chronic illness, parkinson's disease, Parkinson's Health

Happy New Year-2017! By Dr. De Leon

With this in mind, I am aiming for the stars. But, first I want to thank all (you) my readers for almost 6 years of wonderful communication, interaction and allowing me to come into your homes. I think this will be our best year yet. I hope that you will continue to share with me in this journey of life with Parkinson’s disease as the year unfolds.

Surely, we will face challenges as we traverse the hills and valleys of our lives with PD just as certain I am that there will also be many triumphs to rejoice over. No matter what lies ahead for you, I want you to know that you are not alone. God loves you as do I, remember this as you reach for endurance as you begin to climb mountains of despair, pain, misunderstandings, or self-pity  to reach the summit of acceptance, self-love, and inner strength, showing PD who’s boss. When you do, the view will be breath taking, as some of my closest friends who have climbed Kilimanjaro will attest and every bit worth the fight to the top.

There will also be valleys of green grass and flowing water where you can rest and feel at peace helping others who come behind to remain steadfast in the battle; to stay silent when there is nothing to say, laugh as much as you can whenever possible for it is the best medicine there is, lend a helping hand, or simply sit by someone’s side in the midst of adversity. Because those of us who have lived with chronic illnesses in our lives have learned that the race goes to those of us who remain always vigilant, humble, with steady nerves and habits with a keen eye never turning our back to a monster that can destroy us if we lose interest and let our guards down.

So don’t make lofty goals and resolutions you are likely to break rather invest in yourself, prioritizing your time, your energy and your gifts. Make short, intermediate, and long term goals. As I said before, one shuffling step at a time!

Happy New Year!

Topics to be covered this year per the choice award interests survey of PDF ( Parkinson’s disease foundation)-

dystonia, dyskinesia, fatigue, constipation, cognition-ways to maintain, sleep /rem behaviors

Please let me know if there is a special topic you are interested in learning about/ or if you want to be a guest blogger-

send me information to deleonenterprises3@yahoo.com

 

battling stigma in PD, Parkinson's awereness, parkinson's disease

Raising PD awareness ONE shuffling Step at a time. : By Dr. De Leon

As we approach a New Year, I am more determined than ever to continue the fight against Parkinson’s disease both on a personal level as well as a collective effort. As a physician, and patient I have been privy to many extraordinary advances in the understanding of this complex illness over the last decade. However, 2016 saw rise of a new movement towards better understanding the differences among us all (those of us with Parkinson’s), in an attempt to try to find a unifying link that will lead us one step closer to a cure- if not for all perhaps for a number of  distinct subtypes (e.g. LRKK2). There is the large PD study being supported in part by the PDF which aims to unveil different genetic information causing Parkinson’s disease among various ethnic populations (particularly looking at Hispanics with PD).

We also have begun to recognize the importance of gender in the presentation and I believe soon we will also realize that age also plays a factor adding another piece to the puzzle. We have learned that non-motor symptoms are just as/or more important to recognize and treat because not only do they start 10-15 years before motor symptoms; but also can often be the major cause of disability and decreased quality of life. we got several new formulations of old drugs e.g. Rytary and are anxiously awaiting new ones to come out like inhaled levodopa (Accorda) and sublingual Apo morphine.  We saw strengthening of the commitment for a cure as organizations merged (NPF & PDF; MJfox & PAN). We mourned the loss of one of the greatest, Muhammad Ali, who is as much a hero outside as inside of the boxing ring- although, his legacy of courage under fire will live on.

Yet, I am afraid that we have just begun to scratch the surface of one of the most intricate neurological diseases known. One way in which we can continue to peel the layers is by raising awareness nationally as well as globally. The world Parkinson’s congress held this year in Portland brought more diversity than years past helping to disseminate information at a faster rate. We have to take advantage of the fact that the biggest sources of information in any disease especially neurological diseases is not from any doctor’s office but rather from other patients like ourselves. This is especially true in the Hispanic community. So, in order to ensure that accurate information is disseminated is for all of us to share the knowledge we possess with people in the health sciences and healthcare fields and begin an open communication to begin filling in the gaps both sides have. Only when you merge the knowledge can we have effective advocacy to disseminate sound information that will truly elevate and help live a more productive, healthier, happier life despite PD. In the absence of this we will continue to have discrepancies in diagnosis which is only harmful to us the patients and our families.

