Chronicles of PD Fighter

Parkinson disease

2012-01-31T20:58:00.001+08:00

Parkinson’s disease is a disorder that affects nerve cells, or neurons, in a part of the brain that controls muscle movement. In Parkinson’s, neurons that make a chemical called dopamine die or do not work properly. Dopamine normally sends signals that help coordinate your movements. No one knows what damages these cells. Symptoms of Parkinson’s disease may includeTrembling of hands, arms, legs, jaw and faceStiffness of the arms, legs and trunkSlowness of movementPoor balance and coordinationAs symptoms get worse, people with the disease may have trouble walking, talking or doing simple tasks. They may also have problems such as depression, sleep problems or trouble chewing, swallowing or speaking.Parkinson’s usually begins around age 60, but it can start earlier. It is more common in men than in women. There is no cure for Parkinson’s disease. A variety of medicines sometimes help symptomsNo Comments »

2012-01-30T18:40:00.000+08:00

Eating right goes a long way when it comes to a healthy heart.According to the Ministry of Health, Ischaemic Heart Disease accounts for 18.7 per cent of deaths in Singapore in 2010. It is Singapore's number two killer just after cancer.A heart attack occurs when blood flow to part of the heart is blocked causing poor supply of oxygen to the heart muscles. Some people have chest pains when heart attack happens but some people have no symptoms at all.

It is important to be aware of the risks of heart attack because most of them are preventable.About.com reported that dietary advice for reducing heart disease risk includes eating a balanced diet with less saturated fats from red meats, more fresh fruits and vegetables, more fish, less sugar, more fiber and for many people, fewer total calories. Try having these

2012-01-28T10:37:00.000+08:00

These are 15 I will follow myself in 2012, and hopefully beyond. I invite you to join me on these "Rules." Zi think it would make the world a better place.1- Be Truthful to yourself and others. Yes, it is not politically correct. Does a true friend just tell you whats good about you? Friendship begins with honesty to yourself and others. Trust me, honesty will bring closeness and respect. So, wear the same face all the time because truthfully, you can never fool your friends.2- Go through your list of contacts or address book. If you have not communicated in ANY way with that contact in the past year....erase them. Yes, even if it is me. Unless it is a plumber, mechanic, lawyer, etc... Start the year by surrounding yourself with good people with good intentions. "Give and take" does not mean, "I give and you take." If someone is not putting as much into your relationship as you are, then they are taking a piece of you that someone else may need. If you do this, you will be amazed at how few people are in your contact list. Those are your friends.3- TALK, Do Not Text important issues. An "I'm sorry" or "Please forgive me" text has no feeling because you can not see the person's face. An occassional "I love you" or "I miss You" is ok. The serious matters you must take care of in person. Along with this, do not text someone while you are having a conversation with others. Be polite with the phone. Hang it up when your in line at the store, do not text at the dinner table, when face to face with friends or family, etc....COMMUNICATION is what sets us apart from animals (that and opposable thumbs.) Show respect to the person to whom you are face-to-face with. It will go a long way. Plus, while texting you may miss some very important things in life you can not get back. It can be lonely with no one to talk to.4- Do just one good deed for a stranger or a surprise for a loved one. It can be as simple as holding the door for someone, writing "I love you" on a napkin and putting it in their lunch, or just saying "I like that shirt" to someone who looks "down in the dumps" at the store. Just like road rage, kindness is contageous.5- Always end a phone call, family gathering, gathering with friends, etc..with, "I love you." You may never get the chance again.6- Charity is not always about money. At least once in this upcoming year, do something nice for someone less fortunate. It can be a "Red Kettle" donation or, it can be gathering stuff around the house and donate it, it can be delivering a meal to a neighbor, cutting the grass or shoveling snow, it can be donating time to a homeless shelter, volunteering at a school or library, or it can be just listening to someone who has an issue. I am not saying, "Don't donate money (a good choice may be www.parkinson.org--shameless plug)," but there are other options. You have 525,600 minutes in one year. I think we can all spare 15 to 30 minutes to help those in need.7- Hug your children and tell them you love them many times a day. I always ask my girls, "Are you beautiful? Are you smart?" If they answer "No" to either question, or even delay to answer, we talk about it until it is resolved. There is nothing more important than having your children know they are loved, beautiful/handsome, and smart.8- Forgive and try to forget. If you dwell on the past you will never move forward. Forgive those people and things that you need to in order to move forward. When you forgive, you let go of the past, and forgetting will go with it.9- Money is never made, it is only transferred. People rarely get rich working. Some people just make more money than you, but remember they also spend more than you. You work for a company, they transfer the money money they make to you for the work you have done. You, in turn, transfer it to the bank, the mortage company, the auto loan company, the cable company, the gas company, the electric company, etc... When you look at what you owe, you say to yourself, "How do I get out of this?" The United States National Debt is, as of 1/1/2012, $15,125,898,976,398. You do not see our government sweating. If you owe money, call up the companies and tell them you are having trouble paying them. Don't ignore them, they won't go away.10- Try something you have never done before. It does not matter what, just as ling as it is something you have NEVER done before. 12- Keep your change! I have never been a person to search my pocket for 26 cents when my soda cost $1.26. I always give $2.00 and keep the chsnge, even though I know I have it in my pocket. At the end of the day put all the change in a bucket. If you start today, you WILL NOT have to worry about money for Chritmas presents 360 days from now. Trust me on this, it adds up.13- "The 3 Bucket Rule. If you have children, do this with them. If you don't have children, then do it for your grandchildren or even yourself. Use 3 cans, or boxes, or whatever will hold money. Let your kuds decorate the boxes. On Box 1 write "ME," on Box 2 write "BANK," and on Box 3 write "CHARITY." Each week give your kids an allowance (say $3.00). I know many of you are saying that your kids don't do anything for an allowance. Let me ask you this, "Do you get paid per hour or by how much you do, how fast you are, or how neat your work space is?" I think I proved my point and kids should be treated the same. So, every week you give them $3.00. $1 goes into the ME bucket, which they can spend at any time on what they want. $1 goes into the BANK bucket, which you take them to the bank and open an account for them and they put the book in the bucket when they get home (some banks have kids accounts, just ask). $1 goes into the CHARITY bucket, which at the end of each year they get to pick out what charity they want to donate to. This will give your children the life values of: Spend Wisely, Save Accordingly, and Give Back to those in need. 14- Call your family once a week. I have not been very good at this, but this us the year. Your family is always there for you, whether it be Mom, Dad, Bother, Sister, etc... One of them must like you. Call them.15- "Choose to have a great Day! I say this to my wife and our girls every morning before they go to school. It is a choice, and DO NOT let anyone stand in the way of your choice to HAVE A GREAT DAY!I truly care for the well being of all of you deeply, and may this year be your year. It starts today, don't waste 1 minute of the 525,600 minutes you have this year.Your Friend & Phsrmacist,Mark Best of health,Mark R. Comes R.Ph."Ask The Pharmacist"www.parkinson.org 0
Report Back to top of the page up there ^ MultiQuote Reply

15 rules

2012-01-27T16:34:00.003+08:00

Posted 02 January 2012 - 01:11 PMThese are 15 I will follow myself in 2012, and hopefully beyond. I invite you to join me on these "Rules." Zi think it would make the world a better place.1- Be Truthful to yourself and others. Yes, it is not politically correct. Does a true friend just tell you whats good about you? Friendship begins with honesty to yourself and others. Trust me, honesty will bring closeness and respect. So, wear the same face all the time because truthfully, you can never fool your friends.2- Go through your list of contacts or address book. If you have not communicated in ANY way with that contact in the past year....erase them. Yes, even if it is me. Unless it is a plumber, mechanic, lawyer, etc... Start the year by surrounding yourself with good people with good intentions. "Give and take" does not mean, "I give and you take." If someone is not putting as much into your relationship as you are, then they are taking a piece of you that someone else may need. If you do this, you will be amazed at how few people are in your contact list. Those are your friends.3- TALK, Do Not Text important issues. An "I'm sorry" or "Please forgive me" text has no feeling because you can not see the person's face. An occassional "I love you" or "I miss You" is ok. The serious matters you must take care of in person. Along with this, do not text someone while you are having a conversation with others. Be polite with the phone. Hang it up when your in line at the store, do not text at the dinner table, when face to face with friends or family, etc....COMMUNICATION is what sets us apart from animals (that and opposable thumbs.) Show respect to the person to whom you are face-to-face with. It will go a long way. Plus, while texting you may miss some very important things in life you can not get back. It can be lonely with no one to talk to.4- Do just one good deed for a stranger or a surprise for a loved one. It can be as simple as holding the door for someone, writing "I love you" on a napkin and putting it in their lunch, or just saying "I like that shirt" to someone who looks "down in the dumps" at the store. Just like road rage, kindness is contageous.5- Always end a phone call, family gathering, gathering with friends, etc..with, "I love you." You may never get the chance again.6- Charity is not always about money. At least once in this upcoming year, do something nice for someone less fortunate. It can be a "Red Kettle" donation or, it can be gathering stuff around the house and donate it, it can be delivering a meal to a neighbor, cutting the grass or shoveling snow, it can be donating time to a homeless shelter, volunteering at a school or library, or it can be just listening to someone who has an issue. I am not saying, "Don't donate money (a good choice may be www.parkinson.org--shameless plug)," but there are other options. You have 525,600 minutes in one year. I think we can all spare 15 to 30 minutes to help those in need.7- Hug your children and tell them you love them many times a day. I always ask my girls, "Are you beautiful? Are you smart?" If they answer "No" to either question, or even delay to answer, we talk about it until it is resolved. There is nothing more important than having your children know they are loved, beautiful/handsome, and smart.8- Forgive and try to forget. If you dwell on the past you will never move forward. Forgive those people and things that you need to in order to move forward. When you forgive, you let go of the past, and forgetting will go with it.10- Try something you have never done before. It does not matter what, just as ling as it is something you have NEVER done before. 12- Keep your change! I have never been a person to search my pocket for 26 cents when my soda cost $1.26. I always give $2.00 and keep the chsnge, even though I know I have it in my pocket. At the end of the day put all the change in a bucket. If you start today, you WILL NOT have to worry about money for Chritmas presents 360 days from now. Trust me on this, it adds up.13- "The 3 Bucket Rule. If you have children, do this with them. If you don't have children, then do it for your grandchildren or even yourself. Use 3 cans, or boxes, or whatever will hold money. Let your kuds decorate the boxes. On Box 1 write "ME," on Box 2 write "BANK," and on Box 3 write "CHARITY." Each week give your kids an allowance (say $3.00). I know many of you are saying that your kids don't do anything for an allowance. Let me ask you this, "Do you get paid per hour or by how much you do, how fast you are, or how neat your work space is?" I think I proved my point and kids should be treated the same. So, every week you give them $3.00. $1 goes into the ME bucket, which they can spend at any time on what they want. $1 goes into the BANK bucket, which you take them to the bank and open an account for them and they put the book in the bucket when they get home (some banks have kids accounts, just ask). $1 goes into the CHARITY bucket, which at the end of each year they get to pick out what charity they want to donate to. This will give your children the life values of: Spend Wisely, Save Accordingly, and Give Back to those in need. 14- Call your family once a week. I have not been very good at this, but this us the year. Your family is always there for you, whether it be Mom, Dad, Bother, Sister, etc... One of them must like you. Call them.15- "Choose to have a great Day! I say this to my wife and our girls every morning before they go to school. It is a choice, and DO NOT let anyone stand in the way of your choice to HAVE A GREAT DAY!I truly care for the well being of all of you deeply, and may this year be your year. It starts today, don't waste 1 minute of the 525,600 minutes you have this year.Your Friend & Phsrmacist

2012-01-26T22:47:00.001+08:00

I am on bipolar medication for a yearMy medication ; one 1/2 tablets Arip at lunch,night dailyone Zoloft 50mg at night daily1/2 Zydis (olanzapine) nightly1 Stilnox 10mg nightly2 tablet 0.5 Besquil three times dailyParkinson medication6mg requip pd 24 hours daily1 tablet 25/100 daily1 tablet Stalevo 150/37.5/200mg dailyI do not have sleep trouble nightlybut with anxiety, slurred and saliva during day timeKindly advice TEOKIMHOE

2012-01-20T20:59:00.001+08:00

What is Drug Interaction?Medicines are used to treat certain conditions or illnesses, but when two or more medicines are used simultaneously, they may interact with each other and cause complications or unwanted side effects. Drug interactions may occur with prescription drugs, over-the-counter (OTC) medicines, herbal remedies, or dietary supplements, so it is important that the patient realizes the dangers of mixing drugs without consulting a doctor.Parkinson’s Disease MedicinesThe drug therapy most commonly used in Parkinson’s disease usually consists of the following : LevodopaLevodopa + peripheral decarboxylase inhibitors such as carbidopa and benserazide.Dopamine receptor agonists – pramipexole, ropinirole, and rotigotine.MAO-B inhibitors – selegiline and rasagiline.COMT inhibitors – entacaponeAnticholinergics – benzhexol and orphenadrineAmantadine.Drug Interactions with Parkinson’s Disease Medicines LevodopaSince this is the most widely used medicine in Parkinson’s disease, its drug interactions should be understood by all Parkinson’s patients. Certain medicines decrease effectiveness of levodopa hence the dose of levodopa may have to be adjusted if used together. These include Anticholinergics – sometimes used in addition to levodopa for treatment of symptoms in Parkinson’s disease. Over-the-counter cough and cold medicines contain anticholinergics such as diphenhydramine, chlorpheniramine, and phenylephrine. Antispasmodics used for treating stomach or uterine cramps also contain anticholinergics such as dicyclomine and hyoscyamine. Anti-allergic medicines (like

Parkinson disease

2012-01-20T20:42:00.000+08:00

Parkinson’s disease is a long term disease where the patient needs to take medicines on a regular basis for relief of the symptoms> It is important for both the Parkinson’s patient and care givers to realize that these medicines might have various types of interactions with other drugs. Some of these drug interactions can be quite severe, therefore additional medicines should be taken only after consulting a doctor.

other drug interaction with PD medicines

2012-01-20T13:01:00.002+08:00

saliva

2012-01-13T21:56:00.002+08:00

Drooling and Excess Saliva in Parkinson's Disease
From Patrick McNamara, Ph.D., former About.com Guide
Updated May 19, 2009
About.com Health's Disease and Condition content is reviewed by the Medical Review Board
See More About:
parkinson's treatments
parkinson's symptoms
If you have Parkinson's disease you have probably learned to carry around a handkerchief in your pocket so that you can periodically wipe up the spit that seems to regularly leak out of your mouth. Survey studies have recorded the presence of excess saliva or drooling in 70 to 78% of patients with PD. Men drool more than women and it appears to be more embarrassing for men than for women.
Why All the Excess Saliva in Parkinson's Disease?
Scientists have found that the problem is not one of over-production but one of inefficient and infrequent swallowing. In fact, saliva production in PD is typically diminished over normal levels. Persons with PD simply do not swallow as much as other people.
So What Can Be Done?
There are several drug treatments available. Potent drugs knonw as anticholinergics, such as trihexyphenidyl hydrochloride and benzatropine mesilate, are prescribed in an attempt to “dry up” the excess saliva. But this class of drugs often creates troublesome side effects such as constipation, urinary retention, memory impairment, confusion, and even hallucinations, particularly in elderly individuals. Another possibility is to take a drop of 1% atropine ophthalmic solution under the tongue twice daily but this has been tried in only a handful of patients. Injections of botulinum toxin A have also been used to try to eradicate excessive saliva in PD. Although this drug is effective for some people with PD, side effects are again an issue including an excessively dry mouth and dysphagia or trouble swallowing food.

new year resolution

2011-12-28T13:42:00.000+08:00

New Year’s resolutions to help you live well with Parkinson’s disease

For most people, New Year's Eve is the time to look ahead to the promises of the coming year, and reflect on the changes we want to make in our lives. Those of us living with Parkinson’s disease too often find ourselves on the sidelines, afraid to dream in the face of our uncertain future. This is unfair to ourselves and to those who care about us.
Each of us must find our own way to put fear, anger, and sadness behind us and get on with the business of living. Although life will never be the way we had planned in our pre-Parkinson’s days, “different” does not necessarily mean bad. More than 13 years into my own journey with Parkinson’s, I assure you that the daily choices we make will impact our quality of life down the road. I’ve chosen my 10 resolutions for 2012 with this in mind and I am sharing them here to inspire and motivate you to make your own resolutions to put yourself on the path to living well with our shared disease:
1. Make daily exercise a priority. Research reveals it is the one thing that may slow disease progression. It also improves overall health and makes us look and feel better.
2. Get more sleep. Sleeping less than 7 hours a night impairs our ability to concentrate, make decisions, and moderate our emotions. It also contributes to weight gain as well as “excessive daytime sleepiness” and “sleep attacks” that compromise safety behind the wheel and in the workplace.
3. Eat better. The foods we eat impact our fitness level and overall health.
4. Focus on what you can do, not what you can’t. I can do things now that I could not even dream of doing in my pre-Parkinson’s, like swimming half a mile at a time. Friends say I am in the best shape of my life except for the fact that I have PD. Yes, except for that!
5. Live in the moment. Do the best you can today and deal with tomorrow when it comes.
6. Don’t allow Parkinson’s to rob you of the good times still awaiting you. Since learning I had PD I have seen both my sons graduate from college and one from law school, danced at one son’s wedding, welcomed a wonderful daughter-in-law into our family, and seen both sons buy houses and host parties for friends and family. Had I given up from the start, look what I would have missed.
7. Take up a new hobby or learn something new.
8. Volunteer to help others and find new purpose for our lives. Each of us has a gift we can share to make a positive impact on the lives of others.
9. Remain an active participant in your healthcare, learning about clinical trials that may benefit you, regularly visiting the websites of the national Parkinson’s organizations to stay up on the latest Parkinson’s-related news, and attending symposia where I can learn from experts in the field.
10. Spend more time with family and friends, creating a support system that can provide outlets for expressing your feelings. Tending to our emotional health is as important as taking care of our physical health.

If your current mental or physical state is not what you desire, now is the time to change course and alter your destiny. The choice is yours.
Sheryl

medication errors causes of patient injury

2011-12-27T09:37:00.000+08:00

medication errors causes of patient injury

Medication errors are one of the most preventable causes of patient injury, although its incidence varies in different healthcare settings. The sources and avoidance of medication errors are multifactorial and multidisciplinary.Healthcare providers and patients and/or their caregivers have their respective roles to play in reducing the occurrence of medication errors.Patients and/or their caregivers can do so by knowing the medicines, understanding and adhering to instructions, monitoring the effects of the medicines and ensuring there is good communication between patients and their healthcare providers.Dr Milton Lum is a member of the board of Medical Defence Malaysia. This article is not intended to replace, dictate or define evaluation by a qualified doctor. The views expressed do not represent that of any organisation the writer is associated

seret recipe behind the mask

2011-12-22T15:06:00.002+08:00

Secret recipe behind the mask

Hero TeoKuala Lumpur, Malaysiahttp://www.youtube.com/watch?v=sTpu_zBvDMEI

I often smiled when I watched the video recording of my kick-boxing exercise which I uploaded to You Tube. My trainers and videographer told me the same thing – “You do not look like a Parkinson’s patient at all”. Even my doctor shook his head in disbelief and said, “This is shocking. I can’t imagine a 70-year-old Parkinson’s patient doing a very strenuous exercise such as kickboxing. I am sure that you are the only Parkinson’s patient in Malaysia who is doing the kickboxing exercise.”As early as 1998, I already had both the motor and non-motor symptoms. Since my diagnosis in 2002, I went through a period of depression, anxiety, denial and anger. Subsequently, I bounced back after discovering a secret recipe for fighting Parkinson’s, which consisted of: knowledge (is power), exercise, medications, nutrition / supplements and prayer. In my quest for knowledge, I surfed various Parkinson’s websites, raining them with questions, questions and questions. I even started the first Parkinson’s blog in Malaysia (http://www.heroteo.com/). I tried to learn everything about Parkinson’s in order to overcome all complications - the Chinese heroes won the battles by understanding their enemy first. Animal experiments showed that exercise may be neuroprotective. Rats which were forced to exercise had a lesser degree of brain damage after they were exposed to poison. In mice which were made to undergo treadmill exercise, there was increased production of dopamine.Parkinson’s patients are comparable to the car. The medications are needed to help patients to start walking, while fuel or battery is needed to help start the car engine. Exercise is needed to improve the patients’ physical mobility and endurance, while driving helps to recharge the battery. Thus, exercise helps our “engines” warm up before leaving home and keep the “cars” going everyday. Even healthy people such as Bruce Lee, the Chinese Kung Fu master, know that exercise is beneficial. As such, since 2005, I decided to “get physical”. I spend 3-4 hours everyday at the California Fitness gym, doing a wide range of “heavy” exercise such as kick-boxing, weight-training and spinning (indoor cycling). Twice a week, I do yoga exercise at home with the guidance of a trainer.Since this year, my physical condition has drastically improved. I sleep and eat well (I eat to live, and live to eat). I enjoy driving around the Kuala Lumpur city with my wife everyday and going overseas for holiday. I managed to reduce the daily dose of Parkinson’s medications recently. Sometimes, I wonder whether I am just a “normal person” behind the mask.I know that it is technically difficult to prove that exercise has neuroprotective effect in Parkinson’s patients. Despite this, I believe that exercise has slowed down my disease progression. I hope that my video recording will bring hope and happiness to all Parkinson’s patients in this world, by reminding them that they can still live a physically active life.

