Tuesday, January 26, 2010

blood pressure and dizziness

Posted: Sat Jan 23, 2010 10:52 am Post subject: climate changes and blood pressure

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climate changes and blood pressure

I was on three weeks holiday in Europe recently.

It is winter in Europe and am flying from tropicial country, Malaysia.

I have low blood pressure due to sideeffect with Parkinson’s
medication.

I do not have problem during my stay in Europe as I put on enough winter cloth to protect the cold and to warm up our body blood pressure,

The airline compartment is heated against the cold during the journey.

I enjoyed gym exercise at the fitness centre,,steam bath and sauna during the stay..

I have problem on the scecond day after I fly back from Europe.

I feel dizzinness at the taxic backseat after comming back from shopping and I could not stand and feel unstable, as the result I knelt down my body with conscious

In the flying flight they lower down the heated temp. and we have to take down our winter cloth to lower down our body temperature.

Kindly advise

I

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Dr. Fernandez



Joined: 20 Jan 2007
Posts: 90

Posted: Mon Jan 25, 2010 1:29 pm Post subject:

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I am not particularly sure if climate really has an effect on PD.

I practiced for 5 years in the Northeast, now I have been practicing in the Southeast in the last 6 years or so, and I don't see much difference. I also don's really notice if my patients get better or worse in the summer as compared to winter.

When people travel though, it can affect their PD...diet change, routine change, timezone changes which therefore affect sleep patterns are all factors that play a role. My best advice is to keep your routine as much as possible. Adjust to the weather and the new time zone as fast as you can and keep your meal times as consistent as possible.

Consistency is the key.

Yours,
_________________
Hubert H. Fernandez


Warm weather can lower your blood pressure due to increased sweating (loss of fluid from the body) and dilatation (engorgement) of the blood vessels under the skin. The low blood pressure can explain your dizziness and fainting spell. Furthermore, the pooling of blood under your skin diverts the blood from your brain, leading to reduced oxygen supply to the brain.

The Parkinson's medications also have a role to play in your dizziness because they lower the blood pressure.

At the moment, I think there is no need to change your Parkinson's medications. Just remember to drink more fluids the next time you return from european countries.

Dr.Chew







PostPosted: Sun Jan 31, 2010 2:12 pm Post subject: Reply with quote
I have the same problem and actually got off requip because I fainted about 20 times a day and this is not an exaggeration. Eating is the only thing now that causes a major problem for me and I know during digestion a lot of blood is diverted to the digestive system so I have to drink a lot of fluids and eat salty foods or just eat a little salt with the water. I posted about learning how to do a controlled fall because I have this problem and it was terrifying for me and my SO as she can't stop me from falling - only keep my head from hitting the ground. Now that I can do a controlled fall I am much more confidant but still try to drink a lot of fluids. I too have major problems in the summer 90m degree high humidity environment. If we go to an outdoor activity many times I've had to stay in the car with the air conditioning on and I came close to having a heat stroke. So do be careful. This is a dangerous situation. Drink a lot, eat some salty food and learn how to fall so you don't get hurt.

Sunday, January 24, 2010

Hero Teo – the atypical Parkinson’s patient

Hero Teo – the atypical Parkinson’s patient

It has been well documented in the literature that Parkinson’s is associated with a certain type of personality. They tend to be “introverted” and “self-controlled”. In my own experience, I have also observed such “Parkinson’s personality”. Due to their submissive nature, Parkinson’s patients are the most pleasant and obedient patients whom I have treated in my clinic. In general, they are not outgoing. Most of the time, their daily activities are confined to their home, and they keep a distance from the society.

It is difficult to determine the exact origin of the Parkinson’s personality – it could be the direct manifestation of the illness, the reaction to the physical disabilities or society (social stigma). Some researchers have even suggested that it the characteristic personality of Parkinson’s patients that has predisposed to the illness (i.e. increased the risk of getting Parkinson’s).

However, this “Parkinson’s personality” rule certainly does not apply to all patients. I personally know a very small number of Parkinson’s who are pleasant, submissive but very outgoing. These exceptional Parkinson’s patients have even reached out to the whole society, while declaring their illness openly to the whole world. In fact, the existence of such “atypical Parkinson’s personality” is a blessing for the Parkinson’s community, as these “atypical” Parkinson’s patients have overcome the social stigma and brought revolutionary changes to the Parkinson’s care in this country.

So far, I have met three such “atypical” but remarkable Parkinson’s patients. You have heard of the heroic stories of the late Mr. Lloyd Tan and Mr. Chee Liew Seong, who have been the key players in the history of Parkinson’s support group movement in Malaysia. The very fact that Mr. Lloyd Tan was subsequently discovered to have parkinsonism-plus syndrome, a much more severe illness than Parkinson’s, made his personality even much more remarkable.

The third hero of the Malaysian Parkinson’s community is Mr. Teo Kim Hoe, 71, who is much better known as “Hero Teo”.

“As far back as 1998, he was already noticed to have slowness of movement, and a hunched back with his head bent downwards (stooped posture). Even at that moment, his relatives had commented that the way he walked was different from previously – he had a tendency to walk on his toes. Once, my daughters and I were looking for him at a shopping centre. He walked right past us without noticing us at all, as his head was bent downwards. That was how we knew something was not right about him. But, we did not have any clue about what he was suffering from,” recalled Mrs. Teo.

Mr. Teo was diagnosed to have Parkinson’s in 2005. He was already on some Parkinson’s medications when I first met him in 2006. At this moment, his symptoms were fairly well-controlled. It was during this first meeting when I discovered that he had an inherited form of Parkinson’s, which is generally rare in this region. He has a total of eight siblings, two of whom also suffer from Parkinson’s.

