Friday, December 22, 2017

Parkinson's Disease and Tips for Patient Care

Parkinson’s disease is a progressive neurodegenerative disorder that affects the brain, leading to shaking, stiffness, and movement difficulties that worsen over time. Currently, there is no known cure for Parkinson’s disease.

In the United States, approximately 1 million people have the disease. This record continues to climb as 60,000 more are being diagnosed every year, leading to $25 billion in annual medical costs. Worldwide, around 10 million people have to deal with Parkinson’s disease in their everyday life.

The Nature of Parkinson’s Disease

Parkinson’s disease is characterized by a gradual degeneration and death of your nerve cells, or neurons, in the brain area that controls body movement. These neurons are important because they produce dopamine, a chemical that sends signals to other neurons.

When the brain cells that produce dopamine die, the dopamine levels also decrease. This leads to the manifestations of the disease such as stiffness, shaking that is out of one’s control, and balance and coordination difficulties that make it hard to walk. The exact reason why these neurons die is still unknown.

In the earlier stage of the disease, the symptoms usually manifest on one side of the body. As the disease progresses, the symptoms become generalized.

Risk Factors for Parkinson’s Disease

The development of Parkinson’s disease is being linked to genetics. However, only around 10% of cases are believed to be due to certain genes. Individuals with no family history also develop the disease. Old age is also a risk factor but there are also cases of Parkinson’s in the younger population.

Environmental factors are also associated with Parkinson’s such as exposure to certain herbicides and pesticides, drinking well water, living in rural areas, and living near quarries and industrial plants. Research has shown that exposure to pesticides and fungicides can increase your likelihood of having Parkinson’s disease by as much as 80%. The longer your exposure to these chemicals, the higher the risk. Interestingly, studies have found an inverse relationship between Parkinson’s disease risk and caffeine intake, although the underlying biochemical rationale behind this relationship is not fully understood.

Signs and Symptoms of Parkinson’s Disease

The common physical signs of Parkinson’s disease are tremors, bradykinesia, and dystonia.

  • Tremors. Patients commonly manifest with tremors in the early stage of the disease. They usually describe it as nervousness or shakiness and it gets worse when the person is experiencing a high level of stress, fatigue, or anxiety. It is initially experienced unilaterally, in one upper extremity, before becoming generalized. Some patients have resting tremors that occur when they are at rest that disappear upon movement. Tremors are often initially observed when the person is eating.
  • Bradykinesia. People with Parkinson’s move slower. This slowness of body movement is known as bradykinesia. Every patient describes bradykinesia differently. Some describe it as weakness while others report a loss of dexterity (or the skill in doing tasks). Some patients experience body-aches when doing actions repeatedly. Due to bradykinesia, patients with Parkinson’s find it hard to do fine motor activities such as using eating utensils and writing.
  • Dystonia. This symptom is common in patients who develop Parkinson’s disease before they reach 40 years old (early-onset Parkinson’s disease). Dystonia is characterized by muscle spasms, causing involuntary foot inversion (turning in) or flexion (turning down). It is often accompanied by leg cramps. Due to this, people with Parkinson’s can have gait problems and might find it hard to walk.

Living With Parkinson’s Disease

Although there is no available cure for the disease, it is still important to address safety issues and emotional and social problems that a Parkinson’s disease patient might be having.
  • Patients must undergo routine medical checkups. Encourage them to verbalize the symptom that they are having trouble managing. Some medications can help alleviate the symptoms to help the patient live a more comfortable life.
  • Reduce the sources of stress. Stress can exacerbate symptoms like tremors. Make the house as calming and refreshing as possible to prevent agitation and anxiety.
  • Parkinson’s disease has no specific dietary restrictions and recommendations. A healthy and balanced diet is generally preferred. Increasing the amount of high-fiber foods in the diet can help relieve constipation. Utensils for individuals with Parkinson's can make eating easier and more comfortable. Ensure patients are adequately hydrated by drinking lots of water and caffeine-free beverages, which can lessen muscle cramping.
  • People with Parkinson’s disease can still benefit from exercise and physical activities. Doing activities like walking, cycling, dancing, strength training, and even swimming has been shown to improve body coordination, mobility, and balance in patients with Parkinson’s disease.
  • Since Parkinson’s sufferers have balance and coordination problems, make sure that the house is free from tripping and slipping hazards like uneven flooring, trailing wires, and broken furniture. 
Using a bed rail in the bedroom and grab bars in the bathroom can also help prevent injuries secondary to falls.

Overall, the care for patients with Parkinson’s largely focuses on delaying the progression of the signs and symptoms and improving the quality of life.

This is a guest blog entry.

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