If you’ve been told by your doctor, "You have Parkinson’s disease," you probably found it difficult to hear those words. Such a diagnosis can be frightening and leave you filled with questions. How will it affect your life? What are your treatment options? These authors are uniquely qualified to understand your concerns. Steven Schechter, M.D., is a neurologist who has treated thousands of patients with Parkinson's disease, and David Cram, M.D., lived with the disease himself. Among the topics they cover are: diagnosis, symptoms and stages, the emotional side of PD—conquering fear and denial, choosing the right health care team, drug therapy—medications and how they work, surgical options, deep brain stimulation, the importance of exercise, coping with day-to-day problems, and care for caregivers.
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David Cram, M.D. (1934-2009) was an internationally recognized dermatology expert who was diagnosed with Parkinson's disease in 1991. He is the author of three other books: The Healing Touch--Keeping the Doctor-Patient Relationship Alive Under Managed Care, Coping with Psoriasis, and Frequently Asked Questions about Parkinson's Disease. Steven H. Schechter, M.D., conducts a neurological private practice and is a clinical assistant professor of neurology at Wayne State University.
Acknowledgments,
Introduction,
1 A Self-Help Approach to Parkinson's Disease,
2 Parkinson's Disease: An Overview,
3 The Emotional Side of Parkinson's Disease,
4 Your Doctor as Partner,
5 Drug Treatment for Parkinson's Disease,
6 Surgery as Treatment for Parkinson's Disease,
7 The Importance of Exercise,
8 Day-to-Day Coping,
9 Caring for Caregivers,
In Conclusion,
Resources,
Glossary,
About the Authors,
A Self-Help Approach to Parkinson's Disease
If you or someone you love has been diagnosed with Parkinson's disease (PD), it is easy to feel overwhelmed or believe there is nothing you can do. After all, PD is a chronic, progressive disease for which there is presently no cure. But, there is plenty you can do to improve your life or that of someone you love.
Self-help strategies can help improve the quality of life for those with PD. Self-help strategies can't cure the disease, but they can slow its progress and reduce the severity of symptoms. In addition, many new drugs can slow the progression and eliminate many aggravating symptoms. The self-help techniques offered here can help you maintain your independence for as long as possible. Perhaps most important, they can foster a sense of well-being and serenity in your life.
What Is Self-Help?
Self-help is a positive approach to your condition that says, "I have power. I have responsibility. I can make a difference in my disease." There are four important elements of self-help:
1. Attitude
2. Knowledge
3. Partnership with your doctors
4. Taking action
Attitude
Studies have repeatedly demonstrated that attitude can significantly affect a person's health. For example, research has found that people who are chronically angry are more likely to suffer heart attacks. Our minds and bodies are connected. Although eating right, exercising, reducing stress, and getting enough rest are all important, your attitude is perhaps the most essential element of self-help.
We do not yet know how attitude affects the physical aspects of PD. For instance, we do not know whether an upbeat attitude only lessens symptoms or actually slows the progression of the disease. However, we do know that a positive attitude can improve the quality of your life. It can make you feel better. It can also enable you to take the self-help steps you need to keep feeling as well as you can for as long as you can.
Knowledge
Another essential tool of self-help is knowledge. It is important that you and your loved ones learn all you can about PD — what it is, what causes it, its symptoms, and treatment options. Stay abreast of the latest developments in research and treatment. Equipping yourselves with knowledge will reduce your fears and enable you to make the best-informed medical choices.
Partnership with Your Doctors
Self-help does not mean doing everything by and for yourself. Because you have a neurological illness, your doctors must play a major role in your care.
The old model of health care presumed that the doctor had all the power and made all the decisions concerning your medical treatment. In contrast, the self-help model acknowledges that you are an active partner with your doctors in your health care.
Self-help comes with responsibilities. For instance, your doctors must select the right medicine in the correct dosage for your symptoms. Your job is to take the right amount of medication on time, keep track of your symptoms and side effects, let the doctors know how the medication is working, and finally, report any problems you may be having with the treatment regimen.
Taking Action
Taking action means doing the things that make you feel better, slow the disability, and keep you independent for as long as possible. You can use specific self-help strategies to improve your diet, take your medications on time in the right amounts, reduce stress in your life, and get adequate rest. We will discuss each of these strategies further in the coming chapters.
By adopting a positive and upbeat attitude, equipping yourself with knowledge, partnering with your doctors, and taking action, you will give yourself the best possible chance at living better with PD.
CHAPTER 2Parkinson's Disease: An Overview
Parkinson's disease is a progressive brain disorder. Doctors often call it a disorder of the motor system, which is the nerve system that controls body movement. Parkinson's disease (PD) occurs when brain cells, or neurons, decline and cause a deficiency of the brain chemical dopamine. This chemical (one of the brain's neurotransmitters) affects the part of the brain associated with muscle control, attention, learning, and the brain's pleasure and reward system. Low dopamine levels bring about the symptoms of PD.
Major Symptoms
Symptoms vary from person to person. For example, a certain symptom may develop early in one patient but develop much later (or never) in another patient. Symptoms may come on quickly or very gradually. In fact, sometimes the symptoms can be subtle and a person won't notice them for months or longer. Symptoms may affect one or both sides of the body. Often, a symptom will start on one side of the body and become more pronounced on that side.
The list of potential symptoms listed here can be worrisome. That's why it's important to remember not every person with PD develops every symptom listed. And as noted earlier, PD symptoms vary from person to person. Further, the symptoms progress slowly from the onset and generally do not become worse suddenly.
Tremor
Trembling can affect the hands, arms, legs, jaw, and head. The classic PD tremor is a rhythmic back-and-forth movement of the thumb and forefinger, sometimes described as "pill rolling" because the tremor resembles the action of rolling a pill between the forefinger and thumb. The tremor usually begins in the hand but may also begin in the foot or jaw. About 75 percent of people with PD develop tremor; in the early stages of the disease, the tremor affects only one side of the body. The remaining 25 percent of PD patients never develop significant tremor.
Stiffness or Rigidity
For the body to move smoothly, opposing sets of muscles must alternately relax and contract. In a person with PD, muscles of the limbs and trunk may remain constantly tense and contracted. This may cause aching, stiffness, weakness, and jerky movements.
Slowness of Movement
Called bradykinesia, slowness of movement is an unpredictable and frustrating symptom of PD. Simple tasks, such as dressing, that were once performed easily, may become difficult and time consuming.
Impaired Balance and Coordination
This symptom may prevent someone with PD from performing certain motor functions, or have a stooped posture. These symptoms tend to worsen over time. Eventually, the person with PD may experience difficulty walking, talking, or completing otherwise simple tasks. A person is also at risk for falling.
Other Possible Symptoms
Depression and Emotional...
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