PD swing their arms asmmetrically

2011-12-21T20:02:00.002+08:00

1 (1 votes)People with Parkinson's disease swing their arms asymmetrically -- one arm swings less than the other - when walking. This unusual movement is easily detected early when drugs and other interventions may help slow the disease, according to Penn State researchers who used inexpensive accelerometers on the arms of Parkinson's disease patients to measure arm swing. "Scientists have known for some time that people with Parkinson's disease exhibit reduced arm swing during the later stages of the disease, but no one had come up with an easy way to measure this," said Stephen Piazza, associate professor of kinesiology. "We found that not only do people with the disease exhibit reduced arm swing, but they also exhibit asymmetric arm swing, and this asymmetric arm swing can easily be detected early in the disease's progression." No cure for Parkinson's disease exists, but according to Piazza, if taken early, certain drugs can improve some of the disease's symptoms and even reduce the likelihood of death, making early diagnosis important. Some people also believe that changes in nutrition and other lifestyle factors can modify the progression of the disease. The researchers attached inexpensive accelerometers to the arms of eight Parkinson's disease patients who were in the early stages of the disease - within three years of clinical diagnosis. They also attached the accelerometers to the arms of eight age- and sex-matched people who did not have the disease. The team asked the subjects to walk continuously for about eight minutes at a comfortable pace. The researchers downloaded the acceleration data and used software they developed -- that will be available free to interested doctors - to analyze it. They published their results in the current issue of Gait & Posture. The scientists found significantly higher acceleration asymmetry, lower cross-correlation between the arms and reduced synchronization of the arms in the early Parkinson's disease patients. According to Joseph Cusumano, professor of engineering science and mechanics, the lower cross-correlation and reduced synchronization suggest that the arm movements are poorly coordinated. "In other words, if I measure the location of your right arm, it is difficult to use that measurement to predict the location of your left arm," he said. "It is well known that Parkinson's disease has an impact on how people move - neurologists have been using this fact as the basis for clinical examinations for a very, very long time - but here we are for the first time precisely quantifying how the disease not only affects the relative amount of limb movements, but also how well coordinated in time these movements are." To diagnose patients with Parkinson's disease early, some doctors and scientists have proposed the use of a smell test, because people with the disease lose their ability to distinguish odors, according to Xuemei Huang, movement disorders physician, Penn State Milton S. Hershey Medical Center. "But conditions other than Parkinson's disease also can affect a person's ability to smell," she said. The Penn State team's method of evaluating arm swing can be applied quickly and inexpensively by primary care physicians in their own offices when the smell test is inconclusive and before the application of an expensive brain scan. "Measuring arm swing asymmetry and coordination with our method may be the cheapest and most effective way to detect Parkinson's disease early in patients' lives when it still is possible to treat the symptoms of the disease and to improve longevity," said Piazza. The scientists plan to further investigate whether the arm swing evaluation in combination with a smell test can enhance early diagnosis even more. They also plan to further develop their technique so that the accelerometers give immediate readings, which, they said, would save the extra step of downloading the data to a computer and analyzing it, thereby making the arm swing assessments of Parkinson's disease even easier

treatment for bipolar disorder

2011-12-15T17:54:00.002+08:00

Treatment for Bipolar Disorder

If you suspect that you or someone you know are suffering from bipolar disorder, seek help right away. The earlier you catch bipolar disorder and begin treating it, the better your chances of getting and staying well. An experienced mental health professional can make sure your symptoms are caused by bipolar disorder and get you the treatment you need.
Treatment for bipolar disorder can help you live life on your own terms, without the interference of mood swings. Effective bipolar disorder treatment relieves symptoms, reduces the frequency and intensity of manic and depressive episodes, and restores your ability to function.
In This Article:
What you need to know
Diagnosis
Types of bipolar disorder
Bipolar disorder vs. depression
Exploring treatment options
Medication
Therapy
Complementary treatments
Related links
Print Authors
Text Size
Bipolar disorder treatment: What you need to know
Bipolar disorder is a lifelong condition. It runs an unpredictable course of ups and downs. When left untreated, these ups and downs can be devastating. The recurring manic and depressive episodes that characterize the disease make it difficult to lead a stable, productive life. In the manic phase, you may be hyperactive and irresponsible. In the depressive phase, it may be difficult to do anything at all. Early diagnosis and treatment can help you avoid these problems.
Successful treatment of bipolar disorder depends on a combination of factors. Medication alone is not enough. In order to get the most out of treatment, it's important to educate yourself about the illness, communicate with your doctors and therapists, have a strong support system, make healthy lifestyle choices, and stick to your treatment plan.
Recovering from bipolar disorder doesn’t happen overnight. As with the mood swings of bipolar disorder, treatment has its own ups and downs. Finding the right treatments takes time and setbacks happen. But with careful management and a commitment to getting better, you can get your symptoms under control and live fully.
What are some things I can do that might help me feel better?
Know the difference between your symptoms and your true self. Your health care providers can help you separate your true identity from your symptoms by helping you see how your illness affects your behavior. Be open about behaviors you want to change and set goals for making those changes.
Educate your family and involve them in treatment when possible. They can help you spot symptoms, track behaviors and gain perspective. They can also give encouraging feedback and help you make a plan to cope with any future crises.
Work on healthy lifestyle choices. Recovery is also about a healthy lifestyle, which includes regular sleep, healthy eating, and the avoidance of alcohol, drugs, and risky behavior.
Find the treatment that works for you. Talk to your health care provider about your medications' effects on you, especially the side effects that bother you. There are many options for you to try. It is very important to talk to your health care provider first before you make any changes to your medication or schedule.
Source: Depression and Bipolar Support Alliance
Getting an accurate diagnosis for bipolar disorder
Getting an accurate diagnosis is the first step in bipolar disorder treatment. This isn’t always easy. The mood swings of bipolar disorder can be difficult to distinguish from other problems such as major depression, ADHD, and borderline personality disorder. For many people with bipolar disorder, it takes years and numerous doctor visits before the problem is correctly identified and treated.
Making the diagnosis of bipolar disorder can be tricky even for trained professionals, so it’s best to see a psychiatrist with experience treating bipolar disorder rather than a family doctor or another type of physician. A psychiatrist specializes in mental health, and is more likely to know about the latest research and treatment options. For help finding psychiatrists, psychologists, and other mental health professionals in your community, see Resources and References below

2011-12-15T17:08:00.001+08:00

Mania, Depression, Bipolar Disorder and Parkinson Disease Copyrighted Abraham Lieberman MD 4/1/05. Revised 3/22/06 Bipolar disorder, also known as manic-depressive disorder, causes marked shifts in a person's mood, energy, and ability to function. The highs and lows of bipolar disorder, like the “on” and “offs” of Parkinson people, are different from the ups and downs of every day life. The highs and lows of bipolar disorder, like the “on” and “offs” of PD people can result in strained personal relationships, poor job performance, and even suicide. There are similarities and differences between the highs and lows of bipolar disorder, the mania and depression, and the “on” and “off” periods of PD, the periods of mobility or hyper mobility with dyskinesia. The highs and lows of bipolar disorder usually cycle over days or weeks, the “on” and “offs” of PD people cycle over hours, or minutes. The highs and lows of bipolar disorder occur in no relationship to a known drug or chemical although there is a partial relationship to daily changes in hormones including adrenal cortisol and growth hormone. The “on” and “offs” of PD occur in relationship to the dose of levodopa. There are, however, similarities betweens the highs and lows of bipolar disorder and the “on” and “offs” of PD. PD people when they are “on” are often “high”, they are alert, energetic, creative, similar to people with bipolar disorder when they are “high.” PD people when they are “off” are anxious, depressed, panicky, they will do almost anything to be “on.” In this their behavior resembles people with bipolar disorder who are “low” or “down.” Until we understand why cycling occurs in the brain, we should keep an open mind between the highs and lows of bipolar disorder and the “on” and “offs” of PD. It is of note, however, that drugs such as lithium, or depakote, or lamictal, drugs that stabilize mood in bipolar disorder do not stabilize the “on” and “offs’ of PD. More than 3 million Americans, or about 1.0% of the population, have bipolar disorder. This is 3 times the prevalence of PD. Bipolar disorder usually develops in late adolescence. However, some people develop it late in life. It is often not recognized as a disorder, and people may suffer for years before being diagnosed. Like PD, bipolar disorder is a long-term illness. In some people bipolar disorder, like the “on” and “offs” in PD distorts moods, deranges thoughts, incites bad behaviors, and causes panic. Bipolar disorder causes dramatic mood swings—from overly "high" to hopeless, and then back again, often with periods of normal mood in between. Marked changes in energy and behavior go along with the mood changes. Symptoms of mania include: Increased energy, activity, and restlessness, euphoria, irritability, racing thoughts, fast talking, distractibility, inability to concentrate, need for little sleep, unrealistic beliefs in one's abilities, poor judgment, spending sprees (like the compulsive gambling of some PD people), increased sex drive, abuse of drugs, particularly cocaine, alcohol, and sleeping pills. Symptoms include intrusive, or aggressive behavior and a denial that anything is wrong. A manic episode is diagnosed if a high occurs most of the day, every day, for 1 week or longer. Mild to moderate mania is called hypomania. Hypomania is associated with a feeling of euphoria and well being. Hypomania, however, if not suspected and treated may lead to mania or depression. Symptoms of depression include: anxiety, sadness, hopelessness, pessimism, guilt, worthlessness, helplessness, lack of interest in activities once enjoyed, decreased energy, fatigue, difficulty concentrating, difficulty in remembering, difficulty in making decisions. The person may sleep too much or be unable to sleep. There may be change in appetite and unintended weight loss or gain. There may be chronic pain or other symptoms that are not caused by a physical illness. There may be thoughts of death. A depressive episode is diagnosed if symptoms last most of the day, every day, for 2 weeks or longer. Sometimes, episodes of mania or depression include psychosis. Common psychosis symptoms include hallucinations such as hearing, seeing, or otherwise sensing the presence of things not actually there. The symptoms include delusions such as false, but strongly held beliefs not influenced by logical reasoning. The symptoms of psychosis will reflect whether the person in high, or low. For example, if a person is high he will have delusions of grandiosity, such as believing he is the President , or God, or that he has special powers or wealth. If, however, a person is low he will have delusions of guilt or worthlessness, such as believing that his is ruined or penniless or that he has committed a terrible crime. Similar symptoms of psychosis may appear in some PD people who are evolving a dementia when they are “on” or when they are “off.” Some people with bipolar disorder who have symptoms of a psychosis are incorrectly diagnosed as having schizophrenia. The moods of a person with bipolar disorder form a spectrum. At one end is severe depression, then moderate depression and then mild depression, called the "the blues." Then there is normal mood, hypomania, mania, and mania with psychosis. In some people, however, symptoms of mania and depression may occur together in a “mixed” bipolar state. Symptoms of a mixed state often include agitation, trouble sleeping, marked changes in appetite including binge eating or starvation, psychosis, and suicidal thinking. A person with a “mixed” state may be sad, feel hopeless, and at the same time feel energized. A person with bipolar disorder may be brought to a doctor because of alcohol or drug abuse, poor work performance, or strained personal relations and, initially, the underlying bipolar disorder may not be appreciated by the patient, the family, or the doctor. Like many mental disorders, bipolar disorder cannot yet be identified physically, for example, through a blood test or a brain scan. Therefore, a diagnosis of bipolar disorder is made on the basis of initial symptoms, evolution of symptoms, and family history. The diagnostic criteria for bipolar disorder are described in the Diagnostic and Statistical Manual for Mental Disorders, fourth edition (DSM-IV). Descriptions offered by people with bipolar disorder give insights into the moods associated with it. Depression: I doubt my ability to do anything well. It seems as though my mind has slowed down and burned out. I am haunted with the desperate hopelessness of it all. Others say, "It's only temporary, it will pass, you,," but they haven't any idea of how I feel, although they are certain they do. If I can't feel, move, think or care, then what on earth is the point?Hypomania: When I'm high, it's tremendous, ideas comes fast, like shooting stars. . All shyness disappears, the right words and gestures are suddenly there. Uninteresting people become interesting. Sensuality is pervasive, the desire to seduce and be seduced is irresistible. My marrow is infused with unbelievable feelings of power, well-being, omnipotence, euphoria. I can do anything!Mania: The fast ideas become too fast. They are overwhelming, confusion replaces clarity, I can’t keeping up with it—my memory goes. My friends become frightened, I’m irritable, angry, frightened, trapped. Suicide. Some people become suicidal. Anyone who thinks about committing suicide needs immediate help. Anyone who talks about suicide should be taken seriously. Symptoms that may accompany suicidal feelings include: talking about wanting to die, feeling hopeless, feeling nothing will change or get better, feeling helpless, feeling a burden, abusing alcohol or drugs, putting personal affairs ins order as a preparation to dying. Symptoms also include writing a suicide, seeking harmful or dangerous situations. If someone is suicidal, call a doctor, an emergency room, or 911 for help. Be certain the suicidal person is not left alone make. Be certain that he or she has no access to dangerous drugs or weapons. While some suicides are carefully planned, others are impulsive acts that have not been well thought out. With proper treatment, suicidal feelings can be overcome. Episodes of mania and depression occur throughout a person’s life. Between episodes, most people with bipolar disorder are free of symptoms, but as many as one-third of them have some residual symptoms. The classic form of the disorder involving recurrent episodes of mania and depression, is called Bipolar I Disorder. Some people, however, never develop

bipolar disorder symptoms

2011-12-15T11:01:00.001+08:00

Symptoms of bipolar disorder

Bipolar disorder typically develops in late adolescence or early adulthood. However, symptoms of bipolar can also manifest during childhood, and some bipolar symptoms develop late in life. Bipolar may be difficult to diagnose as an illness, and some people may suffer for years before the mental illness is properly identified and treated.
The deep mood swings of bipolar disorder may last for weeks or months. Research suggests that bipolar disorder manifests a wide range of symptoms. The main characteristics of bipolar disorder are quick changes from mania to depression and back again. The periods of highs and lows are called "episodes". Mood episodes are intense. The feelings are strong and happen along with extreme changes in behavior and energy levels. The signs and symptoms of manic episodes and depressive episodes follow.
Signs of a manic episode/ mania
Agitation
Aggressive behavior
Decreased need for sleep without fatigue
Denial that anything is wrong
Difficulty concentrating
Drug abuse (especially cocaine, alcohol, and sleeping medications)
Exaggerated optimism
Excessively "high" or euphoric mood
Extreme irritability
Impulsiveness
Increased drive to perform or achieve goals
Increased physical and mental activity and energy
Increased restlessness
Increased sexual drive
Inflated self-esteem
Poor judgment
Provocative, intrusive, or aggressive behavior
Racing thoughts jumping from one idea to another
Risky behaviors
Shopping sprees
Talking very fast
Unrealistic beliefs in one's abilities and powers
Signs of a depressive episode / depression
Chronic pain not caused by physical illness or injury
Decreased energy,
Difficulty concentrating, remembering, making decisions
Feeling fatigued or of being "slowed down"
Feelings of guilt, worthlessness, or helplessness
Feelings of hopelessness or pessimism
Indifference
Irritability, anger, worry, agitation, anxiety
Loss of energy, persistent lethargy
Loss of interest or pleasure in activities once enjoyed, including sex
Recurring thoughts of death or suicide, or suicide attempts
Restlessness
Sad, anxious, or empty mood
Significant changes in appetite
Sleeping too much, or difficulty sleeping
Social withdrawal
Weight loss or gain (unintentional)
It may be helpful to think of the various mood states in bipolar disorder as a continuous range of moods. At one end is severe depression, which is followed by moderate depression and then mild low mood. Normal or balanced mood is somewhere in the middle of the continuum, after which comes mild to moderate mania and then severe mania.
Bipolar disorder may mimic a problem other than mental illness such as alcohol or drug abuse, poor school or work performance, or strained interpersonal relationships. Such problems, in fact, may be signs of an underlying mood disorder. If you experience any symptoms of bipolar disorder, seek medical help as soon as possible. In order to understand the ins and outs of diagnosis, read the next sectiowhich describes how doctors use a bipolar test here.Read more: Bipolar Disorder Symptoms http://ehealthforum.com/health/bipolar_disorder_symptoms-e88.html#ixzz1gZJX9Ul4

what does this mean?

2011-12-14T18:19:00.001+08:00

What does this mean?

PD is movement disorder caused by the brain not producing (enough) dopamine. It is a progressive neurodegenerative disease for which there is no cure. Someday the symptoms will affect my right leg, them my left arm and leg. Other conditions will also affect my mobility. What’s next? I will be making friends with others who have YOPD. Learning from them about their experiences. Sharing my story with them too. I am not the kind of person to just stand on the sidelines watching. I am sure I will become involved with some local and regional support groups. I will be living every day like any other day pre-YOPD. Admittedly, some things I will be a little slow at. When telling a friend about this situation he said to me, with a look of disbelief on his face, “You like a good challenge. You like to be challenged. You’ll do alright”. I shall maintain a positive mental attitude. I have places to go, people to see and things to do. As with all illnesses there is always hope and advancements in medicine. We will be following the medical research world as they work towards a cure

bipolar and PD

2011-12-11T23:39:00.002+08:00

Dear Dr.Oku

,I am gone to research into bipolar and Parkinson's disorders

My experience why ARE the bipolar's medication after side effects SOME OF THE SYMPTOMS ARE pARKINSON'S DISORDERS'\Why Bipolar disorders is curable but not the Parkinson's disorders?THEY ARE THE SAME FAMILY WHY THEY ARE DIFFERENCES?kindly elaborateRegardsTEOKIMHOE
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families

#2 Dr. Okun

Advanced Member

Group: Ask the Doctor Moderators
Posts: 1,927
Joined: 19-January 07
LocationUniversity of Florida
Posted 28 September 2010 - 09:05 AM
Bipolar and PD are two completely different diseases.Interestingly some patients with bipolar can become Parkinsonian from chronic use of dopamine blocking drugs. Sometimes when in the manic phase the PD symptoms improve.Where they get confused is that they share a lot of the same brain circuitry.
Michael S. Okun, M.D.National Medical Director NPFUF Center for Movement Disorders & NeurorestorationRead More about Dr. Okun at: mdc.mbi.ufl.edu

Back to top of the page up there ^

personal stories

2011-12-03T17:46:00.000+08:00

Personal Stories
Secret recipe behind the mask
Hero TeoKuala Lumpur, Malaysia
http://www.youtube.com/watch?v=sTpu_zBvDME
I often smiled when I watched the video recording of my kick-boxing exercise which I uploaded to You Tube. My trainers and videographer told me the same thing – “You do not look like a Parkinson’s patient at all”. Even my doctor shook his head in disbelief and said, “This is shocking. I can’t imagine a 70-year-old Parkinson’s patient doing a very strenuous exercise such as kickboxing. I am sure that you are the only Parkinson’s patient in Malaysia who is doing the kickboxing exercise.”
As early as 1998, I already had both the motor and non-motor symptoms. Since my diagnosis in 2002, I went through a period of depression, anxiety, denial and anger. Subsequently, I bounced back after discovering a secret recipe for fighting Parkinson’s, which consisted of: knowledge (is power), exercise, medications, nutrition / supplements and prayer. In my quest for knowledge, I surfed various Parkinson’s websites, raining them with questions, questions and questions. I even started the first Parkinson’s blog in Malaysia (www.heroteo.com). I tried to learn everything about Parkinson’s in order to overcome all complications - the Chinese heroes won the battles by understanding their enemy first.
Animal experiments showed that exercise may be neuroprotective. Rats which were forced to exercise had a lesser degree of brain damage after they were exposed to poison. In mice which were made to undergo treadmill exercise, there was increased production of dopamine.
Parkinson’s patients are comparable to the car. The medications are needed to help patients to start walking, while fuel or battery is needed to help start the car engine. Exercise is needed to improve the patients’ physical mobility and endurance, while driving helps to recharge the battery. Thus, exercise helps our “engines” warm up before leaving home and keep the “cars” going everyday. Even healthy people such as Bruce Lee, the Chinese Kung Fu master, know that exercise is beneficial.
As such, since 2005, I decided to “get physical”. I spend 3-4 hours everyday at the California Fitness gym, doing a wide range of “heavy” exercise such as kick-boxing, weight-training and spinning (indoor cycling). Twice a week, I do yoga exercise at home with the guidance of a trainer.
Since this year, my physical condition has drastically improved. I sleep and eat well (I eat to live, and live to eat). I enjoy driving around the Kuala Lumpur city with my wife everyday and going overseas for holiday. I managed to reduce the daily dose of Parkinson’s medications recently. Sometimes, I wonder whether I am just a “normal person” behind the mask.
I know that it is technically difficult to prove that exercise has neuroprotective effect in Parkinson’s patients. Despite this, I believe that exercise has slowed down my disease progression. I hope that my video recording will bring hope and happiness to all Parkinson’s patients in this world, by reminding them that they can still live a physically active life.

