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Friday 31 October 2014

Analyze This

If you have been reading earlier entries ,you will know PWP sometimes have virtual reality dreams. I have had some beauties but none so disturbing as the latest.

I don't remember how it starts but, it involves a church and a young, evil, girl. Someone offered me a church (the one just a block from my house) in which to live. I must have taken up his offer because in the next scene, I was lying on my bed when this obnoxious little girl came in and started jabbering away. I told her I knew who she was and she should stop talking. She kept on blabbering about something I couldn't understand.

"Get out of my room. I know who you are," I said calmly.

She remained where she was, still talking in a language I had never heard before.

"GET OUT OF MY ROOM," I shouted.

She turned on her heel and left.

I looked at another person who had suddenly appeared. It was another adult, female or male I know not. The person loomed over my bed and said, "You told her to get out!!! Don't you realize the baby is in the other room?"

I jumped out of bed into a dark hallway. The girl was nowhere to be seen. I crept into the darkness and came to a dimly lit room. Stealthily, I looked around the corner. The little girl was standing at the head of a crib and was reaching into it to pick up the baby. She heard me and raised her head with the evilest of grins and continued to reach into the crib. I started to breathe loudly, blowing out panicked gasps of air, over and over. I had to do something but I didn't know what. My breathing got louder and louder, more and more frenzied, and then, "Doug, Doug, wake up. Are you OK?" my wife said shaking my shoulder.

It had been only a nightmare, but so realistic I emerged from that dark, haunted world with a shadow following me. I had scared myself and my wife. Even now, 12 hours later, to think of that kid at the head of the crib, makes my neck hairs quiver.

Explain that, if you can

Thursday 30 October 2014

Unbeing dead is not being alive - e.e. cummings

Maybe I have already told you about meeting a friend I had not seen in 40 years? If I did mention it in an earlier entry, too bad, you are about to hear it again. After 40 years apart, we went for lunch during which I informed him I had PD and he replied, "So what. We are all going to get something some time." He was full of life and planning on bringing a cowboy band to the city. I don't remember their name, but they sang "Tumblin' Tumbleweeds". Six months later he called me to tell me he didn't have much longer to live. He died a month later from cancer.

Life can be a bitch sometimes.

Those of us with PD consider ourselves unlucky and lucky at the same time. Unlucky to have been blessed with PD but also lucky to be blessed with PD. If you have to have a degenerative brain disorder, PD is the best of the lot because its symptoms can be controlled. The end game might not be pretty but getting there can be an adventure.

There are always those tribal drums lurking somewhere in the dark recesses of my mind as I make my way toward the end of my journey. Will my death be dignified or will I......I banish the thought. Today will be a good day to be alive even if the day, as it appears it will be, is devoid of the sun and only 2 degrees centigrade.

What is life without adversity? I can't imagine it. A little stress makes me wake up and smell the coffee, which I would if I hadn't lost my sense of smell. I would rather not have PD, but I do and there is nothing I can do about it but ignore it as long as I can. I choose to be alive in the meantime

My phone is ringing. I have to answer it. Until I write again, I leave you with a line from a movie (I forget which one) in which an elderly lady was described as "she is not afraid of dying, she is afraid of not being alive."

To PWP, I say, don't be afraid of the future, be afraid of unbeing dead in the present.

Wednesday 29 October 2014

No thanks Bacchus. I am already there...

Bacchus was the Roman god of wine (Dionysus if you prefer Greek).

In a painting, Bacchus was depicted as having a staggering body almost teetering off the edge of a cliff. In other words folks, he was drunk as a skunk - causing him to be dizzy, clumsy, and out of control.

Guess what, today I achieved that state without having taken a drop of alcohol. The very definition of a person with parkinson's can include dizziness and a staggering gait.

I now know the uncertainty brought upon us by the duet of Bacchus and Dionysus, having been there and done that, without any stimulant.

