Monday, May 11, 2009

Requesting for your Views on Observations

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

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

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

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

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

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