Parkinsons disease
A significant proportion of human beings live the later years of their live confined while still capable of performing a majority of other physiological processes just as good as anyone else. They can see and hear clearly but cannot reach out to the beautiful world around them the only interaction they have with the outside world being only through their painful facial expressions (Langston, Koller, Ellenberg, 1995. As time progresses, even their speech faces dire impairment and may fail completely. This condition threatens people from diverse racial and ethnic groups from all over the world, reaching an impressive one percent of the worlds entire population over fifty years according to statistics (National Institute of Neurological Disorders and Stroke, 2010). These people have what is called Parkinsons disease. As mentioned above, this disease has existed for as long as records have, but there is yet to be found the exact cause and the corresponding cure. Of course, advances in modern medical processes have availed efficient methodological approaches to alleviate the suffering caused by Parkinsons disease, but there still has not been found a procedure to totally reverse the progression of the disease.
Clinical diagnosis is purely symptomatic as all other screens conducted on a patient of Parkinsons disease turn normal (Boelen, 2009). The difficulty in dealing with Parkinsons disease is that its earliest symptoms are more often than not dismissed as those of the normal aging process.
Introduction to Parkinsons disease
Qualitatively, Parkinsons disease can be defined as a condition causing the degeneration of the central nervous system (CNS), mostly occurring in persons mostly over the ages of fifty years, actively diminishing the dexterity of the patients motor functions, his ability to speak fluently or coherently and other basic functions that are necessary for his or her undertaking of day-to-day activities (Rosenbaum, 2006). Categorically, Parkinsons disease falls under a collection of old age conditions collectively called movement disorders. General symptoms are rigidity of the muscles, tremors and inhibitions of comfortable movement, making the patient walk slowly and as if in pain (National Institute of Neurological Disorders and Stroke, 2010). In extreme cases, motion is totally impaired, a condition known as akinesia.
Medical research has shown that for normal motor operations, the basal ganglia are supposed to sufficiently stimulate motor cortex so that all motor functions are well coordinated and synchronized (Fischer, 1999). When this fails, it is because dopamine is not being produced in sufficient quantities in the brain or it is not acting as is necessary (Fischer, 1999). After the primary symptoms have been noticed, Parkinsons disease progressively continues to attack its patient leading to extreme cognitive dysfunction and impairment of speech. Parkinsons disease does not have a cure and its progress is constant as the patient gets older (Langston, Koller, Ellenberg, 1995). It is this disease that causes instability in posture, rigidity of the muscles and the tremor syndrome.
Symptoms of Parkinsons disease
The type of symptoms and their severity vary from one person to another. Parkinsons disease is chronic and progressive, meaning that the symptoms will become more pronounced as the disease progresses. The symptoms that develop early during the sickness gradually increase in severity as the patient continues to live with the disease. In some cases, the earliest symptomatic characteristics that exhibit themselves earliest in one patient may occur much later in another patient, or never at all.
However, the most common symptoms of the disease are as listed below
Tremor syndrome most victims of Parkinsons disease have shaking particularly in the arms or legs (Schwarz, 2006). The arms will often feel numb and tremble when the patient is awake and sitting or standing in an upright position. The trembling then subsidizes when the affected body part is moved or slightly exercised.
Rigidity the muscles of an individual with Parkinsons disease are stiff and painful (Schwarz, 2006). In fact, one of the most common earliest symptoms of this disease is reduced arm swing whereby the patients arms cannot describe the normal locus while they are walking due to stiffness of the arm and shoulder joints. The other joints usually affected are the legs, the neck the back and any other muscles that require to move a lot when the victim is doing the regular exercises and chores of everyday life. A condition called bradykinesia results, which is characterized by small and limited motion. If a patient stays in one position for a considerably long duration of time, like, say sitting in a chair, he or she may experience difficulty in getting out. Patients have even complained of experiencing difficulty while turning in bed.
The throat and mouth muscles become weak and emaciated. As such, a victim of Parkinsons disease will have difficulty swallowing and talking. As the disease progresses, a patient may suffer bouts of coughing and chocking andor drooling. Speech and other vocal sounds become one-noted and monotonous (Medline Plus, 2009). Because the muscles in the face also have difficulty in moving, the patient develops stillness or vacancy in his or her facial expression, a condition known as Parkinsons mask.
Parkinsons disease victims have difficulty in walking and maintaining a constant posture. They are likely to be seen walking in short, forced strides while maintaining a close proximity between their feet to avoid falling. The posture becomes stooped and they tend to turn around using the entire body rather then turning their neck or waist. As the disease progresses, the patient may begin to fall frequently, but this is much later during the illness.