In light of this, how do we then begin to raise awareness along with the standard of care for the families and nearly 10 million people who live with Parkinson’s worldwide?

I would say that the seed to help others understand the in’s and out’s of PD starts with self-love. First, we need to accept our diagnosis not really liking it but just as another life experience from which we can learn and grow from. Don’t get me wrong just because I have accepted living with PD does not mean I am not doing my best to kick its hinny, or that I don’t get worried or frustrated about being forgetful, unable to multi-task, care for my daughter at times, or even practice my beloved profession. However, by owning our disease we can then become an asset to others who come after us, as I have attempted to do over the past few years. Not only can we educate each other and to our physicians by opening up about the things that embarrassing, frustrating, down right infuriating at times, as well as the things that matter most to us in life and in battling this illness, leaving aside the shame which only serves in my experience to make life more difficult.

However, I understand that sometimes we are best able to start the conversations of salient matters in a more intimate setting like a support group. As many of you know from personal experience, support groups are the veins of the vine, the life line to living well with PD and bringing insight back to the health care professionals and vice versa.

Yet, the reality is that not everyone has access to a support group because of distance, economics, place of residence, etc.  Thus, how does one have access to this? Of course there is always social media which can bridge any socio-economic or distance. Another option is starting your own group if you prefer something more intimate, personal and face to face which affords the benefit of having closer people in the same community to lean on when times get tough, because we all know it takes a village to make PD work for us.

Few tips to finding and starting a support group:

First, find one where you feel loved, comfortable, and free to be yourself …where your needs will be addressed, in social media or in your community or both. These groups can make a difference between a barely bearable existences to one worth living to the fullest.

So how do you become involved with one of these? IMG_0001.JPG

Look around at your community to see if there are some groups already established. Ask your friends, your health care communities, the various Parkinson’s organizations, go online. If there are multiple groups in which you are interested attend a few or all to get a feel of the vibes…

For instance if you are young person with PD, you might prefer to join a young support group, a women’s group (because gender issues are different especially if child rearing), or single people with PD, or even one based on PD status like already had DBS (deep brain stimulation) and such. I, myself, truly enjoy meeting with other women with and without PD because independent of our health status most of us share same goals and life challenges like working and having kids, being a mother, a wife etc. Sometimes we simply feel more comfortable in expressing ourselves or talking about sensitive issues if we are surrounded by similar minded individuals. But, above all choose wisely. Stay open to others ideas.

If no such group is available that touches your heart or seems to meet your needs at the present time consider starting a group of your own.

However, before you take such an undertaking seriously think about your health, your time constraints and more important your physical limitations. Is this going to put undue stress on your physical and emotional well-being? Can you handle the responsibility alone or would having one or two people to co-create and share responsibilities for the group work better?

Think about:

  1. How often do you want to meet and where? Monthly, quarterly etc. keep in mind meeting on a scheduled basis is easier to remember and have greater attendance.
  2. How are meetings going to take place- have guests all the time ( this can create a lot of work for one person), or once in a while like special events, are the group going to be free to talk about issues or one person is going to lead?
  3. Is there a need in your community which has been unmet
  4. Is the place accessible to people you are trying to reach? Look for large rooms that are free like a public library, assisted living, nursing home, or hospital conference room. But, make sure this place has good parking, handicap accessibility and preferably access to public transportation.
  5. Time of day for meeting is also extremely important which has to take into account the age group of people trying to reach, are they retired or employed, can they drive themselves or need rides?
  6. Are you opening the group to patients only, caregivers only, both?
  7. What are the meetings going to look like? A lecturer/guest speaker? Open exchange of information, stories? Both? Participate in activities like painting or singing?
  8. How do you plan to get word out to community? Flyers to doctors, place ads in newspapers – note: some communities allow free advertisement, also may get help from hospital, nursing homes, assisted living etc. A web page/ social media can be the easiest most affordable way of getting word out. But, don’t forget about the old phone which always works among the elderly and some groups.