My OCD kicked in about 4:30 AM and I achieved quite a good speed, using my trekking poles, when I went for my early morning walk. I "nordic walked" for only a little over a mile and during the last 5 minutes, I began to feel like I was going to fall over, forward. "Festination," I muttered out loud. I sat down on a stone wall to await a more normal feeling. I lingered only a moment. Home was but a few hundred yards away. I got up and began my trek. My poles were getting out of place and I was staggering but I managed to use my poles to prevent festination and I was successful in remaining upright, that is until I stood on my stoop and teetered head first into the door (my metaphorical Bacchus cliff). I didn't hit the ground but remained stiffly at an angle, with my head against the door for stability. With much cursing, I managed to get my key in the lock and open the door. I entered the house to find I was still in my parkinson's gait mode and headed awkwardly toward the sofa, where I sat for 10 minutes until the feeling passed. It happened yesterday morning but has not returned; perhaps because I spent the today in bed with a cold. I hope it was one of those fleeting symptoms that won't make another appearance for some time. No more vertigo for me please.

Festination is an alteration in gait pattern characterised by a quickening and shortening of normal strides. This phenomenon is most commonly observed in patients with Parkinson's, and is sometimes known as Parkinsonian gait. Festination can be disruptive for a patient and may interfere with the ability to work, exercise, and engage in daily activities. It is also a noticeable sign of Parkinson's which can attract unwanted attention."

This change in gait is the result of hypertonicity in the muscles, where there is too much tension in the muscles and the patient has trouble controlling them as a result. The patient will have difficulty initiating muscle movements, such as those needed to start walking, and it is also hard to slow down and stop. In a patient with a festinating gait pattern the gait can take a hopping or shuffling form and the patient has no control over it.

Tuesday 28 October 2014

JUST WHEN I THOUGHT I WAS OUT.........

IT PULLED ME BACK IN.

I'm talking about the cramp I have christened, the"Beast".

It came back to me a few days ago and has been hitting home runs every 8 hours, or so, in lessening intensity as time passes by; but when it hit on Thursday I realized again that I might get better but I will never get well.

If you have never had one of these cramps, it starts, ever so subtlety, in your toes and while you try to wait out the toe pain which is starting to affect the foot, the Beast strikes, swiftly and harshly. Your cramped foot seems to twist up and inward and the side of your leg has the consistency of an iron bar. The only way to stop it is to stand up, with both feet flat on the ground, and wait. It takes anywhere from 5 -15 minutes for your body to relax.

The beast has left me alone since last night. I think it has gone now. I am fully at ease and just waiting for either the return of the Beast's muscle crunching, but somewhat exquisite, pain or, a cure.

I will take a cure please and thank you.

Thursday 23 October 2014

I was born bald. Not again!!!

I have noticed recently that I am losing hair at an alarming speed. I have male pattern baldness. If you look at the top of my head, you will see that the pattern is stripes. Hair, skin, hair, skin and so on. Uneven as they are, it is still a pattern of stripes.

It has sped up since I started L-Dopa. Hmmm. Coincidence? After all, I am 68 and hair loss can be natural. But, I tell myself, not at Formula One speed! It should advance slowly and steadily. Like a glacier. My loss is more like hair loss on speed.

I google "hair loss Parkinson's" and I find this:

. Levadopa (l-Dopa)
Levodopa, also called L-dopa, which is converted to dopamine in the brain, remains the gold standard for treating Parkinson's disease. The standard preparations (Sinemet, Atamet) combine levodopa with carbidopa, which improves the action of levodopa and reduces some of its side effects, particularly nausea. Dosages vary, although the preparation is usually taken in three or four divided doses per day.

In general L-dopa has the following effects on Parkinson's disease:

  • It is most effective against rigidity and slowness.
  • It produces less benefit for tremor, balance, and gait.

In many patients, levodopa significantly improves the quality of life for many years.

Side Effects

The toxic effects of levodopa with or without carbidopa are considerable.

Physical Side Effects. The physical side effects include:

  • Dyskinesia. Dyskinesia (the inability to control muscles) is a very distressing side effect of levodopa. Dyskinesia can take many forms, most often uncontrolled flailing of the arms and legs or chorea, rapid and repetitive motions that can affect the limbs, face, tongue, mouth, and neck. Dyskinesia is not painful. No specific drug can strongly be recommended to treat dyskinesia. Amantadine (Symmetrel) may help reduce stiffness and improve dyskinesia. There is also weak evidence that deep brain stimulation of the subthalamus area may be helpful.
  • Low blood pressure. Low blood pressure is a common problem during the first few weeks, particularly if the initial dose is too high.
  • Arrhythmia. In some cases the drug may cause abnormal heart rhythms.
  • Gastrointestinal effects. Stomach and intestinal side effects are common even with carbidopa. Taking the drug with food can alleviate the nausea. However, proteins interfere with intestinal absorption of levodopa, and some doctors recommend not eating any protein until nighttime in order to avoid this interference. The drug can also cause gastrointestinal bleeding.
  • Effects in the lung. Levodopa can cause disturbances in breathing function, although it may benefit patients who have upper airway obstruction.
  • Hair loss.

