Parkinson Disease is a disease that I really didn’t have a clear understanding about. I haven’t or at least I don’t know that I have met someone with Parkinson disease. What I thought I knew about Parkinson disease was, that it involves a lot of shaking and seizures. I also thought that Parkinson disease stems from numerously being hit in the head or multiple head injuries. I don’t know anyone personally with Parkinson disease but what I’ve known about this disease is that Michael J. Fox is one of the celebrity’s to have Parkinson disease.
He is an activist and one of the people to make Parkinson Disease well known. The Diagnostic and Statistical Manual of Mental Disorder is a book which breaks down the diagnose disorders, these disorders are clinical disorders, personality disorders and mental retardation, general medical conditions, psychosocial and environmental problems, and Global assessment of function scale. Because Parkinson Disease is not a mental disorder, Parkinson’s would be placed under the Dementia due to general medical condition. Dementia is a loss of brain function that occurs with certain diseases.
It affects memory, thinking, language, judgment, and behavior. What I’ve learned about this disease is that, Parkinson’s disease affects the way you move. It happens when there is a problem with certain nerves in the brain. Those nerves make an important chemical called dopamine. Dopamine sends signals to the part of your brain that controls movement and dopamine lets your muscles move smoothly. Dopamine is produced in the substantia nigra situated in the basal ganglia in the brain and is essential for the control of voluntary and involuntary movement.
The nigrostriatal pathway projects from the substantia nigra to the striarum, and it is here that dopamine is released so that movement can take place (Noble, 2007). People usually start to have symptoms between the ages of 50 and 60, but in some cases people symptoms start earlier. Parkinson’s disease (PD) is a common disorder, affecting people of all ages and ethnic backgrounds in countries around the world. Parkinson’s disease most commonly begins between ages 55 and 60; the majority of patients are over 65 (Kassicieh, 2001). Men are more likely then women to develop Parkinson disease.
It affects men slightly more frequently than women (Kassicieh, 2001). No one knows for sure what makes these nerve cells break down. Despite extensive clinical research, the cause for the loss of these dopamine-containing neurons in the substantia nigra remains a medical mystery (Kassicieh, 2001) Parkinson’s disease affects movement, producing motor symptoms. Four motor symptoms in PD are tremor, rigidity, slowness of movement, and postural instability. The clinical diagnosis of PD is based on early identification of symptoms related to dopamine deficiency.
The symptoms of unilateral resting tremor, muscle rigidity or stiffness and bradykinesia or gradual slowing down and poor co-ordination of movements are well recognized as indications of the condition (Noble, 2007). In time, PD affects muscles all through your body, so it can lead to problems like trouble swallowing or constipation. Swallowing disorders are seen in the later stages of PD. Choking while eating may become a major problem, and patients should exercise care to eat smaller bites and chew food thoroughly (Kassicieh, 2001).
Constipation is seen in the majority of Parkinson patients, as the normal intestinal motility slows down, much like the Parkinson patient himself (Kassicieh, 2001). As well the ability to speak and communicate correctly may become a problem for patients with PD. Communication is severely affected by PD and speech may be hesitant or hypophonic. This can have an adverse effect on the person’s ability to discuss his or her needs and concerns (Noble, 2007). Parkinson’s disease also causes neuropsychiatry disturbances, which can range from mild to severe. This includes disorders of cognition, mood, behavior, memory and thoughts.
This can present in early stage PD and in those patients who have not been diagnosed as having dementia. Typically, there may be bradyphrenia (slowness of information processing), poor executive functioning (that is, planning and sequencing), personality change or behavioral disturbance, poor memory and visucospatial dysfunction – often displayed as hesitation when passing through doorways or in confined spaces(Noble, 2007). Parkinson’s is progressive disease and it gets worse over time.
Modern therapy has provided excellent treatment for many of the symptoms of PD, but it still remains a progressive neurodegenerative disorder (Kassicieh, 2001). In some cases as Parkinson’s becomes worse, PD patients began to show signs of dementia. Dementia is a significant and far too common problem in all patients with PD, and it is estimated that approximately 50 percent of all Parkinson patients will ultimately develop some degree of dementia (Kassicieh, 2001). Dementia is not just a problem of memory, it reduces the ability to learn, reason, retain or recall past experience and there is also loss of patterns of thoughts, feelings and activities.
