Disclaimer: The information on
this website is for your interest only. For medical advice for your individual
needs, please see your doctor or other health professional.
What is Parkinson's?
Parkinson's disease is a progressive neurological condition affecting movements such as
walking, talking and writing. Parkinson's has three main symptoms: tremor,
stiffness and Bradykinesia (slowness of movement). It affects about one in 500
people; approximately one percent of people over 60 have Parkinson's.
With
good medical treatment Parkinson's has a limited affect, if any, on life
expectancy but it can be disabling. With quality medical care, support and a
positive outlook, most people with Parkinson's can lead a productive life for
many years after diagnosis.
The Main Symptoms of Parkinson's
Tremor
About 70 percent of
people with Parkinson's have a tremor and it is slightly less common in younger
people with Parkinson's. Tremors usually begin in one hand or arm and are more
likely to occur when the part of the body affected is relaxed. They usually
decrease or disappear when the affected part is being used and often become more
noticeable when a person is anxious or excited.
Stiffness
Muscular rigidity or
stiffness is a common early sign in people with Parkinson's. People may
experience problems turning round, getting out of a chair, turning over in bed,
or making fine finger movements such as fastening a button, because of rigidity.
Some people find their posture becomes stooped, or that their face becomes
stiff, making facial expressions more difficult. Stiffness can affect everyday
tasks and can sometimes be quite painful. It can lead to deep aching in the arms
and legs.
Slowness of Movement (Bradykinesia)
This means slowness of
movement. People with Parkinson's often find that initiating movement becomes
more difficult or that it takes them longer to perform movements. Lack of
co-ordination when making movements can also be a problem. Bradykinesia can
cause:
- A flat or expressionless face
- Difficulties with rolling over in bed or getting out of a chair.
- Bradykinesia can affect rapid limb movements.
- People with bradykinesia of the hands develop a distinctive change in their
handwriting: progressively, moving across the page, letters get smaller and less
legible.
Loss of Balance
This tends not to
occur in early Parkinson's. People need to learn to get up safely if they have
falls.
Other Symptoms
Individuals may
experience many other symptoms to varying degrees. The list below covers some of
the most frequent:
- Skin sensations and Pain
- Many people develop unusual skin sensations such as electric or tingling
sensations of the limbs. They are often more prominent at night.
- Constipation
- This is common in Parkinson's and is caused by a reduction in the ability of
the bowel to contract.
- Tiredness
- Some find tiredness can be improved with regular exercise and rest. It is
important to recognise when this symptom occurs as people often have to be
careful not to take on too many responsibilities or task that they cannot
complete.
- Depression
- Approximately one third of people with Parkinson's experience depression at
some time.
The Causes of Parkinson's
The causes of Parkinson's is not
completely understood but a known cause is the degeneration of a group of nerves
in the centre of the brain called the substantia nigra. These nerves produce a
chemical messenger called dopamine. When 80% of dopamine is lost, the symptoms
of Parkinson's disease are produced.
At present, it is not known what causes
the degeneration of the substantia nigra.
The Progression of Parkinson's
Parkinson's develops slowly as
the nerves of the substantia nigra gradually degenerate. The first symptom is
sometimes a tremor or slowness of movement.
At the time of diagnosis,
the symptoms may be obvious but are usually not disabling. No treatment stops
the degeneration of the nerves of the substantia nigra. For this reason, early
medical treatment of the condition may not be necessary, and drugs and other
treatments are usually introduced when a person becomes disabled or slowed by
Parkinson's.
Self Help for Parkinson's
People with Parkinson's can
achieve a lot of benefit from a range of self help activities. The main ones
are:
Exercise
Exercise is very
important for people with Parkinson's. As well as improving general health and
well-being, it seems to improve the body's response to dopamine. People with
Parkinson's should attempt to get at least 20 to 30 minutes of exercise each day.
Stretching exercises are particularly beneficial. Always seek expert advice
before beginning any exercise programme.
Sleep
The brain recharges
its dopamine overnight. Most people with Parkinson's feel that they have good
mornings and tend to deteriorate throughout the day. Most people also find that
a good night's sleep leads to a good day with Parkinson's. For these reasons it
is important to get a good night's sleep. This can be very difficult by Field
Officers can provide advice to assist with this.
Work
Simplification and Energy Conservation
Carrying out tasks in
the simplest, least tiring way gives you more energy for other, more pleasurable
tasks. Remember the 4 P's:
- Planning
- Plan your day. Work out what you need to do and what you want to do.
- Organise each task to make it as easy as possible.
- Combine errands with a trip to another part of the house.
- Avoid rushing and last minute jobs.
- Alternate light / heavy tasks.
- Don't worry if everything is not done.
- Priorities
- Set Priorities - if something is unimportant and you don't want to do it,
forget about it. Sort out what is important and what is not.
- Positioning
- Stand straight
- Lift correctly.
- Sit well.
- Take weight off your feet.
- Check your posture throughout the day.
- Sit to do an activity, rather than stand.
- Pacing
- Balance work / rest activity e.g. alternate light / heavy tasks.
- Take short frequent rest periods during the day.
- Break activities down into short tasks.
- Take breaks when tired rather than pushing yourself to exhaustion to
complete an activity.
Support for Carers
Many people with Parkinson's, as
their condition worsens, are supported or cared for to some degree or other by
their spouse, partner or another family member, etc. It is important that anyone
in this supporting role take care of their own physical and mental health.
Such carers may need to make an effort to keep up their own hobbies and
social contacts, have breaks away from the "caring" role, or seek advice and
support from fellow carers.
Medications for
the Treatment of Parkinson's
The symptoms of Parkinson's are
caused by a lack of dopamine and a relative excess of acetylcholine. Most
specialist Parkinson's medication aims to restore the balance between dopamine
and acetylcholine.
There are various forms of the
main medications, eg slow release, different dosages. As some people have
different reactions and sensitivities to the drugs, it is most important to
discuss your needs and reactions with your doctor or specialist to get the best
possible individual prescription.
In additon, the drugs may have
side effects you should be aware of, so again it is important you have full
discussions with your doctor or specialists. Field Officers can provide you with
pamphlets that explain the medication that may be prescribed.
Possible side effects include:
- Dizziness and lightheadedness
- Mood swings, hallucinations and confusion can occur with high doses.
- Headache, dry mouth, constipation and diarrhoea may occur.
Contact your doctor if the above become troublesome or you experience
- Uncontrolled body movements
- A fast heartbeat
- Any unusual behaviour or mood changes.
- Swelling of the feet or ankles, or any leg cramps.
- Loss of bladder control
Disclaimer: The information on this website is for
your interest only. For medical advice for your individual needs, please see
your doctor or other health professional.
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