Wait. What was that last one. Hair loss!!!! Of all the terrible side effects, I get the most benign on the list. I should consider myself lucky but my vanity is getting in the way. I know, I know, suck it up and get on with your life.

OKAY, I heard you.

Sunday 19 October 2014

Diagnosis & Prognosis - don't let the first become the second.

DIAGNOSIS CAN BE QUITE A SHOCK!

As mentioned earlier (much earlier), my first neurologist diagnosed me using a simple test. I had entered his office symptom-free and was reading a paperback, without tremor, which is not easy to do if you are a PWP and I was getting restless. My appointment was for 9:30 and he was already behind. I found out the reason for his backlog. The man came to work an hour late! When he finally called me in, I was showing no signs of having PD. He had me sit up on an examination table, asked me to place my hands, palms up, on my knees and count back from 100 by 7's. By the time I was finished, my right hand had a life of its own. "Early stage parkinson's," he said matter-of-factly.

Now this doctor has been around for awhile - quite awhile - and his experience led to his diagnosis. I wasn't upset. I had lived a charmed life up to that day, so I needed to find out more about it and determine if he was correct.

All the way homeI was not particularly concerned. I had heard of parkinson's but knew nothing about it. My reaction to my diagnosis was "So, what now?"

In the seclusion of my home office, I searched the internet. It dawned on me that his simple test had condemned me to a life with an incurable, degenerative brain disease. I had to make sure he was right. From my research, I found the 4 main symptoms of PD and I had the first one in this list.

  1. Shaking or tremor
  2. Slowness of movement, stage name bradykinesia
  3. Stiffness or rigidity of the arms, legs or trunk
  4. Trouble with balance and possible falls, referred to as postural instability

Generally, there must be 2 of these symptoms present over time in order to make a definitive diagnosis, but I guess if you are a graying neurologist, one symptom will be satisfactory for a diagnosis and looking back, although I never mentioned it to the doctor, I was slowing down. But I needed more information.

I had read on the forum on the UK Parkinson's site of PWP having had a DaTSCAN for diagnosis. I have not heard of such a thing here in Canada. It may or may not exist.

A DaTSCAN is an scanning machine that uses small amounts of a radioactive drug to help determine how much dopamine is available in a person's brain. Apparently it is used in Europe, the USA and probably Canada, to confirm a diagnosis for Parkinson's. The machine itself cannot make that diagnosis. There is no definitive test for parkinson's. I understand it can be used to differentiate between parkinson's and essential tremor, but it cannot diagnose PD alone.

I had to find another neurologist. I was impressed by the first one's experience but I hate sitting in waiting rooms and this guy showed up one hour late for his first appointment? I subsequently went to another neurologist, who confirmed the diagnosis and referred me to a specialist at a movement disorder clinic where the diagnosis of PD was carved into stone. I definitely had PD! What could I do to help myself get through this.

If you are unfortunate enough to be in the 1-2% of the population that is diagnosed with PD, I think that you will find having a good attitude, exercising, eating well and maintaining a sense of humor will certainly lessen the impact of the disease. And, take the drugs! Through drug therapy, I lead a fairly normal life. But what of the future? What lies ahead? I read somewhere that on the average, depending on age, you can expect 5 normal years, 5 - 10 decent years and thereafter it will depend on if you are one of the unlucky 20% who fall victim to dementia.

Occasionally you might get angry at the gods for giving you PD, but worse, giving you the inability to predict its course and the ability to know all the possible outcomes. Stop it. Think positively. I cling to the very real hope that science will find a cure, or at least a way to stop its progression within the next 10 years. Dr. Oz predicted a cure in the near future. Meanwhile I will lead a normal life. I just don't let my diagnosis get me down. Life goes on, even after a diagnosis of PD.