If you are reading this then you are already involved most likely in a support group or perhaps still feel isolated now you have some basic information to help you start the New Year on a positive note knowing full well that you are loved, you matter and are not alone and together we are going to make 2017 the BEST year possible by breaking down barriers one small shuffling step at a time!

Happy New Year 2017!!!

All the best from the desk of Dr. De Leon a.k.a. Parkinson’s Diva

Stay tune for my new book coming out next year-

@copyright  2017

all rights reserved by Maria De Leon MD

 

 

chronic illness, diet, memory loss, parkinson's disease, Parkinson's Health

The Need for Vitamin D in PD: By Dr. De Leon

“Them bones…them bones..”

Now that we just spent the last week or so traveling, spending time with family, and of course indulging in that delicious Thanksgiving meal is time to get back to basics especially as winter months approach where days are shorter with fewer hours of sunshine.  Are you getting enough Vitamin D in your diet?

Many recent studies show this essential vitamin to be low or deficient in many of us with chronic illnesses like diabetes, lupus, and of course Parkinson’s disease among others. In fact, as per Archives of Neurology Vitamin D is so compromised in PD patients that roughly 1/2 of the people with PD have  Vitamin D insufficient, while a 1/4 have show a clear deficiency.
[The Endocrine Society
 uses the following guidelines for vitamin D blood levels in adults and children:
Vitamin D deficiency-20ng/ml or less
Vitamin D insufficiency- 21-29ng/ml
Vitamin D sufficiency – 30ng/ml or greater (NL) ]

Thus, if your Vitamin D levels have not been checked recently by your health provider they should be; plus you should have vitamin supplement in your medicine cabinet. The reason for this is not only that most of us with chronic illnesses have a deficiency but even for those of us who are otherwise healthy can’t seem to get enough of it as per recent studies despite being present in many ordinary foods we eat. Some of the reasons for insufficiency despite adequate nutrition is small quantities in food and although we should be able to absorb what we need from the sun rays. It seems many of us at least in this country are not getting enough sunlight perhaps because we have become more indoor and sedentary and when we are outdoors we wear more UV light protective clothing and make up.

So why is Vitamin D such a big deal?

Well I think we all know about its relationship to calcium and strong bones. When its deficient we are more prone to fractures a common problem with PD especially since we are more likely to have falls as disease advances.

Vitamin D is also a key to boosting our immune system and reducing inflammation – this may be one of the crucial treatments in helping those with LLRK2 gene carriers to help with PD symptoms ( still not fully understood role of inflammation in this subtype). another reason to take Vitamin D supplement is the studies which suggest a decrease in blood sugars ( in type 2 diabetics) in those with higher Vitamin D levels. As I have mentioned before, people with PD are more likely to develop insulin resistance due to dopamine replacement which can potentially lead to diabetes; especially in those of us who are already at risk. Thus having a higher level of Vitamin D in your system can lower your risk for developing type 2 diabetes. Furthermore, Vitamin D is also important in memory and fatigue but it does not stop there. Early reports have suggested problems in kidney, nerves, and eyes with low levels.

If you have had gastric bypass, inflammatory bowel disease, have dark skin, are obese, older, or have limited exposure to sun are at an even higher risk of having severe deficiency when compounded with PD.

According to the USDA fatty fish ( e.g. salmon) is a top source as well as eggs (yolks), and liver (beef). many of us believe that milk is an excellent source of calcium although vitamin D fortified in order to get dietary needs met you would have to consume 13 cups daily.

  • The Endocrine Society- recommends 1,500 IU while NIH suggests 600 IU –
  • Look for supplements labeled D3- same as body makes
  • Eat a fat source such as peanut butter, avocado, or egg with supplement to better absorb the vitamin
  • Try app-dminder.ontometrics.com to gauge how much vitamin D you need

However, in the end the best way to determine how much supplement you need is by talking to your physician first.