Right from the first time I met him, I had noticed some remarkable characteristics in him. The most obvious was his strong optimism in coping with his illness. Just like other Parkinson’s patients, Mr. Teo has experienced many complications such as dizziness due to low blood pressure, insomnia and nightmares. Last year, he was admitted to my hospital for sudden onset of slurring of speech, dizziness and limb weakness. The brain scan confirmed that he had suffered from stroke. Despite this, he persevered and recovered completely within one week. His “never-say-die” attitude has helped him to pull through all these complications.

Another unique characteristic of Mr. Teo is his openness in facing his illness. With the help of his son-in-law, he started his personal blog (“Hero Teo – Chronicles of a PD fighter” - www.heroteo.ikonxept.com) in 2005. In fact, Mr. Teo is the first Malaysian Parkinson’s patient (and the only one) who has started a blog.

In his blog, Mr. Teo has described his illness in a very illustrative and comprehensive manner - almost every aspect of Parkinson’s is included. Despite not having any medical qualification, he has discussed many medical issues which are considered to be difficult for the general public. Once, he sent me an email, asking me about non-motor symptoms of Parkinson’s, something no Parkinson’s patient has ever discussed with me.

When I asked him why he decided to set up a blog, he said, “I have always wanted to tell the world how I fight my Parkinson’s. By creating a blog, I hope to send a strong message to all the readers that there are people suffering from Parkinson’s who need the support of the general public. Malaysians need to be aware of the existence of Parkinson’s, and its physical, emotional and mental complications. Through this blog, I can share my experience on how I cope with and understand my illness.”

“Don’t you worry about revealing your illness to the whole world? I am sure that you know about the social stigma associated with Parkinson’s, and the prejudice that people might have against you,” I asked.

“Even though I have Parkinson’s, I don’t consider myself to be a disabled person. I know that nowadays we have effective treatment for Parkinson’s which can help me attain a fairly good quality of life. Furthermore, by revealing my illness to other people, it enables them to understand and help me solve my problems. These are the reasons why I don’t feel embarrassed to tell the whole world that I have Parkinson’s,” he replied.

I have to admit that I was amazed and impressed by his reply. The truth is, the negative perception of Parkinson’s patients towards their own illness is one of the reasons that contribute to the social stigma. Many Parkinson’s patients consider themselves to be disabled or physically inferior, even before they face the general pubic. Coupled with the wrong perception of the general public about Parkinson’s, the social stigma of Parkinson’s is intensified. In other words, the Parkinson’s patients’ own perception of illness does have a significant influence on their long-term well being and social life.

Throughout all these years, Mr. Teo was the very first Parkinson’s patient who has a very “physical” approach in coping with the illness. I have met many Parkinson’s patients who are involved in relatively light physical exercise programs such as Tai-chi and Wai-dan-gong. In contrast, Mr. Teo attends a much more strenuous physical exercise program for five days in a week at a local health centre. During each session, which lasts about 3-4 hours, he carries out all sorts of exercise programs such as muscle stretching, running on treadmill, balancing exercise on “fit-ball”, kick-boxing and spinning (i.e. stationary cycling). He even hired an instructor to teach him Yoga twice a week at home. In fact, I have never met any Parkinson’s patient who is so aggressive in carrying out physical exercises.

“I believe that in addition to the Parkinson’s medications, complementary treatment such as physical exercise is also useful in maintaining good muscle tone, strength and posture. This is why I have hired two trainers to help me with my exercise program,” commented Mr. Teo.

Even today, Mr. Teo is still physically fit, despite his age and having Parkinson’s for ten years. As I write this article, Mr. Teo and his wife are preparing for a holiday I Hong Kong. In fact, he has been traveling to many countries over the past few years, such as Thailand, Singapore and Australia. I am glad that he is making the best out of his old days.
Don’t mess with me – Mr. Teo doing his kick-boxing exercise

I have to admit that my personal experience in treating Mr. Teo over the past two years has been really special and encouraging. At least I know that there is a minority of Parkinson’s patients who are different from the rest, and attempted to make life better for the others.

Mr. Lloyd Tan, Mr. Chee Liew Seong and Mr. Teo Kim Hoe are the heroes of the Malaysian Parkinson’s community.

Posted by teo at 8:31 PM

Friday, January 22, 2010

climate changes and blood pressure

nonymous







PostPosted: Wed Jan 20, 2010 6:41 am Post subject: climate changes and blood pressure Reply with quote
I was on three weeks holiday in Europe recently.

It is winter in Europe and am flying from tropicial country, Malaysia.

I have low blood pressure due to sideeffect with Parkinson's
medication.

I do not have problem during my stay in Europe.

I have problem on the second day when I fly back from Europe as I feel dizzinness and fainted after comming back from shopping.

Kindly advise



I
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Kathrynne Holden, MS



Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com

PostPosted: Thu Jan 21, 2010 3:43 pm Post subject: Reply with quote
.
Dear Friend,

I am not certain that the dizziness was due to the climate change.

Although that might be the case, I think it is more likely that perhaps you might have been experiencing some other concern, such as dehydration. With low blood pressure, it is important to drink plenty of fluids to build up the blood volume as much as possible; and travel can change our habits, schedules, and the way we normally eat and drink. If you had not been drinking as much fluid as usual, I think that would be a more likely cause of the blood pressure drop than the climate change.

However, I suggest you address your question to “Ask the Doctor,” as they may have other information they would like to suggest.
_________________
Best regards,
Kathrynne Holden, MS
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/
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Tuesday, January 19, 2010

Tips and Pointers on Some Parkinson's Symptoms

Soft voice, slurred speech and masked face

Parkinson's patients have difficulty with voice and speech. We have shortness of breath. We don't speak loud enough. Our speech is almost unintelligible. Our face is expressionless ("poker-face"), so people thought we are not interested or unhappy, even though that is not truly how we feel.