You've probably read in People that I'm a nice guy - but when the doctor first told me I had Parkinson's, I wanted to kill him. (Michael J. Fox)

Monday 13 October 2014

Every day I get out of bed with a headache; then my wife told me, "feet first, idiot!"

The Setting: My wife and I sleep in a huge king sized bed. I think the makers of the bed were expecting a flood because when I fully sit up on it, with my legs hanging down, my feet do not touch the floor. It is one high bed!

The characters: Neurologist, bed, blankets, me.

The Foreshadow: Some time ago, my neuro asked me if I had trouble moving in bed. I thought that was an odd question! I replied "No, not that I have noticed."

He nodded his head, looked at the computer screen showing... well, just about everything medical about me. He went to one file on the screen and typed something in. I don't know what the input was but he turned toward me and said "None?"

I wasn't sure if it was a question or a statement of surprise but I answered, "No, none."

Rising Action: I take amantandine and miripex (both max doses) 4X a day and L-dopa three times with the other two but I do not take it in the evening.

Yesterday,with some difficulty, I reached the summit of the bed and joined my wife watching our latest film fix, the Spanish drama "Grand Hotel". The program ends and it is lights out, I turned into my regular sleeping position, on my side, facing out of the bed on the right side. I awoke, on my stomach, facing inward toward my sleeping wife. I must have had a restless night.

It is 4:30 AM, my usual time to arise for the day. I try to turn over over to get back to facing outward. I can't do it. The covers seem to have a grip on me, as if they are deliberately obstructing my escape from the bed. I struggle to sit up but there is no strength in my arms. I tug at the covers and manage to get them out from under my body. I try to roll over to the edge of the bed. No dice. Rolling is out.

Can't sit up, can't roll over. What to do? What to do?

I eventually solve my dilemma by sliding my body, on my back, to the edge of the bed, one inch at a time. I reach my destination and them am confronted with a new problem. Now that I am lying on the edge, what do I do next. My left arm is too weak to lift me to a sitting position. Do I just roll off the bed? That's a long way down! I might kill myself.

Climax: Eureka! I know what I will do. I will ease my lower half, "waist down" off the bed and as that is happening my body will naturally turn over so that my trunk will facing inward and downward with my chest on the bed and I will simply back off of he bad. This I did but somehow, I don't remember how, it all happened so fast, I ended up on the floor,on my haunches with my back against my bed. I must have fallen. No harm done but noisy enough to waken my spouse.

Falling Action: I struggle to stand and my wife says, "What are you doing? Are you OK?"

"I am having a little difficulty getting out of bed. I'm OK. Go back to sleep". I get on my knees and manage to stand. I am a bit dizzy and a little embarrassed. I walk slowly, unsteadily. I close the door behind me as I leave our room and head straight for the bathroom. I need relief. I need my pills. I stuff them into my mouth and swallow them without water. One, the big one gets momentarily lodged but I manage o gulp it down.

Resolution: Now I know what the neuro was asking. It was like I was suffocating, caught in a tangle of seaweed. Just another of PD's little gifts. I don't want any more presents, thank you. My schedule is already chock-a-block.

My life needs someone to edit it!

Saturday 11 October 2014

This poor chap thinks he might be a hypochondriac

On a PD forum, one participant, wondering about his condition, described his symptoms as:

  • External tremors in my arms and legs
  • Shaking and jolting while asleep
  • Foot Dragging
  • Swallowng issues
  • Masking- it used to upset me why people thought I was always so angry.
  • 'Vibrating' feeling over the whole body
  • Falling if I stand quickly
  • Not having complete control of my hand when taking coffee out of a jar etc
  • Bursting into tears at the smallest thing
  • Lack of arm swing when walking

And he has not been formally diagnosed. These are the classic symptoms of PD. I have seen and suffered them. If you have them, you got it. But don't panic, everything will be OK - drugs now. Cure coming sooner than later.

To those newly diagnosed, it is not the end of the world to be diagnosed with PD. If you are upset with your diagnosis that is how it should be. Let the bad luck consume you for awhile, then get mad at it, then fight it and and remember that if there is no peril in the fight, there can be no glory in victory. And we will win. PD is already on its knees. In the meantime, find yourself a good forum like Parkinson's UK. There are experienced PWP,there who will help you come to terms.

Friday 10 October 2014

Life after diagnosis

Let me summarize the past 4 years. The following is a scary list of symptoms and an account of my acquaintance with them.