2011-11-24T19:06:00.001+08:00

Famous people with eating disorders

Glossy magazines,the right angles, air-brushing and careful lighting sometimes give celebrities the image that they live in a picture-perfect, wrinkle-free, not-an-inch-more world of perfection.

The result can wreak havoc on the self-esteem of women of average proportions, who may begin to wonder if there is something seriously wrong with their physical appearances because they do not possess a size zero body, perfectly straight and white teeth, glossy sleek hair and flawless skin.

Famous personalities such as Calista Flockhart, Kate Beckingsale, Kelly Clarkson and even Princess Diana have admitted they have has eating disorders before.

The fashion industry in particular bears much of the blame for encouraging the notion that 'thin is beautiful.' As supermodel Kate Moss once famously said: "Nothing tastes as good as skinny feels."

Such obsession with weight can lead to dangerous eating disorders such as anorexia and bulimia nervosa.

The anorexia suffer consumes just 600 to 800 calories per day (the average recommended calorie intake is 1,800 to 2,000 calories), and extreme cases of complete self-starvation are known.

Anorexia, in addition to causing a host of health complications such as heart, kidney, gastro-intestinal and fertility issues, has one of the highest rates of mortality for any psychiatric condition.

Bulimia - characterised by binge eating then purging by vomiting, taking laxatives or excessive exercise - can cause cardiac arrest, infertility, dehydration and erode the teeth.

Read on to find out which celebrities suffered from eating disorders, and what it did to their bodies.

serotonin issue in PD

2011-11-13T20:22:00.003+08:00

I was looking around and trying to find some answers and put 2 and 2 together for myself- also to help make sure that Dr do not keep giving me things that will make me ill- and i began to wonder if problems with Serotonin are caused by Parkinson's or meds like Carbidopa-Levodopa?Why I ask:I have been taking Carbidopa-Levodopa basically since last March- (also take armour thyroid, and thiamine) During all of this- I have had issues with my stomach in tolerating new meds- and a lot of them haven't help much anyway(requip, comtan etc) On top of motor symptoms, this past summer depression and anxiety really increased in a way I have never experienced- so I sought help (counseling and Psychiatrist(was referred there after starting counseling- I see both- counseling once a week and psych as needed depending on med trials etc) well the psychiatrist tried Cymbalta, could not tolerate it and made me feel jittery, then Remeron (OMG I felt wound up and shaky and just freaked out), the he was going to have me start ZOloft- I am glad I did NOT! right before I was to start they had me take zolfran for my stomach issues- it helped but made me again feel wound up and after 4 days I had what I thought was a panic attack but I had a panic attack before and this was nothing like that in some ways- it felt different- for 8 hours my pulse was up near 150 and my BP spiked, i couldnt stop moving, kept holding my breath feeling like I had to yawn over and over, (this started only a few hours after a dose of the zolfran - at the ER the kept saying it was the zolfran, flushed fluids and gave ativan- went home with xanax- My PCP said she also felt it was the zolfran and that the neuro on call should not have given to me for this reason- she did not think it was a panic attack but a reaction to the medication and she documented it as such (based on her knowledge of ME over the last few years before all of this- the ER reports- and my current history etc) the xanax is the only med I have take since all of this that has helped my anxiety(they come on like rushes but just feelings of anxiousness and shaking etc that I cannot control- NOTHING like I went through on the zolfran)- I only had 10 tabs and took them only as needed after the first 2 days- it lasted me like 3 weeks- i can take half of one to reduce the anxiety 'rush' and increase in tremors and it calms it down- My counselor still felt I could benefit from something for the anxiety- even if it were just AS NEEDED- but I am very nervous about trying other meds bcause of these past reactions- then by accident I came across information on Serotonin syndrome- not saying I HAD this- but looking over the symptoms, a LOT of them were spot on to what happened the day I had to goto the ER- and these things happened to a lesser extent with the SSRI, SNRI, and Zolfran and I felt better with Xanax-all fit also to the Serotonin syndrome info- all of those meds can cause it and xanax can help calm it- it may not actually be serotonin syndrome but it made me wonder even more if there was more to my reactions- something pointing to elevated serotonin already that would cause my body to react that way with these meds- I did see some info online about serotonin levels possibly being effected by Levodopa or Parkinson's itself- but most info was very vague.- I am not sure I want to try anymore drugs in tht effect serotonin just incase- but I really wonder if this is part of the whole parkinson's and/or Carbidopa-Levodopa situation or if it could point to something else? The more I know the more informed I can be when they present a new treatment medication or if there were a way to test any of this out or if it is all in theory? Hope this made sense- and sorry if this has been covered elsewhere on the forum and I missed itany information you may be able to provide would be helpful and could point me in the correct direction possibly in understanding it allThank you for your time!
0

l
Group: Ask the Doctor Moderators
Posts: 1,865
Joined: 19-January 07
LocationUniversity of Florida
Posted Yesterday, 08:28 AM
Thank you for the question. You certainly have some of the symptoms of serotonin syndrome, but when we see it it is usually mixing medications together (like an antidepressant and a pain med like meperidine). Based on your description it sounds more like adverse events to the actual medication itself-- and also associated anxiety.Some of my patients with PD have very severe anxiety. We often try plain sinemet given frequently in a sufficient dose to help anxiety and avoid wearing off. This helps sometimes, and in severe cases patients may have to take meds every 2 hours. If this doesn't help, then we suspect a generalized or other type of anxiety disorder. In these cases it is very helpful to have a psychiatrist and also regular counseling. Some patients have a lot of medication sensitivity. For nausea we like to add a powerful medicine called domperidone.Anxiety in PD is very difficult to treat and we continue to search for better approaches.
Michael S. Okun, M.D.National Medical Director NPFUF Center for Movement Disorders & NeurorestorationRead More about Dr. Okun at: mdc.mbi.ufl.edu
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my story

2011-11-03T21:10:00.000+08:00

19.10東方家庭報導：黃美慧攝影：徐慧美圖說：20111010hhmC031 張金和在網絡上創辦了“帕金森病分享部落格”，引起了廣泛關注，同時也寫了一本抗病自傳- “Hero Teo”。圖說：20111010hhmC033 儘管患上帕金森，張金和堅持每年出國旅遊，探訪長居國外的兒子和媳婦，與太太攜伴周遊列國，打開視野。圖說：20111010hhmC023 李雅妹一力擔起照顧丈夫的責任，同時也必須兼顧健康，不讓自己倒下。一路走來，確實不容易。圖說：20111010hhmC030 由於張金和大量涉獵帕金森症的知識，幾乎成了一名自學成才的帕金森症專家。平日閒來無事，上網寫部落格就是他的愛好。圖說：20111010hhmC012 張金和被帕金森折磨了6年是很不幸，但他有一位賢惠勤勞、堅強勇敢、富有家庭責任感的好太太李雅妹。引言：他的人生並沒有因為晚年與帕金森搏鬥而變得暗淡，反而在逆境中站了起來。 70旬的張金和提倡的是：做個快樂的帕金森老人。導語：他的生活變慢了，所有東西也都要放慢速度，慢慢地說話、慢僈地吃東西、慢慢地走路……張金和被帕金森症折磨了好幾年，從中對人生有了另一番的詮釋與透徹。他說，他要活得更快樂。主文：憑著一股韌勁，張金和一邊抑制病情的蔓延速度，一邊籌劃起自己的晚年生活。他的家不僅請人裝置了一部私人電梯，還為往後的日子打算，買下了一張“私家”病床。書櫃擺滿了一大堆來自國內外的治療書籍；住家的每一面牆上，也貼滿了數十張小紙條，時刻提醒自己一些重要的大小事。就連日常的生活作息，張金和也有了周全的安排。私人健身教練和治療專人會依時上門授課和進行物理治療。儘管手腳不聽使喚，在專人的訓練下，他可以紮起馬步，甚至進行簡單的運動。每天一、兩個小時，歇一會兒，再繼續運動，一日復一日。說起效果，他也是喜上眉梢，因為上完課後，精神抖擻。經過幾年的堅持鍛煉，他的帕金森症狀得以控制。豁達的他，不斷地以積極且正面的心態，面對晚年逆境。說起帕金森病因和症狀，張金和頭頭是道，擺起半個醫生的架子。積極樂觀的態度，不得不讓人刮目相看。就連主治醫生也大讚他的毅力，更借助他對抗病魔的故事，勉勵其他病友。除了學會認識這病症的可怕，這頑強的老人還學會了與他人分享自身的遭遇，激勵同樣患上帕金森的病友。為了不與社會脫節，他開始學起電腦來，在網上創辦了「帕金森病患分享」的論壇，分享對抗帕金森的心得。他的網站成功引起了社會的廣泛關注。他說：「我希望所設立的網站可協助帕金森病友更加瞭解自己的病因，並知道社會沒有忘記我們。」「現在，我的生活過得很充實。雖然不能完全像一個正常人那樣生活，但一直都在儘自己的最大努力，目的是協助同樣患上帕金森的朋友，獻上最衷心的祝福與支持。」如今，只要搜獲新的醫藥資訊或個案，他都會把相關資訊放上論壇。「除了自己的論壇，我也經常到其他相關的帕金森網站與論壇，與他人分享自身的經驗與見解。」張金和積極地透露。所以，說張金和是個非常積極知命的老人，一點也不誇張。副文：當習慣了快節奏的步伐，突然要慢下來，是需要一段時間的適應。於2005年前，張金和是一名快樂、日子過得悠閒健康的退休老人。退休生活規律的他，經常保持健康的生活態度，過著悠閒日子。與妻兒一家幾口的日子，亦過得安逸幸福。意想不到的不幸，悄悄地降臨他的晚年生活。隨著醫生的一紙宣判他患上了帕金森症後，從此改變了他的人生軌跡。還記得初見張金和，難以相信他是帕金森病患。動作俐落、思路清晰的他，魄力不輸常人。再見到張金和，已是相隔3年後的事。張金和依然是一副樂天知命的老樣子，他的病情明顯加重，難以自持。儘管精神不錯，但行動吃力。過程中，張金和用標準但是不算清晰的話語，說出了自己患上帕金森的來龍去脈。一直陪伴在旁的太太李雅妹豎起大拇指說：“你看，他能記住這些就很好了！” 張金和的手腳因為帕金森綜合症不停顫抖。當他說要去如廁，李雅妹在旁扶著他進出，稍後，她又扶著丈夫回來，小心翼翼的。“習慣了，這幾年都是這樣。”李雅妹坐著但不閒著，她繼續用小面巾為丈夫抹汗。有時候，丈夫陰晴不定的脾氣，讓李雅妹深感無奈，但她從沒想過放棄，繼續留守在丈夫身邊。“碰到他心情不好、發脾氣的時候，我都盡量忍讓。畢竟，我知道他根本無法控制突來的情緒。”李雅妹不感委屈，每當丈夫鬧情緒時，她不出聲，待丈夫情緒稍微緩和，她才走開。副文：當習慣了快節奏的步伐，突然要慢下來，是需要一段時間的適應。於2005年前，張金和是一名快樂、日子過得悠閒健康的退休老人。退休生活規律的他，經常保持健康的生活態度，過著悠閒日子。與妻兒一家幾口的日子，亦過得安逸幸福。意想不到的不幸，悄悄地降臨他的晚年生活。隨著醫生的一紙宣判他患上了帕金森症後，從此改變了他的人生軌跡。還記得初見張金和，難以相信他是帕金森病患。動作俐落、思路清晰的他，魄力不輸常人。再見到張金和，已是相隔3年後的事。張金和依然是一副樂天知命的老樣子，他的病情明顯加重，難以自持。儘管精神不錯，但行動吃力。過程中，張金和用標準但是不算清晰的話語，說出了自己患上帕金森的來龍去脈。一直陪伴在旁的太太李雅妹豎起大拇指說：“你看，他能記住這些就很好了！” 張金和的手腳因為帕金森綜合症不停顫抖。當他說要去如廁，李雅妹在旁扶著他進出，稍後，她又扶著丈夫回來，小心翼翼的。“習慣了，這幾年都是這樣。”李雅妹坐著但不閒著，她繼續用小面巾為丈夫抹汗。有時候，丈夫陰晴不定的脾氣，讓李雅妹深感無奈，但她從沒想過放棄，繼續留守在丈夫身邊。“碰到他心情不好、發脾氣的時候，我都盡量忍讓。畢竟，我知道他根本無法控制突來的情緒。”李雅妹不感委屈，每當丈夫鬧情緒時，她不出聲，待丈夫情緒稍微緩和，她才走開。

retirement

2011-10-16T21:52:00.002+08:00

RETIREMENT is perhaps one of the most significant of life events. It brings
on a new role which is often difficult to accept. Retirees are often treated
lightly and made to feel unwanted or worthless.
Perhaps the biggest impact is felt by people who have occupied senior
positions in the civil service or in the private sector. Senior civil servants
are often pampered by underlings. A simple thing as a sudden withdrawal of a
personal driver just a day after retirement can unsettle the newly retired.
The maxim "people only respect the chair you sit on" often rings true.
Financial challenges, loneliness, loss of status and plain idleness can lead
to depression, or what is commonly known as post retirement blues. This is seen
more in men. It is said that women handle retirement better than men because
women also look after children and do household chores despite being career
minded.
Our own Tan Sri Rafidah Aziz admitted that even at the height of her career
as a cabinet minister, she used to try to rush home and cook for her family.
That probably explains why she is all smiles these days!

YOGA AND SCIENCE

2011-10-07T19:09:00.003+08:00

Yoga is a science and science does not require arguments to stay alive.Yoga will exist as long as the sun shines and air is still in the atmosphere.

We do not need to classify yoga as belonging to a certain sect,religion, country,race or spirituality. It is a standalone science . a science of mind body balance and an advanced mind development tool.

Yoga is and can only be known by practise, it is too abstract to be known by philosophical discussions, debates,study of the yoga tests, worship of gurus,nor by intellectual

yoga

2011-10-04T18:27:00.000+08:00

By Anusha K.

IT takes lots of practice to reap the benefits of hatha yoga. Like any other form of exercise, discipline is also required.

Many people today have bloating and constipation problems attributed to over-eating and lack of fibre respectively.

"Yoga can be performed even by those with medical problems," says P. Manisekaran, president of Malaysian Yoga Society And Malaysian Association Of Yoga Instructors.

"Yoga does not require much physical strength or energy. Those who are fasting, semi-fasting or just out of the hospital after a surgery can perform the postures. The best part is that the practice of yoga and its benefits are best attained when done on an empty stomach."

One doesn't strain certain body parts because of the low-impact postures.

"But once a person experiences a faster heart beat, it's best to stop and relax," says Manisekaran, who's had 15 years of experience in practising and teaching yoga.

Manisekaran recommends certain poses beneficial to the digestive system. In addition to these postures, one should eat more vegetables and fruit.

monitoring

2011-10-04T18:12:00.001+08:00

Monitoring

Most medicines have side effects and they can be minimised by taking certain measures, eg eating prior to taking a medicine to reduce abdominal upset, avoiding alcohol, etc. It is advisable to ask the doctor or pharmacist about these measures.

You should also know what to do when side effects are experienced and when to inform the doctor.

When taking a medicine, you should be aware of how you feel and whether there are any bodily changes. If there are any changes, it is advisable to write it down so that you can remember to inform the doctor, pharmacist or nurse.

You should also know when an improvement will be felt and when the next appointment with the doctor is.

understanding depression

2011-10-03T21:18:00.000+08:00

Understanding depression

We all feel sad from time to time. But when this sadness never seems to fade away, it might be a symptom of depression. Knowing how to spot depression can help protect you and your loved ones. With early detection, you can beat the blues.

What is depression?
Depression is more than feeling down or being sad. Depression may affect your work, interest in activities and quality of life. It is not a sign of weakness and it does not just 'go away'. Depression can happen to anyone.

Depression is a medical condition that affects how you think and behave, and the way you feel and function. It is one of the most common mental health problems and is faced by over 121 million people worldwide. In Singapore, an estimated 5.6 per cent of the population are affected by depression during their lifetime.

» Learn more about myths and common misconceptions about depression

How to recognise depression
Depression is different from normal sadness as it interferes with your day-to-day life making it hard for you to work, rest and have fun. People with depression experience five (5) or more of the following symptoms almost every day, for two weeks or longer:

Persistent sadness or emptiness
Loss of interest in all or almost all activities
Decrease or increase in appetite; unintentional weight loss or gain
Difficulty in sleeping or sleeping excessively
Restlessness or feeling agitated
Fatigue and lacking in energy
Difficulty concentrating or having trouble thinking and making decisions
Frequent thoughts of death or suicide
Feelings of worthlessness or excessive guilt
» Take our quiz to find out if you may be experiencing symptoms of depression

Risk factors for depression
Challenging life events can increase your risk of depression especially when you find it difficult to cope with them. Some of the life stressors that can increase the risk of depression may include:

Relationship problems
Financial difficulties
Physical illnesses
Unemployment
Lack of support
Loss of a loved one

Symptoms of Alzheimer's

2011-09-29T16:56:00.001+08:00

Symptoms of Alzheimer's

Alzheimer's disease can affect different people in different ways, but the most common symptom pattern begins with difficulty in remembering new information. This is because disruption of brain cell function usually begins in regions involved in forming new memories.

As damage spreads, individuals experience other difficulties. The following are some warning signs of Alzheimer's:

Progressive memory loss, especially forgetting recently learned information
Behavioural, mood and personality changes
Difficulty finding the right words and performing familiar tasks
Misplacing things or putting them in unusual places, like milk in the bathroom
Problems with abstract thinking, loss of initiative and poor judgment
Getting lost in familiar surroundings, and disorientation
Previous << >> Next

testimonal

2011-09-28T13:48:00.001+08:00

My name is Michele Holderby, and I refused to let Parkinson's disease control my life.

I was diagnosed with Parkinson's at 45 years old. I cried all the way home. As a physical therapist, I knew what to expect from having worked with Parkinson's patients.

But I am pretty optimistic, so I was able get on with my life. I found the Parkinson's part I could live with. The worst was the dystonia. My arms would go up, and my head would arch back. It is really painful. It stretches and pulls at your muscles, and you can't do anything about it. It was stealing my life away.

Allow yourself to cry... but don't stay there.

So I went to the University of Florida Center for Movement Disorders & Neurorestoration in Gainesville, an NPF Center of Excellence, where I met Dr. Okun and Dr. Foote. Dr. Okun said they could help me, and I almost burst into tears.

In 2009, I underwent one deep brain stimulation (DBS) surgery, followed by a second outpatient surgery to install the battery pack in my chest. As soon as they started to test my limbs during the first surgery, I started giggling because I was so happy — they were moving my limbs and there was no stiffness! It was amazing. The difference between my life then and now is night and day.

If you have Parkinson's, you need to educate yourself. Know how to communicate with your healthcare team so you can help manage your own health. Keep hoping — there is always hope for a cure. Allow yourself to cry because it makes you feel better sometimes just to get that all out. But don't stay there and feel sorry for yourself, continue. It is a battle.

Parkinson's may be part of your life, but it doesn't have to take over your life.

