By Marlene Nakamoto
It may start with a slight, barely noticeable trembling in one hand. The torso, arms or legs may become rigid or stiff; movements such as walking become slower. Tone of voice becomes flat, softer and a little hoarse. Gradually, the symptoms become more pronounced; tremors may affect the arms, legs, jaw and face. Simple tasks -- talking, chewing and swallowing -- become difficult.
Parkinson's disease is a chronic, progressive condition that affects nearly 2 million Americans. Each year, about 70,000 new cases are diagnosed.
This motor system disorder was first described in 1817 by Dr. James Parkinson, an English physician, who called it the "shaking palsy." The disease is caused by a loss of dopamine-producing brain cells; dopamine is a chemical that helps transmit messages to parts of the brain that control muscle movements. Low levels of dopamine short circuit these muscle messages, causing tremors, stiffness, and lack of coordination.
It's not entirely known what causes the loss of these brain cells. Some experts believe it may be the result of damage from genetic and environmental factors. (Prolonged exposure to pesticides and herbicides are examples of environmental factors.) People who have a parent or sibling with PD have a slightly higher risk of developing the disease than those who don't. Most often, the disease strikes people age 50 and above, although it doesn't spare those who are younger. Actor Michael J. Fox was diagnosed with young-onset Parkinson's disease in 1991, at age 30.
Although the reasons why dopamine-producing brain cells are lost remains speculative, experts know for certain that there is no way to stop the loss of the cells and no way to restore them.
Treating Parkinson'sIt would seem logical that treating PD would be as easy as taking dopamine supplements. Unfortunately, human physiology prevents ingested dopamine from reaching the brain. Other medications circumvent this dilemma, however. One widely prescribed medication is metabolized by the body into dopamine, while another medication working in tandem allows the dopamine to enter the brain and minimizes some side effects.
Because medication needs may change as the disease progresses, patients need to work closely with their doctors to ensure that the types of medications and dosages are appropriate.
Surgery can also ease symptoms of PD, but like medicine, it is not a cure. Surgery is used infrequently because most patients respond quite well to drug therapy. Also, most patients are not candidates for surgery because of their age or other medical problems.
Active LivingIn many instances, exercise can be extremely helpful for PD patients, whether the disease is in its early or later stages. Exercise won't stop the disease from progressing, but can be helpful in improving a patient's confidence and self-esteem. In his practice, neurologist Terry Shimamoto has observed that patients who remain active with an exercise program fare much better over time than those who don't. "Stretching and balancing exercises help alleviate rigidity and stiffness," says Shimamoto. "This makes patients less prone to falling or losing their balance." They also maintain their level of motor functioning, especially walking, adds Shimamoto, and don't tire as easily.
"Of all the exercises, tai chi and swimming seem to be the best activities," says Shimamoto. "If they are able to do these, it can be helpful overall to their condition."
Some patients may want to include complementary therapies in their treatment, he says. "If a patient has any pain, acupuncture may help. And massage can be helpful in relieving tight, stiff muscles."
For more information on Parkinson's disease and support groups available in Hawaii, visit Island Scene magazine’s web site at www.islandscene.com.