In order to solve these problems, there are ways to improve the muscles around the mouth:

Use tongue in your mouth to massage the muscles around the mouth.
Gargle with water full on your throat and blow air through it without swallowing, twist your mouth to the extreme left, right, up and down, to strengthen the facial muscles.
Blow air deeply into balloon to exercise the muscles around the mouth.

Do it 3 to 4 times a day.

Small (micro) handwriting

As our Parkinson's progresses, our handwriting becomes smaller and unrecognisable. The bank had trouble recognising my signature on the cheques that I issued. Often, the bank had to call me to verify that I had indeed issued those cheques. Once, I even had to go to the Commissioner for Oaths to authenticate a document that was signed by me.

In order to solve this problem, I have relegated all signing of cheques to my wife.

Unstable walking posture

Due to our weak and stiff muscles, Parkinson's patients have an unstable walking posture, hence, often resulting in falls, which cause bone fractures or concussions.

I would like to share my experience in discovering that one of the reasons for my unstable walking posture was that both my arms were rigid (not swinging) while walking.

I tried to correct it and make it a habit to swing both arms when walking, in order to give a better balance for my body.

Besides doing arms stretching, walking upright and swinging the arms, I go down to the swimming pool's shallow end (3 feet depth) in order to immerse my body below the surface of the water and massage my own body muscles for half an hour daily, accompanied by a helper in case I need help.

Make it a habit and you will enjoy a good quality of life.

Muscle cramps

I have frequent muscle cramps, stiffness, tightness and pain on my hips, thighs, shins, ankles, hamstrings (tendons behind the knees), cheeks, shoulders and neck for the past of 20 years, before I was even diagnosed with Parkinson's. It comes and goes a few times a day, either when walking, standing or seated.

I used to go for physio-therapy and massage. Now, I realised that the muscle cramps are caused by the disorders in my nervous system, due to the lack of dopamine. Dopamine is a neurotransmitter, a type of chemical that helps messages travel between nerve cells, including our brain cells. Brain cells need dopamine to send messages to other parts of our brain, and to nerve cells and muscles throughout our body. With the lack of dopamine, messages were not transmitted adequately, causing my body muscle movements to be disrupted and not running smoothly. Hence, the muscle cramps developed. Muscle cramps are also caused by reasons other than Parkinson's.

To solve the problem of frequent muscle cramps, I do the following:
· Take the optimal dosage of Parkinson's medications to supply the much-needed dopamine to the brain cells.
· Do physical exercises at least 2 hours daily.
· Have a healthy diet.
· Have proper intake of supplementary nutrition.
· Have a body massage once a week to stretch my neck, back, arms and legs up and down, left and right.
· Place a hot/cold pack on the affected muscles to ease the pain from the cramps.
· On my own at home, I also stretch my legs. I place one leg against the wall in order to stretch my leg up and down, front and back, 20 times for each leg. I do this many times daily.

Hamstring pains

Muscle pains are common in Parkinson's. I have hamstring (tendon behind my knee) pains and have difficulty standing on my right leg. I find it difficult to do the "tree posture" in yoga, when I have stand on one leg. I am fortunate that I have no problem with the other leg (left).

In order to solve the hamstring pains, I place one leg against the wall in order to stretch my leg up and down, front and back, 20 times for each leg. I do this many times daily.

After stretching, I place hot/cold pack on the hamstring and joints. Besides that, I ensure that I take optimal dosage of medications, have a healthy diet and have proper supplementary nutrition.

Difficulty swallowing

Chew a piece of chewing gum or hard candy in the mouth to encourage swallowing. Use sugarless gum or candy so as not to cause tooth decay. It is also helpful to stop drooling and dry mouth. It also maintains a good oral health.

It is cheap and has no side effects.

Eye problems

Parkinson's does not affect the eyes' ability to see but there can be some eye-related concerns. Due to the problem of masked (stiff) face in Parkinson's, there can be a decreased rate of automatic blinking. There could also be a lack of eye coordination due to the motor (physical) disorder symptoms, causing double vision when looking in a certain direction. I have these eye problems. As a result, my eyes feel tired easily and I cannot see clearly when driving at night or during rainy days.

I use eye drops a few times a day and I avoid driving at night or during rainy days.

Dehydration

I suffer from dehydration. It is a side effect of levodopa and the dopamine agonist medications for Parkinson's. Dehydration is a loss or deficiency of water in our body tissues. This condition may result from inadequate water intake and/or excessive removal of water from the body, i.e. from sweating, vomiting or diarrhoea.

Symptoms include great thirst, nausea and exhaustion. Thirst leads to dehydration. In order to prevent and solve the problem with dehydration, I do the following:
· Drink two litres of water daily, as I am doing strenuous physical exercises daily.
· Apply "Biotane" gel to moisturise my dry lips.
· Chew "Biotane" gum to minimise dryness in my mouth.
· Use "Biotane" mouth wash to minimise rough and sticky tongue.

Anxiety, depression and stress

Due to death of neurons that make dopamine, Parkinson's have non-motor (mental) disorder symptoms, such as anxiety, depression, tension, stress and insomnia. Side effects of medications could also give rise to these symptoms.

Unknown to most Parkinson's patients, non-motor disorder symptoms are even more complicated and difficult to treat than the motor (physical) disorder symptoms. It affects the feelings and moods of the Parkinson's patients and the entire family. I have had my share of mental problems that caused upheavals and tears in my family. You can read the story written by my son-in-law in the inset panel.

