by Vishnuprasad on  April 11, 2015 at 8:06 PM Health In Focus
Significance of World Parkinsonís Day 2015
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 in 1817. It is in his honor, and also to raise awareness of the disease, that European Parkinson's Disease Association 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!"

Krishna hasn't missed his medication since then and has been following all instructions from his doctor.

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."

Balakrishnan also 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 such as 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)

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