  1. Bradykinesia is the slowing down and loss ofspontaneous and voluntary movement. I continue to suffer from that. My walking is quite slow; however, when going for a walk at 4:30 am, using my trekking poles, I can more than double my speed over longer distances.

  2. Rigidity / unusual stiffness in a limb or other body part. Sometimes but quite manageable
  3. Resting Tremor/ an uncontrollable movement that affects a limb when it is at rest and usually stops for the duration of a voluntary movement. Early on, before amantadine, this was the bane of my existence - a hand with a mind of its own. This starts jumping at the slightest stressed and for some reason, I am easily stressed. I am currently watching the Spanish drama "Grand Hotel", a fabulous story filled with minor stress that keeps one finger on my hand jumping around. For the most part the drugs keep everything relatively normal

  4. Postural Instability / problems with standing or walking, or impaired balance and coordination, which can lead to falls. I can't say this is a bother in my life. I sometimes get a "head rush" upon standing and I have fallen three times probably due to dragging a foot while running.

  5. Dystonia / involuntary movement with muscle contraction, such as a cramp and I am talking cramps to the nth degree. Early on my leg would go rigid and my foot would start twisting inward and upward. The drugs took care of those very quickly so that now I still suffer from cramps periodically, but they are just bothersome and not the monster type I suffered early on

  6. Reduced facial expression / “mask-like” face due to bradykinesia. My wife commented on it during our vacation in South Beach one year, but it disappeared shortly thereafter and has not returned.

  7. Speech and swallowing problems Speech - big time? People couldn't hear me and when I did speak, I would have trouble word finding. It is still a problem only much reduced with the introduction of L-dopa. As for swallowing, there was a period of 3 weeks, several months prior to official diagnosis where I at soup and drank milkshakes because I just couldn't swallow solids. This condition returns every now and then, stays a day or two and then goes away

  8. Dyskinesia / involuntary, twisting/turning,jerky movements that can result from long-term use of medications that treat Parkinson’s disease. Not part of my life....................yet.

  9. Impulse Control / inability to resist an impulse that is harmful to self or others that can result from use of medications that treat Parkinson’s disease. Fortunately I have avoided this little gem.

    Non-movement/ Non-motor-related Symptoms

  • Cognitive Impairment decline in ability to multi-task (no problem) and/or concentrate;(not me) potential decline in intellectual functioning (so far so good and onset of psychosis (don't think so, but you never know)
  • Mood Changes / can include depression,apathy or anxiety- no more than usual which is very infrequently
  • Sleep disorders / for example, REM sleep behavior disorder, where individuals act out their dreams. I can't sleep without zopoclone and My wife has mentioned me having bad dreams and she says I have monster twitches while sleeping
  • Hyposmia which means the loss of sense of smell. I lost my sense of smell a good 5 - 10 years before official diagnosis. Comes in handy in some instances.
  • Fatigue overwhelming at times but I keep on slugging through.
  • Constipation You betcha but in my case, it is a welcome relief as I used to suffer from Montezuma's Revenge at the most unfortunate times. I can do things with confidence knowing that it takes super human effort to clear my bowels
  • Bladder Problems / a sudden need to urinate or incontinence. No incontinence, thank God. Need to urinate is no more than usual
  • Orthostatic Hypotension / low blood pressure upon standing. Sometimes a little dizzy but no big deal
  • Pain central pain other than pain caused
  • by posture problems or dystonia - I suffered unexplaned pains for year.
Hope for the Future - As long as the pills keep working the future looks bright, but then those jungle drums startle me when I see the great Ali in a wheel chair. Then I remember he had it for 30 years and I doubt I will last another 26 years. So all is good - well - except for the death part.

Tuesday 7 October 2014

Sat on the Park Bench Like Bookends

I had breakfast with a couple of old friends. I am the oldest by one year. We are all past 65 and tending toward the morbid. We were estimating the number of years we have left. I give myself an outside chance of 18 years, the other two gave themselves 13 to 15 years. I think I am being optimistic, but if not, I hope that when I die, I die with dignity.

Anyway, as we older folks tend to do, our conversation drifted into our various ailments. For me there is only PD. I know that because of my exercise machine, I am in better physical shape than both my companions.

Conversation One with a man who has been unable to work since the late 90's - early this century, legitimate I hasten to add. I had not seen him since 2001.