This is how I relieve my mental disorders:
· Concentrate on other issues and pastimes that I enjoy or have interests in.
· Indulge in physical exercises, which is very effective for me because:
- I am able to let out the pent-up frustrations and anger inside me;
- I am able to feel totally relaxed, through a deep breathing technique.
· Study the Bible and get involved in the church activities.
· Take medicines at the optimal dosage in order to counter the Parkinson's symptoms and the effects of emotional disorders.
· Have the attitude that I am not alone and that there is still life after Parkinson's.
· Giving and serving others will bring more happiness than receiving and being served.
· Participate in online discussion forums with other fellow Parkinson's patients and medical practitioners, such as PatientsLikeMe, National Parkinson's Foundation (NPF) and Parkinson's Discussion Forum (PDF).

The deep breathing technique (to feel relaxed) is achieved from strengthening the core (body trunk) muscle:

While doing physical exercises, inhale and exhale deeply, with the stomach tucked in and out according to rhythm of breathing.
The core muscle lies roughly between the rib cage and the hips, in the abdomen, lower back and pelvis. A strong core muscle protects the spine and straightens our body posture. Our exercise movements become more powerful, stable, balanced and coordinated and we will not fall down easily.

In short, we can use the technique above in all exercises in order to deal with our overall health, both mentally and physically, because when we feel relaxed while doing our physical exercises, it becomes more effective and fulfilling. Some examples of exercises which incorporate deep breathing are tai chi, yoga, pilates, running and cycling.

When not doing exercises, we can also do deep breathing, anywhere and at any time:

Take 5 to 10 deep breaths in and out slowly (to a count of 5 each time), while relaxing your body.
At the same time, pick one word or phrase (some people call it a "mantra") to repeat as you breathe in, and again as you breathe out. It helps you to concentrate on your breathing, and distracts you from the stressful situation.

The basic benefit of this type of breathing is, more oxygen gets into your body and will improve your ability to think clearly, thus helping you to cope better with the situation at hand.

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Monday, January 18, 2010

overactive bladder

Here are the results of your Overactive Bladder (OAB) Self-Assessment Survey.
Your score is

If your score is 8 or greater you may have OAB
Based on the results of this survey, you may have the signs or symptoms of OAB

The good news is that ENABLEX is an effective treatment for OAB. You and your doctor can decide if ENABLEX is right for you, so make sure you talk to him or her about your bladder control symptoms. Please print this page and share it with your doctor during your next visit. If you don’t have a scheduled appointment, make one today.

My Self-Assessment Survey Results
1.Frequent urination during the daytime hours?
You answered -
2.An uncomfortable urge to urinate?
You answered -
3.A sudden urge to urinate with little or no warning?
You answered -
4.Accidental loss of small amounts of urine?
You answered -
5.Nighttime urination?
You answered -
6.Waking up at night because you had to urinate?
You answered -
7.An uncomfortable urge to urinate?
You answered -
8.Urine loss associated with a strong desire to urinate?
You answered -
9.Are you male or female?
You answered -

symptoms of parkinson's disease

Symptoms of Parkinson's usually begin slowly, develop gradually and in no particular order.

Everyone with Parkinson's is very different and may have a different collection of symptoms and response to treatment.

The nature and severity of symptoms and the rate at which the condition progresses will also be individual. The symptoms may take years to progress.

However, since Parkinson's is a progressive condition, symptoms will worsen over
time and new ones may appear. It is difficult to estimate how quickly or slowly Parkinson's
will progress in each person. It may progress more quickly in people who are older when the
symptoms first begin.

Currently, there is no cure for Parkinson's. However, many of the motor symptoms can be
treated with medications. Medications used to treat the symptoms either replace the lost
dopamine or mimic the action of dopamine in the brain. Medications can alleviate the symptoms,
but do not slow the progression of Parkinson's. As the symptoms change, medications will need
to be adjusted.

4 people marked this post as helpful.


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fainting attack in parkinson's disease

Fainting attacks in Parkinson’s Disease

Fainting attacks are episodes of loss of consciousness that occur due to various reasons. It starts suddenly, usually within seconds and so fast that many patients fall onto the floor before they can react to it. The episodes are generally short, ranging from seconds to several minutes. Following the attack, patients usually regain consciousness. It can occur only once or more depending on how soon patients are brought to the hospital for treatment.

Fainting attacks, even if it occurs only once, are serious matter. Patients must be brought to the hospital immediately for two reasons. Firstly, they may indicate the presence of serious medical problems such as heart disease. Secondly, during the falls, some patients may be unlucky enough to develop internal injury. The most serious and potentially life-threatening is head injury with bleeding in the brain.

Fainting attacks do not just affect patients with Parkinson’s Disease (PD). It can happen in any patient, sometimes healthy people. Despite this, particular attention should be paid to PD patients because they have a higher risk of developing fainting attacks than anyone else. This is because most PD patients are elderly people who commonly have heart or brain diseases that can cause fainting attacks. In this article, I will discuss the various causes of fainting attacks among patients with such as follows;

a) Heart diseases

This is the most serious disease because heart problems can lead to immediate death. The usual heart problem that can cause fainting attacks is cardiac arrhythmia, which is a disorder of heart rhythm. Patients with cardiac arrhythmia get fainting attacks because the abnormal heart rhythm affects the normal heart function. This leads to reduced amount of blood and oxygen that go to the brain. As a result, the brain activity is disturbed and patients lose consciousness. Following the fall, patients regain consciousness within less than a minute.

