Health & WellnessLifestyles

The ‘closeted disease’

Doctor: Best therapy for Parkinson’s is exercise

One of the best therapies for Parkinson’s, a disease that has no cure, is exercise, according to neurologist Dr. Nestor Galvez-Jimenez.

While there are treatments on the market to help manage the symptoms — tremors, stiffness, slower movement, among others — Galvez-Jimenez, from Cleveland Clinic Florida, said his best patients are those who exercise regularly. The doctor said he has patients with Parkinson’s disease (PD), who are in their 90s, who go on the treadmill and walk.

“Of the exercises, the ones that have shown to be helpful is tai chi for balance; biking, either stationary or non-stationary, has been shown to be helpful; and boxing has also shown to be helpful.”

He said the exercises keep participants moving, but noted that tai chi, tennis and boxing are particularly good for balance and reflexes.

“I just tell patients you need to keep active. And whatever you do is better than nothing, because the normal tendency for someone with Parkinson’s is to just slow down and become a couch potato.”

He encourages his patients to read and to keep social.

PD, Galvez-Jimenez said, is a condition of the aging brain – a progressive, neurodegenerative disorder that typically impacts people over the age of 50.

To help raise awareness of PD in The Bahamas, Galvez-Jimenez teamed up with the Kingdor Parkinson National Foundation and local neurologist, Dr. Edwin Demeritte, to discuss life for people diagnosed with the disease.

Parkinson’s is believed to impact far more Bahamians than those who seek professional help, according to Mavis Darling-Hill, Kingdor Parkinson National Foundation president. She described it as a “closeted disease”.

“We imagine, looking at our population of older persons over 60 years old, there could be a couple of thousand [cases] here, because … the signs and symptoms are very difficult in the early stage, a lot of persons will try to hide the disease. And only when it gets to the point where they cannot hide it enough, they’d come forward or admit to it,” said Darling-Hill.

Demeritte, one of three neurologists in The Bahamas, and the lone pediatric neurologist, said the lack of uniform medical record-keeping also complicates the issue.

“When we look at our record-keeping systems, we’re not uniform with electronic medical records. So, again, one of the issues is using paper records instead of electronic medical records in coming up with the exact numbers. So, at this point in time, we probably may have maybe somewhere between 500 and 1,000 people who have come forth, but a lot of those persons are not captured in our system because there’s no uniform medical record-keeping.”

Galvez-Jimenez also spoke to the importance of educating people on PD to avoid social stigmatization.

“There’s nothing wrong with Parkinson’s. It’s another condition that affects the brain.”

The doctor said he tells his patients that if someone has diabetes or high blood pressure, people don’t think about it and just take their medication. He said people have to start thinking about PD and the Parkinsonian syndromes the same way.

“We have treatment options – but the idea is to make people comfortable enough to open up and speak about it, so education is important,” said Galvez-Jimenez.

Kingdor Parkinson National Foundation is an affiliate of the Parkinson’s Foundation in the United States. The foundation has assisted many people over the years, and educated and sensitized people about the signs and symptoms of PD.

The Parkinson’s Foundation, Kingdor’s parent organization, makes life better for people stricken by PD by improving care and advancing research toward a cure.

According to the foundation, it can be hard to tell if a loved one has PD, but there are 10 signs that a person may have the disease – tremor, small handwriting, loss of smell, trouble sleeping, trouble moving or walking, constipation, a soft or low voice, masked face, dizziness or fainting, stooping or hunching over.

A tremor while at rest is a common early sign of PD.

A change in handwriting may be a sign of PD called micrographia.

If you seem to have more trouble smelling foods like bananas, dill pickles or licorice, you are encouraged to speak to your doctor about Parkinson’s.

Sudden movements during sleep may also be a sign of PD.

An early sign, experts say, may also be stiffness or pain in the shoulder or hips; people sometimes say their feet seem “stuck to the floor”.

Straining to move your bowels can be an early sign of PD.

If there has been a change in your voice, you are encouraged to see your doctor about whether it could be PD. Sometimes, you may think other people are losing their hearing, when really you are speaking more softly.

If plagued with a serious, depressed or mad look on your face, even when you are not in a bad mood – often called facial masking – you are encouraged to ask your doctor about PD.

Feeling dizzy or fainting can be a sign of low blood pressure and can be linked to PD.

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 PD.

According to the foundation, no single one of the signs means a person should worry, but a person with more than one sign, they say, should consider seeking medical attention.

And there is no “one way” to diagnose PD but there are various symptoms and diagnostic tests used in combination. And that making an accurate diagnosis of Parkinson’s – particularly in its early stages – is difficult, but that a skilled practitioner can come to a reasoned conclusion that it is PD.

The foundation said that two of the four main symptoms must be present over a period for a neurologist to consider a PD diagnosis – shaking or tremor; slowness of movement, called bradykinesia; stiffness or rigidity of the arms, legs or trunks; and trouble with balance and possible falls, also called postural instability.

Scientists believe a combination of genetic and environmental factors are the cause of PD. And while no two people experience Parkinson’s in the same way, there are some commonalities. PD affects about 10 million people worldwide.

According to the Parkinson’s Foundation, genetics cause about 10 to 15 percent of all Parkinson’s.

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Shavaughn Moss

Shavaughn Moss joined The Nassau Guardian as a sports reporter in 1989. She was later promoted to sports editor. Shavaughn covered every major athletic championship from the CARIFTA to Central American and Caribbean Championships through to World Championships and Olympics. Shavaughn was appointed as the Lifestyles Editor a few years later.

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