Thanks to the generous support of friends like you, the National Parkinson Foundation can continue its life-changing work.

Sincerely,

Michele Holderby

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PD isn't the end of your life

2011-09-23T22:07:00.002+08:00

PD isn’t the end of your life. It can be the start of a new life. If you use the power of positive thought, you can change your life for the better. I’m a better, more caring person now. Think about what you can do, not what you can’t doI think there's still a need for better information for people with Parkinson's disease, at all stages of their illness. Greater public awareness about Parkinson's is also needed, so that people understand that the disease does not just affect the elderly and isn't just about wheelchairs and disability

for people w1th parkinson's

2011-08-02T20:23:00.001+08:00

For People With Parkinson's

The words “you have Parkinson’s” have changed your life. For some of you, it is fresh, raw and startling news—often poorly told. Others may have grown more accustomed over the years. Some of you have loving support of friends and family. Others may feel very alone. For everyone who hears those words, life is forever changed.
Parkinson’s is an extremely individual syndrome. And you have a great deal of power to decide how your life will unfold. Yes, it is still possible to live your best life. The information on these pages is intended to arm you with knowledge, understanding, and power. This portal will help you take an active role in educating yourself and give you the tools to live to the fullest with Parkinson's.

PD 101: Read more to understand the symptoms, diagnosis, treatment and how to live well with the disease.

PD Library: Gain access to a comprehensive listing of articles, checklists, books, DVDs, videos, webcasts and web sites to help you learn more about PD.

Local Resources: Search for a health care professional, center, chapter or support group in your area.

Discussion Forums: Get connected with professionals and other people diagnosed with PD.

Personal Stories: Learn how others continue to live well with this experience.

On the Blog: Stay up-to-date with the latest in PD research, "What's Hot in PD?"

Clinical Trials: Interested in participating in a PD research study

2011-07-30T07:33:00.000+08:00

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I survived DBS...
created by Kindle July 25, 2011

Tags for this topic: Deep brain stimulation (DBS) (3)
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Add to My Favorites Saving... Jul 25, 2011 06:44PM Kindle
First Symptom: 10/08
KindleSex: F Data Quality: 0 stars Parkinson's: 2 yrs Hoehn-Yahr 1 Type: Parkinson's disease On Mouth/throat: none Arms: mild Chest: none Legs: none

68 posts , 37 helpful marks I just did Unilateral Thalamic DBS one week ago, and wanted to share my experience with anyone who is interested. I have never been diagnosed with Parkinson's disease, although the doctors are always quick to tell me I may have it "some day". I had a severe tremor on my right side (leg and arm), and muscle contractions on my right side.

DBS was first scheduled for July 6, at UVA (University of Virginia) which is 3 hours from here. My husband and I left at 2 the day before to drive over there, and as soon as I got in the car I called to the neurosurgery department because I wanted confirmation that they had gotten preauthorization for the surgical procedure. (Previously they had only told me they would call me if it was denied or there was a problem - in other words, no news is good news. I'm an accountant, and I wanted to hear the words that it had been authorized.) I was told it wasn't authorized yet, but they were working on it and it should be fine, so we just kept going. Three hours and three phone calls later as we pulled into the parking lot of our hotel, they called and said they had to cancel the surgery because the insurance company hadn't gotten back in time. AGGHHH! It's hard enough to get yourself emotionally prepared for this! Needless to say my husband and I were very frustrated, ended up staying the night in the hotel since we had to pay for it anyway, and came back home the next day.

As soon as I got home, I called my insurance company, and at 11:00 they said, "it's authorized!" When I asked them when, they said at 9:00 that morning. I wanted to strangle somebody.

Moral of this story: MAKE SURE YOUR INSURANCE COMPANY HAS AUTHORIZED THE PROCEDURE IN ADVANCE!!!

The consolation prize was that the neurosurgeon said he would install both the electrode and the neurostimulator in one surgery, and my surgery was rescheduled for July 18.

So on July 17, we are on the road again...I was told nothing to eat or drink after midnight...I could drink water only up until 3:30, and had to be at the hospital at 5:30.

We were there on time, and were quickly taken up to the surgical floor. For the next hour I did a combination of changing into a hospital gown, having an IV started, vitals taken, and everyone on the surgical team stopping by to introduce themselves, to make sure I was the correct patient, to confirm what was being done to me, to confirm I hadn't had anything to eat and drink...

Somewhere around 6:30-7:00, I got wheeled into the room where the stereodactic frame was so they could install that. I had 4 shots of lidocaine on my head, and then it was literally screwed onto my head. Honestly, I didn't feel a thing other than the shots. And in April I had just completed 12 weeks of treatment for myfascial pain dysfunction (trigger spots), and so I quickly got over my fear of needles from that. The injections in the head didn't even phase me. My doctor told me that putting the frame on was probably the most painful part of the procedure.

Then it was downstairs for a CT scan with the frame on. I read somewhere previously that that was so they could get gps readings of your brain to find the best angle to put the electrodes in. Then it was one more stop back to my room to say goodbye to my husband, and it was off to surgery.

Now I was not anesthetized at all except for local anesthetic, except for the very end when they tunnel the wires and install the neurotransmitter. So I could hear all the conversation in the room, and my neurosurgeon was very good at narrating what was happening. I knew when they shaved the area, did the incision, could hear the suction thing running, and (this was where I almost lost it) WHEN THE DRILLING WAS HAPPENING! That part just about did me in. It sounded like a jackhammer was going against my head! It was so LOUD!! I was holding the anesthesiologist's hand on my left side, and the Medtronics rep on the right, and I'm sure they were very happy when I finally relaxed. I heard the anesthesiologist say, "her blood pressure is rising! Do you want me to give her a beta blocker?" To which the neurosurgeon said no, he was almost finished.

I felt absolutely nothingwhen they put the electrodes in-not pressure, nothing! I didn't even know they had done it until the three surgeons were standing in front of me (1 attending and 2 residents) waiting for the programmer to do his thing. Now, before I tell you about the next part, let me tell you about my symptoms. I had a very severe right sided tremor. My medication (sinemet/klonapin) were only good for at the most 5-6 hours, and even with that I still had tremor, just somewhat reduced. I always have had muscle contractions on the right side - primarily my right shoulder blade. That problem resulted in myfascial pain dysfunction-severe shoulder pain from trigger spots. I had just finished 12 weeks of treatment for that. The 2nd week in June my right foot started turning in severely so that I couldn't walk on it in the mornings until I had taken my first sinemet. That was happening almost every day. So I had bought a set of crutches just to get around in the morning. I'm an accountant, and had reduced my work hours to 5-6 a day (the amount of time I could get out of the sinemet), but I was very borderline disabled. If this procedure didn't work for me, I was going to have to call it quits.

So my doctor nodded to the programmer, who "turned me on!" (I still think that's a funny expression!) And, within seconds, my tremor stopped. Completely. Unbelievably. I just couldn't believe it. Everything relaxed - all the muscles on my right side. I cried - I was totally overwhelmed emotionally. You spend a lot of emotional energy wondering: is this it? Is this as good as it gets? And trying to prepare yourself for the worst. I was never worried about the procedure - I was worried about the outcome. I couldn't bring myself to believe this was reallly going to work for me. (Maybe for everyone else, but not me!) I did the infamous spiral, and it was nice and smooth! I could write like you write on the blackboard. I was OK again. Then they turned me off.

From the time they wheeled me into surgery to that point was only 1 hour. Soon after that they put me under to finish the rest.

I woke up in the post-anesthesia care unit, and was there for several hours before getting taken to an actual room (not ICU, just a normal room). I had compression units on both legs to make sure my blood kept circulating. I was given heparin, an antiobiotic to fight off any staff infection, and I can't remember the rest. I was very tired that day, into the next. I had an MRI that night which was very uncomfortable, and the next morning my doctor told me no swelling, bleeding, and that the electrodes had good placement. My surgeon told within a week I would feel perfectly fine and could do anything I wanted within reason. When I asked about work, he told me to wait for the turn on for that one.

I was discharged the next day, and felt every bump on the three hour trip from the hospital to my house.

By day 4, I just felt a mild discomfort where the neurotransmitter was installed. By day 5, I felt perfectly fine.

Just from the surgery, my symptoms have been greatly reduced. I understand this is the "honeymoon period", and I'll take whatever I can get.

My turn on date is August 2 - can't wait.

The neurotransmitter is an Activa PC. It's bigger than I thought it would be, and it does stick up from your chest a little. I also notice the weight, but I'm pretty small (5'4", 118 lbs.) The only problem I've had post-surgery is I feel something pushing against my throat on my left side (the side the neurotransmitter was installed), which affects my swallowing and speech. It could be drainage, swelling, or something else. I will ask the surgeon when we visit next.

Let me mention...my head was not shaved. They just did a little bit of shaving in the same area as my natural part. I've only been home a week, and anyone who has seen me since then who didn't know I had gone through the procedure didn't even notice. But, I will comment, the goop they put on your hair for the surgery makes your fair feel like straw! Then you can't wash your hair for so many days. Definitely a challenge if you have any length at all!

That's all I can think of for now. I've gotten a lot out of reading other people's stories, and wanted to give back if I could.

9 | Mark this post as helpful ..Jul 26, 2011 12:26AM vigwig
First Symptom: 04/98
Dx: 07/98
vigwigSex: M Data Quality: 0 stars Parkinson's: 13 yrs Hoehn-Yahr 3 Type: Parkinson's disease On Mouth/throat: mild Arms: mild Chest: mild Legs: mild

1861 posts , 1159 helpful marks Kindle,
I am amazed at your recall of everything. It was so good of you to write down as much as you did. I remember the sign-in desk, or counter, and the people there, the friendly faces, the nurse who got me ready with thrombosis hose and gown, IV and all that. Then being wheeled out to be parked in the hall alone for awhile like a railroad car on a siding. Then two nurses who came around to survey what they were going to shave and me asking them to "take a little off the sides," knowing that Dr Simpson would cut it all off when I asked him that beforehand and him saying that turning people out with half a haircut wasn't his style. I considered it part of the stuff you put up with to get the operation done without any complications. Then the anesthesiologist and me confirming that Dr Simpson's first name wasn't Homer. There was a lady who came and said was it alright if she observed because she was with the manufacturer (I have an ANS unit) and I referred to her as a government agent. It was a scary thing to go through. I had an old-fashioned halo that was screwed to my head. The drilling WAS like a jack-hammer and at one point I asked him if there was any "thing" left he could give me as a souvenir and his reply that there was nothing to save.

There was also a nurse holding my hand and relaying info between patient and surgeon. I asked for her to come back and holdmy hand wen she left for awhile; I was in need of childish reassurance. Then I conked out and came to in the recovery room. After some jocularity on my part with whoever would listen to my jokes, they finally found me a place in NICU (no, not the neonatal one) and I was allowed to have my mp3 player and about 1 a.m. they made me turn it off because my singing along with my oldies was not well received. I went home later the second day.

I came back in 14 days to have the second stage done. It hurt afterwards while the first one didn't. I went home the same day as I went in for the second one. I was programmed in December, the whole operational thing taking 5 or 6 weeks. I was a poster child for DBS. Still am.

Have had the batteries and wiring replaced once already. The conventional wisdom is ANS batteries wear out kind of fast. And you can break those wires. Enough already.
Vic

4 | Mark this post as helpful ..Jul 26, 2011 08:54AM Kindle
First Symptom: 10/08
KindleSex: F Data Quality: 0 stars Parkinson's: 2 yrs Hoehn-Yahr 1 Type: Parkinson's disease On Mouth/throat: none Arms: mild Chest: none Legs: none

68 posts , 37 helpful marks It sounds like you recalled quite a bit also! (Are you sure that hand holding thing didn't have a side motive?!)

I was much more sore from the neurostimulator that from what they did to my head. My head just had a dull headache for a couple of days, and then it was fine. And really, the neurostimulator was really sore for only 3 days, which is nothing to complain about. The 4th day was just mild discomfort.

So far so good. If I can get this pressure on my throat addressed, I'll be good to go.

1 | Mark this post as helpful ..Jul 26, 2011 08:54AM Kindle
First Symptom: 10/08
KindleSex: F Data Quality: 0 stars Parkinson's: 2 yrs Hoehn-Yahr 1 Type: Parkinson's disease On Mouth/throat: none Arms: mild Chest: none Legs: none

68 posts , 37 helpful marks I forgot to mention a weird thing that happened the night I was in the hospital. I had the surgery in the morning, and about 5:00 pm I started hearing a ticking sound (like a clock ticking). I looked around the hospital room trying to figure out where it was coming from, and asked my husband if he heard it (he didn't). Eventually I figured out it was coming from my head! I talked to the nurse about it a couple of times, and she talked to the neurosurgery resident, who said it was nothing to worry about. I saw my doctor in the morning, and he said it was from loss if cerebral spinal fluid, and said it refreshes within a day. And, I didn't hear it again. So I guess he was right.

Mark this post as helpful

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this post was last edited by Kindle on Jul 28, 2011 04:09PM
..Jul 26, 2011 09:28AM Mdgirl51
member since Nov 2008
Mdgirl51Data Quality: 0 stars Sex: Female Age: 53 Condition: Quality of Life:
Social: Unreported Mental: Unreported Physical: Unreported I am: None
Caregiver

266 posts , 163 helpful marks YAY!!!!!!!!!!!!! So happy you survived the DBS!!!!! I've been thinking about you and am so pleased with your outcome! I pray to God every day that Jeff will have great results when he gets his approval, if it ever happens. They are giving us the run around and Jeff just steadily declines...SO HAPPY FOR YOU KINDLE!!!!!

1 | Mark this post as helpful ..Jul 26, 2011 09:46AM HarleyNutz
First Symptom: 02/94
Dx: 01/95
HarleyNutzSex: F Data Quality: 2 stars Parkinson's: 17 yrs Hoehn-Yahr 2 Type: Parkinson's disease On Mouth/throat: none Arms: none Chest: none Legs: mild

628 posts , 759 helpful marks Kindle -- GREAT NEWS! Your description of the process and experience was EXACTLY like mine with one exception -- I was sedated enough during the drilling that I remember nothing about that part, which I was thankful for since I've heard that's the worst part. Your detailed description will be very helpful to those who are considering DBS but are concerned about the process. Good luck with your programming!

Lori

1 | Mark this post as helpful ..Jul 26, 2011 09:50AM amh612
First Symptom: 04/10
Dx: 09/10
amh612Sex: M Data Quality: 0 stars Parkinson's: 1 yr Hoehn-Yahr 3 Type: Parkinsonism (unknown cause) Mouth/throat: none Arms: mild Chest: none Legs: mild

10 posts , 8 helpful marks Most of the patients on this forum report really good results from DBS, which is encouraging. However, my neurologist has told me horror stories about some Parkinson's patients who've had the procedure. Incidentally, were you able to drive before the DBS?

1 | Mark this post as helpful ..Jul 26, 2011 04:32PM fowki
First Symptom: 01/98
Dx: 05/06
fowkiSex: F Data Quality: 0 stars Parkinson's: 13 yrs Hoehn-Yahr 3 Type: Parkinson's disease Mouth/throat: none Arms: moderate Chest: none Legs: mild

25 posts , 15 helpful marks I, too, survived DBS. It has been a lttle over a year (06/22/2010) and I am 100% DRUG FREE!!! I tell everyone that it is nothing short of a miracle.

I had a very similar experience, except that I was under when they placed the frame, and was brought out in the O.R. I tell people that the drilling was like having a giant MixMaster in my head. I never realized just how much the skull muffles sound, until I had that done!

I also got "turned on" in the O.R. and it was a very emotional moment for me too! I begged to be left "on", but, alas, no one would cooperate with that request....

I had both procedures on the same day, so they put me back under to implant the IPG. That was really the only pain I had, the IPG surgical site. I didn't expect it to be so big, even though I had seen one of the units at a symposium. Now I can "see" it under the skin, but my daughters have both told me that looking at me front-on, if they didn't know to look for it, they wouldn't notice it.

I was in the hospital just overnight. Less time for brain surgery, than for my Aunt's knee replacment!

I was going for programming every two months, but this time I have gone four months! My next appointment is the first week of August. The worst part of programming is when they turn the settings almost "off"....I am amazed that I ever lived "like that"!

There needs to be DBS support groups where those who are pending DBS can talk to those of who have survived it....the good and the bad experiences.

5 | Mark this post as helpful ..Jul 26, 2011 08:21PM Mintex
First Symptom: 06/05
Dx: 12/08
MintexSex: M Data Quality: 2 stars Parkinson's: 6 yrs Hoehn-Yahr 3 Type: Parkinson's disease On Mouth/throat: mild Arms: mild Chest: mild Legs: mild

851 posts , 1245 helpful marks Great news Kindle!

Steve

Mark this post as helpful ..Jul 26, 2011 11:29PM blader44
First Symptom: 12/06
Dx: 03/07
blader44Sex: M Data Quality: 3 stars Parkinson's: 4 yrs Hoehn-Yahr 2 Type: Parkinsonism (unknown cause) On Mouth/throat: none Arms: mild Chest: none Legs: none

503 posts , 502 helpful marks Now Methodist Medical Center in Brooklyn now has DBS surgery.

Maybe some local candidates may not have to travel far out-of-town

for the procedure. I personally am not ready for it, but for someone

it may be a useful thought.

Blader

Mark this post as helpful ..Jul 27, 2011 01:00PM rgduncan
First Symptom: 02/09
Dx: 07/09
rgduncanSex: M Data Quality: 2 stars Parkinson's: 2 yrs Hoehn-Yahr 1 Type: Parkinson's disease Off Mouth/throat: none Arms: mild Chest: none Legs: none

100 posts , 104 helpful marks Thanks for recording your DBS experiences kindle. I expect to "go there" some day and your account was very helpful.

Richard

1 | Mark this post as helpful ..Jul 28, 2011 04:16PM Kindle
First Symptom: 10/08
KindleSex: F Data Quality: 0 stars Parkinson's: 2 yrs Hoehn-Yahr 1 Type: Parkinson's disease On Mouth/throat: none Arms: mild Chest: none Legs: none

68 posts , 37 helpful marks AMH612-I could drive, but my right leg tremor was getting so bad I started driving with my left leg! (I don't recall that being illegal!) I really didn't feel comfortable doing that, but I was still trying to work and had to get back and forth. Anytime my husband and I were together he drove.

No one has told me I can't drive since the surgery either. I've just been cautious, and didn't drive until yesterday (day 10).

MDGIRL - Keep praying and I will for you also. The wait can be agonizing.

Thanks to everyone else for the good wishes...

Mark this post as helpful ..Jul 28, 2011 06:57PM Mdgirl51
member since Nov 2008
Mdgirl51Data Quality: 0 stars Sex: Female Age: 53 Condition: Quality of Life:
Social: Unreported Mental: Unreported Physical: Unreported I am: None
Caregiver

266 posts , 163 helpful marks AMH612...I can't understand why your neurologist would tell you horror stories about dbs. Yes, any surgery has it's risks but man, I have met sooo many people who have said it's "life changing". Jeff and I can't wait for the day to arrive, it could be as early as 6 months!!!! His neuro suggested it, even said he should have done it yrs ago........

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defination a Cure

2011-04-01T09:20:00.001+08:00

A cure is usually when the disease has been completely eradicated from an individual patient.

Symptomatic therapy is when a therapy helps improve individual symptoms.

Disease modification is when a therapy improves the course or slows the course of the disease.

Hope that helps.

Michael S. Okun, M.D.

anxiety and parkinson's

2011-03-20T09:07:00.001+08:00

Anxiety is a very common non-motor symptom of PD. It was one of my first non-motor symptoms 20 years ago, before I was officially diagnosed with PD 3 years ago. I treated my anxiety with an anti-depressant after many years of struggling with it and thinking I could over-come it on my own. I have taken Paxil for many years and although most people think of it as an anti-depressant - SSRI drugs such as Paxil are "a fix" for anxiety as my doctor explained to me - not just a temporary band-aid like Xanax would be (Xanax is also very addictive and not a good drug to take everyday unless prescribed by your doctor). Paxil was so effective at relieving my severe anxiety that I expect I will be on it for many, many more years.

If your doctor does prescribe an anti-depressant for you, start out with a super low dosage to avoid any uncomfortable side effects in the beginning. I started with a 10 mg tablet (not capsule) that I cut in half for a 5 mg dose and took that for the first week or so and then upped it to 10 mg for the next week and then very slowly upped it to the dose my physician prescribed for me. This way I avoided all side effects, which can be very disturbing for a week or so, if you start on a higher dose.

