Parkinson’s Disease

Physical Therapy for Parkinson's
Physical Therapy for Parkinson’s

Parkinson’s Disease is a Really Common Condition

Parkinson disease is really common.  So common that each of us probably knows someone who has now or had it and is no longer with us.  Worldwide, it’s one of the most common disorders of the nervous system.  About 1 out of every 100 people over age 60 will eventually get Parkinson’s.

Young Onset Before Age 50

Whit it is and is usually viewed as a condition of the elderly, Parkinson’s is not that unusual in younger individuals.  For every 20 people who have Parkinson’s it’s likely that one of the 20 will be age 50 or younger.  Saying the same thing in another way, about 5% of people with Parkinson’s have the onset before age 50.

Parkinson’s – First Signs that It’s Coming

The first thing that people will likely notice or feel is a bit of a tremor, like a mild shakiness.  Typically this is a shaking tremor of one hand or the other.  But, the tremor could be in an arm or a leg instead.  It’s called a “tremor at rest”.  That means that the shaking stops when the person actually uses his hand, such as reaching to pick up something.  It’s when the person’s hand is relaxed and at rest that the tremor comes back.  The usual way people describe the hand tremor is as a “pill-rolling” tremor.  The individual’s hand is lying there, relaxed, and the thumb and forefinger move as though the person is rolling a pill or a pea between them.

Gradually other things change.  A person’s stride while walking will start to change, and the way they stand will be different.  The look on their face changes, having less movement of face muscles.

The Stages of Parkinson’s

As time goes by more symptoms appear.  The person’s arms don’t swing in quite the same way relaxed way when they walks.  Their face muscles moves less when they talk, or smile, or frown.  Their voice gets quieter.  Parkinson’s experts talk of several stages of the condition.  The links below will give a great deal more information on these stages and the evolution of Parkinson’s over time.

Parkinson’s Signs You Don’t See

In addition to these visible changes, which are easy to see, there are body changes that you can’t see.  The individual might lose some or all of his sense of smell.  His thinking might slow down as compared to his previous quick-minded self, and overall he might feel physically weak, and/or maybe just a bit sick all the time.  Life becomes no fun at all, which might slide into a depression.

What Happens and How Fast It Gets Worse is Unpredictable

Doctors don’t have a crystal ball to predict what will happen next and how fast everything will move along.  However, it’s important to understand that It’s an ongoing condition with treatment but no cure.  There’s no way to stop it.  Once it starts it continues for the rest of the person’s life.  And it does change over time.  As time goes by it gradually but continually gets worse.  Some people are lucky in that they have only minor signs and symptoms, such as a bit of tremor.

There’s an Intense International Push for Research on Treatments and Cures

There are well-known celebrities who push public opinion for research for Parkinson’s.  The actor Michale J. Fox, for example.  Everyone wants answers, and a lot of public interest improves the amount of money for research and care.  The result is a major, worldwide push to beat Parkinson’s.  The research is across many areas, like the types of exercise one can do to slow the progression of Parkinson’s.  Drug companies and universities search for new medicines.  Medical tech companies want to find new non-drug treatments.  Genetically-modified animals have been made that behave as people do when they have Parkinson’s.  Researchers can test trial medicines using these animals to see if they are safe to give to people.

And Now for a Bit of Medical History About Parkinson’s Disease

In Egypt a description from 3200 years ago was found about an elderly king drooling.  The king might have had Parkinson’s.  Ancient texts in India and China talk about the elderly with tremor.  We’re not sure if any of this is really Parkinson’s because there are a lot of conditions in older people that cause tremor or drooling.  But one seems more specific.  In a 3000 year old text it describes a person with tremor, a lack of movement, drooling, and other symptoms.  The patient was given drugs from a tropical legume, the mucuna plant family that contains a drug that treat Parkinson’s.  Now that makes us pretty sure it was Parkinson’s.  Galen, the famous doctor, gave a description that almost had to be Parkinson’s.  This was about 2000 years ago.  Galen’s patient had resting tremors, changes in posture, and paralysis.

Getting to more Modern History

As usual, during the Dark Ages, no one mentioned Parkinson’s.  The first good medical descriptions are found in the 1600s and 1700s with the typical symptoms of tremor at rest, odd walking, other odd movements, and having a rigid body.  Then came James Parkinson in 1817 with six cases of what he called “paralysis agitans“, the first real, sure description of Parkinson’s.  In the 200 years since 1817 we have a better understanding, more helpful treatments, and learning subtypes of Parkinson’s.  But, Parkinson’s still looks the same.

Did You Know That…  Michael J. Fox has Parkinson’s?

Michael J. Fox’s fans were just about everybody when, in 1998, he said that he had Parkinson’s disease.  His fans were so upset!  He was only 29 years old when first diagnosed in 1991.  In 2000, he established the Michael J. Fox Foundation for Parkinson’s Research.  He’s one of those actors that everyone automatically loves.  His research foundation has grown to be the world’s largest source of funding for medicine research for Parkinson’s.

Okay, Michael, Back to Work

He went back to acting full-time in 2012, playing the character Mike Henry on his The Michael J. Fox Show.  He also makes many guest appearances in movies and TV, usually playing clever attorneys.  In the spring of 2019 he let people know that his health had taken a turn for the worse.  He began having difficulty feeling his legs, and as a result, had frequent falls, a dangerous sign.  To keep his legs working and to keep walking he needed spinal surgery, then a lot of physical therapy.  After his surgery and physical therapy he slipped in his kitchen, fell, and fractured his arm.  His surgeon fixed his arm with a metal plate and 19 pins.  Michael is now back to soldiering onward, but it’s getting harder.

Helpful links:

Clinical Trials for Parkinson’s Treatments – CllinicalTrials.gov

Parkinson’s Information Page – National Institutes of Health

Parkinson’s – National Institute on Aging

Parkinson’s – MedlinePlus – U.S. National Library of Medicine

Understanding Parkinson’s – Parkinson’s Foundation

About Parkinson’s – The Michael J. Fox Foundation

Parkinson’s – The Mayo Clinic

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