 

Sources:

“The Need for Vitamin D”: Diabetic Living. (winter 2016), 56-57.

Devere Ronald, MD FAAN, “Cognitive Consequences of Vitamin D Deficiency”, Practical Neurology,Vol. 13, No.1,January/February2014.

“Low Vitamin D levels Associated with Parkinson’s Disease’, Parkinson’s Disease Foundation News & Review, winter 2009

chronic illness, parkinson's disease, Parkinson's Health

Lack of Health Care Continuity is a Growing Crisis in America Especially for Those of Us with PD: By Dr. De Leon

“Broken trust is like melted chocolate. No matter how hard you try to freeze it  can never return to its original shape.”

 

Being a patient who is chronically ill has definitely made me more aware of one of the great problems we have in health care today- poor continuity of care. As we approach the next Presidential election, I am holding my breath just like the majority of Americans. But for me the biggest issue of this election is one which has plague me and my family for a decade particularly since Obamacare was enacted into law.

As a doctor who struggled to bring difficult and challenging patients to some kind of balance (between medications side effects and quality of life); the careless dismissal of my plan by a hospitalist who decided patients were on “too many”  or that a “cheaper ” medicine would work the same sent me screaming. Especially when they did not bother to consult me even when patients asked for me to be consulted because it was not cost effective or deemed necessary by some administrator.

This new practice of medicine was brought about by the new trend to attempt to “socialize medicine” and have physicians act as employees of institutions instead of self-entrepreneurs who had autonomy over their own destiny and their patients. The discontent of been treated as perpetual “residents” is seen in the eyes and mannerism of walk of hospitalists everywhere. Those that I have spoken to while taking care of my dad told me could not wait to do something else. This despondency was caused by extensive hours of work, increasing demands by the hospital, and little control over their work because the ultimate decision making is left to the whims of administrators and insurance companies who know nothing about the practice of medicine. For instance, not long ago a hospital CEO was attempting to promote their new mammogram equipment for their hospital; so he thought that he would advertise for women to ‘buy one get one free’ (not a pair of shoes!) or to bring their daughters for a free mammogram at the same time of their visit….

This type of actions exhibits a totally out of touch mentally with the practice, the law, and recommendations / guidelines by American academy of Radiology.

What insurance companies and people behind affordable health care ignore is the bond that exists between a doctor and patient. For those of us with chronic illnesses, this bond is a crucial and vital part of our lives- it is an actual relationship forged through months and years of trust building – big part of following your doctor’s recommendations is having trust in their counsel. Unfortunately, much of the noncompliance is because of lack of trust. When we are placed in a position of sharing our most intimate details, fears and vulnerabilities with stranger after stranger leads to total dissatisfaction in the field of medicine in both patients and health staff. We are meant to have long lasting relationships in which trust can be forged over time.

Furthermore, the increase government interventions and regulations in medicine have taken the pride of a job well done from those practicing. How is anyone to take responsibility of any one patient outcome when there is not one single person in the medical field in charge? Now imagine you are the patient with a long list of problems and an equally long list of medications and all you want is to have someone develop a plan and follow through but when one day you see one person spend an hour delineating a plan and are asked to follow up in clinic only to have another physician see you who has neither spent time reading your history nor last visits plan because as soon as they walk in door they have to fill out a million little esoteric data required by law in order for them to be compensated so they don’t even shake your hand or bother to look at you at times. So without taking time tor really asses you who are sitting in front of them or listen to the fact that the data (labs) pulled up in their electronic medical records (who are often known to be inaccurate and incomplete) are of another patient who happens to share your name, they formulate a new plan of action leaving you completely frustrated.