That was my experience. Hopefully it will be helpful for you.

Lexie

2011-03-05T18:14:00.000+08:00

Subject: Living With Parkinson's Disease: Understanding and Managing Low Blood Pressure

Date: 10/25/2006

Most people think of PD as shaky hands (tremor), stiffness (bradykinesia), slow movements (bradykinesia), and trouble with balance or walking (postural instability). However, PD can also lead to many other challenges. These include constipation, trouble with controlling or emptying the bladder, difficulty swallowing, excessive sweating, sexual difficulties, and control of blood pressure. All of these problems—known as nonmotor symptoms—are related to a part of the nervous system called the autonomic nervous system. This article focuses on problems with blood pressure that is too low when you stand up or sit up after lying down, called orthostatic hypotension. Future articles will address other nonmotor symptoms of PD.

What is blood pressure?
Blood pressure is the force created by your blood against the walls of the blood vessels that carry blood away from your heart. When healthcare professionals check your blood pressure, they usually record two numbers in the form of XXX/XX, for example, 137 over 75. These numbers represent the pressure when your heart is squeezing and pumping the blood through your body (systolic blood pressure) over the pressure when your heart is at rest between beats (diastolic blood pressure). Your blood pressure should ideally be less than 120/80, but not too low. To get an accurate reading, your blood pressure should be checked about five minutes after you lie down, when you're sitting, when you first stand up, and about one to two minutes after you stand up.

Your blood pressure depends upon many different things, including
* How well your regulatory system and autonomic nervous system are working
* Air temperature
* Whether you have been drinking enough fluids
* Whether you are standing, sitting, or lying down
* How long you've been sitting or lying down

What is orthostatic hypotension and what causes it?
Because of gravity, your blood tends to pool in the veins of your legs when you stand up. Your body responds to this pooling by increasing your heart rate and squeezing or constricting the blood vessels to send the blood to your brain and other vital organs. If you have orthostatic hypotension, something interferes with your body's response. Instead of increasing, your blood pressure falls 20 or more points when you stand up or when you sit up after lying down. Another problem in people with PD is a similar fall in blood pressure that occurs soon after you eat a large meal. This is called postprandial hypotension.

Some people have a combination of high blood pressure when they are lying down and low blood pressure when they are standing up. This type of problem is particularly difficult to treat. You will need to work closely with your doctor to find ways to regulate your blood pressure if you have this problem.

A number of things can cause orthostatic hypotension in people with PD. These include underlying problems with the autononmic nervous system and side effects of medicines used to treat PD.

How can orthostatic hypotension be treated in someone with PD?
People who have orthostatic hypotension and PD should keep in mind some simple points:
* Drink plenty of water.
* Eat five or six small meals throughout the day rather than two or three large meals.
* Use more salt on your food (check with your doctor before doing this if you have the combination of orthostatic hypotension and high blood pressure when lying down).
* Wear thigh-high compression stockings that gently squeeze your legs to prevent the pooling of blood in your legs.
* Don't sit with your legs crossed.
* Stand up slowly after you have been sitting.
* Sit up slowly after you have been lying down, and sit on the side of the bed for a few minutes before standing to let your body adjust to the new position.
* Use blocks to raise the head of your bed about 10 to 20 degrees.

If necessary, there are also medicines that the doctor can order for you to raise your blood pressure. If you find that you are having problems with dizziness, lightheadedness, or even fainting, make sure that you discuss this with your doctor. Working together, communicating about orthostatic hypotension, and finding solutions will help you have a better quality of life with PD.

The Autonomic Nervous System
The autonomic nervous system (ANS) is the part of the nervous system that controls the involuntary functions of your body. These functions, which happen without you thinking about them or "making them happen," include heart rate, breathing, blood pressure, the breakdown of the food that you eat (digestion), and others. Although you're not often aware of it, the ANS is constantly regulating glands and muscles through the release or uptake of chemicals that control the messages that nerve cells use to communicate with each other.

The ANS is made up of three parts: the sympathetic, parasympathetic, and enteric systems. The sympathetic nervous system prepares your body for emergencies or times of stress. This part of the ANS is responsible for your body's "fight or flight" response when you are faced with a dangerous situation. During this response, your heart rate and blood pressure increase, the pupils of your eyes get bigger, and your digestive system slows down. The parasympathetic system helps your body's functions return to normal after they have been stimulated by the sympathetic nervous system and also helps your body to fight off or respond to infections. The enteric nervous system is made up of nerve fibers that send signals to your stomach, intestines, pancreas, and gall bladder. After you eat, these nerve fibers send signals to your brain to drive more blood to this area of your body to help process or digest your food.

E-MOVE Editor: Richard Robinson, NASW, WE MOVE

Related CME Activities - Valid for AMA PRA Category 1 Credits(s)™
•A Core Curriculum in Movement Disorders: The

anxiety

2011-02-16T09:18:00.000+08:00

Anxiety, stress and fear are a normal part of life at any age. Young children can be fearful of strangers and separation from parents. Early childhood fears include animals, the dark and monsters. Older children face academic performance anxiety, social anxiety and fear of natural disasters. Young adults often feel anxious before a first date, job interview or a speech to a large audience. Anxiety can help people cope with situations by giving them energy and focus. For instance, anxiety can provide the drive to study for a final examination. Many people, however, have an anxiety level that is too high for them. Anxiety in children and adolescents often does not raise concerns because many anxious children are high achieving, quiet and compliant. Such children may not feel safe enough to express their feelings openly and, therefore, not seek help. To further complicate matters, signs of anxiety are often misinterpreted as attention problems, slow processing speed, learning disabilities or argumentative behavior. Similarly, adolescents and young adults tend to be embarassed by their anxiety symptoms and they are hesitant to ask for help

shoes for parkinson's patients

2011-02-11T08:02:00.001+08:00

There are shoes helpful for parkinson's patients:

It helps you walk upright and swing your arm whilst go jogging.

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 putting on "MBT" shoes

I am sure there are shoes besides "MBT" suitable for Parkinson's patient.

However it is individual choice.

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 choice.

2 people marked this post as helpful.

shortness of breath

2011-01-30T11:11:00.001+08:00

Shortness of breath results from a combination of chest wall rigidity and abnormal, drug-induced muscle movement.

I have gone through CT Chest and Lung XR and confirmed I have short of breath caused by Parkinson’s.

My medications daily are as follows:

9 dosages Prednisolone (Stiroid)
1 ” Nexium 40mg (gastric)

Kindly comment

Regards

TEOKIMHOE

Posted 30 December 2010 - 03:13 PM

Are you on any Parkinson medication? Parkinsons can cause the shortness of breath due to the smooth muscle contraction/spasm. If you are on any PD medication, this should help limit these issues.
Prednisone can also cause muscle cramps or pain, muscle weakness, and pain in arms, back, hips, legs, ribs, or shoulders. These issues can also exacerbate the PD symptoms or sometimes mimic them.

Best of health,
Mark R. Comes R.Ph.
“Ask The Pharmacist”
www.parkinson.org

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#3 MComes RPH
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Posted 30 December 2010 - 03:16 PM

I also wanted to let you know that you should separate nexium from yourPD Meds by a couple of hours. Any medication that can increase or decrease stomach acid acid or GI movement, can alter the absorbyion time of your PD, and other Meds, also.

Best of health,
Mark R. Comes R.Ph.
“Ask The Pharmacist”
www.parkinson.org

Tags: General |

Chronicles of PD Fighter

2011-01-04T18:56:00.000+08:00

Chronicles of PD Fighter

about myself

2011-01-02T21:23:00.001+08:00

I feel proud that I am able to write a book about parkinson's disease without any medical trainning and knowledgeable about PD.

I feel proud I joined PLM Forum for the awareness of PD and able to discuss PD with PLM forum members all over the world irrespective of colours, language, culture, education,religion,practice. We are in one family.

I feel proud I am able to contribute my experience and knowledge how I confronted with PD emotional and non emotional disorders and slow down its progression.

I do not suffer from depression by positive attitude to life. I am not alone.

1 person marked this post as helpful.

message

2010-12-24T22:56:00.001+08:00

Dear teokimhoe,

Jean and I would like to thank each and every one of you who have chosen to walk beside us on our shared journey with Parkinson’s. Your feedback is as inspiring and motivating for us as our stories are for you. It is what keeps us keepin’ on the darker days.

Your word of mouth support of pdplan4life has introduced people far and wide to our web site and the presentations we make at conferences around the country. We now have 30,000 visitors representing every state and 34 countries.

We couldn’t have achieved this success without you. As the New Year approaches, we raise our chocolate malts and toast to you and your families…

short breath muscle movement

2010-12-21T16:17:00.001+08:00

shortness of breath

2010-12-21T07:54:00.000+08:00

Dear Doctor,

Just to be informed I have shortness of breath as shown in my CT Scan. Besides I have inflammation around the lungs.

Question:

Can shortness of breath lower your normal blood pressure or vice versa?

Shortness of breath causes less oxygen,dizziness,black out,unstable on foot,"drunken crowd"

Besides steriod for inflammation are any medication more effective?

Exercise relief you for shortness of breath,depression /anxiety vice versa

Merry christmas

LOrd bless

TEOKIMHOO

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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#2 Dr. Okun

Advanced Member

Group:
Ask the Doctor Moderators Posts:
931 Joined:
19-January 07 LocationUniversity of Florida Posted Today, 11:30 AM

Please get better soon and our prayers are with you.

This is a PD only website so we will defer these questions to your general doctor.

You have asked before about shortness of breath and PD, and it can occur most commonly when wearing off PD medications.

Michael S. Okun, M.D.

Druken Crowd

2010-12-17T21:19:00.003+08:00

Druken Crowd
Posted on December 17th, 2010 by heroteo
I think I may need to clarify my situation because the actual chain of events may not be clearly stated out in my last post.

There are three separate incidents prior to my experience of “drunken crowd”. Firstly, I went under a procedure called Procedure for Prolapse and Hemorrhoids to remove my piles. After the surgery, I noticed that my level of energy and movement were affected. During the surgical procedure, I was given an injection through my spine. After my surgical procedure, I consulted my Parkinson’s physician, who then substituted Sinemet with Stalevo as stated in my previous post. The following day, I went to my physiotherapist for heat treatment to my neck and upper body, because I suffer from stiffness of the neck. A heated cloth/mask was applied to my neck region. It was after the treatment, I suffered from “drunken crowd”.

Given the clarification above, I would be very helpful for your explanation on the following :-

(a) Is Stalevo been known to have side effects, particularly on the Comptan portion of it?

(b) By applying heat treatment to my neck region, could it have affected my nerves or affected the dopamine level in my brains?

Could Procedure for Prolapse and Hemorrhoi have caused my experience of “drunken crowd”?

Best regards

Teo Kim Hoo

Posted Today, 05:03 PM

Given that you worsened after a medication change you should contact your doctor. There are many potential reasons for worsening and it could be as simple as a dose issue, but it could also be a side effect. You need an in person look by someone who knows you.

Michael S. Okun, M.D.

Dear Doctor,

Just to be informed I have shortness of breath as shown in my CT Scan. Besides I have excess inflammation around the lungs.

stalevo

2010-12-14T07:47:00.000+08:00

Recently my sinemet CR was substituted by my doctor with Stalevo 100gm.

My medication are Requip 4mg, sinement regular 4 , Stalevo 100 X 4 and 5 mg Jumax daily.I started with 1/2 Stalevo 100 three times daily and later was increased to 4 X 100mg on the third day.
.
I started "Druken Crowd" on the fourth days as I was light-headed,short of breath and unable to move steadily or stand up with my foot alone.

Luckly my wife was behind to support me by putting me in the moving trolley chair.

Questions:

Is it overdose?
Is Stalevo suitable for me?
Is it side effect on Stalevo and entacapone?

Kindly elaborate

Regard

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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#2 Dr. Okun

Advanced Member

Group:
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904 Joined:
19-January 07 LocationUniversity of Florida Posted Today, 12:56 PM

Hard to say. Could be under-dosed, overdosed, or just that you don't do well with Comtan. You and your neurologist will need to carefully sort this out. Good luck.

Michael S. Okun, M.D.

Not a" going *away disease

2010-11-21T09:47:00.000+08:00

Parkinson's is a chronical neurogical illness i.e. not a going away" disease.

PD patients are different from what we define themself as "patient" i.e only during acute, self-limited illness or injury that temporarily impact their lives as an inconvenience or comfort.

The major functions of muscles are to produce movements of the body, to maintain the position of the body against the force of gravity,to produce movements of structures inside the body, and to alter pressures or tensions of structures in the body.

The symptoms of muscles disorders are as follows:

'1. Bradykinesia i.e. slowness of movement

2. Resting tremor i.e shaking,either one or both side

3. Rigidity i.e. marked stiffness

4.Decreased arm wing on one or both side

5. Problems with walking and balance i.e. freezing being unable to initiate a step forward

6. Small, cramped handwriting

7. Masked face ie. reduced facial expression

8. Low voice i.e not clear

Therefore PD patients have to choose an exercises that gets their muscles moving i.e stretching, in order to overcome the muscles stiffness, rigidity and slow movement.

A physiotherapy, doctor or personal trainer my be consulted as how to start on an exercise routine that encourages flexibilty, improves stamina and helps to maintain balance.

There is some evidence that tai chi and yoga help maintain flexibility and improve posture.

stoop posture

2010-11-21T09:43:00.000+08:00

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.

low blood pressure

2010-11-21T09:33:00.001+08:00

I am taking Lavodopa,Carbidopa and dopamin agonist for two year Close monitoring is required for people with certain medical condition. After I have a minor stroke (T.I.A) recently, I experience two different blood pressure i.e. decreased blood pressure when rising from a seated position or lie-down on bed after lengths of times. I feel dizziness on standing,headache or fainting. My mouth run dry and thirsty Insomnia, anxiey, and fatigue, malaise..

I usually have 145/76 normal blood level for the past two years .
Recently I have low blood pressure which is below 100/60 standing after rising up from sitting or lie-down on bed.

It causes me feeling dizzness, and vision blurring.
I understand the syndromes can vary from person to person

Normal blood pressure is regulated by specific reflexes in the nervous system. Parkinson's disease can impair this reflex mechanism and result in lowered blood pressure.Low blood pressure usually presents itself as side-effect of anti parkinson's medications. Levodopa -carbidopa, dopamine agonists and other antidepressions and sleeping medications may potentiate a hypotensive event

2010-11-18T17:54:00.000+08:00

The shy dragger disease and shy dragger syndrome is a very rare disorder that greatly affects the control of the body’s automatic nervous system, which controls one’s blood pressure, vision bowel, heart rate and bladder functions.

The Shy Drager disease has a lot many features are same as Parkinson’s disease like slowness, muscle rigidity and poor balance. The disease Shy Drager symptoms also include very low blood pressure, dizziness and feeling very lightheaded. However, some individuals also have very high blood pressure when lying down. As the disease moves forward and progresses, other symptoms like bladder incontinence, slurred speech, constipation, having difficulty in swallowing anything and also not able to control emotions are also visible.

The Shy Drager disease normally occurs in people aged in the 50s and is more seen in men than women.

The reason why the disorder develops is still not known but the brain scan shows generalized shrinkage of the brain which controls the automated nervous system of a human’s body. No cause has yet been found.

The main difference between Shy dragger and Parkinson is the low blood pressure, which is the key to diagnosis.

Sky Drager is treated with medications which would increase blood pressure and other anti Parkinson drugs is also used. Also other treatment includes pacemaker to control slow heart rate, incontinence care and feeding tubes.

Majority of the individuals do not respond to drugs and the disease continues. A lot many people rapidly become disabled and have poor prognosis. Print | Post comment

Parkinson’s Disease: Top 5 Symptoms

2010-11-17T21:50:00.002+08:00

Parkinson’s Disease: Top 5 Symptoms
Tuesday, 16 Nov 2010 03:55 PM Article Font Size

Around five million people around the world suffer from Parkinson’s disease. In America alone, the number is around 1 million people. The disease generally occurs in people who are around sixty or older. Some sufferers can lead an extended and productive life while others degenerate more quickly.

The most fundamental of Parkinson’s disease symptoms affects both voluntary and involuntary functions and begins on one side of the body. The symptoms may be mild and subtle at first, and then gain momentum, turning aggressive and fully manifested. The top five symptoms to watch out for are:

1. Tremors. Tremors extend themselves to multiple body parts including the hands, fingers, jaws, legs, feet, head, and neck. The states of these tremors vary according to the level of stress or excitement that the person is under. They disappear with voluntary movement and sleep.

2. Stiffness. The second most well-known symptom of Parkinson’s is rigidity or stiffness of the limbs and trunk, increasing with the individual’s movement and locomotion. The stiffness can give rise to muscle pain and muscle cramps. The restriction of fine and relaxed muscle movements can prevent normal functioning like handwriting (micrographia) and eating

3. Slow movements. This symptom of Parkinson’s disease is also known as Bradykinesia. The individual, with the progression of the disease, finds it difficult to begin a particular motion and conclude the same movement. This symptom of Parkinson’s can also cause a lack of facial expression.

4. Instability. This affects the posture of individuals. They may have impaired reflexes and cannot remain balanced in one fixed position. The "Parkinson’s gait" is a distinctive walk in a shuffling and stooped manner.

5. Secondary symptoms. The most common secondary symptoms of Parkinson's are constipation, difficulty in swallowing, and depression. Additional Parkinson’s disease symptoms include excessive sweating and excessive salivation. Dementia, or loss of intellectual capabilities, occurs in the last stage of the disease’s progression.

secret recipe behind the mask

2010-11-16T20:09:00.006+08:00

I often smiled as I watched the video recording of my kick-boxing exercise which I have uploaded to YouTube a few weeks ago. My trainers and videographer told me the same thing – “You do not look like a Parkinson’s patient at all”. Even my doctor shook his head in disbelief and said, “This is shocking. I can’t imagine a 70-year-old Parkinson’s patient doing such a strenuous exercise such as kickboxing. I am sure that you are the only Parkinson’s patient in Malaysia who is doing the kickboxing exercise.” As early as 1998, I already had both the motor and non-motor symptoms. Since my diagnosis in 2002, I went through a period of depression, anxiety, denial and anger. Subsequently, I bounced back after discovering a secret recipe for fighting Parkinson’s, which consisted of: knowledge (is power), exercise, medications, nutrition / supplements and prayer. In my quest for knowledge, I browsed various Parkinson’s websites, raining them with questions, questions and questions. I even started the first Parkinson’s blog in Malaysia (www.heroteo.com). I tried to learn everything about Parkinson’s in order to overcome all complications - the Chinese heroes won their battles by understanding their enemies first. . Animal experiments showed that exercises may be neuroprotective. Rats which were forced to exercise had a lesser degree of brain damage after they were exposed to poison. In mice which were made to undergo treadmill exercises, there was increased production of dopamine. Parkinson’s patients are comparable to the car. The medications are needed to help patients to start walking, while fuel or battery is needed to help start the car engine. Exercises are needed to improve the patients’ physical mobility and endurance, while driving helps to recharge the battery. Thus, exercises help our “engines” warm up before leaving home and keep the “cars” going everyday. Even healthy people such as Bruce Lee, the Chinese kungfu master, know that exercises are beneficial. As such, since 2005, I decided to “get physical”. I am spending 3-4 hours everyday at the California Fitness gym, doing a wide range of “heavy” exercises such as kick-boxing, weight-training and spinning (indoor cycling). Twice a week, I do yoga exercises at home with the guidance of a trainer. Since this year, my physical condition has drastically improved. I sleep and eat well (I eat to live a healthy and good life). I enjoy driving around the Kuala Lumpur city with my wife everyday and going overseas for holiday. I managed to reduce the daily dose of Parkinson’s medications recently. Sometimes, I wonder whether I am just a “normal person” I know that it is technically difficult to prove that exercise has neuroprotective effect in Parkinson’s patients. Despite this, I believe that exercise has slowed down my disease progression. I hope that my video recording will bring hope and happiness to all Parkinson’s patients in this world, by reminding them that they can still live a physically active life. Mr. Hero Teo, Kuala Lumpur

low blood pressure affected your lifestyle

2010-11-13T19:17:00.002+08:00

The consensus definition is a drop of > 20 mm Hg systolic, 10 mm Hg diastolic, or both.

I have low blood pressure caused by side effect of parkinson's medication and insomina drugs.

The medication of requip and Jumax are the one that causes me with low blood pressure

The symptoms are dizziness on standing up and expereince a fall sitting on the floor, faintness, light-headedness, confusion or blurred vision occur within seconds to a few minutes of standing.

