Parkinson's disease (PD) is a degenerative neurological disorder
that causes a gradual loss of muscle control. The disease kills
dopamine-producing nerve cells in the brain that is responsible for planning
and controlling body movement. Tremors, rigidity, slowness of movements and
impaired balance are some of the characteristic symptoms of the disease.
Dr. James Parkinson, a British
physician, was the first to explain the symptoms of PD in an article titled, An Essay on the Shaking Palsy
It is in his honor, and also to raise awareness of the disease, that European Parkinson's Disease
observes 'World Parkinson's Day' annually on April 11.
People usually begin to have symptoms between the ages of 50-60
years of age. Globally, around 1% of the population,
over the age of 60, is estimated to have Parkinson's. Medical experts in India claim that seven to nine
million people suffer from this debilitating disease in the country.
Symptoms of Parkinson's Disease
There are five stages in Parkinson's disease:
- Stage 1: Symptoms affecting only one side of the body.
- Stage 2: Symptoms affecting both sides of the body. But still balance is intact.
- Stage 3: Symptoms are mild to moderate and balance is impaired. But the person is still
able to function independently.
- Stage 4: People are severely disabled, but can still walk or stand without assistance.
- Stage 5: The patient becomes wheelchair-bound or bedridden.
Not everyone with Parkinson's will get these symptoms in the order
listed here, and there is no telling how the progression of the disease will
affect someone. Symptoms and their progression vary from person to person.
There is no known cure, or way to prevent Parkinson's. You cannot
diagnose it through a lab test. The only way to diagnose Parkinson's is through
a neurological exam that includes testing your reflexes and observing your
muscle strength, coordination, balance, and other details of movement.
Notwithstanding the debilitating nature of the disease, medical
experts argue that† Parkinson's can be managed if you can identify
individual symptoms and determine a proper course of treatment.†
Dr. U. Meenakshisundaram, Head of†Neurology,
Sri Ramachandra University (SRU), Chennai,†says that hand tremor is
an early symptom for about 70% of people with Parkinson's. "It usually starts
in one finger or the hand when it's resting.†As the disease progresses,†some patients also face other symptoms such as
speech slurring, indigestion, low blood pressure and stress," he explains.
The senior neurologist advices people with Parkinson's to understand
their symptoms and individual needs to manage the disease effectively.
"Parkinson's affects everyone differently. One patient will not experience the
same symptoms of someone else. So learn more about your condition, choose a
good doctor and share your problems with the expert. Also, you should follow
advice given on medication and other instructions, precisely," he says.
Krishna***, a 49-year-old from Chennai, India, says† that his symptoms got worse when he skipped
his medication for just two days. "I had been taking Parkinson's medication for
the last four years. Last year, I didn't take them for just two days; the drugs
were not available in the medical store. Then, my symptoms - tremor and
excessive sweating - got worse. I had to be admitted to a hospital, where I
spent Rs. 2 lakh in 15 days! I also suffered a lot of pain for skipping
medication for just two days. It was awful and terrifying!"
missed his medication since then and has been following all instructions from
Treatment of Parkinson's Disease
Dr. R. Balakrishnan, head of Psychiatry at SRU, says that people with Parkinson's from different age-groups respond
to treatment differently. So, patients and, also caregivers
, need support from a healthcare group.
"I give advice to patients and caregivers depending on the stage of
the disease and the patient's emotional state," he explains. "For instance,
younger people often have a more sensitive response to drug treatment,
especially in terms of side-effects. Patient's family background and
socio-economic factors are also relevant while giving them advice and support."
recommends daily exercises for people with Parkinson's. "Include anything -
from walking to physiotherapy and yoga just to keep you active. You should work
on building your strength and balance, as well. Also, working-out every day
reduces risk of Parkinson's in undiagnosed people. However, seek expert advice
before starting with a physical activity," he said.†
Balaraman***, a 35 year-old patient keeps himself active with
moderate daily activities including household work. "Two years back, my right
leg started shivering. Then, my hands affected and I could not write anything;
I couldn't even sign my office documents. Exercise recommendations from doctors
made a lot of difference. I'm not doing intensive exercises,but, walking and
some household activities keep me active throughout the day and help me mange
my symptoms," he said.
Dr. Alok Gupta, senior consultant neurosurgeon at Neurosurgery
Artemis Hospital, Gurgaon, explains that Parkinson's affects many aspects of
your life but with proper medication, such as Levodopa drug, and some lifestyle
changes, it is manageable.†
"The brain converts Levodopa to dopamine. The drug has been used
since the 1970s and it is still the most effective Parkinson's medication. It
reduces rigidity helping people to move more easily. But, the drug should not
be taken with a high-protein diet," he says.
Dr. Gupta also says that Deep Brain Stimulation (DBS) can be used but "only on individuals whose symptoms cannot
be controlled with medications. The procedure can improve social functioning in patients."
A well-balanced diet is crucial for everyone and it is no different
for someone with Parkinson's. However, there are no special dietery
requirements you need to follow, says Dr. A.J. Hemamalini, associate professor
at the department of Clinical Nutrition, SRU. "Include high-fiber foods
vegetables, cooked dried peas and beans, whole-grain foods and fresh fruit in
your diet. Choose foods low in†saturated fat†and†cholesterol.
Maintain a healthy weight†and try to limit sugars," she explains.
(***Names changed to protect identity)