This common scenario which occurs more often than not thanks to Obamacare is particularly bothersome for patients and the loved ones of those with chronic illnesses who are hospitalized – thankfully some physicians are more aggressive than others and still are free thinkers thus are more willing to fight for the patient independent of what administrators or insurances call for ( because insurance, hospital and government penalize doctors for spending money on patients, running tests and keeping patients in hospital over 3 days!). Of course, these doctors are often penalized for taking proper care of their patients – if it happens enough they too will soon go with the flow giving in to the broken system and perpetuating the lack of continuity of care chain. Lack of cohesiveness among the treating physicians only creates more anxiety in patients and their families. Same thing happens in the out- patient setting to a lesser degree. This is worst when dealing with PD patients or others with chronic diseases especially if known to have multi -system involvement requiring multiple specialists. These patients more than anyone are at the mercy and of insurance plans who have unfortunately the power to dictate when, where, and which test will and will not be covered.

This is where I, like many of you, become completely unhinged; however, I try as best I can to respect the opinion of other physician’s being one myself and fully understanding the challenges of the new healthcare system. Yet, I politely inquire reasoning behind new idea, treatments and changes of tests and medications to make sure it is something they feel as doctors is necessary or important vs recommending simply do to pressures from outside sources. However, sometimes although the reasons behind medical treatment is one imposed by administrators etc., we have no choice but to comply because we are hospitalized or our health plans coverage change suddenly removing access to our previous physicians or making our follow- up visits with our specialists incredibly unaffordable that we have no choice but to look for a replacement and start all over.
Let us voice our discontent and let government know is not ok with us to have poor continuity of care…we need health care revamped! hopefully this new election will bring necessary changes to better the care of all of us with chronic illnesses like PD. also let them know we need more neurologists not just more primary care physicians.

 

caregivers and chronic illness, parkinson's disease, parkinsons health and beauty tips

Health & Beauty tip # 30 : Put on some lipstick & show Parkinson’s who’s Boss? By Dr. De Leon

As we draw near to another years end, I want to write about something near and dear to me as a woman, mother, cancer survivor, Parkinson patient/ doctor and advocate!
Female power!
I began this blog, as away of coping with this illness and also as a way to show women everywhere who struggle with this illness in their daily lives as patients, wives, mothers, daughters, caregivers -that they TOO had the power within themselves to beat anything that is thrusted their way.
But best of all, I want to stress to my readers that the positive energy that empowers them to be able to crush Parkinson’s comes from the fact that we are women.

I started writing about dressing shabby chic despite Parkinson’s and feeling sexy and beautiful in spite of having a chronic neurological disease like Parkinson’s ….in between I wrote about many coping skill strategies in dealing with the diagnosis.
Today, we have come full circle.
I am asking my readers to keep their lipstick handy! In whatever shade they prefer….personally a red or pink will do!

Because like Suzy Toronto, I too, when I think about the women I admire and have made a big difference in my life and in the world….”before they ministered to the sick, the poor, or changed the face of politics… They put on their lipstick first!”
“This small act throws us back to a much simpler time when women showed their determination & focus by placing on lipstick and then going out to the world and doing what needed to be done.”

I grew up always PUTTING on some lipstick even if it was a very light shade of pink before tackling any job…even while in medical school when I had no time to eat or sleep …I would grab my only make up at the time…my ever trusted lipstick which I always carried with me no matter what…and apply on the way to operating room or to visit a dying patient ..”as if it would magically give me the strength and willpower to tackle whatever challenge stood my way.” Now, as I live with my PD diagnosis putting on some lipstick not only helps me feel “normal” but like I can still tackle the world! This shear act makes me feel pretty and feminine even if that’s the only thing I managed to accomplish during the day that required any fine motor skills!….

Lipstick helps me face the day’s adventures, challenges, and strength to dive into the daily world of Parkinson’s. Before I put on my big girl panties, I start with a “fresh face and a gorgeous shade of (red)” to go with my shabby chic diva look!

For you, my readers it may not have to be a lipstick…it can be anything that makes You feel good and empowered ….like riding your favorite bike, putting on your favorite tennis shoes to go for a run, putting a comfy shirt to inspire you to paint with all the colors of the rainbow, or wearing a pair of favorite shoes ( red or any other color that inspires you!). In short, whatever it is that empowers you and helps you tackle the world head on, allows you to take care of yourself and your loved ones, be a better mother, spouse, sister, daughter, Parkinson’s advocate…make it a part of your daily routine for the whole of next year and every year!
Use what works to get your female power flowing to change the world around you and make living with Parkinson’s disease an amazing ride!

parkinson's disease, parkinsons health and beauty tips

Consejos De Belleza #16 ¿Que es el Parkinsons? por La Dra. De Leon

¿Qué es la enfermedad del Parkinson?