The low blood pressure affected my lifestyle and make me changes

Standing up slowly rather than quickly, as the delay can give the blood vessels more time to constrict properly. This can help avoid incidents of syncope (fainting).

Take a deep breath and flex your abdominal muscles while rising to maintain blood and oxygen in the brain.Maintaining a proper fluid intake to prevent the effects of dehydration.

As eating lowers blood pressure, take your food in a larger number of smaller meals. Take extra care when standing after eating.
When orthostatic hypotension is caused by hypovolemia due to medications, the disorder may be reversed by adjusting the dosage or by discontinuing the medication.
When the condition is caused by prolonged bed rest, improvement may occur by sitting up with increasing frequency each day. In some cases, physical counterpressure such as elastic hose (stockings) or whole-body inflatable suits may be required.
Many people who experience orthostatic hypotension are able to recognise the symptoms and quickly adopt a "squat position" to avoid falling during an episode. This is because they are usually unable to co-ordinate a return to sitting in a chair, once the episode has commenced.
Avoiding bodily positions that impede blood flow, such as sitting with knees up to chest or crossing legs.

2 people marked this post as helpful.

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DBS

2010-11-09T19:36:00.000+08:00

DBS is only suitable for late stage of pD as all the available source to slow down the disease unsuccessful and the canditate by choice of medical team to receive the DBS. The canditate who receives the treatment has to take life risks during the surgery and does not guarantee the PD recovery to normal. He has to continue to take medication and do battery service and maintance by doctor and have to replace every three years

Is parkinson's not the end? End stage of parkinson''s disease

2010-11-07T10:17:00.002+08:00

Is parkinson's not the end?
End Stage of Parkinson's Disease

At the beginning of the Parkinson's disease, the symptoms are mild but as it progresses towards the end stages the symptoms become more severe. In the first stages slight tremors, forgetfulness and fatigue is observed. As the disease progresses to its next stages, the symptoms like loss of balance, rigidity (Muscle stiffness) and walking problems are observed. These symptoms are often noticeable to family members or friends. In the next stages, the people find so much problem in balancing themselves that they gradually fall. A change in handwriting and speech is also observed.

In the fourth and fifth stages of Parkinson's disease, the symptoms become worse. By this time, the symptoms become so severe that the person is completely disabled and has to completely depend on some one else. Muscles become so stiff that the movements become slow and the person is unable to perform his daily tasks. As the disease comes to its end stage or final stage, it is developed fully.

The end stage takes over all the physical movements of a person. The person is not able to take care of himself. He is unable to walk or stand and is restricted to chair or bed. They lose their urinary and bowel control and can't even turn around by themselves. The speech becomes very slurred. They find problems in speaking and can take long time in expressing themselves as it might take time for the thoughts to reach words.

The person with end stage of Parkinson's disease can't swallow the food due to the choking. The mouth becomes dry. Sometimes the food can even enter into the lungs, which can cause breathing problems. In some cases with the end stages of the disease a feeding tube is inserted for feeding the things. Hallucinations are also observed in some people.

Here is the brief review of all what can happen in the end stages of Parkinson's disease. End stage of Parkinson's disease may include one or more of the following symptoms:

* Progressive decline in the symptoms despite medical treatments
* Progressive weight loss
* Frequent hospitalization
* Decreased appetite
* Repeated infections
* Trouble in breathing
* Trouble in swallowing
* Decline in mental status
* Weakness
* Drowsiness
* Fatigue

At the end stages of the disease person requires a constant nursing care. The end-stage of the Parkinson's disease can lead to pneumonia, choking, severe depression, and even death. Though there is no cure for the disease, use of medication is the most common way of slowing down the progression of the disease and keeping the patient healthy

Symptoms of Parkinson's

2010-11-07T10:05:00.000+08:00

Symptoms of Parkinson's usually begin slowly, develop gradually and in no particular order.

Everyone with Parkinson's is very different and may have a different collection of symptoms and response to treatment.

The nature and severity of symptoms and the rate at which the condition progresses will also be individual. The symptoms may take years to progress.

However, since Parkinson's is a progressive condition, symptoms will worsen over
time and new ones may appear. It is difficult to estimate how quickly or slowly Parkinson's
will progress in each person. It may progress more quickly in people who are older when the
symptoms first begin.

Currently, there is no cure for Parkinson's. However, many of the motor symptoms can be
treated with medications. Medications used to treat the symptoms either replace the lost
dopamine or mimic the action of dopamine in the brain. Medications can alleviate the symptoms,
but do not slow the progression of Parkinson's. As the symptoms change, medications will need
to be adjusted.

Dizziness

2010-11-06T18:55:00.000+08:00

Dizziness, lightheadedness, and the feeling of passing out is a common complaint in patients who have low blood pressure.

When the blood pressure is too low, not enough oxygen-rich blood is being delivered to the brain, and its function can be affected. It lead you a fall. you have to learn how to monitor standing up, sitting on and lie down

Anemia (decreased red blood cell count)

Bleeding

Dehydration (loss of water in the body) often occurs with infections that cause vomiting and diarrhea. Fever also can cause a significant amount of water loss due to increased metabolic rate and excessive sweating as the body tries to cool itself.

Heat-related illnesses associated with dehydration such as heat cramps, heat exhaustion, or heat stroke (a medical emergency).

.

My experience with mild seizures

2010-11-06T18:51:00.000+08:00

I have been diagnosed as suffering from fluctuations in my blood pressure (BP). I have taken the Upright Tilt Test, and the results confirm that my BP fluctuates depending on the various positions I am in. As a result, my physician has prescribed Minirin to me to stablelize my BP.

Recently, owing to my stress due to personal issues and also the effect of Minirin, my BP shot up to 210/50. I vomitted and felt dizzy, and was subsequently hospitalized for observations. During my stay at the hospital, I also fell. It was discovered that the sodium level in my blood was very low. That apparently led to my dizziness and possibly blackout, which in turn led to my fall. I was given sodium solution through intravenous injection to increase my blood sodium level. I was subsequently discharged.

Subsequent to my discharge, my physician changed the dosage of my medication for both Parkinson's Disease (PD) and also the medication to maintain my BP. Minirin was substituted with Florinef. As far as PD is concerned, prior to my hospitalization, my daily dosage was Requip (6 mg), Sinemet 25/100 (6 tablets) and Jumax (50 mg). Both Requip and Jumax was stopped. I was asked by my physician to only take Sinemet 25/100 (6 tablets) daily to contain the progression of PD.

I subsequently experienced mild seizures, whereby I cannot move my hands and legs for perhaps a time span of 5 to 10 minutes. I would be frozen, so as to speak. This seizure episodes would take place nearly once everyday. It must be stressed that I didn't suffer from any seizure prior to the change in the dosage of my medication

check on the causes of your dizziness

2010-11-06T08:33:00.000+08:00

Check on your Dizziness Causes

Dizziness may be caused or attributed by a wide variety of things. Some of the causes of dizziness require immediate medical attention. Examples of causes of dizziness include:

high blood pressure,
low blood pressure,
heart diseases or conditions (for example heart attack, arrhythmia,
strokes,
tumors,
headaches,
fainting,
dementia,
medication (for example, high blood pressure medications, sedatives, tranquilizers, antidepressants, pain relievers, certain antibiotics, and diuretics),
metabolic disorders (hypoxia, hypoglycemia, dehydration,
effects of aging,
internal bleeding,
anemia,
prolonged bed rest,
infections,
endocrine diseases (thyroid or pituitary gland),
depression,
anxiety,
panic disorders,
hyperventilation, and
somatization.

orthostatic hypotension

2010-11-05T18:30:00.004+08:00

compression stocking

2010-11-05T17:55:00.005+08:00

The first approach in treating orthostatic hypotension is to decrease the pooling of blood in the legs with the use of special stockings called compression stockings. These tight stockings “compress” the veins in the legs, helping to reduce swelling and increase blood flow. There now are a number of companies that make these stockings in a wide variety of sizes, and they usually can be found at stores that sell medical supplies, as well as at some pharmacies.

You should wear these stockings when you are up and about. You do not need to wear them when you are in bed. Further, it is recommend that you put the stockings on first thing in the morning while in bed and before getting up for your daily activities. It is important that you do not let the stockings bunch, gather, or roll, since this can compress the veins too much and could harm circulation. You should always watch for signs of decreased circulation, which could include discoloration of the skin, as well as pain or cramping, and numbness of the lower legs and feet.

If the stockings only provide some but not complete relief of symptoms, an abdominal binder can be used. The binder is another type of compression garment that is worn around the waist to help increase blood pressure. If these products fail to alleviate symptoms, certain drugs can be given to help increase blood volume. If you are taking these drugs, be sure to watch for signs of too much fluid in the body, such as swelling, bloating, or difficulty breathing. If these symptoms occur, call your doctor immediately

is to decrease the pooling of blood in the legs with the use of special stockings called compression stockings. These tight stockings “compress” the veins in the legs, helping to reduce swelling and increase blood flow. There now are a number of companies that make these stockings in a wide variety of sizes, and they usually can be found at stores that sell medical supplies, as well as at some pharmacies.

You should wear these stockings when you are up and about. You do not need to wear them when you are in bed. Further, it is recommend that you put the stockings on first thing in the morning while in bed and before getting up for your daily activities. It is important that you do not let the stockings bunch, gather, or roll, since this can compress the veins too much and could harm circulation. You should always watch for signs of decreased circulation, which could include discoloration of the skin, as well as pain or cramping, and numbness of the lower legs and feet.

If the stockings only provide some but not complete relief of symptoms, an abdominal binder can be used. The binder is another type of compression garment that is worn around the waist to help increase blood pressure. If these products fail to alleviate symptoms, certain drugs can be given to help increase blood volume. If you are taking these drugs, be sure to watch for signs of too much fluid in the body, such as swelling, bloating, or difficulty breathing. If these symptoms occur, call your doctor immediately

Is there a cure for parkinson's?

2010-11-05T17:46:00.001+08:00

There is no cure for Parkinson’s at present. Drugs are used to try to control symptoms of Parkinson’s. There are no perfect drugs, although there are many promising developments.

Although there is no cure for Parkinson’s disease, there is effective treatment. No treatment has been definitively shown to stop or slow disease progression, but several studies are underway. The main two treatment approaches are medical and surgical.

Regular exercise promotes a feeling of physical and mental well-being, important in the management of PD. Although exercise does not slow progression of PD symptoms it can prevent or alleviate orthopedic effects of akinesia, rigidity and flexed posture such as shoulder, hip, and back pain and has also been shown to improve some motor functions. Supervised training including cardiovascular fitness exercise, muscle stretching and strengthening, and balance training have been found to be useful in some short- and long-term studies

The main aims of drug treatments for Parkinson’s are to:

•increase the level of dopamine that reaches the brain
•stimulate the parts of the brain where dopamine works
•block the action of other chemicals that affect dopamine.
In most newly diagnosed people considerable improvements can be achieved by careful introduction of anti-parkinsonian drugs.

As Parkinson’s is a very individual condition, medication is prescribed and adapted to individual needs. Response to medication varies from person to person and not every medication will be considered suitable for everyone. It is important to discuss appropriate medication or any changes in medication with your health care professional.

It is important to also maintain a healthy lifestyle, focusing on exercise, relaxation and diet.

Maximize your bodies potential with YOGA

2010-11-05T16:18:00.002+08:00

http://www.patientslikeme.com/forum/show/83775?post_id=1237567#1237567

Govt pressured to set up Parkinson's clinic

2010-11-05T16:13:00.002+08:00

http://www.abc.net.au/news/stories/2010/10/03/3028190.htm

parkinson's,exeercise and physical speechy therapy

2010-11-05T16:06:00.001+08:00

http:/knol.google.com/k/parkinson-s-disease#Exercise_and_physical(2F)speech_therapy

I started my PD medication again?

2010-11-03T19:30:00.001+08:00

I have once stopped taking requip and sinemet when they give me vivid dream and complusive behaviour disorders
Sinemet and requip also caused me side effects with medications for acid reflex, Vit 6 and bladder by causing masked face, slurred speech,dizzines and stool with blood. I started continue my PD medication and stopped medication for other illness after my movement developing slow and tremors.

1 person marked this post as helpful

bladder and urinary difficulties

2010-11-03T08:49:00.002+08:00

http://www.zaobao.com/http://www.zaobao.com/

Gastric reflux and parkinson's

2010-11-01T19:01:00.000+08:00

Gastric reflux is one of the non-motor symptoms of PD. It can cause irritation of the vocal folds and throat and can potentially cause voice hoarseness. It is possible that a person who has reflux doesn't have any symptoms of reflux that they recognize. For example, sometimes people feel as though they "have something stuck in my throat" after swallowing. These people may even seek a swallowing evaluation which turns out to be within normal limits. The reason is that when reflux irritates the vocal folds and throat area it can give the person the sensation that there is something stuck in their throat when, in fact, there is not. Another possible symptom of reflux is frequent throat clearing.

Parkinson disease itself can cause voice changes as well including soft voice, monotone voice, and hoarseness. Frequently people with PD have bowing of the vocal folds meaning that the vocal folds don't come together completely during talking. When the vocal folds do not close completely air can leak through resulting in a breathy or hoarse sounding voice. If you have reflux and vocal fold bowing the combination of these two factors can cause changes in your voice that could potentially interfere with functional communication.

If you think that you might be experiencing symptoms of reflux or changes in your voice you should consult with your physician. Successful management of reflux is usually a combination of medication and behavioral modifications. For example, it may be recommended to stop eating several hours before going to bed at night, eating more frequent smaller meals, raising the head of your bed, or making changes in your diet. A speech-language pathologist can advise you about behavioral modifications that may help you and can also advise you about receiving behavioral voice treatment to improve your communication abilities.

Leslie Mahler

Is there a cure for parkinson's?

2010-11-01T18:51:00.000+08:00

There is no cure for Parkinson's at present. Drugs are used to try to control symptoms of Parkinson's. There are no perfect drugs, although there are many promising developments.

The main aims of drug treatments for Parkinson's are to:

increase the level of dopamine that reaches the brain
stimulate the parts of the brain where dopamine works
block the action of other chemicals that affect dopamine.
In most newly diagnosed people considerable improvements can be achieved by careful introduction of anti-parkinsonian drugs.

As Parkinson's is a very individual condition, medication is prescribed and adapted to individual needs. Response to medication varies from person to person and not every medication will be considered suitable for everyone. It is important to discuss appropriate medication or any changes in medication with your health care professional.

It is important to also maintain a healthy lifestyle, focusing on exercise, relaxation and diet.

possibility cure for parkinson's?

2010-11-01T18:48:00.000+08:00

Researchers at Iowa State University have found an essential key to possibly cure Parkinson's disease and are looking for others.

Anumantha Kanthasamy, a distinguished professor of biomedical sciences and W. Eugene and Linda R. Lloyd Endowed Chair in Neurotoxicology at the ISU College of Veterinary Medicine, has been working to understand the complex mechanisms of the disease for more than a decade and thinks he has found hope for the cure.
's disease
Parkinson's disease sufferers lack a sufficient amount of a brain chemical called dopamine.

Kanthasamy's research shows that there is specific protein that is naturally present in human brains that -- for no known reason -- kills the brain cells that make dopamine.

The cells that are being killed are the ones that produce the needed dopamine.

"We have millions of cells in our brains," said Kanthasamy, "In Parkinson's, about 10,000 of these brain cells die; no one knows why."

Kanthasamy discovered that a novel protein -- known as protein kinase-C (specifically PKCδ) - is killing the dopamine-producing cells.

Kanthasamy and his research staff discovered a compound that neutralizes the cell-killing kinase-C and allows the dopamine-producing cells to survive and function.

"With a lot of hard work, and little bit of luck, we found something important," he said. "And when you find something like this you say, 'This is great because it can be a target for developing new drugs.'"

Now, Kanthasamy's group is looking for additional compounds that also can serve to neutralize protein kinase-C. By identifying more compounds that perform the function of neutralizing kinase-C, researchers are more likely to locate one that works well and has few side effects.

This discovery is expected to provide new treatment options to stop the progression of the disease or even cure it.

The study is being funded by a Grow Iowa Values Fund grant. The goal of the grant program is to support development of technologies with commercial potential and to support the growth of companies using those technologies. Kanthasamy is working on this research with PK Biosciences Corp., an Iowa-based startup company. Funding was also provided by the National Institutes of Health.

"Once we find the compound, we need to make sure it's safe. If everything goes well, it could take about 10 years, and then we might be able to see something that will truly make a difference in the lives of people with this disorder," said Kanthasamy.

Parkinson's disease strikes around 50,000 people each year, and there are approximately 1 million people with the disease. Parkinson's sufferers include actor Michael J. Fox and former boxing champion Muhammad Ali.

As people grow older, the cells that produce dopamine naturally die, causing dopamine levels to fall gradually over time. When the levels continue to drop below 60 to 70 percent, the person will start to have Parkinson's disease symptoms, according to Kanthasamy.

"Everybody has a little Parkinson's in theory," he said. "But you can't see it until the level of dopamine gets too low."

Eliminating the symptoms of Parkinson's disease doesn't require people to be restored to 100 percent of previous dopamine levels, but only to a fraction of that.

"If you can bring dopamine up to the 40-50 percent level, you'll see a functioning, normal person," he said.

Currently, there is no cure for Parkinson's and available therapies only treat the symptoms.

Major contributing factors for getting Parkinson's disease include prolonged exposure to metals or pesticides and other environmental chemicals, according to Kanthasamy.

Symptoms of Parkinson's disease include trembling in hands, arms, legs, jaw, and face; rigidity or stiffness of the limbs and trunk; slowness of movement; and impaired balance and coordination. As these symptoms become more pronounced, patients may have difficulty walking, talking, or completing other simple tasks. Because the disease typically affects people over the age of 50, the National Institutes of Health anticipates the incidence of Parkinson's will increase as the nation's population ages.

Source: Anumantha Kanthasamy
Iowa State University

8 people marked this post as helpful.

fluctuation of blood pressure

2010-10-30T08:04:00.001+08:00

The pressure with which the blood flows in the body is known as blood pressure. Normal adult blood pressure should be 120/80 mmHg. But it fluctuates many times in a day. The lowest blood pressure can be measured when we are sleeping or in a relaxed state, but if the blood pressure goes below 90/60 mmHg then this condition can be considered as low blood pressure. Low blood pressure is also known as hypotension. There are several side effects of low blood pressure. If not taken care of on time, it may take you to dangerous consequences.

Depending upon the causes and the condition of the individuals body the side effects of low blood pressure can be mild or dangerous. Some of the causes of low blood pressure are dehydration, severe bleeding due to injury, inflammation of any organ, heart diseases, heart blockage, low pulse rate, pregnancy, etc. It may also be caused due to the drug toxicity or due to the side effects of some medication. Age can also be a factor responsible for low blood pressure. It is very important to keep an eye on these causes so as to understand the risk factor of low blood pressure.

Low Blood Pressure: Side Effects

If the blood pressure is low, the organ will not be able to get enough oxygen. This may result in many complications and life threatening consequences. Hence it becomes very important to understand the side effects of low blood pressure. Following are some of them.

Nausea
This is one of the most common signs of low pressure. As the blood flow slows down in low blood pressure, there is a deficiency of blood and oxygen in the brain. This usually results in nausea. It can be caused due to the gastrointestinal distress.

Dizziness
Low blood pressure can result in dizziness and lightheadedness. Sudden change in the posture like immediately getting up from the bed after sleeping can also cause dizziness. This condition is also known as hypotension. It is mostly seen in people above the age of 60. It can also be a result of severe dehydration.

Fainting
Low blood pressure is considered as the most common cause for fainting. Insufficient amount of blood flow and scarcity of oxygen causes fainting. Due to this the people are at a greater risk of getting injured, as they can faint whenever their blood pressure drops drastically.

Effects on Heart
As the blood flow becomes slow and there is not enough pressure for the heart to pump blood to different parts of the body, it may result in many heart diseases. It may even result in heart attacks.

Effects on Brain
Due to the low blood pressure the brain is unable to get proper blood and oxygen. This may affect the nervous system and may result in confusion, metal illness, strokes, nerve damage etc. It may also affect the functioning of other parts of the body as every part of the body receives command from the brain.

Effects on Kidney
The work of a kidney is to eliminate the toxins from our body. But low blood pressure can hinder its work and may result in toxin build up in the kidney. This may even damage the kidney and increase the toxicity in the blood.

