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Living with Someone
Who has PD
No two PD patients are alike
Symptoms of PD vary in each person,
and there’s no reason
for a “worst-case” attitude following a diagnosis.
PD usually progresses slowly, and patients may receive significant
relief from medication.
Subtle early signs
The early signs of Parkinson's disease are often subtle and
may include:
• tremor
• shyness
• depression
• soft voice
•
handwriting that’s hard to read
•
complaints that it’s hard to do the usual things
Many patients who display the most common symptoms of Parkinson's
never experience anything worse. However, if the subtle symptoms
shift, patients may notice things like:
• more tremor
• muscle stiffness
• slowness of movement
• sexual problems (men)
In cases where these symptoms are present, the disease may
be managed successfully for many, many years, especially with
the help of prescription drugs. Often, patients taking these
drugs may never experience the worst symptoms of Parkinson's.
The most difficult symptoms happen to the smallest number
of patients
More serious PD symptoms include:
• problems maintaining balance
• periods of extreme confusion or hallucinations
• severe depression and/or withdrawal
When these symptoms do occur, they tend to show up much later
in the course of the disease. Caregivers and family may be
challenged to effectively take care of patients with serious
symptoms. In such cases, some form of professional assistance
or nursing home support is generally recommended.
Pharmaceutical drugs have proven to be highly
effective in treating Parkinson's disease, with levodopa/carbidopa
leading the way as the most prescribed drug for PD. Newer drugs
like Zelapar® (selegiline HCl) make this form of treatment
even more promising. In clinical trials, Zelapar has proven
to be a safe and effective way for PD patients with a reduced
response to levodopa/carbidopa to get more active hours each
day.
Levodopa/carbidopa and most drugs used in
the treatment of Parkinson's disease work to imitate and enhance
the effects
of dopamine, the chemical responsible for movement, in the
brain. Possible side effects of levodopa/carbidopa that caregivers
will want to be aware of include swelling and increased sexual
drive in men. If a patient has one or more of these side
effects, physicians may try another drug.
Surgical options are also available for patients who do not
respond well to drug therapy.
Knowing the PD patient’s rhythm
Caregivers will want to familiarize
themselves with the “ON/OFF” cycle
that governs the PD patient’s life. ON times are those
times when medications are in effect, and patients move and
operate in a symptom-free or relatively symptom-free fashion.
OFF times are those times between dosages when symptoms return.
Independence
While the challenge of PD is encouraging
as much independence for the patient as possible, this means
different things to
different people at different times — patients can fluctuate
between being fully functional to requiring assistance for
even basic things several times a day.
It is important for family members to recognize the variable
and sometimes unpredictable nature of PD disability. By staying
alert and offering help when it is needed, they can find the
right balance between protecting the patient and encouraging
his or her independence.
Of course, some individuals with PD insist on attempting things
they should not, such as climbing ladders or carrying heavy
bags of groceries. Handling these situations requires judgment
and tact and it is important to reach agreement among the family
members about setting reasonable limits.
Some patients who no longer wish to perform tasks of daily
living may actually be suffering from depression and apathy.
It is important that this problem be recognized as separate
from the physical challenges of PD. If depression is present,
it should be discussed with the treating neurologist since
medication or therapy may be necessary. |
