Information on Parkinson's?

Question

My dad was recently diagnosed with Parkinson's. I'm very worried about him and have a few questions that I'd greatly appreciate some answers to.

Some background: my dad is a white, bald, 55 year old and is somewhat overweight. Some time ago he noticed a tremor in his hand and got it checked out- we were told it was an "essential tremor" I believe, but not Parkinson's. He's been having trouble walking across the college campus he teaches at, though, and got it checked oh again- this time the diagnosis was Parkinson's, and he was prescribed medication. He diagnosis was last Wednesday.

I feel I need to know how advanced his Parkinson's is, and I'm worried he may be depressed. He says he isn't depressed, but didn't want to come to church this week "because of a cold," and doesnt want to go on a picnic my family planned for the same reason. He hasnt had any noticable cognitive loss yet, and the tremors in his hand have improved with medication intended for the essential tremor- he can still type and hand write (although writing is difficult).

How advanced is his Parkinson's? How much time will he still have a good quality of life? Could he be depressed? How would I know?

Thank you. I'm very worried.

Answer 1

You've asked a question which we can't answer easily. It's a good question and you've put forth some interesting points..



Parkinson's disease is a chronic, incurable, progressive neurodegenerative disorder which has both motor and non-motor symptoms. PD is a collection of syndromes with varying symptoms and varying rates of progression. Therefore, if your father actually has PD, it would be difficult to predict his progression.



To see the generalized progression stages, read the article and look at two of the PD rating scales in the linked article.

http://parkinsonsfocustoday.blogspot.com/2009/03/questions-about-parkinsons-disease-part_3744.html



Chris has provided some excellent information about the possibility of a misdiagnosis. Without a diagnosis by a neurologist specializing in motion disorders or sometimes just a physician who specializes in parkinsonian disorders, you father my not have received the proper diagnosis. Until the lab diagnostic tests are available, the PD diagnosis usually involves lab tests to rule out other conditions, personal medical and family medical history, symptom history, observation by the neurologist and a UPDRS (Unified Parkinson's Disease Rating Scale now revised).



While Propranolol a beta-adrenergic receptor antagonist (beta blocker) is used by some people with Parkinson's disease with about 50% success as a treatment, it is the standard Essential Tremor treatment. Neither disease is curable so treatments to control the disease to one extent or another are protocol.



I checked Patients Like Me in the Parkinson's Community where 45 people indicated that they were or had taken Propranolol with some success for PD. Many people take it for several other conditions.



Both you and your father can join Patients Like Me. Registration is free and does provide an opportunity to learn more about the disease as well as treatments and therapies. It also gives you, as a caregiver or your father as a patient to track the progression of his condition as well as keep a record of his medications, nutritional supplements and other supportive therapies. His progression record and others he can create on PLM can actually be printed and taken to his doctor(s).

http://www.patientslikeme.com/conditions/4-parkinson-s-disease



It is, as Chris mentioned, not unusual for people with Parkinson's or any tremor disorder to feel uncomfortable in public. And I would say that this shunning of public appearance does often improve until family, friends and therapy helps to reassure the person of their self worth and safety. Yes, he may have a form of depression common in at least 40% of people with PD.



There are many ways to learn about tremor disorders but because the diagnosis is possibly questionable, you need to familiarize yourself with the other possibilities.

http://www.medical-library.org/journals3a/essential_tremor.htm



An excellent resource is We Move.org where you can begin with the Parkinson's disease section but view other options from the left margin.

http://www.wemove.org/par/



Because there are many symptoms of the disease, perhaps you and your dad could make a chronological list of his symptoms. For better understanding of his condition, read the article about the precursor symptoms common to many people later diagnosed with PD.

http://parkinsonsfocustoday.blogspot.com/2011/04/early-warning-signs-of-parkinsons.html



I would also encourage his primary caregiver or the future designee to have your father sign a medical HIPAA release at his doctors offices. When this is necessary, it could be too late for him to provide informed consent. This will also provide for the right to discuss issues with his doctor(s) in the event of unforeseen events or changes in his condition.



Many people with PD lead productive lives for many, many years limited only by their ability to push through and the difference in being a person who happens to have PD and a person who defines himself (herself) by the disease.



You would do well to acquaint yourself with the current therapies and treatments for PD. Although I would add some off-label treatments to the list below written in 2009, it is still timely:

http://parkinsonsfocustoday.blogspot.com/2009/12/treatments-for-parkinsons-disease.html



At some point your father might be able to go through his grieving process about the diagnosis but he is going to need the support of people who care about him. This isn't a wake for his past life, it is a way of planning for the journey. But don't nag him and don't plead. Remind him of the fun he's had in the past. You might be able to bring him around



I can't stress how important it is to be able to smile and to laugh to get those feel-good endorphins going. Laughter is even more important than sunshine for PD.



I can be reached through Y!A or through contact us at the site below.

Answer 2

First, you did not say who diagnosed your father. Did he go to a movement disorder center or to his family doctor. Essential Tremors does not turn into Parkinson's, so someone is misdiagnosing. A third possibility is a dystonia. A movement disorder neurologist should be able to tell the difference. Essential tremors can come with a dystonia. I wanted to mention the dystonia angle because being able to type, but not write is common with a focal dystonia of writers cramp. (I am just like your father, right down to being a college professor (though I am not bald)). I no longer can write longhand at all. It doesn't bother me; I correct papers with a recorder and type everything out. I do not have parkinsons, but I do have writers cramp and essential tremors. The writers cramp I have had for 15 years, though I have only been shaking for about 5 years.



Anyway, parkinsons, essential tremors, and dystonias can sometimes respond to the same drugs. At some point, the drugs may not work (especially with parkinsons) and your father may need deep brain stimulation. A neurosurgeon places thin wires into the center of the brain which are attached to a battery and controller in his chest. A tiny current often fixes the movement problems. This is an approved treatment so insurance usually pays for it.



Your father may not want to go to church because he doesn't want people to ask him why he shakes. Many people are embarrassed. I'm not. I put my problems right on my course syllabus so my students will understand why their papers are corrected with a recorder. If I'm in a meeting, I often have someone next to me sign me in. They all know that I don't write. I type my notes and put them on the screen for the students. My students know to not hand me loose papers (I will drop them) and to hand me anything in writing that the professor would normally write down. They are all helpful, and I have had students stop and ask to hold my books while I try to unlock my door. They are very helpful. I carry a master key to my building as I can't handle a key card. It becomes a part of me and not a disability. When I teach human resource management, I hide my problems for a week or so, so I can bring them out as an example of a hidden employment disability.



Anyway, your fathers neurologist is the one to ask how the progression of the disease will affect your father. This could take decades to worsen, or it could worsen much quicker. They could even have a cure before it become really bad. Good luck.

Answer 3

The Parkinson's Reversing Breakthrough?

Answer 4

I do not, however I consider it is feasible. I believe it probably develops in core elderly persons. "In nations in which Parkinson's Disease is natural, the typical age at which signs start is fifty five-60. Symptoms can arise at any age. In 1875, Henri Huchard (1844-1911) defined the primary case of minor Parkinson's disorder, who was once a three-yr-ancient little one who had the entire medical elements of Parkinson's disorder. However, it's particularly exceptional for persons below 30 to broaden Parkinson's Disease." -- Wikipedia.

Answer 5

I'm sure anyone would be depressed with this diagnosis. Just be supportive and make sure he is following his treatment regimen and seeing his doctors (if you can, I'd go with him). If you're really worried, I would try to have him see a psychologist. This might be hard because of the stigma of going to counseling. There's many more treatments available now, I'd consider seeing a neurologist.