“Breathing is the greatest pleasure in life.” ~ Giovanni Papini
They say doctors make the worst patients- I am no exception. In my entire medical experience, I have found that those of us who work in the medical field when confronted by illness typically have the worst most complicated and rarest disorders. I am any primary doctor’s and sometimes specialist’s worst night mare. If I were my own patient, I would be pulling my hair at times because trying to maintain a balance in such delicate system where the slightest shift throws everything (me) into total chaos is hard to manage to say the least. As predicted by Murphy’s Law, I am not an easy patient to manage. To complicate matters, out of the clear blue I have develop asthma of all things…
I thought for sure I had one organ system intact that I did not have to check a box in the review of systems form. C’est la vie! I suppose. Yet, I often feel it might be easier for my doctors to ask me what I don’t have than the reverse. So, while I waited for my appointment to see my pulmonologist (one more specialist to see and coordinate care with!), I wondered why it was that I am becoming asthmatic; of course my first thought was to blame the radiation therapy I received for my thyroid cancer …but then again…it seems like Parkinson’s, at least the type I have LRRK2 gene, appears to be associated with inflammatory disease all of which are immunological in nature. What is asthma after all? But another autoimmune disease problem. I thought could there be a relation between my PD and asthma? Then, today I see an article talking about an increased risk of PD in those with asthma.
I began to think some more about the matter, a dangerous thing I tell you; But a sign that my dopamine is working JUST fine!
We know that asthma is widespread (~235 million worldwide) because of prevalence is easily identified and diagnosed as opposed to Parkinson’s despite the nearly 7 million plus worldwide. Because PD can have a very prolonged prodrome (pre-motor period) making diagnosis more challenging in the earlier stages. Playing devil’s advocate here- perhaps biasing results towards asthma leading to PD.
This led me to launch my own search of the literature for association between PD and asthma and unfortunately not unlike a lot of things in medicine in which we don’t have an answer the results are all over the place. Yes! PD can causes asthma. No! Rather asthma causes PD. Asthma prevalence is higher among those with inflammatory bowel disease such as ulcerative colitis which we know is more common in those with LRRK2 gene. One thing is for certain there is a clear relation and association between the two. The question remains to find out which came first the chicken or the egg?
In meantime, although most commonly patients experience shortness of breath particularly in advance stages due to wearing ‘off’ periods and stiffness of respiratory muscles; it may perhaps be worthwhile to keep in mind other possibilities and not assume it’s related to Parkinson’s medications directly because an asthmatic attack can be life threatening. There are more than 3,600 deaths per year due to asthma. While all the details are sorted out especially if you are like me (female gender higher risk) are LRRK2 carrier and have had or have other inflammatory immunological diseases such as ulcerative colitis / Crohn’s disease and have shortness of breath – at least consider the possibility of Asthma.
Things to look out for that are common in asthma:
- frequently Coughing especially at night
- Wheezing or coughing after exercise Shortness of breath or losing your breath easily, short winded
- Chest tightness, pressure, pain
- Feeling tired, fatigued, easily upset, grouchy, irritable, or moody
- Trouble sleeping
Sometimes may be hard to differentiate since most of them can be seen with PD when in doubt consult your physician. Of course if shortness of breath gets worst with exercise or during cold weather or during viral infections like a cold, all of these are indicators of possible asthma Follow up with your physician immediately!
Now, I have one more medicine to carry in my already overflowing medicine bag…. but breathing freely once more. You, too, may be in need of some extra evaluation if experiencing any of these symptoms and not improved with increasing dopamine. Don’t Delay & BREATH HAPPY!