly normal (just annoying) or medications like dopamine agonists or brain chemistry could have pushed it towards obsessive/compulsive thoughts or behaviors (interferes with the quality of your life).
Anyone on a dopamine agonist needs to consult with their doctor immediately if they experience an increase in compulsive behavior! (A small or even cute obession could quickly become a huge problem; gambling, sex, spending, etc) And yes, heriditary does make you a bit more vulnerable to the medication caused compulsions.
If you are not using an agonist, you might ask yourself if the thoughts interfere with your enjoyment of life, your relationships, or your functioning....many people are helped by cognitive behavior therapy, by behavior modification, by medication, or by changing a medication that causes compulsions