Parkinson's Disease
A progressive, debilitating disease of the nervous system
Most of us have heard of Parkinson's Disease, and many know someone who has been inflicted with it. Famous people and ordinary folks alike, no-one, it seems, is immune. It can present at any time of life, although it is predominantly an ailment of the middle-aged and elderly; frequently males, but not always. So, what is Parkinson's and how can it be treated?
Named after the English surgeon James Parkinson who first discovered it in 1817, he originally called it The Shaking Palsy having noticed the symptoms of tremors and uncontrollable, sometimes erratic movements in some of his patients.
Modern research has identified the main cause of the disease being a decrease in Dopamine levels in the brain. Dopamine is a messenger which transmits instructions from the brain to the nerve cells which trigger movement in different parts of the body. Once levels of this necessary chemical drop below the accepted norm, brain-to-body communications are interrupted resulting in delayed reactions. As an example, a person with Parkinson's may have it in mind to walk from A to B so their upper body begins to move forward; but the message doesn't make it to the legs in time. Their feet still planted on the spot, they feel themselves about to topple as their centre of gravity shifts. When they try to correct the imbalance, the best they may be able to produce is a shuffling stutter of the feet rather than normal steps.
There is no cure for Parkinson's; however, medications are available to combat the irregularities caused by the reduction in Dopamine and these need to be monitored and adjusted over time as the disease progresses. No patient is the same and some experience a gradual decline in motor functions, whereas others less fortunate can be consumed by the effects far quicker. A disturbing complication arises when patients are being prescribed drugs for other medical conditions, and these may affect the efficacy of those being taken for Parkinson's; and of course vice versa. So, whatever the cocktail of drugs being administered, effects have to be carefully monitored to ensure the correct balance is preserved while the disease progresses through the various stages.
Generally five stages are recognised as significant. Stage One is when the first symptoms become apparent. These may be so mild as to be unnoticeable, at least as far as an observer is concerned; but the patient will know something is not quite right. In Stage Two, tremors and difficulty of movement start to impact on the patient's normal lifestyle and routine, often to the point where changes have to be made to cope with activities that were previously no problem. Gripping and holding something as simple as a teacup becomes harder because the hand can shake uncontrollably. Involuntary jerking may be a problem. My brother-in-law had Parkinson's and he found playing golf an embarrassment when his hand flinched at the wrong moment. Even clicking with the mouse on his computer was erratic at times, occasionally sending his cursor off somewhere he hadn't intended. Progressing to Stage Three, movement becomes slower and there may be problems with eating. By Stage Four mobility is further restricted; and when Stage Five is reached patients have to accept that they are immobile and may be bedridden.
Unlike many illnesses that others might fail to accept as genuine because the complainant is a known hypochondriac, for Parkinson's Disease sufferers, their condition truly is in the mind, is very real, and eventually becomes extremely debilitating.
Although treatable, there is no cure. A number of drugs have proved successful in controlling the disease; but because it is progressive, medical experts are continually playing catch-up. Other methods have been trialed such as deep brain stimulation for patients at least five years into the disease and who find no relief from medication. This procedure uses a generator to send electrical signals via a thin wire lead inserted into that part of the brain causing the problem.
There is also Duopa therapy, a means of administering measured doses of the required drugs from an external pump through a tube into the body; this method found to be more easily controlled and adjusted than oral medications. As for surgery, although not as effective as deep brain stimulation, the Gamma knife procedure is said to be less invasive, more beneficial and has a 70-90% success rate.
For those of us not personally affected we can only look on and sympathise. Carers in particular will find it harder to cope as the disease progresses. For them, and for the rest of us, we must all remember that none of the sufferers asked for it to happen. Parkinson's just came calling. Medical professionals are doing their best to treat the symptoms and find a cure; but it takes time. Maybe we can do nothing but leave it to the experts; we can and should, however, give our support to make the lives of those with Parkinson's Disease more bearable and as comfortable as possible.
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