What Makes Pd Hard To Predict
Parkinsonâs comes with two main buckets of possible symptoms. One affects your ability to move and leads to motor issues like tremors and rigid muscles. The other bucket has non-motor symptoms, like pain, loss of smell, and dementia.
You may not get all the symptoms. And you canât predict how bad theyâll be, or how fast theyâll get worse. One person may have slight tremors but severe dementia. Another might have major tremors but no issues with thinking or memory. And someone else may have severe symptoms all around.
On top of that, the drugs that treat Parkinsonâs work better for some people than others. All that adds up to a disease thatâs very hard to predict.
Drinking Well Water Is Linked With A Higher Likelihood Of Developing Parkinson’s
A growing body of research suggests that there is a correlation between drinking well water and developing Parkinson’s Disease later in life. One particular study, conducted by a team at UCLA and published in the journal Environmental Health Perspectives, found that those who consume well water are statistically more likely to develop PD. After reviewing the medical records and personal histories of 700 people living in California’s farm belt between 1974 and 1999, they determined that those who ultimately developed PD had consumed private well water on average 4.3 years longer than those who did not.
Using Cbd For Treating Parkinsons Disease Symptoms
Without clinical trial data however, we do not know whether CBD is safe and effective for a particular symptom, and if it is, what CBD formulation and dosage is best to be used for a particular symptom.
We also dont know the side effect profile of CBD in people with PD. At baseline, people with PD may have various non-motor symptoms that may make them more prone to side effects from CBD, including fatigue and nausea.
If you would like to try CBD for one of your PD symptoms, have a conversation with your movement disorders specialist about it. Your doctor may be willing to oversee your trying it, or may feel that it is too risky for you without evidence that it will help. At the very least, he/she can make sure that there are no drug interactions between CBD and anything else that you take and discuss with you any potential side effects that you need to be aware of.
The Increased Interest In Cbd Products As Supplemental Treatment
There is also a very confusing array of CBD products that are available for purchase. These vary in:
- What the manufacturers state is in the product. That is, some formulations of CBD will state on their label that they also contain a small amount of THC or that they contain other cannabis-derived compounds, but not THC. Others state that they are pure CBD.
- The formulation. CBD is available in oils, creams, pills, inhalants and more.
It is not just the Parkinsons disease community that has taken an interest in CBD. There are countless health claims that CBD is helpful for a whole host of conditions. Clinical trial evidence to support the use of CBD however, is minimal. The only FDA-approved indication for CBD is to reduce seizure frequency in certain rare and severe forms of childhood epilepsy. A purified form of CBD, sold under the brand name Epidiolex® was tested in a well-designed clinical trial in order to gain this approval. .
For all the other health claims, there is not enough clinical trial data to allow the FDA to state whether or not CBD is effective. And there definitely is not enough data to support the use of one type or formulation of CBD over another.
This has not dimmed the enthusiasm of millions of CBD users for a wide range of medical conditions.
Key Measures For The Prevention Of Complications
Parkinsons disease nurse specialists should support patients and caregivers by clarifying concerns and implementing a treatment plan.
Patients, caregivers and medical staff are responsible for bringing all the medication updated, and paying attention to medication timings.
If at all possible, avoid changing abruptly or changing more than one antiparkinsonian medication at a time.
Patients and caregivers should be provided with a list of drugs capable of worsening parkinsonism.
Patients taking dopamine agonists should be informed about sleep attacks and risk of impulse-control disorders before starting treatment and regularly during follow-up.
Periodically, at least annually, review falls, sleepiness, cognition, autonomic disturbances and psychiatric symptoms.
Disease rehabilitative therapy should be proposed to minimise complications such as falls and swallowing problems.
In case of elective admission, it is important to plan in advance how to make medication changes. If oral medication intake is limited, consider transdermal agonists, enteral administration of usual medication, and levodopa-carbidopa intestinal gel infusion.
