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February 26, 2018

What is Parkinson Disease?

My wife passed away three years ago, after suffering from the Parkinson’s Disease (PD). The disease must have set in about eight years before that. However, we learned it was PD only about three years before her demise. It was because this disease is difficult to be detected in the early stages. Unlike other diseases it cannot be detected by any equipment or instrument or laboratory test. It is an incurable disease up to this day. Researches are being extensively going on to find the right cure and hopeful they would succeed soon.
What is PD?
I must admit, the medical is not my field of expertise. However, I am trying to impart some knowledge that I had acquired through reading and from my experiences gained while taking care of my sick wife. My intention is to give some idea of what PD is, as I found that this disease is still not understood by many. Unlike other life threatening diseases, the family members should have basic knowledge about the disease, as they must play important roles as care givers.
The Parkinson’s Disease or the Parkinsonism, was first identified by an English physician, named Dr. James Parkinson in 1817. It is a neurological disorder, the root cause of which is not fully understood yet. The patient commonly suffered difficulties of movement, loss of balance resulting in falls and slurred or, in extreme cases, loss of speech. People over 50 are the most at risk. It is a progressive disease and no cure has been found until today, except to slow down its progress to a certain extend. There may be options for cure, such as by medication or surgery in the near future.
The disease is not easily detected. Here, I would like to cite the story of a US astronaut. He had travelled into space many times. One day the astronaut noticed that his right hand didn’t swing along when he walked. He thought it was nothing serious. Nonetheless, he went to the NASA medical center and consulted a general physician. The physician referred him to a neurologist. The latter, after making thorough investigations diagnosed it to be PD. When his past history was traced, the neurologist found that he had PD some years before he was selected for the astronaut programme.
It was interesting that the astronaut was allowed to go on space missions even after he was diagnosed as having PD. Unlike the life threatening disease such as cancer, the PD patients could live nearly normal lives, if they are diagnosed in the early stages, take proper treatments and know how to look after themselves with the help of their family members.
From my point of view, astronaut trainings are very rigorous and thus, they must be in outstanding states of fitness and health. Their medical exams at entry must be very thorough and stringent. So how did he slipped through? It must be because, as I had mentioned above, the disease is difficult to be detected in the early stages, unless the symptoms and the early warning signs of the PD was known and mentioned to the medical examiners.
That was what happened to my wife. Some symptoms and early warnings signs were showing up many years before she was diagnosed as having PD. However, as we were ignorant of them we weren’t able to mention them to the doctors, thus it was not correctly diagnosed. However, as some symptoms of PD are similar to paralysis, we consulted with a neuro physician and also a neuro surgeon early on.
The CT scan of the brain did not reveal any abnormality, so the surgeon referred back to the physician. The latter must have confused those symptoms with the myasthenia gravis medicine overdose. As that neurologist was the one who treated my wife for the myasthenia gravis, some years before, we believed it was drug overdose as we were told. When the real disease was diagnosed, it was too late. The progress was very fast.
As soon as I learned it was PD, a disease that we had never heard before, I started to search for literatures on PD, online. I found many interesting informations regarding the disease. I read them thoroughly and tried to understand them. I translated some important informations and wrote an article in Myanmar, to make people aware of the PD. A young lady, our neighbour, who helped me look after my wife, ask me about PD. I let her read the draft article I had written. She offered to print that article in a pamphlet form, with her own expenses, and distribute them free.
The pamphlets proved to be very helpful. According to her no less the ten elderly persons who received them were able to know that they had PD after consulting with neurologists as advised in the article.
For the benefit of the readers, I will describe briefly the symptoms and the early warning signs of PD, which I had mentioned in the said article that made some people to consult with the neurologists and learned they had PD.
The CT scans cannot detect the PD. Only specialized MRI (magnetic resonance imaging) machines can detect and pinpoint the locations of the brain defects that caused the PD. At present, only some specialist hospitals around the world are equipped with such machines. These machines are also used in brain surgeries that are purported to aid in curing PD. Until such time that PD could be detected by such machines or some sort of tests, knowing the symptoms and the early warning signs of PD would be the only option in our country, at present, in detecting and diagnosing PD.
The Symptoms of PD
PD can have several different symptoms, varying from one person to another.
The most common symptoms are:—
1. Tremor of the hands, arms, legs, jaws and face.
2. Rigidity or stiffness of the limbs and trunk.
3. Bradykinesia or slowness of movement.
4. Postural instability or impaired balance and coordination
The Ten Early Warning Signs of PD
The followings are the early warning signs that could assist the neurologists to detect and diagnose PD correctly. It is necessary for everyone to know them as they could become useful some day. It should not be assumed that a person has PD just by observing any one of the signs. However, if two or more signs are detected, a neurologist should be consulted.
1.    Tremor or shaking. Slight shaking or tremor in the finger, thumb, hand, chin or lip could be an early sign of PD.
2.    Smaller handwriting. If the hand writing changed or the letters become smaller, it may also an early sign.
3.    Loss of smell. If you cannot smell foods like banana, dill pickles or or licorice, you should ask your doctor about PD.
4.    Trouble sleeping. Thrashing around in bed, punching, kicking or falling out of bed while fast asleep, may be signs of PD.
5.    Trouble moving or walking. Stiffness in the body, legs, arms and shoulders cause trouble in moving or walking. If the stiffness goes away after walking awhile, it’s not to worry, but if it’s persistent, it could be the sign of PD. If the arm doesn’t swing when walking and if the legs are frozen and couldn’t move, it’s a sure sign of PD.
6.    Constipation. Difficulty to move bowels could be an early sign of PD.
7.    A soft or low voice. If your voice changes and become soft or low, see your doctor. It could be the sign of PD.
8.    The masked face. A serious, depressed or mad look though not angry and a blank stare or not blinking the eyes often, is a sign of PD.
9.    Dizziness and fainting. Feeling dizzy or fainting can be signs low blood pressure and can also be linked to PD.
10.    Stooping or hunching over. Stooping, leaning or slouching when standing could be a sign of PD.
These signs could also be caused by some less serious or normal health conditions. It is advisable that they should not be taken for granted as being normal or not serious. If two or more signs are observed, a neurologist should be consulted. By the time my wife first consulted the neurologist, there were at least four warning signs already showing. However, as we were ignorant of those signs and their relations to PD, we hadn’t mention them to the doctor then.
In writing this article I tried to avoid using medical terms wherever possible. I studied any piece of literature on PD that I could lay my hands on and tried to understand them before writing the article as I, a layman, understood. If there should be any discrepancies in my presentations, from the medical point of view, I would like to apologize for my mistakes in advance. However, my sincere intention is to share my knowledge and experiences, so that others may not be thrust into a situation like my wife, because of the ignorance of the early warning signs and the symptoms of the Parkinson’s Disease.


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