Cardiac arrhythmia is a manifestation of several types of heart diseases. This could be a disorder that is called “sick sinus syndrome” that usually occurs in elderly people. In this disorder there is disruption of the electrical circuit in the heart due to ageing process. As a result, the heart rhythm is chaotic. The proper treatment for this problem is a heart pacemaker, whereby a battery sends electric signals to the heart in order to regulate the heart rhythm. Another type of heart disease is a heart attack that is caused by blockage of the blood vessels in the heart. Heart attack is also more common in the elderly people. In view of the strong tendency of elderly people to get heart diseases, anyone who has have a fainting attack must seek specialist treatment without delay.

b) Brain diseases

The most common brain disease that can cause fainting attacks is seizure or fit. This disorder is characterized by uncontrollable jerking of the limbs with loss of consciousness. The attack starts suddenly. Sometimes there are also dribbling of saliva, urine incontinence (passing urine without being able to control it) and bluish discolouration of the lips. Each attack usually lasts several minutes. Following the attack, the patient complains of headache and sleepiness. Sometimes, the patient becomes confused for up to one hour.

Seizure / fit can be either a disease on its own (epilepsy) or due to various other diseases such as stroke, brain tumour, brain infection, etc. The patient should be investigated immediately at the hospital and treated with drugs to prevent seizure from happening again.

c) Low blood pressure (postural hypotension)

This is condition which results in reduced amount of blood / oxygen going to the brain. Consequently, the patient loses consciousness. The fainting attacks typically occur when the patient is standing up from a sitting position or walking. The patient usually regains consciousness immediately following the attack (within less than one minute).

There are many reasons why a patient can develop postural hypotension. The most common cause in a PD patient is the medication itself (Madopar, Sinemet, Jumex, bromocriptine, Trivastal, etc). Occasionally, it is due to the PD itself. Other less common causes are dehydration (due to severe vomiting, diarhoea, bleeding in the stomach) and heart failure.

The treatment of postural hypotension depends on the cause. If it is due to Parkinson’s drugs, the dose of the drugs should be reduced. Usually, the dose of all other drugs is reduced before Madopar / Sinemet, because these two drugs are the most efficacious drugs in PD. At the same time, the patient is advised to sit on the bed or chair for about several minutes before standing up.

If these measures fail (and investigations have determined that there is no other causes such as heart failure), fludrocortisone can be used. This drug helps by elevating the blood pressure.

d) Low blood sugar (hypoglycemia)

In this condition, the blood sugar level is lower than normal (less than 2.5 mmol / l). As a result, patients lose consciousness. Hypoglycemia usually occurs in diabetic patients, either due to overdose of diabetic pills or missing the meal. In less severe cases, patients do not faint but develop symptoms such as dizziness, hunger, cold sweat and weakness of body.

Hypoglycemia is dangerous because it can kill a patient in a very short time. It is important to get a blood sugar level immediately to detect this condition. The immediate treatment of hypoglycemia is administration of sugar by giving sweet drinks (three to four teaspoons of sugar in a cup of water, Coca Cola, Pepsi, etc). If there is immediate access to hospital, the doctor can set up a drip to give sugar solution.

e) Sleep attacks

This is actually a very rare condition. During the attacks, patients just dose off without any warning. It happens at certain situation when people usually do not sleep, such as driving, doing computer work, having meals, etc. Sleep attacks are one of the very rare side effects of PD drugs.

f) Emotional problems

Occasionally, patients who have emotional problems may develop fainting attacks. It can be caused by extreme anger / sadness, e.g. hearing a very bad news. It should be emphasized that all other causes of fainting attacks must be excluded before the fainting attacks are attributed to emotional problem.

In conclusion, fainting attacks are serious disorder that are caused by various other potentially life threatening diseases. Patients should be immediately brought to the hospital for extensive investigations and treatment.

freezing

Parkinson patients experience symptoms of freezing as follows

l. stop suddenly while walking

2. beginning to initiate walking and unable to move forward

3. stuck to the ground but the body still wants to move on

4. doing activities:

stepping off after rising from sitting,beginning to speak; when raising
a cup to drink; or starting to get out of bed.

Freezing, which is often preceded by frequent
and small shuffling steps (festination), can also
lead to problems with balance. This increases
the risk of falling and makes freezing a
potential dangerous symptom of Parkinson's.



Tips:

When you have leg freezing whilst walking instead going forward going backward to prevent a fall.

Holding both leg and slap side of both knees to release the freezing

Stay horizon the place where you are to release the freezing.

The reason why you have leg freezing because you are under medication and wearing off.

It is strange why the parkinson patient does not have leg freezing problem whilst on cycling?


Is it we concentrate our movement to balance?

1 person marked this post as helpful.


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this post was last edited by teokimhoe on Jan 16, 2010 07:27AM

possible cure parkinson's disease

Researchers at Iowa State University have found an essential key to possibly cure Parkinson's disease and are looking for others.

Anumantha Kanthasamy, a distinguished professor of biomedical sciences and W. Eugene and Linda R. Lloyd Endowed Chair in Neurotoxicology at the ISU College of Veterinary Medicine, has been working to understand the complex mechanisms of the disease for more than a decade and thinks he has found hope for the cure.
's disease
Parkinson's disease sufferers lack a sufficient amount of a brain chemical called dopamine.

Kanthasamy's research shows that there is specific protein that is naturally present in human brains that -- for no known reason -- kills the brain cells that make dopamine.

The cells that are being killed are the ones that produce the needed dopamine.

"We have millions of cells in our brains," said Kanthasamy, "In Parkinson's, about 10,000 of these brain cells die; no one knows why."

Kanthasamy discovered that a novel protein -- known as protein kinase-C (specifically PKCĪ“) - is killing the dopamine-producing cells.

Kanthasamy and his research staff discovered a compound that neutralizes the cell-killing kinase-C and allows the dopamine-producing cells to survive and function.

"With a lot of hard work, and little bit of luck, we found something important," he said. "And when you find something like this you say, 'This is great because it can be a target for developing new drugs.'"

Now, Kanthasamy's group is looking for additional compounds that also can serve to neutralize protein kinase-C. By identifying more compounds that perform the function of neutralizing kinase-C, researchers are more likely to locate one that works well and has few side effects.

