An Introduction to Parkinson's Disease by Joseph H. Friedman, MD

Parkinson's disease is a disorder that affects small regions in the brain that control movement, posture and balance. It is a complex disease that has many different symptoms, so that not everyone with the condition suffers from the same problems.

Comebacks At Work: Using Conversation To Master Confrontation by Kathleen Reardon, PhD

NEW BOOK BY KATHLEEN KELLEY REARDON – COMEBACKS AT WORK: USING CONVERSATION TO MASTER CONFRONTATION

Kathleen is a professor, artist and person with Parkinson’s. She lives in Jamestown, RI with her husband, Chris, co-author of their new book and she goes to the YMCA – West Bay Parkinson’s exercise group on Mondays and Thursdays at 12:30. Kathleen has written several other books, but this one is relevant to most of us whether we work or not, volunteer or just try to get things done each day. Here are some of her thoughts:

Diagnosing Parkinson's Disease by Joseph H. Friedman, MD

Although Parkinson's disease is a specific, well defined disease that can be reliably diagnosed at autopsy, it is defined in life by clinical criteria. This means that the diagnosis rests entirely on the information (history) that the patient provides plus the physical examination. There is no test to diagnose PD.

Constipation in Parkinson's Disease by Neil R. Greenspan, MD, FACG

Constipation is the most common gastrointestinal complaint affecting approximately 15 % of the North American population. Certain subgroups have an even higher risk (e.g. in the over 65 population 26% of men and 34% of women are affected). It is remarkable that for such a common disorder there is great debate on the definition of constipation.

Eye Problems in PD Patients by Elliott Perlman, MD

PD patients often have a lot of difficulty with their vision, although, when I examine them in the office, the visual acuity is often normal. Problems can come from difficulty in moving the eyes and eyelids, as well problems with blinking and dryness. Most of these conditions arise from PD itself, while others may be caused by the medications required to treat PD.

Good days, bad days by Joseph H. Friedman, MD

Good days, bad days

Joseph H. Friedman, MD

One of the many issues that PD patients often have that no one understands are good days and bad days. So many times, PD patients come into the office and the patient or family says, "Today's a good day, he's not usually this good at home." "Today's a bad day. Usually he can walk a lot better than you see." I have given up trying to figure out what makes one day good and another bad.

Rhinorrhea in Parkinson's disease by Joseph H. Friedman, MD

Rhinorrhea is the technical term for runny nose. It literally means "fluid from the nose" and can refer to anything flowing from it. Carol Jacques, the nurse practitioner who worked with me for several years, pointed out many years ago that a lot of our patients with Parkinson's disease had a runny nose. I didn't think much of it.

Slowness in PD by Joseph H. Friedman, MD

One of the major problems in PD is called "bradykinesia," which means "slow" (brady) "movement" (kinesia). This is somewhat different than "akinesia" which is discussed in a different section.

Tremor in Parkinson's disease by Joseph H. Friedman, MD

Although many lay people, and even PD patients themselves think of tremor as being the main problem in PD, it isn't, at least not for most patients. Tremor is common in PD. It affects about 80% of patients with PD, but not 100%. One in five PD patients does not have tremor. And for most patients, tremor is annoying but not debilitating. It is an uncommon patient whose tremor is the main problem.

Weakness in PD by Jospeh H. Friedman, MD

It is common for PD patients to feel weak. They frequently describe their legs as feeling, "like they're made out of lead," "like they're in concrete." But they will also feel weak all over, or describe weakness in their hands or arms.

"Atypical parkinsonism" and "Parkinson plus" syndromes by Joseph H. Friedman, MD

"Parkinsonism" means "looks like Parkinson's disease." To neurologists this means that the person has a somewhat flexed posture, moves slowly, is stiff and usually walks slowly, with small steps and reduced or no armswing. We call the syndromes "atypical" because they usually differ from PD in a few ways:

There's Only One Reason to Nag by Joseph H. Friedman, MD

Some of the lessons that doctors learn are incorporated into clinical practice but may never get written down because these common sense, hard learned observations aren't "publishable." They comprise the "art" of medical practice.

Death in PD by Joseph H. Friedman, MD

This article was written at the request of a PD patient who wanted to know how patients die from PD. Most patients die with PD and not from it.