The first symptom of Parkinsons disease victims is tremor. Tremor is very visible, however, it is important to note that a significant percentage of people over the age of fifty may develop the tremor syndrome from other causes and therefore every person who tremors does not necessarily have Parkinsons disease. Tremors usually first manifest themselves in a given part of the body, maybe the hand, a leg or one half of the entire body. The chin or tongue may also be affected. As time goes on the entire body may be affected but the tremor in most cases remains on one side of the body. Once affected, the patient may develops emotional stress making the tremor more noticeable. A victim of Parkinsons disease is thus advised to have more sleep and do the things that will help him or her to be at ease because physical and emotional relaxation helps to minimize or completely stop the tremor. There is a difference between tremor caused by Parkinsons disease and other causes in that tremor resulting from other conditions usually subsidizes when the affected body part is subjected to total rest and becomes more severe when the concerned part is moved even slightly.
Corresponding to the rigidity of muscles, a variety of other symptoms also occur. Dexterity in movement is greatly hindered and the patient therefore cannot do things that need great precision and fine movement like fitting a thread inside the hole of a needle (Schwarz, 2006). The victims handwriting may change, with the numbers written getting smaller than has usually been the case. Athletic prowess spirals down and the ability to do the simple things like dressing, eating and taking a bath becoming more difficult to do. The skin becomes oily and the patients scalp has more dandruff. Body muscles and the joints also suffer from cramps.
Another symptom of Parkinsons disease involves the digestive system. Victims of the disease usually experience persistent bouts of indigestion and constipation (Weiner, Shulman Lang, 2001). It may also become difficult to control bowel movements, particularly in controlling urination. The patient may get the urge to urinate frequently and at times with a lot of urgency failure to which urine will pass out involuntarily. The unfortunate incident is that the drugs prescribed to alleviate the suffering caused by Parkinsons disease usually amplify the symptomatic characteristics of the condition associated with the digestive and urinary systems (Schwarz, 2006). Parkinsons disease makes a person experience problems with involuntary body functions like sweating, blood pressure and hormonal balance. When the patient is standing up, his or her body may experience low blood pressure, a condition medically known as orthostatic hypotension. The sexual and reproductive system is also affected as a result of secondary effects of the disease of the medicine used to control the disease and its symptoms.
Making an early Diagnosis of Parkinsons disease
In a majority of diseases, the earlier the condition is identified, the more effective it is to deal with the condition (Langston, Koller, Ellenberg, 1995). Early diagnosis of Parkinsons disease enables the patient to seek immediate medical redress before other symptoms can begin to be experienced or the current ones become more pronounced. Any anomaly in the normal physiological process should not be taken for granted as it could be a sign of an underlying serious condition needing immediate medical attention. Someone may wake up with a swelling on the limb joints without any explanation whatsoever or with traces of blood in the urine. These are some of the signs the body gives to indicate that there is a problem somewhere. In the case of Parkinsons disease, the symptoms listed below should be taken seriously and perceived as a call for immediate conclusive diagnosis.
Signs of paralysis, no matter where they occur in the body should never be ignored. When an aged person experiences persistent sensations of numbness, confusion, tingling sensations in the arms or limbs, blurriness in vision and disrupted thought, speech and visual patterns, especially if these occur in one side of the body, he or she should consult a qualified physician as soon as is possible (Rosenbaum, 2006). These could even be an indication of blockage in the blood vessels delivering fresh blood to the brain slowly killing the brain cells meaning the person is under threat of suffering from a brain attack.
Diagnosis of Parkinsons disease is typically performed with emphasis being laid on the medical history of the patient (Medline Plus, 2009). Neurological examination is conducted conducting an oral interview with the patient and by physical examination using a scale known as the Unified Parkinsons Disease Rating Scale (UPDRS). There are specialized electronic machines used to obtain a spectrum of the activity around the basal ganglia of the brain but they are not readily available as their patent only permits they be marketed only in Europe. Therefore while screening for Parkinsons disease, it is hard to be sufficiently accurate especially during the early stages of the disease as its symptoms overlap with those of other old age conditions and the normal aging process (Boelen, 2009). The practice physicians have adopted is to continuously observe an individual suspected to be suffering from Parkinsons disease for a considerably long duration of time until the consistency of the symptoms is enough to identify a positive diagnosis. The symptoms usually monitored include the persistent shuffling of the feet when the patient is in sitting position and the lack of normal swing in the forearms while the person is walking on a flat surface.