Working memory is affected and this can affect learning strategies. There may be reduced verbal fluency and reduced word retrieval. The patient may also display subtle deficits in understanding complex sentences (Noble, 2007). Also The concept that PD is chronic and will only get worse, along with the realization that you may not be able to do the things you used to be able to do, can bring about feelings of depression and anxiety. Depression occurs in many PD patients and can range anywhere from a mild to a severe, disabling major depression.
It is important for family members, caregivers, and medical personnel to be aware of this serious problem, since early identification and treatment of depression can significantly improve the patient’s quality of life (Kassicieh 2001). There is no known cure for PD but medications and multidisciplinary management can provide relief from the symptoms. Modern therapy has provided excellent treatment for many of the symptoms of PD, but it still remains a progressive neurodegenerative disorder (Kassicieh, 2001). There are good treatments that can help people with PD live a full life.
Levodopa, also known as L-Dopa has been the most widely used treatment. Since motor symptoms are happening because a lack of dopamine in the substantia nigra, when taking the prescription of Levedopa, L-DOPA temporarily diminishes the motor symptoms and helps the motor skills run smoothly. The symptoms of Parkinson’s disease are due to a brain deficiency of the neurotransmitter dopamine, and the most logical approach to correcting this problem is to replace the dopamine (DA). Unfortunately, one cannot take dopamine orally as it does not cross the blood brain barrier (BBB).
L-dopa is a chemical precursor to DA, and can cross the BBB to be converted in the brain to dopamine. L-dopa was introduced for treatment of PD in the late 1960s, and L-dopa therapy is now the gold standard treatment for the disease (Kassicieh, 2001). Another medicine that may work for PD patients is dopamine agonist. Dopamine agonists exert a similar effect to Levodopa, however, they are not as effective (Noble, 2007). Dopamine agonist is a compound that activates dopamine receptors when there is no dopamine.
Dopamine agonists are chemical agents that mimic the action of dopamine but, unlike L-dopa, do not need to undergo enzymatic transformation to exert their clinical effects. These agents can be taken orally, cross the blood brain barrier, and act directly on the dopamine receptor sites (Kassicieh, 2001). Patients with Parkinson Disease are required use physical therapy and exercise because it slows the chances of deteriorating faster and also helps with motor skills. Physical therapy with gait rehabilitation can be beneficial in patients who have had significant deterioration of balance, walking abilities, and overall functioning.
Unless patients continue, at home, what was taught in therapy, their condition will again deteriorate thereby making therapy pointless. This therapy must also be combined with some form of regular exercise to be maximally effective (Kassicieh, 2001). Diet can help reduce symptoms in a major way. Diet can play an important role. High protein diets may interfere with L-dopa absorption, and it is best to take medications containing L-dopa on an empty stomach or with low protein meals. This can help minimize problems with motor fluctuation that occur in some patients.
A high fiber diet with good fluid intake will help to control constipation, which is a problem that plagues most Parkinson patients (Kassicieh, 2001). Being able to talk with other with the disease is another form of emotional therapy and education patients seek out. Local PD support groups provide the patient, family and caregivers with the needed educational and emotional support that is frequently lacking. These groups are a good source for up-to-date information on PD and the newest therapies that become available (Kassicieh, 2001).
What I learned about this disease is, it is not a disease you can to deal with on your own. In the beginning stage of Parkinson Disease, you may be able to deal because it just involve are tremor, rigidity, slowness of movement, and postural instability, but PD does gradually get worse and tends to lead to depression and also dementia. That is where you will need the most help. From my understanding of this disorder, I think the most difficult aspect of this disorder is, knowing that there is no cure and or knowing that this disease gets worse.
Also like a lot of people, I am a very independent person and knowing that I might have to rely on family, friends or even a caregiver to help me with simple everyday task would be the most difficult aspect I would have to deal and adjust to.
Work Cited American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed. , text rev. ). Washington, DC: Author. Noble, C. (2007). Understanding Parkinson’s disease. Nursing Standard, 21(34), 48-56. Retrieved from EBSCOhost. Kassicieh, D. V. (2001) Parkinson’s Disease: The Disorder and Current Therapy. Parkinson Report. 14-20. SIRS Researcher. Web.