Having Parkinson’s disease along with other chronic conditions, however, can often compound symptoms.
“Depression can be the first symptom of Parkinson’s disease,” says Hagestuen. “If someone has a history of depression or anxiety, it can worsen with Parkinson’s— either from the disease itself or as a side effect of medication.”
If you have chronic obstructive pulmonary disease (COPD), speech and swallowing symptoms may be worse. “If your lung capacity is already diminished because of COPD, your speech may be further affected in Parkinson’s disease,” says Hagestuen. “Aspiration pneumonia (pneumonia from inhaling food or fluids) is also a common late-stage problem.”
Managing symptoms with medications
There is no cure for Parkinson’s, but medications are available to control symptoms. The most common is levodopa combined with carbidopa (Sinemet). This combination helps to increase the amount of dopamine in the brain. There are also drugs that prevent the breakdown of dopamine.
Parkinson’s medications dosing schedule can be complicated. “The fine-tuning of medications in Parkinson’s disease is a huge concern,” says Hagestuen. “Communication must be consistent between individuals, families, doctors, and institutions to avoid any disruption in dosing or drug interactions if a new medication is introduced.”
“There are currently no medications that slow the progression of Parkinson’s. The goal of medical therapy is to get a smooth distribution of medicine throughout the body in order to control symptoms,” Hagestuen says. “Managing symptoms has been a big research focus for the last ten years because good symptom management contributes significantly to quality of life.”
The effects of medications can decrease over time, however, as the disease progresses. Other treatment options, such as surgery, can help control symptoms if medication can’t. A therapy called deep brain stimulation is used in which a pacemaker-like device is implanted in the chest wall, and electrodes stimulate the portion of the brain that controls many aspects of muscle movement.
New drug developments
Researchers are constantly developing new medications to help control and slow symptoms. The U.S. Food and Drug Administration (FDA) has recently approved a skin patch, the Neupro patch, for early stage Parkinson’s disease. The active drug, rotigotine, activates body processes that mimic the effects of dopamine. “The main advantage to the skin patch,” says Hagestuen, “is it assures an even distribution of the drug over a 24-hour period, which helps to better control symptoms.”
Northwestern University researchers have discovered a drug that slows—and may even halt—the progression of Parkinson’s disease. The drug, isradipine (a calcium channel blocker) is widely used for high blood pressure and strokes. Studies suggest isradipine recharges and protects dopamine nerve cells in animal models. Researchers will next launch human clinical studies.
Parkinson’s disease and exercise
Exercise has been shown to not only benefit people with Parkinson’s, but may lower the risk of getting the disease. At the American Academy of Neurology’s 2007 annual meeting, researchers from the Harvard School of Public Health presented a study that followed 143,000 people with an average age of 63 over a ten-year period.The researchers found that people with moderate to vigorous activity levels were 40% less likely to develop Parkinson’s disease than those with no or light activity levels.
“We know for sure that exercise for people who already have Parkinson’s is excellent therapy,” Hagestuen says. “It can help them be more functional.”
Your doctor’s role
If you are diagnosed with Parkinson’s disease, your primary care doctor is a valuable resource. “Typically when you think of Parkinson’s disease you think of tremor and balance problems, but very often these people have skin problems from excess perspiration, urinary or constipation problems, or depression,” Suneja says. “Your primary care doctor is the ideal person to help you manage these symptoms and to make sure that none of your other medications will interfere with your Parkinson’s medications—or worsen your symptoms.”
“Much of my job with Parkinson’s individuals involves educating them and their families about the disease, communicating with other specialists, and coordinating services to provide the best care,” Suneja says.
Parkinson’s disease is a complex, chronic illness that can impact every dimension of your life. “The best way to manage Parkinson’s,” Hagestuen says, “is using a team approach involving the individual, family, an excellent primary care physician, a neurologist who is a movement disorder specialist, and access to nurses, physical therapists, speech therapists, social workers, and wellness experts.”
Parkinson’s self-care 1-2-3
You can do a few simple things to care for yourself if you have Parkinson’s disease:
Pay attention to nutrition:
Eat a balanced diet high in fiber, and drink plenty of fluids. This will help with any urinary or constipation symptoms you may have.
Keep up with physical activity:
Regular physical activity helps to improve your mobility, balance, and emotional well-being.
Avoid falls:
Parkinson’s disease can disturb your sense of balance, making it difficult to walk with a normal gait. Take your time, and have good walking shoes. Do exercises that improve balance, like tai chi.