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Foster A Good Relationship
Lastly, maintaining your relationship and communication with the person with Parkinsonâs can be the most challenging and rewarding aspect of caregiving. As Parkinsonâs disease progresses, the roles change and the person with Parkinsonâs may go from being an independent head of the household to a very dependent person requiring a significant level of care. However, research shows that despite high levels of strain, caregivers with good quality relationships have reduced depression and better physical health. Remember, as a caregiver your service to your loved one is beyond measure in terms of love, depth of care, and concern.
What Is Parkinson’s Disease
Parkinsons disease occurs when brain cells that make dopamine, a chemical that coordinates movement, stop working or die. Because PD can cause tremor, slowness, stiffness, and walking and balance problems, it is called a movement disorder. But constipation, depression, memory problems and other non-movement symptoms also can be part of Parkinsons. PD is a lifelong and progressive disease, which means that symptoms slowly worsen over time.
The experience of living with Parkinson’s over the course of a lifetime is unique to each person. As symptoms and progression vary from person to person, neither you nor your doctor can predict which symptoms you will get, when you will get them or how severe they will be. Even though broad paths of similarity are observed among individuals with PD as the disease progresses, there is no guarantee you will experience what you see in others.
Parkinsons affects nearly 1 million people in the United States and more than 6 million people worldwide.
For an in-depth guide to navigating Parkinsons disease and living well as the disease progresses, check out our Parkinsons 360 toolkit.
What Is Parkinson’s Disease?
Dr. Rachel Dolhun, a movement disorder specialist and vice president of medical communications at The Michael J. Fox Foundation, breaks down the basics of Parkinson’s.
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The Nervous System & Dopamine
To understand Parkinson’s, it is helpful to understand how neurons work and how PD affects the brain .
Nerve cells, or neurons, are responsible for sending and receiving nerve impulses or messages between the body and the brain. Try to picture electrical wiring in your home. An electrical circuit is made up of numerous wires connected in such a way that when a light switch is turned on, a light bulb will beam. Similarly, a neuron that is excited will transmit its energy to neurons that are next to it.
Neurons have a cell body with branching arms, called dendrites, which act like antennae and pick up messages. Axons carry messages away from the cell body. Impulses travel from neuron to neuron, from the axon of one cell to the dendrites of another, by crossing over a tiny gap between the two nerve cells called a synapse. Chemical messengers called neurotransmitters allow the electrical impulse to cross the gap.
Neurons talk to each other in the following manner :
The Relationship Between Parkinsons Disease And Sleep
Its unclear whether poor sleep causes parkinsonian symptoms to worsen or whether worsening parkinsonian symptoms cause poor sleep. In many cases its likely a case of bidirectionality, with each one exacerbating the other.
Fragmented sleep and sleep deprivation appear to leave the brain more vulnerable to oxidative stress, which has been tied to the development of Parkinsons disease. Parkinsons disease is not usually diagnosed until individuals have developed sufficient motor symptoms, by which time a significant portion of brain cells have already been damaged. If poor sleep quality or having sleep disorders foreshadows the development of parkinsonian symptoms, these could be useful in early diagnosis of the disease.
More research is needed to clarify the multifaceted relationship between Parkinsons disease and sleep. A better understanding of this connection may offer medical experts the unique opportunity to screen at-risk individuals and perhaps delay the onset of the disease.
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How Does Alcohol Affect Parkinsons Medication
The interaction between Parkinsons medications and alcohol is a common topic on MyParkinsonsTeam. I miss my red wine and whiskey on occasion, one member wrote. I found that it just makes my meds stop working. Another member said, My husband has been told he shouldn’t drink with his meds.
I have to limit myself to one Scotch on the rocks now, a MyParkinsonsTeam member said. I used to have three or four, but the side effects are too bad. Another wrote, Never really a good idea to mix alcohol with meds.
Whether you decide to continue your current drinking habits, cut down, or eliminate alcohol altogether, its important to listen to your body and have open conversations about these topics with your neurologist.
