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Something a little different

April 9, 2010

April is Parkinson’s Disease month.  I’m not really sure what that means to others, but to me it means I must do all I can to promote awareness of the disease.  So here is a Q and A session about PD.  If any reader has a specific question, shoot me an email, and I’ll do my best to answer it.

Q: Why is PD so hard to diagnose?

A: PD’s onset is generally recognized when your brain’s dopamine output drops from 50 to 90% of what it is supposed to be.  So by the time you start exhibiting symptoms, you’re already in trouble.  It’s like taking a walk and finding you’re in quicksand.  Adding to the problem is the brain’s “blood brain membrane/barrier”.  This little feature protects the brain against microbes, such as bacteria.  It also stops certain chemicals from passing across it.  Chemicals like dopamine.  So you can’t draw a blood sample, run a test, and determine dopamine level.

Q: So how is it diagnosed?

A: One way is symptom observation and handwriting analysis:  People with PD generally make tiny letters when they write.  Doctors watch how a person walks and observe facial expressions as they talk.  Another way is  to give the patient a dose of Sinemet, which mimics dopamine.  If it’s PD, things improve. 

Q: So why is it so hard to treat?

A: It’s the same reason it’s hard to diagnose: the blood brain barrier.  You can’ t give someone a shot of dopamine, it will never enter the brain.  You have to give a chemical that get’s across the barrier and then gets converted into a dopamine-like substance.

Q: What are PD’s symptom?

A: In no particular order they include, but are not limited to: depression; body stiffness and immobility; bad or vivid dreams; insomnia; trembling; inability to taste or smell; constipation; bad posture resulting from spine curvature; urinary or fecal incontinence; and cognitive disorders.  Poor balance and the inability to smile (really!)  There’s probably more but I get confused and forget…

Q: Is PD fatal?

A: No.  But problems resulting from the PD often get you.  For example, people with advanced PD often have difficulty chewing and swallowing.  As a result they inhale food and get pneumonia.  The pneumonia kills them.

Q and A to be continued, but I’ll leave you with a personal example.

When I dream, it’s almost like real life.  I have detailed colors, conversations, see people, places and things; all very, very real.  One night I dreamed that a vampire was attacking me.  It grabbed me.  I had to get away!  I did the only thing I could to save myself: I bit the vampire as hard as I could!

My wife’s screams woke me up.  I had woken her up first, with my yelling at the vampire, and she had tried to wake me up and comfort me.  So thinking she was a vampire, I had bit her arm as hard as I could.  It took five weeks for the teeth marks to go away.  I still feel bad about that.

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