This discovery is expected to provide new treatment options to stop the progression of the disease or even cure it.

The study is being funded by a Grow Iowa Values Fund grant. The goal of the grant program is to support development of technologies with commercial potential and to support the growth of companies using those technologies. Kanthasamy is working on this research with PK Biosciences Corp., an Iowa-based startup company. Funding was also provided by the National Institutes of Health.

"Once we find the compound, we need to make sure it's safe. If everything goes well, it could take about 10 years, and then we might be able to see something that will truly make a difference in the lives of people with this disorder," said Kanthasamy.

Parkinson's disease strikes around 50,000 people each year, and there are approximately 1 million people with the disease. Parkinson's sufferers include actor Michael J. Fox and former boxing champion Muhammad Ali.

As people grow older, the cells that produce dopamine naturally die, causing dopamine levels to fall gradually over time. When the levels continue to drop below 60 to 70 percent, the person will start to have Parkinson's disease symptoms, according to Kanthasamy.

"Everybody has a little Parkinson's in theory," he said. "But you can't see it until the level of dopamine gets too low."

Eliminating the symptoms of Parkinson's disease doesn't require people to be restored to 100 percent of previous dopamine levels, but only to a fraction of that.

"If you can bring dopamine up to the 40-50 percent level, you'll see a functioning, normal person," he said.

Currently, there is no cure for Parkinson's and available therapies only treat the symptoms.

Major contributing factors for getting Parkinson's disease include prolonged exposure to metals or pesticides and other environmental chemicals, according to Kanthasamy.

Symptoms of Parkinson's disease include trembling in hands, arms, legs, jaw, and face; rigidity or stiffness of the limbs and trunk; slowness of movement; and impaired balance and coordination. As these symptoms become more pronounced, patients may have difficulty walking, talking, or completing other simple tasks. Because the disease typically affects people over the age of 50, the National Institutes of Health anticipates the incidence of Parkinson's will increase as the nation's population ages.

Source: Anumantha Kanthasamy
Iowa State University

5 people marked this post as helpful.

Friday, January 15, 2010

dizziness/fainting

Dear Mr Teo

Xatral causes low blood pressure, which leads to dizziness (or even fainting attacks) when you shift your body position from sitting or lying flat to standing.

I suggest that you stop taking Xatral.

Dr Chew

Monday, January 11, 2010

moving and walking

Posted: Wed Jan 06, 2010 9:11 am Post subject: moving and walking

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Parkinson is a movement disorder and lost movement coordination.

Parkinson's sufferers have problems

1. Incoordination on moving both hand whilst walking.

2.Walking are more faster than both hand moving

Kindly elaporate

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Kathrynne Holden, MS



Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Fri Jan 08, 2010 10:44 am Post subject:

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.
Dear Friend,
I am not the best person to describe and explain the symptoms of PD. I recommend you direct your question to “Ask the Doctor” as the physicians are all neurologists who are Parkinson specialists, and can give you a much better explanation. My scope of practice is nutrition, and I will be happy to address questions in that area.
_________________
Best regards,
Kathrynne Holden, MS
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/

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Anonymous






Posted: Fri Jan 08, 2010 2:45 pm Post subject:

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The PD can cause some rigidity in one or both arms. In this case, when walking, one arm or perhaps both do not swing freely. In my case, I almost had to consciously swing my left arm but it was not a natural swing. The arm almost hung motionless unless I forced a swing.

If I understand the second question, walking faster will not cause the affected arm to swing faster.

Hope this helps.

Rich

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Anonymous






Posted: Fri Jan 08, 2010 5:01 pm Post subject:

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The attached article explains it better than I did ...

http://www.medicalnewstoday.com/articles/173800.php

Rich

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Kathrynne Holden, MS



Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Sat Jan 09, 2010 9:40 am Post subject:

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.
Thank you Rich! That was an excellent explanation. Wish I'd thought of that.
_________________
Best regards,
Kathrynne Holden, MS
--
For a Parkinson Tip of the Day visit:

Chronicles of PD Fighter: Early signs and symptoms of parkinson’s disease

Chronicles of PD Fighter: Early signs and symptoms of parkinson’s disease

Tuesday, January 5, 2010

swallowing difficulties in PD

Anonymous






Posted: Wed Jan 14, 2009 8:00 pm Post subject: Treating Swallowing Difficulty in Parkinson's disease

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What does treatment for swallowing difficulty in the later stages of Parkinson’s disease entail? Is teaching compensatory strategies most effective or are other treatment techniques more beneficial?

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lmahler



Joined: 02 Apr 2007
Posts: 1

Posted: Sat Jan 17, 2009 3:37 pm Post subject: Treating Swallowing Disorders in the Late Stages of PD

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Changes in swallowing are frequently found in PD. It has been reported that as many as 95% of people with PD have dysphagia (Bird, Woodward, Gibson, Phyland, & Fonda, 1994; Logemann, Blonsky & Boshes, 1975; Potulska, Friedman, Krolicki & Spychala, 2003). When dysphagia is present it has a negative impact on quality of life by interfering with the ability to take medications, maintain hydration and nutrition, and may result in aspiration pneumonia. Pneumonia is one of the leading causes of death in PD (Beyer, Herlofson, Arsland, & Larson, 2001; D’Amelio, Ragonese, Morgante, Reggio, Callari, Salemi & Savettieri, 2006). Swallowing disorders in PD are caused by motor and sensory components. Muscle rigidity, weakness and bradykinesia can affect all phases of swallowing and sensorimotor abnormalities may reduce the person’s awareness of symptoms of dysphagia (Robbins et al. 1986; Labuszewski & Lidsky, 1979).

Although swallowing difficulties can be present in early stages of PD, typically they are more prevalent as the disease progresses. Given the complexity of normal swallowing and the variability of changes in swallowing due to PD, it is not possible to describe which type of treatment intervention might be most appropriate for a given individual.