La enfermedad del Parkinson es un trastorno crónico y progresivo el cual produce movimientos anormales causado por la falla o falta o muerte de vitales células vitales nerviosas en el cerebro, llamadas neuronas. Algunas de Eestas células moribundas producen dopamina, una químicao llamada dopamina que envía mensajes a la parte del cerebro que controla el movimiento y la coordinación. A medida que la enfermedad progresa, la cantidad de dopamina producida en el cerebro se reduce, dejando a la persona sin capacidad de controlar sus movimientos normales- antes se especulaba que al principio de la enfermedad ya se habia perdido mas de 60% de las cellulas dopaminergicas pero en los recientes años los cientificos nos han dado ESPERANZA de poder aliviar o combater esta enfermedad porque hoy se estima que al comienzo de los sintomas solo el 20% se ha perdido o no funciona adecuada mente!!!

Los signos motores más importantes de la enfermedad de Parkinson incluyen temblores, lentitud, rigidez, inestabilidad en la postura, así como otros síntomas no motores [estos incluyen síntomas como falta de olfato, problemas con el sueño, depresion, constipacion, problemas con el orine , dolor y fatigua corporal].

¿Cuántas personas viven actualmente con la enfermedad del Parkinson?

A nivel mundial, se estima que hay entre siete y 10 millones de personas viviendo con la enfermedad del Parkinson. En los Estados Unidos (EE.UU.), se estima aproximadamente un millón de personas viviendo en con la misma enfermedad, este numero representa una cifra más grande que el número combinado de personas que padecen de esclerosis múltiple, distrofia muscular y esclerosis lateral amiotrófica (la enfermedad de Lou Gehrig). Aproximadamente 60,000 Eestadounidenses son diagnosticados con el Parkinsons cada año. Este número no refleja los miles de casos que permanecen sin ser aun detectados.

¿Cuales son los síntomas motores de esta enfermedad ?

1) Temblor al estar en reposo- este puede o no ser el mayor síntoma – como todos los otros síntomas empieza unilateralmente pero a medida que avanza la enfermedad se transforma bilateral pero siempre mas predominante en el lado que empezó. Por lo general empieza en la mano pero puede empezar en el pie esto es menos común.

2) Rigidez -tiene que haber rigidez, al igual que los temblores este también empieza unilateral y después avanza. Por lo general la rigidez es mas fuerte en el lado contrario de donde los temblores son mas fuertes. Al principio a causa de la rigidez los pacientes pueden presentar con dolor muscular (esto ocurre en 10% o menos), también puede presentarse como debilidad muscular por causa de la rigidez y esto puede imitar un infarto o embolia cerebral por ser unilateral! también a causa de la rigidez uno necesita mas fuerza para hacer la misma actividad y de pronto dar la apariencia que uno esta perdiendo fuerzas del lado afectado, algunos pacientes presentan dolor en el hombro del lado mas rigido – o el lado donde empiezan los síntomas esto hace que aveces vayan a ver varios otros especialistas como ortopédicos antes de ser diagnosticados apropiadamente por un neurologo.

3) Lentitud de movimientos (Bradykinesia)- de repente unos notan que no pueden empezar los movimientos voluntarios e involuntarios con la misma rapidez que antes. Por ejemplo notan mas dificultad para pararse de una silla especialmente si han permanecido sentados por largo tiempo o la silla esta muy baja y tienden a usar otros músculos para levantarse o tener que menearse para poder arrancar hacia el frente …se balancean hacia el frente y atrás o usan los brazos de la silla para asistirse a levantarse.