If you find yourself drinking alcohol to cope with other issues, such as depression and anxiety, you may find that healthy practices such as physical activity can help. In addition, participating in activities such as tai chi, yoga, and meditation may help ease the symptoms and complications of PD.
Certain Chemicals Lead To More Dangerous Contamination
Those who consumed well water in close proximity to certain pesticides were found to be at a higher risk than others. In particular, the UCLA study found that people drinking well water within 500 meters of fields sprayed with pesticides had a 66 percent increased risk of later developing PD. Those drinking well water near land treated with the insecticides propargite or chlorpyrifos had a 90 percent higher risk. This translates into a nearly doubled risk of someday developing Parkinson’s.
“The chemical with the most data linking it to an increased PD risk is paraquat,” says the APDA, referring to a chemical herbicide used to kill weeds. Exposure to paraquat is “associated with a 2-3 fold increased PD risk over the general population,” the organization warns.
If you regularly consume well water, especially in areas being sprayed with chemical pesticides or herbicides, be sure to have your water filtered and regularly tested.
The 5 Stages Of Parkinsons Disease
Getting older is underrated by most. Its a joyful experience to sit back, relax and watch the people in your life grow up, have kids of their own and flourish. Age can be a beautiful thing, even as our bodies begin to slow down. We spoke with David Shprecher, DO, movement disorders director at Banner Sun Health Research Institute about a well-known illness which afflicts as many as 2% of people older than 65, Parkinsons Disease.
The Challenge Of Regulating Cbd Products
Practically, CBD products can be obtained relatively easily at health food stores and online. They are not considered drugs , and therefore are not regulated by the Food and Drug Administration . This can be very problematic because without FDA oversight:
- There is no assurance that what is stated on the package is what is being sold. For example, even if the bottle says it is pure CBD, the product may contain other chemicals from the cannabis plant, or a higher amount of THC than advertised
- The manufacturing process, which is also not regulated, may introduce contaminants
- There is no assurance that the dosage written on the bottle is correct
- Medication interactions between CBD products and other drugs are not clear to consumers
The FDA is aware of the health claims that are made by manufacturers about various products and issues warnings to companies who market CBD products with unsubstantiated health claims.
What Medications Are Used To Treat Parkinsons Disease
Medications are the main treatment method for patients with Parkinsons disease. Your doctor will work closely with you to develop a treatment plan best suited for you based on the severity of your disease at the time of diagnosis, side effects of the drug class and success or failure of symptom control of the medications you try.
Medications combat Parkinsons disease by:
- Helping nerve cells in the brain make dopamine.
- Mimicking the effects of dopamine in the brain.
- Blocking an enzyme that breaks down dopamine in the brain.
- Reducing some specific symptoms of Parkinsons disease.
Levodopa: Levodopa is a main treatment for the slowness of movement, tremor, and stiffness symptoms of Parkinsons disease. Nerve cells use levodopa to make dopamine, which replenishes the low amount found in the brain of persons with Parkinsons disease. Levodopa is usually taken with carbidopa to allow more levodopa to reach the brain and to prevent or reduce the nausea and vomiting, low blood pressure and other side effects of levodopa. Sinemet® is available in an immediate release formula and a long-acting, controlled release formula. Rytary® is a newer version of levodopa/carbidopa that is a longer-acting capsule. The newest addition is Inbrija®, which is inhaled levodopa. It is used by people already taking regular carbidopa/levodopa for when they have off episodes .
What Are The Surgical Treatments For Parkinsons Disease
Most patients with Parkinsons disease can maintain a good quality of life with medications. However, as the disease worsens, medications may no longer be effective in some patients. In these patients, the effectiveness of medications becomes unpredictable reducing symptoms during on periods and no longer controlling symptoms during off periods, which usually occur when the medication is wearing off and just before the next dose is to be taken. Sometimes these variations can be managed with changes in medications. However, sometimes they cant. Based on the type and severity of your symptoms, the failure of adjustments in your medications, the decline in your quality of life and your overall health, your doctor may discuss some of the available surgical options.