Treatment options include postures such as chin down to alter the bolus flow, maneuvers such as an effortful swallow to improve bolus clearance in the pharynx, changes in consistency of liquids or foods, and possibly adding non-oral feeding alternatives such as a feeding tube in the stomach. An evaluation with a speech-language pathologist who is experienced in treating people with PD will determine which treatment strategy is best for an individual.

If you or a family member are experiencing changes in swallowing that make it difficult to take pills and/or coughing during meals, please talk to your physician and seek a referral to a speech-language pathologist (SLP). An SLP can evaluate communication and swallowing.

Leslie Mahler, PhD, CCC-SLP
_________________
Leslie Mahler, PhD, CCC-SLP
Assistant Professor
University of Rhode Island

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tongue tied

Anonymous






Posted: Wed Apr 08, 2009 9:58 pm Post subject: Tongue problems

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I was diagnosed with Parkinson's last summer. In 51 years old and taking Requip XL 12 mg, Aslect 1 mg, Zoloft 100 mg and just recently provincial provigil 100 mg.

It seems as if over the last few months it has become more difficult to talk because my tongue gets tied. It seems to be worse later in the day when I'm tired or under stress. Because of this I feel that my speech becomes confused.

Do you think this is related to the Parkinson's? If so, what can I do about it?

Thanks,
Dave

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lmahler



Joined: 02 Apr 2007
Posts: 1

Posted: Wed Apr 22, 2009 1:49 pm Post subject: Tongue-tied

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Dave,

It sounds like the symptoms you describe may be related to your Parkinson's disease (PD). Speech problems are very common in people with Parkinson disease! It has been reported as high as 89% of people with PD have trouble with their speech or voice. The most common difficulties include reduced vocal loudness, monotone, imprecise articulation (often related to the tongue), and a hoarse or breathy sounding voice. In addition, some individuals have difficulties similar to what you have described - there are changes in tongue movement and symptoms are worse when you are fatigued.

Without seeing you in person, it is difficult for me to determine exactly what is going on with your oral/pharyngeal muscles. However, given the high incidence of speech (and swallowing) problems in PD I would strongly urge you to seek an evaluation with a speech-language pathologist. IF it is the PD that is causing the difficulties you describe, then treatment may help and you should get started as soon as possible.

I'm glad you wrote.

Leslie
_________________
Leslie Mahler, PhD, CCC-SLP
Assistant Professor
University of Rhode Island

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Anonymous






Posted: Sat Apr 25, 2009 7:11 pm Post subject:

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Yesterday my neuro said my voice has decreased volume. This is confirmed by my wife. Is there anything I can or should do about this? Is this progressive? I have to do a lot oftalking in my job and I am some what worried.

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lmahler



Joined: 02 Apr 2007
Posts: 1

Posted: Mon Jun 08, 2009 7:25 pm Post subject: Reduced Loudness in PD

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Dave,

Reduced loudness is a very common complaint of family members of people with PD. I say family members because they are usually the ones to notice first since the person with PD is often unaware that they are speaking too softly to be understood easily.

YES, therapy can help. It should be intensive, effortful treatment according to the neuroscience literature. The LSVT LOUD treatment is administered 4 times a week for 4 weeks for individual 0ne-hour sessions. This is one option for you that has Level I efficacy data. Level I efficacy data means that the treatment has been studied in a randomized control trial comparing it with an alternate treatment and with no treatment. Those data are published in:
Ramig, L., Sapir, S., Countryman S., Pawlas, A., O’Brien, C., Hoehn, M., & Thompson, L. (2001). Intensive voice treatment (LSVT LOUD) for individuals with Parkinson disease: A two-year follow-up. Journal of Neurology, Neurosurgery, and Psychiatry, 71, 493-498.

If you are still working and communication is important in your profession then I encourage you to begin treatment to improve your voice and speech abilities as soon as possible.

Leslie
_________________
Leslie Mahler, PhD, CCC-SLP
Assistant Professor
University of Rhode Island

Voice and tongue

Anonymous






Posted: Tue Jun 02, 2009 8:34 am Post subject: Voice and tongue

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I was diagnosed with Parkinson's last summer. I am 51 years old and taking Requip 4 mg, three times a day, Azilect 1 mg, Zoloft 100 mg and provigil 100 mg.

I previously asked a question about being tongue-tied. I also asked a question about my voice. Apparently that did not get through or somewhere along the line it was missed.

Yesterday while talking on the phone I realized my tongue was not moving correctly. It seemed to be moving slowly. As I thought back, this does not happen often, just occasionally, at lease this severely.

Also, my neurologist and my wife have indicated that they believe my voice has decreased in volume.

Do you think these symptoms are related to the Parkinson's disease? Is there anything that can be done about it? Any other thoughts or suggestions you have would be appreciated.

Thanks,
Dave

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CBassich



Joined: 20 Sep 2007
Posts: 0

Posted: Thu Jun 04, 2009 7:24 pm Post subject: Loss of Voice Volume (loudness)

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You mentioned that your wife and neurologist have noticed a change in the loudness of your voice. This is a very typical, early symptom experienced by persons with Parkinson Disease. Research has suggested that persons with Parkinson Disease loose the ability to monitor their feeling of loudness. That is, when you are talking in what you feel is a normal level of loudness- the listener feels you are talking softly. When people ask you to "Talk Louder" or "Speak Up" you can do so, but it feels that you are talking too loud. You need to feel comfortable that when you talk at a level your listener hears as "just right" it actually feels loud to you. This is a hard thing to train yourself to do, because no one wants to feel that they are talking too loud! This retraining is actually an integral part of the treatment/training strategy used in the Lee Silverman Voice Treatment, which was originally developed for persons with Parkinson Disease. You might want to devise a secret hand signal with your wife that cues you to "Speak Louder".

