Today, I have a coffee-meeting with Maruxa and Pepe, two old friends from the Parkinson’s association where I worked. Since I joined my new position four months ago, we have exchanged only a few messages on WhatsApp.
I hope to find them in the state they were in when I left. It is difficult to predict because Parkinson’s disease, the disease from which they suffer, does not evolve in the same way in all patients.
What causes Parkinson’s disease?
Parkinson’s disease is a progressive and fairly complex neurodegenerative pathology. They are origin It is unknown, but several factors can influence its appearance: environmental, genetic or even the aging process itself.
It is characterized by the fact that the body does not generate enough dopamine, a neurotransmitter produced in the substantia nigra, in the basal ganglia. This structure is located in the center of the brain and is responsible for coordinating motor activity, muscle tone and movement.
The drop in dopamine is the cause of symptom that we all have in mind when we talk about a patient with Parkinson’s disease: slowness of movement or bradykinesia, tremors at rest, muscle rigidity and postural instability. However, there are no two identical cases of Parkinson’s disease.
Maruxa and Pepe, for example, have suffered from Parkinson’s disease for a few years. While it brought them closer in terms of diagnosis and made them great friends, the way they manifested was clearly different and still is.
Maruxa has lived with the disease since the age of 56, while Pepe was diagnosed when he was about to turn 44. They are now 63 and 50 respectively. Maruxa began her story with PD after going to the doctor worried about feeling “slower” moving, but more importantly losing her sense of smell. For his part, Pepe noticed that “things were not going well” when he began to suffer from certain urinary problems: both nocturia, or the need to get up at night to urinate, as well as urgency and increased frequency of going to the bathroom.
Like Maruxa, he also remembers feeling sluggish, though he attributes this to fatigue caused by waking up every night to use the bathroom. Both with motor symptoms (slowness of movement or bradykinesia) and non-motor symptoms (anosmia in the case of Maruxa and urinary disorders in that of Pepe). And in both cases, that too, reaching the diagnosis took a few months of testing, something far more common than desirable.
Tremors, slow walking, and lack of arm movement
The main engine symptom it is the slowness to make a movement or bradykinesia. This implies that the person has difficulty initiating a certain movement, developing a sequential movement or performing simultaneous tasks (walking and performing a mathematical operation, for example).
It is also manifested by loss of automatic movements, lack of facial expression, lack of arm movement when walking, and a tendency to walk slowly and with small steps.
The symptom most recognizable to the public is undoubtedly tremor at rest, but it may not occur in 30% of patients. In addition, muscle stiffness is common, which impairs range of motion, and postural instability, which leads to balance problems. Associated with rigidity, as the progression of Parkinson’s disease, it leads to adopting a hunched posture, the trunk projected forward and the arms bent.
Non-motor symptoms of Parkinson’s disease
The bone non-motor symptoms they can be diverse, both because of the affected function and its severity. Although they are largely unknown to society, they often handicap more than the motor symptoms, with a significant impact on the quality of life of the patient and his carer.
Among others, we can cite autonomic disorders (incontinence, erection disorders, sexual disorders, swallowing disorders, etc.), neuropsychiatric and cognitive disorders (hallucinations, dementia, difficulty concentrating, difficulty performing several tasks in same time…), affective disorders – emotional disorders (depression, apathy, anxiety…), sleep disorders (insomnia or excessive daytime sleepiness), sleep disorders gastrointestinal (drooling, dysphagia, constipation…), respiratory disorders and sensory disorders.
With all this list of symptoms, it is easy to understand that the quality of life Parkinsonian patients may be affected. Firstly, because of the severe blow that this disease imposes both on the patient and on his social and family environment, especially among those who suffer from it before the age of 50. Later, as the years go by and the treatments stop being as effective, due to the degenerative progression that the disease itself causes.
The importance of having a coffee or taking a walk
Parkinson’s disease is usually a slowly progressive, lifelong disease. Hence the importance of early diagnosis and adapting the treatment to each patient.
Fortunately, there are many professionals from different disciplines who update, specialize and they investigate by and for Parkinson’s disease: neurologists, physiotherapists, nurses, speech therapists, psychologists, occupational therapists or nutritionists. Together they can offer a multidisciplinary treatment and help patients live their lives more fully and with a better quality of life.
Given the gradual degenerative course, attention should also be paid to how this change occurs over time. Especially to make adjustments in the treatment received based on the needs of each patient. All with the idea of avoiding, as far as possible, situations of dependency.
It is essential not to leave patients in “their world”, to ensure their social participation and to involve them in an active lifestyle, based on exercise, specialized nutrition and adequate rest. In addition to having consolidated social networks with which to simply have a coffee or take a walk.