Now that you know about various side effects of low blood pressure you may need to go for a proper check up to find out the cause behind it. If the cause behind it is diagnosed, then treatment for low blood pressure will be easy but should be immediately. As it may take a life threatening turn, you should not ignore it at all.
By Niharika Arya
Published: 10/1/2010

Blood pressure

2010-10-30T08:00:00.001+08:00

PLM reader

2010-10-27T19:59:00.001+08:00

I really liked your positive attitude about the importance of exercise in fighting PD and in keeping mobility.

Before PD I was a fitness instructor-- now, I've had to take a break and reassess my own exercise plan but I could use some help and encouragement... Maybe we can find a way to keep each other motivated.

I created a forum on an exercise and fitness website called, "Living With a Chronic Illness-- Yet Keeping Fit!" recently and would really like to see you join and post specifics on your exercise plans and struggles to keep fit. TOGETHER we can fight this disease and exercise is the one thing to show we are still in control.

Please take a moment to look at the forum and feel free to join and start submitting to discussion!!

Here's the link to forum:

http://www.realsolutionsmag.com/idealbb/forum.asp?forumID=107

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2010-10-25T19:26:00.000+08:00

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Personal Stories.Secret recipe behind the mask

Hero Teo
Kuala Lumpur, Malaysia

http://www.youtube.com/watch?v=sTpu_zBvDME

I often smiled when I watched the video recording of my kick-boxing exercise which I uploaded to You Tube. My trainers and videographer told me the same thing – “You do not look like a Parkinson’s patient at all”. Even my doctor shook his head in disbelief and said, “This is shocking. I can’t imagine a 70-year-old Parkinson’s patient doing a very strenuous exercise such as kickboxing. I am sure that you are the only Parkinson’s patient in Malaysia who is doing the kickboxing exercise.”

As early as 1998, I already had both the motor and non-motor symptoms. Since my diagnosis in 2002, I went through a period of depression, anxiety, denial and anger. Subsequently, I bounced back after discovering a secret recipe for fighting Parkinson’s, which consisted of: knowledge (is power), exercise, medications, nutrition / supplements and prayer. In my quest for knowledge, I surfed various Parkinson’s websites, raining them with questions, questions and questions. I even started the first Parkinson’s blog in Malaysia (www.heroteo.com). I tried to learn everything about Parkinson’s in order to overcome all complications - the Chinese heroes won the battles by understanding their enemy first.

Animal experiments showed that exercise may be neuroprotective. Rats which were forced to exercise had a lesser degree of brain damage after they were exposed to poison. In mice which were made to undergo treadmill exercise, there was increased production of dopamine.

Parkinson’s patients are comparable to the car. The medications are needed to help patients to start walking, while fuel or battery is needed to help start the car engine. Exercise is needed to improve the patients’ physical mobility and endurance, while driving helps to recharge the battery. Thus, exercise helps our “engines” warm up before leaving home and keep the “cars” going everyday. Even healthy people such as Bruce Lee, the Chinese Kung Fu master, know that exercise is beneficial.

As such, since 2005, I decided to “get physical”. I spend 3-4 hours everyday at the California Fitness gym, doing a wide range of “heavy” exercise such as kick-boxing, weight-training and spinning (indoor cycling). Twice a week, I do yoga exercise at home with the guidance of a trainer.

Since this year, my physical condition has drastically improved. I sleep and eat well (I eat to live, and live to eat). I enjoy driving around the Kuala Lumpur city with my wife everyday and going overseas for holiday. I managed to reduce the daily dose of Parkinson’s medications recently. Sometimes, I wonder whether I am just a “normal person” behind the mask.

I know that it is technically difficult to prove that exercise has neuroprotective effect in Parkinson’s patients. Despite this, I believe that exercise has slowed down my disease progression. I hope that my video recording will bring hope and happiness to all Parkinson’s patients in this world, by reminding them that they can still live a physically active life.

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Q & A

2010-10-25T18:40:00.002+08:00

HI! teokimhoe, at your age of 71 yrs. it is difficult for your body to cope up with the different medications for different ailments you suffer from. You need to take up a complete evaluation of your condition from different specialists like a cardiologist, neurologist, neurosurgeon, psychiatrist and a physician. Thus you need to find a hospital or a health centre which has all the above specialist, who after examining you will evaluate your present condition and then coordinate between themselves so that they offer you a treatment which takes in to perspective the pros and cons of all the drugs to be prescribed to you. PD is a progressive disease and as the age increases the neurons and the muscle groups affecting them will be increasing in number as well as size. Doctors treating you presently are doing a good job, so it will be advisable to tell them to refer you to a hospital in Los Angeles or San Francisco, that has all the specialties mentioned above. The advantage will be that the new centre can get back to your doctors as they will need the input in your case from time to time for smooth progression of your treatment. Take care.

Comment by Dr.Kokil Mathur on Mon 25, Oct 2010 08:17am: Hi Teo Kim Hoo! Yes seizure is a side effect of Zoloft and Zydis causes twitching resembling uncontrolled movements of eyes, lips, tongue, face, arms, or legs almost mimicking seizures. So this is one possibility you will need to discuss with your doctor. Dehydration, certain medications (like the ones you are taking), heart problems, untreated diabetes, and nervous system disorders can all cause postural hypotension or fluctuation of Bp with change in position. TIAs or transient ischemic attacks can also be the cause. Certain internal ear problems can also affect blood pressure monitoring by the body by not properly signaling a change in position. Blood pressure monitoring, tilt table test (this you had), EKG, heart echo, ambulatory blood pressure recording are all required to monitor the problem. Uncontrolled shaking, dizziness and a feeling like you will pass out is usually seen with Requip. This may be the reason it was stopped. Minirin causes low sodium so this was changed to Florinef. PD may not have progressed in your case but yes a proper dose adjustment is what is probably required to control symptoms. Despite proper medications PD patients often feel spasms and twitching. Talk to your treating doctor and ask for a referral for a specialist in the US. It is difficult to suggest someone on net and it is always advisable to go through proper reference so that your case can be properly discussed between the treating doctors. Please let me know if there is any thing else and do keep me posted. Take care!

compression stockings and hypontremia

2010-10-23T18:51:00.007+08:00

I have been diagnosed as suffering from fluctuations in my blood pressure (BP). I have taken the Upright Tilt Test, and the results confirm that my BP fluctuates depending on the various positions I am in.Due to my upright tilt table test conclusions

Asymptomatic through passsive tilting & given S/L GT
Postural hypotension 168/81 dropped to 91/51mmHg
Negative tilt table test

As a result, I put on compression stockings to stablelize my BP.
People who have low blood pressure may also be told by their doctors that they should make use of the compression stockings typically used to deal with varicose veins. Low blood pressure can cause a pooling of blood in the veins which may or may not lead to varicose veins. Compression stockings can reduce that problem and can help keep people with low blood pressure medically safe.

My previous blood clot (T.I.A) in the year 2008 was caused by this fluctuation in my blood.
The side effects on my parkinson's medicationn were also caused by this fluctuations in my blood i.e dizziness,lightheaded,nausea ,up and down, go and off. Some people have low blood pressure all the time. They have no symptoms and their low readings are normal for them. In other people, blood pressure drops below normal because of some event or medical condition. Some people may experience symptoms of low pressure when standing up too quickly. Low blood pressure is a problem only if it causes dizziness, fainting or in extreme cases, shockcauses dizziness, fainting extreme cases, shock.

Most normal blood pressures fall in the range of 90/60 millimeters of mercury (mm Hg) to 130/80 mm Hg. But a significant drop, even as little as 20 mm Hg, can cause problems for some people.

How Is Orthostatic Hypotension Treated?
The first approach in treating orthostatic hypotension is to decrease the pooling of blood in the legs with the use of special stockings called compression stockings. These tight stockings “compress” the veins in the legs, helping to reduce swelling and increase blood flow. There now are a number of companies that make these stockings in a wide variety of sizes, and they usually can be found at stores that sell medical supplies, as well as at some pharmacies.

You should wear these stockings when you are up and about. You do not need to wear them when you are in bed. Further, it is recommend that you put the stockings on first thing in the morning while in bed and before getting up for your daily activities. It is important that you do not let the stockings bunch, gather, or roll, since this can compress the veins too much and could harm circulation. You should always watch for signs of decreased circulation, which could include discoloration of the skin, as well as pain or cramping, and numbness of the lower legs and feet.

If the stockings only provide some but not complete relief of symptoms, an abdominal binder can be used. The binder is another type of compression garment that is worn around the waist to help increase blood pressure. If these products fail to alleviate symptoms, certain drugs can be given to help increase blood volume. If you are taking these drugs, be sure to watch for signs of too much fluid in the body, such as swelling, bloating, or difficulty breathing. If these symptoms occur, call your doctor immediately

:Some suggestions for minimizing the effects include:

Standing up slowly rather than quickly, as the delay can give the blood vessels more time to constrict properly. This can help avoid incidents of syncope (fainting).
Take a deep breath and flex your abdominal muscles while rising to maintain blood and oxygen in the brain. This, however, may be contraindicated in individuals with Stage 2 hypertension. Usually medical personnel have their patients "dangle" before rising from bed to decrease the likelihood of dizziness/falling due to orthostatic hypotension. The dangling is done by having the patient sit on the side of their bed for about a minute so they do not have the sudden dizziness.
Maintaining an elevated salt intake, through sodium supplements or electrolyte-enriched drinks. A suggested value is 10 g per day; overuse can lead to hypertension and should be avoided.
Maintaining a proper fluid intake to prevent the effects of dehydration.
As eating lowers blood pressure, take your food in a larger number of smaller meals. Take extra care when standing after eating.
When orthostatic hypotension is caused by hypovolemia due to medications, the disorder may be reversed by adjusting the dosage or by discontinuing the medication.
When the condition is caused by prolonged bed rest, improvement may occur by sitting up with increasing frequency each day. In some cases, physical counterpressure such as elastic hose (stockings) or whole-body inflatable suits may be required.
Many people who experience orthostatic hypotension are able to recognise the symptoms and quickly adopt a "squat position" to avoid falling during an episode. This is because they are usually unable to co-ordinate a return to sitting in a chair, once the episode has commenced.
Avoiding bodily positions that impede blood flow, such as sitting with knees up to chest or crossing legs.
[edit] Prognosis

--------------------------------------------------------------------------------

My story with hypontremia

2010-10-18T21:16:00.009+08:00

A wrongly prescription Minirin for hypontremia by doctor resulted my sodium at low level and have to stay for five day in the hospital I was released from hospital until my sodium level to normal level 135.

In the hospital I was inserted with sudium into my body days and night for five days and slept with sleeping pills.
.
The side effects of Minirin are vomitting, dizziness and short of breath and lowering down your normal sodium level

As the result I was instructed to stop taking requip and jumax except Sinemet regular.

Hyponatremia is the result of insufficient sodium in the body fluid that surrounds cells. Proper sodium levels are important in maintaining blood pressure and in keeping nerves and muscles functioning properly. The condition of having insufficient or low levels of sodium is called hyponatremia.
.

Common symptoms of hyponatremia include fatigue, irritability, headache, and water retention, loss of appetite, and nausea or vomiting. Other signs or symptoms of hyponatremia are mental in nature and include abnormal or confused mental status, hallucination, and possibly unconsciousness. Often times abnormal presence of mind and confusion are the first serious symptoms of hyponatremia as the brain cells cannot accommodate swelling due to the water retention that accompanies hyponatremia.

Hyponatremia is diagnosed through serum and urine testing. There is generally always an underlying cause of hyponatremia, which must also be diagnosed and treated. Insufficient sodium levels can be treated with intravenous fluids, restricted diet, and supplemental oxygen. Medications that offset some of the symptoms of hyponatremia can also be administered to restore comfort and prevent seizures.

Causes of hyponatremia include burns, dehydration due to excessive vomiting or diarrhea, congestive heart failure, as a side effect of diuretics, kidney disease and certain other diseases. Acute hyponatremia, such as a sudden reduction in sodium levels over a 24 to 48 hour period due to extreme physical exertion or dehydration, is considered more dangerous than chronic hyponatremia that can occur with certain diseases or disorders.

Praise Lord I started again my requip and Jumax without problems as they are essential to stable my foot on floor without freeze,

I am glad to start again going to gym to attend my exercises program.

Teo's experience is one we should all be aware of. He is describing one of a dozen electrolyte problems that can catch us by surprise. Not only sodium but also minerals like potassium, calcium, and magnesium - all are absolute requirements for nerves and muscles to function. The symptoms merge seamlessly with those of PD and the causes can range from medication problems to simple polyuria. In fact, if you have to pee much in the night you should not only think in terms of water loss but also mineral. Ditto if you exercise a lot. The effects can be dramatic but are easily written off as PD.

Thanks for sharing. I hope you have fully recovered and are up and running.

Kind regards/Lawrence

Hi Mr Teo,

Hope everything is well with you now. :)

Take care.
Chai HowEDear Doctor I have been diagnosed as suffering from fluctuations in my blood pressure (BP). I have taken the Upright Tilt Test, and the results confirm that my BP fluctuates depending on the various positions I am in. As a result, my physician has prescribed Minirin to me to stablelize my BP.Recently, owing to my stress due to personal issues and also the effect of Minirin, my BP shot up to 210/50. I vomitted and felt dizzy, and was subsequently hospitalized for observations. During my stay at the hospital, I also fell. It was discovered that the sodium level in my blood was very low. That apparently led to my dizziness and possibly blackout, which in turn led to my fall. I was given sodium solution through intravenous injection to increase my blood sodium level. I was subsequently discharged.Subsequent to my discharge, my physician changed the dosage of my medication for both Parkinson’s Disease (PD) and also the medication to maintain my BP. Minirin was substituted with Florinef. As far as PD is concerned, prior to my hospitalization, my daily dosage was Requip (6 mg), Sinemet 25/100 (6 tablets) and Jumax (50 mg). Both Requip and Jumax was stopped. I was asked by my physician to only take Sinemet 25/100 (6 tablets) daily to contain the progression of PD.I subsequently experienced mild seizures, whereby I cannot move my hands and legs for perhaps a time span of 5 to 10 minutes. I would be frozen, so as to speak. This seizure episodes would take place nearly once everyday. It must be stressed that I didn’t suffer from any seizure prior to the change in the dosage of my medication. My worries are as follows :- (a) Is it normal for patients suffering from PD to have episodes of seizures? Are these seizures a sign that my PD has advanced in progression? (b) Is it correct for my physician to reduce the dosages of my PD medication so significantly? And does such a reduction result in my seizure, or perhaps an advance in the progression of PD? (c) What are the causes of such seizures? For your information, I am also under treatment for Bipolar Syndrome, and I am on medication of Zoloft and Zydis. Does this medication also contribute to seizures, as a side effect? I shall be very grateful if you could revert to me on the above. I am also considering coming over to the US for continued treatment of PD and possibly Bipolar Syndrome. I shall be very grateful if you could refer some of the good physicians for consultation, preferably in Los Angeles or San Francisco. Best regards Teo Kim Hoo

PLM Post Yoga

2010-10-18T20:13:00.001+08:00

incredible! Teo, I just watched your Yoga Youtube video. How incredible! Thank you so much for the motivation. The half moon, tabletop and scale postures are really challenging. You give me hope. I added that clip to my favorites

2010-10-18T07:32:00.002+08:00

Doing facial therapy helpful to relief facial masked.

Is it helpful for slurred speech?

Is relief the facial muscle helpful people with slurred speech?

Kindly advise

TEOKIMHOE

to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families

Dr. Mahler

Advanced Member

Group:
Speech Clinician Moderators Posts:
13 Joined:
02-April 07 Posted Yesterday, 02:28 PM

There is no evidence that facial therapy helps slurred speech. That is because the movements for facial therapy are very different from those required for speech movement. If a person with PD wants to improve their understandability, then they need to engage in intensive voice and speech exercise. As one example, there is a lot of literature supporting LSVT LOUD, an intensive voice treatment that incroporates some of the principles of neural plasticity.

Communication is very important for quality of life. I recommend anyone who is wanting to learn more about therapy to help slurred speech get a prescription from their doctor for an evaluation by a speech-language pathologist familiar wtih treatment of people with PD. The neuroscience literature supports early intervention before it is hard to understand the person.

My experience with Minirin 2

2010-10-08T18:08:00.002+08:00

I had negative upright table test in Raffles Hospital Singapore

My doctor prescribes me Minirin to increase my low blood pressure

I vomitted by taking Mirnirn on the five day. I had dizzinness, tiredness and low blood pressure too.

My doctor instructed me to do MRI brain screening and heart XR again with anticipation of a second stroke as I had once T.I.A in 2008.
I have to stop taking Requip and Jumax dosages.

I have been with these medication more than 5 years.

As the result I have duminess leg and could not stable on standing up.
My sodium had gone down to 120 level.
.
I had to stay in the hospital to receive my first times compond sudium lactate Intravenous B.P Three bottles daily to increase my sodium level to normal.

Minirin
Minirin works by increasing the amount of water that is reabsorbed by your kidneys.
When it is given in higher doses, it can also raise your blood pressure.

Because the medication is causing your kidneys to reabsorb water, this can lead to your sodium levels to drop.
If your sodium levels drop too much, this can make you very ill. At sodium levels of 120, you can feel nauseated, more short of breath, dizzy, fatigued and be vomiting.

So, much of your symptoms were likely due to your low sodium, which was

There are many potential reasons for orthostasis or dizziness on standing up. Dopamine agonists and TCA antidepressants can have this as a side effect. Alternatively it could be an issue of hydration and you may need 6-8 glasses of water a day and compression stockings. Occassionally drugs like midodrine, florinef and mestinon are needed to keep the BP up._________________Michael S. Okun, M.D.
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Bipolar,disorder

2010-10-08T17:09:00.000+08:00

Dear Dr.Okun,

I have bipolar disorder resulted I have up and down blood level.

My doctor advises me to consult Psychiatrist.

I have to stop taking my PD medication Jumax and Requip;

My upright Tilt table test is 168/81 mkmHg dropped to 91/51 mmHg.

Regards

TEOKIMHOE

to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0

My experience with Minirin

2010-10-08T17:04:00.000+08:00

I have been diagnosed as suffering from fluctuations in my blood pressure (BP). I have taken the Upright Tilt Test, and the results confirm that my BP fluctuates depending on the various positions I am in. As a result, my physician has prescribed Minirin to me to stablelize my BP.

Recently, owing to my stress due to personal issues and also the effect of Minirin, my BP shot up to 210/50. I vomitted and felt dizzy, and was subsequently hospitalized for observations. During my stay at the hospital, I also fell. It was discovered that the sodium level in my blood was very low. That apparently led to my dizziness and possibly blackout, which in turn led to my fall. I was given sodium solution through intravenous injection to increase my blood sodium level. I was subsequently discharged.

Subsequent to my discharge, my physician changed the dosage of my medication for both Parkinson’s Disease (PD) and also the medication to maintain my BP. Minirin was substituted with Florinef. As far as PD is concerned, prior to my hospitalization, my daily dosage was Requip (6 mg), Sinemet 25/100 (6 tablets) and Jumax (50 mg). Both Requip and Jumax was stopped. I was asked by my physician to only take Sinemet 25/100 (6 tablets) daily to contain the progression of PD.

I subsequently experienced mild seizures, whereby I cannot move my hands and legs for perhaps a time span of 5 to 10 minutes. I would be frozen, so as to speak. This seizure episodes would take place nearly once everyday. It must be stressed that I didn’t suffer from any seizure prior to the change in the dosage of my medication.

My worries are as follows :-

(a) Is it normal for patients suffering from PD to have episodes of seizures? Are these seizures a sign that my PD has advanced in progression?
( Is it correct for my physician to reduce the dosages of my PD medication so significantly? And does such a reduction result in my seizure, or perhaps an advance in the progression of PD?
© What are the causes of such seizures?

For your information, I am also under treatment for Bipolar Syndrome, and I am on medication of Zoloft and Zydis. Does this medication also contribute to seizures, as a side effect?

I shall be very grateful if you could revert to me on the above.

I am also considering coming over to the US for continued treatment of PD and possibly Bipolar Syndrome. I shall be very grateful if you could refer some of the good physicians for consultation, preferably in Los Angeles or San Francisco.

Best regards

Teo Kim Hoo

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 answered most of these already in your previous posts, so I would ask that you look back through those posts.

There is a NPF center of excellence at UCSF in San Fran and one at USC in LA.

