Parkinson's disease (PD) is a neurodegenerative brain disorder that progresses slowly in most people. Most people's symptoms take years to develop, and they live for years with the disease.
In short, a person's brain slowly stops producing a neurotransmitter called dopamine. With less and less dopamine, a person has less and less ability to regulate their movements, body and emotions.
Here are the 10 signs you might have the disease. No single one of these signs means that you should worry. But if you have more than one symptom you should make an appointment to talk to doctor.
Tremor or Shaking Have you noticed a slight shaking or tremor in your finger, thumb, hand, chin or lip? Does your leg shake when you sit down or relax? Twitching or shaking of limbs is a common early sign of Parkinson's disease.
What is normal? Shaking can be normal after lots of exercise or if you have been injured. Shaking could also be caused by a medicine you take.
Small Handwriting Has your handwriting suddenly gotten much smaller than in it was in the past? You may notice the way you write words on a page has changed, such as letter sizes are smaller and the words are crowded together. A sudden change in handwriting is often a sign of Parkinson's disease. What is normal? Sometimes writing can change as you get older, if you have stiff hands or fingers or poor vision, but this happens over time and not suddenly. Loss of Smell
Have you noticed you no longer smell certain foods very well? If you seem to have more trouble smelling foods like bananas, dill pickles or licorice, you should ask your doctor about Parkinson's disease.
What is normal? Your sense of smell can be changed by a cold, flu or a stuffy nose, but it should come back after you are better.
Trouble Sleeping Do you thrash around in bed or kick and punch while you are deeply asleep? You might notice that you started falling out of bed while asleep. Sometimes, your spouse will notice, or will want to move to another bed. Sudden movements during sleep may be a sign of Parkinson's disease. What is normal? It is normal for everyone to have a night when they 'toss and turn' instead of sleeping.
Trouble Moving or Walking Do you feel stiff in your body, arms or legs? Sometimes stiffness goes away as you move. If it does not, it can be a sign of Parkinson's disease. You might notice that your arms don't swing when you walk, or maybe other people have said you look stiff. An early sign might be stiffness or pain in your shoulder or hips. People sometimes say their feet seem 'stuck to the floor.'
What is normal? If you have injured your arm or shoulder, you may not be able to use it as well until it is healed, or another illness like arthritis might cause the same symptom.
Constipation Do you have trouble moving your bowels without straining every day? Straining to move your bowels can be an early sign of Parkinson's disease and you should talk to your doctor.
What is normal? If you do not have enough water or fiber in your body, it can cause problems in the bathroom. Also some medicine will cause constipation. If there is no other reason such as diet or medicine that would cause you to have trouble moving your bowels, you should speak with your doctor.
A Soft or Low Voice Have other people told you that your voice is very soft when you speak in a normal tone, or that you sound hoarse? If there has been a change in your voice you should see your doctor about whether it could be Parkinson's disease. Sometimes you might think other people are losing their hearing, when really you are speaking more softly.
What is normal? A chest cold or other virus can cause your voice to sound different, but you should go back to sounding the same when you get over your cough or cold. Masked Face Have you been told that you have a serious, depressed or mad look on your face more often, even when you are not in a bad mood? This serious-looking face is called masking. Also, if you or other people notice that you have a blank stare or do not blink your eyes very often, you should ask your doctor about Parkinson's disease.
What is normal? Some medicines can cause you to have the same type of serious or staring look, but you would go back to the way you were after you stopped the medication.
Dizziness or Fainting Do you notice that you often feel dizzy when you stand up out of a chair? Feeling dizzy or fainting can be signs of low blood pressure and can be linked to Parkinson's disease.
What is normal? Everyone has had a time when they stood up and felt dizzy, but if it happens on a regular basis you should see your doctor.
Stooping or Hunching Over Are you not standing up as straight as you used to? If you or your family or friends notice that you seem to be stooping, leaning or slouching when you stand, it could be a sign of Parkinson's disease.
What is normal? If you have pain from an injury or if you are sick, it might cause you to stand crookedly. Also, a problem with your bones can make you hunch over.
PD can’t be cured. Treatment aims to slow disease progression and reduce disability while minimizing complications. One might think that simply administering dopamine directly into the brain (if that were possible) would cure the disease. But dopamine doesn’t cross the blood-brain barrier, so getting it to its intended target would require more than just dopamine administration. Also, many medications have adverse effects, and multiple drugs are needed to treat all aspects of the disease. (See chart by clicking the PDF icon above.)
Levodopa and carbidopa Treatment focuses on symptom management, and levodopa (L-dopa) remains the gold standard. The immediate precursor of dopamine, L-dopa is converted to dopamine by decarboxylation both in the brain and peripheral tissues. L-dopa is given in combination with carbidopa to minimize peripheral conversion, which allows more of the drug to reach the brain and thus prevent nausea. A peripheral decarboxylase inhibitor, carbidopa replaces the dopamine lost in PD. It takes effect within 15 to 30 minutes of administration. Levodopa is combined with carbidopa in various medications, including Sinemet, Sinemet CR, and Parcopa (orally disintegrating tablets). Stalevo combines L-dopa, carbidopa, and entacapone, a catechol-O-methyltransferase (COMT) inhibitor designed to inhibit end-of-dose “wearing off.”
Unfortunately, clinical benefits of these drugs decline over time, necessitating additional doses, which in turn may cause dyskinesia. Challenges You as a Caregiver Are Likely to Face There are challenges that a person with Parkinson's disease confronts. First, the disease can vary from day to day. There will be times when he or she can function almost normally and then other times when he or she will be very dependent. This is a natural part of the disease. But it can make a caregiver feel that the person is being unnecessarily demanding or manipulative. Keep in mind that Parkinson's is unpredictable and each day can pose new challenges for you and your loved one.
Also, keep in mind that Parkinson's is a progressive disorder. While medications and surgery can provide significant relief of symptoms, they do not stop the progression of the disease.
Depression is also very much a part of the disease. It is important to recognize the signs and symptoms of depression so you can help your loved one seek treatment promptly. And, if you are feeling depressed and having trouble coping, it's just as important to get care for yourself.
Communicating With Your Loved One Parkinson's disease can make verbal communication very difficult for your loved one. That can get in the way of your ability to care for his or her needs.
Here are some ways that can help you better understand your loved one. Talk to your loved one face-to-face. Look at him or her as he or she is speaking. In the case of advanced disease, ask questions that your loved one can answer "yes" or "no." Repeat the part of the sentence that you understood. (For example, "You want me to go upstairs and get the what?") Ask your loved one to repeat what he or she has said, or ask him or her to speak slower or spell out the words that you did not understand.