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Eat Plenty Of Protein But Not With Levodopa Medications
If youre taking a levodopa medication, your doctor may tell you to avoid protein when taking your meds. Both animal and plant protein can interfere with the absorption of levodopa medications.
But you should still eat plenty of protein. Just be strategic with the timing. Dont take levodopa medications with meals, Dr. Gostkowski says. Its best to take it on an empty stomach either 30 minutes before your meal or an hour after eating.
If you get nauseous from the medication, eat a small amount of starchy food with it, such as crackers. Make sure whatever you eat with your medicine doesnt have protein. Its a misunderstanding that people with Parkinsons should avoid protein, Dr. Gostkowski says. You definitely need protein in your diet. Just dont eat it when youre taking your levodopa medication.
Parkinsons Sleep Problems: Diagnosis And Treatment
Parkinsons disease is chronic and progressive, meaning it tends to get worse over time. However, there are treatment options that can help manage symptoms and allow patients to get more restful sleep.
The simplest way to start sleeping better with Parkinsons disease is by adopting healthy sleep habits. Sleep hygiene tips for Parkinsons disease sufferers include:
- Sticking to regular bedtimes
- Following a consistent bedtime routine with soothing activities such as listening to music or reading a calming book
- Getting regular exercise, preferably early in the day
- Getting adequate exposure to light, whether outdoors or through light therapy
- Avoiding long naps and naps late in the day
- Creating a cool, dark, and comfortable sleeping environment
- Restricting bedtime activities to sex and sleep only
- Turning off screens an hour before bedtime
- Reducing liquid intake before bedtime
- Avoiding caffeine, alcohol, and tobacco
- Eating a healthy diet and avoiding large meals at night
Light therapy, exercise, and deep brain stimulation have been successfully used to improve overall sleep quality and to treat specific conditions, such as REM sleep behavior disorder, in patients with Parkinsons disease. Cognitive behavioral therapy for insomnia has proven effective at reducing insomnia in healthy adults, although further research is needed on the effects of CBT in patients with Parkinsons disease.
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Fourth Type Of Leg Pain Is Radicular Pain
In this case, the pain is caused by compression of nerves in lumbar area which results in weakness, numbness and tingling, and loss of reflexes from buttocks to foot in a distribution of a nerve. It can be acute or chronic, and can be worse with standing and sitting, or better with laying down. Of note: in my experience many patients including myself have these symptoms not because of physically herniated disc but rather by the stretching of a nerve in the canal as it exists due to severe musculoskeletal rigidity and abnormal posturing.
Sidebar: Advances In Circuitry Research
The brain contains numerous connections among neurons known as neural circuits.
Research on such connections and networks within the brain have advanced rapidly in the past few years. A wide spectrum of tools and techniques can now map connections between neural circuits. Using animal models, scientists have shown how circuits in the brain can be turned on and off. For example, researchers can see correlations between the firing patterns of neurons in a zebrafishs brain and precise behavioral responses such as seeking and capturing food.
Potential opportunities to influence the brains circuitry are starting to emerge. Optogenetics is an experimental technique that involves the delivery of light-sensitive proteins to specific populations of brain cells. Once in place, these light-sensitive proteins can be inhibited or stimulated by exposure to light delivered via fiber optics. Optogenetics has never been used in people, however the success of the approach in animal models demonstrates a proof of principal: A neural network can be precisely targeted.
Thanks in part to the BRAIN Initiative, research on neural circuitry is gaining momentum. The Brain Research through Advancing Innovative Neurotechnologies Initiative is accelerating the development and application of new technologies that enable researchers to produce dynamic pictures of the brain that show how individual brain cells and complex neural circuits interact at the speed of thought.
NIH Publication No. 15-5595
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