Good luck.

wrongly prescription Minirin

2010-10-08T16:54:00.000+08:00

Wrongly prescription minirin
Posted on October 8th, 2010 by heroteo
I have been diagnosed as suffering from fluctuations in my blood pressure (BP). I have done the Upright Tilt Table Test and the results confirmed fluctuations in my BP on various positions. My physician prescribed me Minirin to stablelize my BP. Due to my stress from personal issues and also the effect of Minirin, I discovered one day that my BP had increased to 210/50. I started vomitting and I was thereafter hospitalized for observation. It was there they discovered that the sodium level in my blood is low, and that further led to me falling. I was eventually discharged.

Upon discharged, my physician decreased my intake of Parkinson’s daily medication from Requip (6 mg), Sinemet 25/100 (6 tablets) and Jumex (10mg) to only Sinemet 25/100 (6 Tablets). Requip and Jumex has been stopped. He had also substituted Minirin to Florinef to stablelize my BP level.

Lately I have experienced mild seizures in the sense that I temporarily cannot move my legs and limbs for approximately 5 - 10 minutes duration. This has happened nearly once everyday. This could very well be due to an immediate decrease in my BP when I stand up.

However, my worries are as follows :-

(a) Whether seizures are common amongst patients suffering from PD. If yes, is it a sign of advancement of PD progression?
( What is the exact cause for such seizures to occur?
© Has my PD medication been decreased too significantly? For your information, I have never experienced seizures before the change in medication dosages.

For your further information, I am also on medication for Bipolar Syndrome, namely, Zydis 5 mg daily, Zoloft 50 mg. Does these medication also result in side effects?

I would be grateful for your input.

Best regards
Teo Kim Hoo

Teo, I will post for you. Seizures is not common in PD and seizures have a different etiology than PD

PLM reader

2010-10-08T16:15:00.001+08:00

I subscribe to your page because you seem to have the energy and the will to fight PD and I would like to be like you. I am trying to fight as you do!

Posted Oct 20, 2009 10:29PM

Minirin

2010-10-06T08:17:00.000+08:00

Minirin works by increasing the amount of water that is reabsorbed by your kidneys.
When it is given in higher doses, it can also raise your blood pressure.

Because the medication is causing your kidneys to reabsorb water, this can lead to your sodium levels to drop.
If your sodium levels drop too much, this can make you very ill. At sodium levels of 120, you can feel nauseated, more short of breath, dizzy, fatigued and be vomiting.

So, much of your symptoms were likely due to your low sodium, which was due to the minirin.

2010-10-06T07:49:00.001+08:00

Medical
Ask a Medical Question, Get an Answer AS

why Minirin caused side effects vomiting,short of heart breath,tired and sodium at abnormal level at 120

Your Expert needs more information
From Dr. Abby
Tuesday, October 05, 2010 6:52 PM EST

Hello,

First, why were you on the medication?

to increase my low blood level as there are at negative level upright and sit down. short of breath, tir

Expert

You have received an Answer!
From Dr. Abby
Tuesday, October 05, 2010 7:13 PM EST

Ok, thank you for clarifying,

Minirin works by increasing the amount of water that is reabsorbed by your kidneys.
When it is given in higher doses, it can also raise your blood pressure.

Because the medication is causing your kidneys to reabsorb water, this can lead to your sodium levels to drop.
If your sodium levels drop too much, this can make you very ill. At sodium levels of 120, you can feel nauseated, more short of breath, dizzy, fatigued and be vomiting.

So, much of your symptoms were likely due to your low sodium, which was due to the minirin.

Feel free to ask any follow up questions,

Dr Abby

defination of cure of PD

2010-10-04T19:07:00.001+08:00

The word “cure” is often used as the stated, or assumed, ultimate goal of Parkinson’s disease research. The more I think about it, the less sure I am just what constitutes a “cure” in connection to PD. A big part of the difficulty of coming up with a definition may be because it’s tough to separate effects of the disease itself, medications and the simple process of aging.

So …. can you offer a working definition of what a “cure” is in relation to PD?

Great question.

A cure is usually when the disease has been completely eradicated from an individual patient.

Symptomatic therapy is when a therapy helps improve individual symptoms.

Disease modification is when a therapy improves the course or slows the course of the disease.

Hope that helps.

Michael S. Okun, M.D.

new drug for hypotension

2010-10-04T08:29:00.001+08:00

Advanced Member

Group:
Ask the Doctor Moderators Posts:
732 Joined:
19-January 07 LocationUniversity of Florida Posted Today, 01:08 PM

Dear forum members,

Forty percent or more of PD patients suffer from orthostatic hypotension (dizziness when standing, passing out, etc.). Dr. Lowe from the Mayo clinic presented some very promising results at the World Congress for PD in Scotland last week.

There is a drug called droxidopa in trials; which is a hydroxylated form of levodopa.

Though this may be above some heads I want to mention the two mechanisms of action:

1- post-ganglionic alpha 1 receptor is stimulated on aterioles
2- there seems to be repletion of adrenergic terminals with the neurochemical norepinephrine in both the peripheral nervous system and the central nervous system

The preliminary data is yet to be released but what was presented was very promising.

Midodrine which is another drug available to treat this condition has a greater effect on the blood pressure when lying down. Droxidopa has a greater effect when standing which is potentially more clinically important to patients.

The droxidopa seems to be well tolerated.

We await to hear about the 20-25% of patients who were excluded from the studies because the drug didn't seem to be effective enough in the dose titration part of the study,

We will keep you posted as more data becomes available.

Michael S. Okun, M.D.

parkinson and blood pressure

2010-10-04T08:06:00.000+08:00

Posted: Fri Apr 18, 2008 6:13 am Post subject: Parkinson’s medication and Blood pressure

Dear Doctor, I am taking Lavodopa,Carbidopa and dopamin agonist for two year Close monitoring is required for people with certain medical condition. After I have a minor stroke (T.I.A) recently, I experience two different blood pressure i.e. decreased blood pressure when rising from a seated position or lie-down on bed after lengths of times. I feel dizziness on standing,headache or fainting My mouth run dry and thirsty Insomnia, anxiey, and fatigue, malaise Kindly elaborate Thanks TEOKIMHOE
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Sun Apr 20, 2008 7:05 pm Post subject:

There are many potential reasons for orthostasis or dizziness on standing up. Dopamine agonists and TCA antidepressants can have this as a side effect. Alternatively it could be an issue of hydration and you may need 6-8 glasses of water a day and compression stockings. Occassionally drugs like midodrine, florinef and mestinon are needed to keep the BP up._________________Michael S. Okun, M.D.
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Anonymous
Posted: Sun Apr 20, 2008 9:47 pm Post subject:

Normal blood pressure is regulated by specific reflexes in the nervous system. Parkinson’s disease can impair this reflex mechanism and result in lowered blood pressure.Low blood pressure usually presents itself as side-effect of anti parkinson’s medications. Levodopa-carbidopa, dopamine agonists and other antidepressions and sleeping medications may potentiate a hypotensive event Source: Linda P.Miller,R.N.Med Posted by Hero Teo at 10
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Anonymous
Posted: Sat Apr 26, 2008 2:16 am Post subject: dizzinness and parkinson’s medication

I am glad that your dizziness has subsided. Dizziness is a very common symptom among Parkinson’s patients. It needs extensive work-up, e.g. blood pressure, heart rhythm, blood tests (diabetes) and even brain scan. A common cause of dizziness among Parkinson’s patients is the medications for PD, which can lower the blood pressure. Commonly, I use fludrocortisone to elevate the blood pressure. Parkinson’s patients need regular blood pressure monitoring (lying position and standing). Dr Chew Nee Kong, Kuala Lumpur.
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Sun Apr 27, 2008 8:48 am Post subject:

Thanks for the nice comment._________________Michael S. Okun, M.D.

As dopamine agonists Ropinirole (Requip) can have this as a side effect (dizzinness at all time) I stop taking them i.e 6 mg Requip daily. I substitute Lavodopa 25/100 Sinemet 2 1/2 dosages with 2 dosage Jumax 5mg daily immediately.

florinef

2010-10-04T07:43:00.000+08:00

Dear Doctor, I am taking Lavodopa,Carbidopa and dopamin agonist for two year Close monitoring is required for people with certain medical condition. After I have a minor stroke (T.I.A) recently, I experience two different blood pressure i.e. decreased blood pressure when rising from a seated position or lie-down on bed after lengths of times. I feel dizziness on standing,headache or fainting My mouth run dry and thirsty Insomnia, anxiey, and fatigue, malaise Kindly elaborate Thanks TEOKIMHOE
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Sun Apr 20, 2008 7:05 pm Post subject:

There are many potential reasons for orthostasis or dizziness on standing up. Dopamine agonists and TCA antidepressants can have this as a side effect. Alternatively it could be an issue of hydration and you may need 6-8 glasses of water a day and compression stockings. Occassionally drugs like midodrine, florinef and mestinon are needed to keep the BP up._________________Michael S. Okun, M.D.
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Anonymous
Posted: Sun Apr 20, 2008 9:47 pm Post subject:

Normal blood pressure is regulated by specific reflexes in the nervous system. Parkinson's disease can impair this reflex mechanism and result in lowered blood pressure.Low blood pressure usually presents itself as side-effect of anti parkinson's medications. Levodopa-carbidopa, dopamine agonists and other antidepressions and sleeping medications may potentiate a hypotensive event Source: Linda P.Miller,R.N.Med Posted by Hero Teo at 10
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Anonymous
Posted: Sat Apr 26, 2008 2:16 am Post subject: dizzinness and parkinson's medication

I am glad that your dizziness has subsided. Dizziness is a very common symptom among Parkinson's patients. It needs extensive work-up, e.g. blood pressure, heart rhythm, blood tests (diabetes) and even brain scan. A common cause of dizziness among Parkinson's patients is the medications for PD, which can lower the blood pressure. Commonly, I use fludrocortisone to elevate the blood pressure. Parkinson's patients need regular blood pressure monitoring (lying position and standing). Dr Chew Nee Kong, Kuala Lumpur.
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Sun Apr 27, 2008 8:48 am Post subject:

Thanks for the nice comment._________________Michael S. Okun, M.D. 4/28/08 by teo Delete

Born Parkinson's

2010-10-04T07:33:00.001+08:00

I have heard of Parkinson’s Disease. I don’t understand how you get it. I was told you are born with it. Is this true and how do you know if you have it or not?
(anonymous)

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A:

At this time, we really don’t know if one is “born” with Parkinson’s disease
or becomes affected with it as he grows older. One theory suggests that some people are born with fewer dopamine-producing cells (either genetically
or that there is some problem during pregnancy - such as trauma or a virus -
which contributes to being born with fewer dopamine-producing cells). Then,
as the individual ages and naturally loses cells, this person would pass
the 80% dopaminergic neuronal loss that is needed before PD symptoms appear. Other theories suggest some sort of environmental insult causing the drop in
dopamine cells. Unfortunately, we just don’t know yet as these are theories
that must either be proven or disproven via research.

How do you know you have Parkinson’s disease? The best way is to consult a
neurologist who specializes in movement disorders. Neurology, while a
specialty itself, is split into sub-specialties. Parkinson’s disease is a
movement disorder so one who has additional training in movement
disorders, and thus sees primarily patients with such movement disorders, is the best type of physician to consult for a diagnosis.

Tags: Discussion by heroteo
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comment

2010-09-29T20:34:00.001+08:00

comment
Just want to say what a great blog you got here!
I've been around for quite a lot of time, but finally decided to show my appreciation of your work!

Thumbs up, and keep it going!

Cheers
Christian, iwspo.net

Shy-Dragers

2010-09-29T11:25:00.001+08:00

Dear Mr Teo,

I'm sure you will have a very good discussion with Dr Chew on the "Shy-Dragers" syndrome.

You are a fantastic PD patient - very resourceful to dig all the relevant medical information. Your knowledge can be as good as the medical specialist. Well done!

Take care & warm regards,
Hooi Hoon

reader PLikesME

2010-09-29T11:16:00.001+08:00

Hi Teokimhoe

I would like to congratulate you on your approach to Parkinsons. I know of no-one who has had it as long as you. Your comments are very helpful and your disciplines something to be proud of.

One thing does amaze me. You take very little in the way of Parkinson’s medication (ie Sinemet and Requip). In fact people who are only at the beginning take more than you.

I am 72 years of age and have had PD for 15 years. I wonder if you could let me know how you handle the above meds. I do see from your profile you take medication for other problems of the body, probably related to your disease.

God Bless and keep on helping - it is so necessary as professionals seem to have no compassion.

Lippard (Freda Fewtrell from New Zeland

reader PLikesME

2010-09-29T11:14:00.001+08:00

Hi Teokimhoe

I would like to congratulate you on your approach to Parkinsons. I know of no-one who has had it as long as you. Your comments are very helpful and your disciplines something to be proud of.

One thing does amaze me. You take very little in the way of Parkinson's medication (ie Sinemet and Requip). In fact people who are only at the beginning take more than you.

I am 72 years of age and have had PD for 15 years. I wonder if you could let me know how you handle the above meds. I do see from your profile you take medication for other problems of the body, probably related to your disease.

God Bless and keep on helping - it is so necessary as professionals seem to have no compassion.

Lippard (Freda Fewtrell from New Zealand)

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differences bt bipolar and PD

2010-09-29T00:55:00.000+08:00

Dear Dr.Okun,

I am gone to research into bipolar and Parkinson's disorders

My experience why ARE the bipolar's medication after side effects SOME OF
THE SYMPTOMS ARE pARKINSON'S DISORDERS'?

Why Bipolar disorders is curable but not the Parkinson's disorders?

THEY ARE THE SAME FAMILY WHY THEY ARE DIFFERENCES?

kindly elaborate

Regards

Bipolar and PD are two completely different diseases.

Interestingly some patients with bipolar can become Parkinsonian from chronic use of dopamine blocking drugs. Sometimes when in the manic phase the PD symptoms improve.

Where they get confused is that they share a lot of the same brain circuitry.

Michael S. Okun, M.D.

bipolar disorder and parkinson's

2010-09-28T19:12:00.001+08:00

IT IS STRANGE THE AFTER SIDEEFFECTS OF PD IS THE SYMPTOMS OF BIPOLAR DISORDEER MEDICATION

it's very interesting that you say that. When I was experiencing all of the crazy side effects from Requip I saw a neuro-psychiatrist. He told me I was bipolar and wanted to give me more medication and I quote him as saying, "It may make your Parkinson's much worse...". I was so lucky to meet my current neurologist who told me flat out that I needed to get off the drug. My life is normal again. Well, normal? Hmm, maybe that's the wrong word but I certainly have no side effects and that to me is just amazing.

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flunction on blood pressure level (1)

2010-09-28T07:57:00.000+08:00

Dear Doctor

I have been diagnosed as suffering from fluctuations in my blood pressure (BP). I have done the Upright Tilt Table Test and the results confirmed fluctuations in my BP on various positions. My physician prescribed me Minirin to stablelize my BP. Due to my stress from personal issues and also the effect of Minirin, I discovered one day that my BP had increased to 210/50. I started vomitting and I was thereafter hospitalized for observation. It was there they discovered that the sodium level in my blood is low, and that further led to me falling. I was eventually discharged.

Upon discharged, my physician decreased my intake of Parkinson's daily medication from Requip (6 mg), Sinemet 25/100 (6 tablets) and Jumex (10mg) to only Sinemet 25/100 (6 Tablets). Requip and Jumex has been stopped. He had also substituted Minirin to Florinef to stablelize my BP level.

Lately I have experienced mild seizures in the sense that I temporarily cannot move my legs and limbs for approximately 5 - 10 minutes duration. This has happened nearly once everyday. This could very well be due to an immediate decrease in my BP when I stand up.

However, my worries are as follows :-

(a) Whether seizures are common amongst patients suffering from PD. If yes, is it a sign of advancement of PD progression?
( What is the exact cause for such seizures to occur?
© Has my PD medication been decreased too significantly? For your information, I have never experienced seizures before the change in medication dosages.

For your further information, I am also on medication for Bipolar Syndrome, namely, Zydis 5 mg daily, Zoloft 50 mg. Does these medication also result in side effects?

I would be grateful for your input.

Best regards
Teo Kim Hoo

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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#2 Dr. Okun

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19-January 07 LocationUniversity of Florida Posted Yesterday, 03:03 PM

Teo, I will post for you. Seizures is not common in PD and seizures have a different etiology than PD.

Michael S. Okun, M.D.

flunction on blood pressure level

2010-09-28T07:54:00.000+08:00

Dear Doctor Okun,

I have been diagnosed as suffering from fluctuations in my blood pressure (BP). I have taken the Upright Tilt Test, and the results confirm that my BP fluctuates depending on the various positions I am in. As a result, my physician has prescribed Minirin to me to stablelize my BP.

Recently, owing to my stress due to personal issues and also the effect of Minirin, my BP shot up to 210/50. I vomitted and felt dizzy, and was subsequently hospitalized for observations. During my stay at the hospital, I also fell. It was discovered that the sodium level in my blood was very low. That apparently led to my dizziness and possibly blackout, which in turn led to my fall. I was given sodium solution through intravenous injection to increase my blood sodium level. I was subsequently discharged.

Subsequent to my discharge, my physician changed the dosage of my medication for both Parkinson's Disease (PD) and also the medication to maintain my BP. Minirin was substituted with Florinef. As far as PD is concerned, prior to my hospitalization, my daily dosage was Requip (6 mg), Sinemet 25/100 (6 tablets) and Jumax (50 mg). Both Requip and Jumax was stopped. I was asked by my physician to only take Sinemet 25/100 (6 tablets) daily to contain the progression of PD.

I subsequently experienced mild seizures, whereby I cannot move my hands and legs for perhaps a time span of 5 to 10 minutes. I would be frozen, so as to speak. This seizure episodes would take place nearly once everyday. It must be stressed that I didn't suffer from any seizure prior to the change in the dosage of my medication.

My worries are as follows :-

(a) Is it normal for patients suffering from PD to have episodes of seizures? Are these seizures a sign that my PD has advanced in progression?
( Is it correct for my physician to reduce the dosages of my PD medication so significantly? And does such a reduction result in my seizure, or perhaps an advance in the progression of PD?
© What are the causes of such seizures?

For your information, I am also under treatment for Bipolar Syndrome, and I am on medication of Zoloft and Zydis. Does this medication also contribute to seizures, as a side effect?

I shall be very grateful if you could revert to me on the above.

I am also considering coming over to the US for continued treatment of PD and possibly Bipolar Syndrome. I shall be very grateful if you could refer some of the good physicians for consultation, preferably in Los Angeles or San Francisco.

Best regards

Teo Kim Hoo

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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#2 Dr. Okun

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19-January 07 LocationUniversity of Florida Posted Today, 05:44 PM

I have answered most of these already in your previous posts, so I would ask that you look back through those posts.

There is a NPF center of excellence at UCSF in San Fran and one at USC in LA.

Good luck.

Michael S. Okun, M.D.

uplight tilt table test

2010-09-24T07:54:00.000+08:00

Due to my upright tilt table test conclusions

Asymptomatic through passsive tilting & given S/L GT
Postural hypotension 168/81 dropped to 91/51mmHg
Negative tilt table test

My doctor advises me to stop taking my medication Requip, Jumex due to sideeffect on me.

I have been with these medication more than 5 years.

As the result I have duminess leg and could not stable on standing up.

Besides I have low blood pressure. I have negative upright tilt table test report: postural hypotension 168/81 mmHg dropped to 91/51 mmHg

My doctor prescribed me Slow -K 600mg tablets two dosage daily.

I received first times compond sudium lactate Intravenous B.P Three bottles daily to increase my blood pressure five days stays in the hospital

i am advised to consult Psychiatrist as I have bipolar disorder due to depression and anxiety up and down and off and on days.

The bipolar disorder affecting my up and down blood pressure, not the PD medications.

Regards

TEOKIMHOE

Bipolar

2010-09-24T07:49:00.000+08:00

I was admitted because my doctor wrongly prescribed Minirin as I had a difference on my upright tilt table postural hypotension from 169/81 mmHg dropped to 91/81 mm Hg

As I had T.I.A two years back I have to do Brain MRI and x ray as my sodium dropped by 120/138 in antipation there might be a second stroke. Besides I had vomitted and dizzinness.

I have to stay at hospoital five days to push up my sodium to normal level.

My doctor advises me to consult psychiatrist that I had Bipolar disorders.

My negative blood pressure are caused by bipolar disorder where I have anxiety and depression up and down on and off days resulted mu blood level.

Therefore there are reason for stopping taking the requip and Jumax'

to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families