Brain scans are also used while diagnosing for Parkinsons disease. Because symptoms of this disease overlap with those of many other conditions occurring in old age, the objective is to use elimination and rule out the other conditions so that it can be confirmed it really is the disease the patient is suffering from (Rosenbaum, 2006). Medical standards have guidelines recommending that patients of Parkinsons disease be referred to specialists of neurological disorders, usually to neurologists and geriatricians.
Treatment
As stated earlier, Parkinsons disease is a chronic, progressive disorder without a completely effective cure. The available medical solutions only act to alleviate the severity and discomfort of the symptomatic characteristics and involve broad and committed management from the patient and his or her family members, welfare or support groups, regular exercises and physiotherapy (Boelen, 2009). It is advisable that family members of a Parkinsons disease patient source the services of an occupational therapists and other specialized equipment so that the patient can achieve a better management of the condition in terms of personal care, leisure and remaining productive (Schwarz, 2006).
Medical prescriptions and surgery are increasingly being used as methods of relieving the symptoms of Parkinsons disease. A drug named L-dopa, existing in various forms is induced into the patients nervous system (Boelen, 2009). L-dopa, once in the brain, is transformed into the dopamine hormone in the dopaminergic neurons inside the basal ganglia to increase stimulation of the motor cortex and improve motor functions. However, not all of the administered dosage is converted in this region the rest is metabolized elsewhere in the central nervous system causing undesired side effects, in some cases adverse reactions. L-dopa induces a feedback inhibition slowing the bodys release of dopamine in the natural process thus its use eventually becomes counterproductive, leading to dependency (Boelen, 2009).
Conclusion
Counseling patients of Parkinsons disease
As is the case with most chronic illnesses, Parkinsons disease induces a lot of physical and mental stress. Patients therefore need to be comforted and shown much support, love and affection in order for them to realize that they are not alone (Langston, Koller, Ellenberg, 1995). It is for this reason that most specialists will recommend that they seek counseling. Sometimes, people avoid getting external help while suffering from conditions like this because of bearing feelings of resignation, guilt or isolation. However, the decision to seek counseling is a very important one as it leads one to a more productive and fulfilling life.
Once depression sets in from this disease as it affects the brain and the nervous system, a doctor should refer the patient to a qualified mental health specialist who should conduct a thorough assessment of the patients mental condition (National Institute of Neurological Disorders and Stroke, 2010). This assessment is used to determine the main areas of concern and the best approaches towards correcting them. From this assessment, the therapist can then recommend either crisis intervention counseling or individual counseling.
Crisis intervention counseling is usually applied as an emergency response when the patient has gone into panic and despair mode after he or she has been diagnosed with Parkinsons disease (Langston, Koller, Ellenberg, 1995). The counselor helps to restore confidence, hope and zeal to go on living despite the affliction. Individual counseling is employed when the problems come from within the patient and his or her perceptive, behavioral and thinking patterns. It is recommended for patients who demonstrate difficulty in coming into terms with their affliction and are experiencing grief and anxiety over how to deal with the situation.
Living with Parkinsons disease
Victims of Parkinsons disease have problems with movement and maintenance of posture and stability. During the latter stages, falls become a common factor. Falls could lead to serious injuries and accidents and avoiding them becomes very necessary (Fischer, 1999). Patients or their families should the work with the physician to make sure that the treatment accorded is optimal while still attending therapy sessions to alleviate the progressive degradation of motor functions (Weiner, Shulman, Lang, 2001). The living quarters of a Parkinsons disease patient should also be optimized to minimize the risk of accidental falls. All loose wires and other appendages should be removed from the floors, grab bars installed in the bathroom facilities and high-grip mats used in places with slippery floors of mats.
The lighting should be proper in all rooms, halls and staircases. All treads, mats and grip bars should be firmly installed and the general arrangement made in such a way as to maximize safety. The patient, on the other hand, should ensure that he or she has one hand free at all times. The use of a backpack should be employed instead of carrying items using both hands. Exercise is very important in maintaining physical shape (Fischer, 1999). Even while just taking a stroll, the patient should consciously swing both arms as wide as possible to exercise his or her joints and muscles. The patient should also try as much as possible to lift his legs from the ground while walking to avoid loosing balance as occasioned by habitually shuffling the feet (Schwarz, 2006). All in all, how well someone copes with Parkinsons disease depends much on individual effort as well as the involvement of family and loved ones.
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