Me: So how is your health these days?
Ga: Better (I hear some doubt in his voice)
Me: What was the problem?
Ga: Bipolar and Chronic Fatigue Syndrome. The medication helps with the bipolar but I am still tired.

At this point our colleague returned to the table, hears the chatter and joins in.

Ge: You know, I am tired and stiff and my right arm feels weak. My right leg too Sometimes, when I am relaxed, one of my fingers starts to jump. My doctor says I might have had a stroke<.br> Me: I doubt it. I think there would be more severe signs.
Ge: What were your symptoms.
Me: I went to my GP complaining about weakness in my arms - I didn't mention the hand tremor because it only came after a hard workout so I thought nothing of it. My doc took some tests, said he didn't think it was anything serious but referred me to a neuro just to be sure. By the time I saw him, my symptoms were a hand that tremored when at rest, weaknees on the fight side of my body, a loss of the sense of smell and exhaustion.
Ge: That sounds like me. Do you think I should see someone? Do you think I have Parkinson's?
Me: The odds are against it but I would get it checked anyway.

But what are the chances my friend has PD

If you look at the odds, in 2012 there were approximately 100,000 Canadians with PD out of 35 million people. The odds are very low.

However, that number is expected to double by 2016. Why. Because we are the baby boomers and we are living longer. More aging people + better health care system = longer life.

But you never know. Here from http://www.parkinson.org/parkinson-s-disease/pd-101/10-early-warning-signs-of-parkinson-s-disease are ten warning signs of PD. What do you think? PD or no PD? I will let you know.

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, if you have been injured, or could 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 too. 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.

Risk Factors

WHAT ARE THE RISKS

(Re printed from A PD Blog at http://parkinsonsjourney.com/what-are-the-odds-of-developing-parkinsons-disease/)

Lighter colored hair. Yes, that’s right. A person with black hair has the best chance of escaping a diagnosis of PD than that of a person with red or blonde hair, red being the greatest chance. I don’t think dyed hair counts.

Family history. Hereditary factors/genetics can play a part. If you have a close relative who has Parkinson’s disease (such as a parent/sibling) your chances increase.

Men tend to be more at risk than women for unknown reasons. However, this fact can also depend on what country you live in.

If you are over the age of sixty, the likelihood of developing PD is greater. However, there are a select few rare known cases of PD starting at the age of two.

The Amish community seems to have the highest rate of PD among any other communities. It is thought that the culprit may be all the pesticides used in their farming. Which leads to… Exposure to toxins playing a large part in some PD cases as well as those individuals who relied on well water for drinking and cooking. This is due to the chemicals/pesticides found in the water. It is said that Nebraska has the highest rate of PD in the United States, most likely due to the pesticides used in their farming, as well.

Trauma to the head may play a role as damage is done to the dopamine that producing neurons in the brain. If you were one to bang your head against the wall in frustration, well… you shouldn’t have.

Manganese, a known cause of Parkinson’s if the concentrations are high enough, is found in a town in Italy. The concentrations there are high enough and approximately 410 out of 100,000 people have been diagnosed with PD.

Ethnicity has been studied, showing Caucasians have greater odds over African Americans.

Illicit drugs use may be a factor as the drugs have a bulls-eye target for the dopamine producing neurons inside the brain.

Studies have shown that PD is much more prevalent amongst welders, significantly higher amongst physicians, dentists, teachers, lawyers, scientists, computer programmers (young onset PD diagnosis greater for this group), clerical occupations, agricultural workers, hunting and forestry occupations were also positively associated with Parkinson’s Disease. Those people involved in manufacturing and transportation were less likely to get Parkinson’s Disease.

So… what does this all mean? Here it is:

If you are a welder, physician, dentist, teacher, lawyer, scientist, computer programmer, person involved in clerical work, agricultural worker, hunting and forestry vocation person, and… have a family history of PD, are male, are over 60, Amish and are growing manganese plants as a hobby; if you are Caucasian, take illicit drugs, banged your head against a wall, live in Nebraska, have red hair and a family history of PD, then chances are – you MIGHT get PD. Then again, it depends on which country you live in, too.

Another interesting tidbit? Those involved in the manufacturing and transportation fields were less likely to get PD. Caffeine and smoking are said to help prevent PD.