As for your feeling of being "tongue-tied" - I am sorry if a previous posting was not answered. If you feel your tongue is moving slowly, that also could be due to your Parkinson disease. Persons with Parkinson disease often feel that arms, legs, and even the tongue move slowly. Again, talking louder and using a slower speaking rate will help you to speak more clearly.

You might want to consult with a speech pathologist about Lee Silverman Voice Treatment or alternative voice and speech therapy that would focus on the problems you are experiencing. I suggest that you find a speech pathologist who has experience treating persons with Parkinson Disease. The National Parkinson Foundation has sponsored an interdisciplinary training program at a national level - Allied Team Training for Parkinson Disease. The Speech Pathologists who have completed this training have participated in a four and one-half day workshop that focused on specific treatment of speech, language and swallowing problems experienced by persons with Parkinson Disease. This training also taught them about other problems that persons with Parkinson disease experience and how other professionals, such as Physical Therapists, Occupational Therapists, Nurses, Nurse Practioners, Neurologists, Music Therapists, and Social Workers can network in treating persons with Parkinson Disease. Also, there are speech pathologists that are certified for the Lee Silverman Voice Treatment, which is an intensive speech therapy program for persons with Parkinson Disease.

Celia J. Bassich, Ph.D., CCC-SLP
Allied Team Training for Parkinson Disease, NPF

Monday, January 4, 2010

How different is Stalevo from Sinemet?

Sinemet is actually a combination of levodopa and carbidopa. Levodopa is the active ingredient that enters the brain and gets converted to dopamine once it arrives at its destination. When levodopa was marketed alone (without the carbidopa) a lot of the patients had significant nausea and vomiting. This is because the levodopa that was not absorbed in the gut and was converted to dopamine. In the gut, dopamine cannot be absorbed and therefore it cannot enter the brain beyond its “iron curtain” (called the blood brain barier) (it can only enter if it is in levodopa form). Unfortunately, when outside the brain, dopamine is an irritant. It causes nausea and the vomiting. This is because the one area of the brain (called area postrema) is exposed and stimulated as it is not situated behind the brain’s ‘iron curtain’. Carbidopa blocks the enzyme that coverts levodopa to dopamine in the gut so that more of it gets absorbed and less of it stays in the gut as dopamine. Since carbidopa has been automatically incorporated with levodopa, there has been less nausea experienced by patients. Sin-emet is in fact derived from the latin words, sin (meaning “without”) and emet (meaning “to vomit”). Sinemet therefore means, “without vomiting”. Of course this is not always the case, and some patients actually need extra doses of carbidopa than the one that is built in the sinemet tablet.

It gets even better. Stalevo combines three ingredients: levodopa, carbidopa, plus entcapone. Entacapone blocks another enzyme that breaks down levodopa in the gut. The net result is more levodopa getting absorbed and entering the brain. It is therefore a good drug for those with wearing off as it prolongs the life of levodopa (Hauser 2004).

A double-blind clinical trial known as STRIDE-PD (STalevo Reduction in Dyskinesia Evaluation) to determine if Stalevo is effective in delaying the start of dyskinesias was recently concluded. Unfortunately, it showed that patients who started on stalevo did not have lesser dyskinesias than those who started on sinemet. So for now, unless one is experiencing wearing off symptoms, it might be better to simply use sinemet.
_________________
Hubert H. Fernandez

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Anonymous






Posted: Mon Dec 21, 2009 2:40 pm Post subject: Parkinson's symptoms and Nausea

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Doctor,
My Mother is not able to walk, bathe, or dress herself due to her Parkinson's. She has been taking 5 doses of Stalevo (125mg) 5 times a day with extra Carbidoba and a Sinemet CR before bedtime. She has a big problem with nausea which we fight continuously. We are staggering the meds/food now, but it does not seem to help too much. Is there a combination of meds that we can try to help alleviate both Parkinson's and the nausea.
Any help is appreciated.
Thanks,
Chris

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Dr. Fernandez



Joined: 20 Jan 2007
Posts: 90

Posted: Mon Dec 21, 2009 9:47 pm Post subject:

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Actually, i would recommend NOT to stagger food and meds. She should take it with food if she has a lot of nausea.

If this does not work, i would double the dose of carbidopa.

See if those work first, before we do anything else. Talk to her doctor of course.

Yours,
_________________
Hubert H. Fernandez

Melatonin,insomnia and PD

Kathrynne Holden, MS



Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Sun Jan 03, 2010 5:14 pm Post subject: Melatonin, insomnia and PD

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.
Melatonin, insomnia and PD

Melatonin has helped many people suffering from jet lag. An animal study
has appeared promising in terms of preventing cell death, but human
studies are lacking. If you’d like to try melatonin for sleep, discuss it
with your doctor first. The Dietary Supplement advises: “For minor
sleeping problems, start with 0.3-0.5 mg (300-500 mcg; cut the pill if
necessary), a dose that maintains blood concentrations at healthy levels.
Take it 30 minutes to an hour before bedtime and be careful, for melatonin
can impair mental alertness and physical coordination as it lowers body
temperature and blood pressure slightly. Incrementally increase the dose
up to 5 mg/night if smaller amounts aren’t helpful, recognizing that you
may feel tired and sleepy the following morning if you take too much....If
you have persistent insomnia or chronic sleep problems....Get a medical
evaluation to identify the cause. Unless a doctor advises otherwise,
melatonin should not be taken for more than a few months at a time since
its long-term safety hasn’t been studied.”
Thomas, P.R. Melatonin. The Dietary Supplement. V 4 No 1 Jan-Feb 2003.
_________________
Best regards,
Kathrynne Holden, MS
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/