4) Problemas de balance (instabilidad de posturas o desequilibrio) – a medida que la enfermedad va avanzando también este problema se va empeorando lo que causa que los pacientes o personas que padecen de este problema tengan mas propensión a caerse. Esto porque el centro de gravedad se va haciendo mas al frente a medida que las personas se van encorvando hacia el frente por causa de la rigidez muscular. Una forma simple de evaluar si las personas tienen buen balance es cuando ( por lo general el doctor o especialista) se pone detrás del paciente cuando el paciente esta descansando parado con las piernas un poco separadas y el doctor dan un tirón hacia adelante y hacia atrás sin que la persona pierda el balance. Lo mismo puede hacerse de frente.

¿Cuales son los síntomas del Parkinson?

Como dije antes el diagnostico esta basado en la presentación de los cuatro síntomas cardenales pero no todos tienen todos los síntomas en la misma proporción. Ademas también hay otros síntomas nombrados no -motores que no son causados por la deficiencia de la dopamina como la perdida de olfato, depresión, constipación, ansiedad, problemas del sueño y movimientos de las piernas por nombrar algunos y la presentación de estos hace que cada individuo sea diferente. También hay dos tipos de Parkinson uno que es caracterizado por el temblor ( temblor dominante) y otro que tiene muy poco o muy leve los temblores ( akinetic o sea falta de movimiento caracterizado mas por rigidez y problemas de postura y balance).

¿Cuales son los síntomas no-motores?

Ya mencione unos pocos….anteriormente

Aparte de los cuatro síntomas documentados anteriormente que son la base del diagnostico del Parkinson, hay otros síntomas que también forman parte del cuadro clínico causados por deficiencias de otras químicas en el cerebro aparte de la dopamina. Estos síntomas ( muchos de ellos pueden presentarse hasta 20 años antes del diagnostico mucho antes de que los temblores o la rigidez de principio).

-constipación
-problemas de orine
-disturbio de sueño
-depresión y ansiedad
-dificultad de deglutir
-alucinaciones y psicosis
-problemas de cognición
-baja presión y mareos
-problemas con la visión o sequedad de ojos
-problemas con sexo
-frecuencia de salivación
-aumento de sudor

¿Cual es la causa de la enfermedad?

La causa exacta todavía se desconoce en la mayoría de las personas que padecen de esta enfermedad..una porción pequeña es causada por ciertos problemas genéticos. Pero a la verdad es que hay muchos factores que contribuyen y hasta el momento todos se desconocen… Pero factores como toxinas en el medio ambiente desempeñan un gran papel, también hay una porción pequeña de Parkinson que es conocida mejormente como familiar o hereditaria.

¿Cuales son los factores que aperentemente contribuyen al de riesgo de contraer el Parkinson?

El hecho de vivir o crecer en áreas rurales aumenta el riesgo de contraer Parkinsons. Los estudios han demostrados que las toxinas y pesticidas pueden aumentar los riesgos, al igual que beber agua de noria. Por cieto hay cietas areas que son conocidas como” el cinturon del Parkinson” por la alta frecuencia de pacientes en estos lugares…unos de estas areas es aqui en el ESTE de TEXAS se especula que es por cause de las quimicas de las industrias de papel…..Por hecho También ultimamente han habido unos estudios que parecen indicar que ciertas razas como ser Hispano portiend emas riesgo que cualquier otro -el porque todavia no se sabe…estaremos al pendiente de estos estudios en adelante pare aver si son ciertos y ver la causa aligual de como resolver el problema.
También golpes ala cabeza contribuyen al riesgo.

¿Cuales son los factores Genéticos que contribuyen al Parkinsons?

La mayoría de la gente que padece del Parkinsons no tiene ninguna anormalidad genetica hasta hoy conocida. Algunas personas se especula que estan mas vulnerables a causa de su composición genética y atraves del tiempo pueden padecer un insulto a su organism ya sea por el medio ambiente o trauma y esto los desbalancea a medida que no pueden recuperar se del insulto y alli se desemvuelve la enfermedad como una basura que no puede ser eliminada y a medida que va pasando el tiempo por tartar de sacarla y qumarla y arrestar su desarrolo eso mismo hace que cresca hacia puede bien ser el papel de la proteina alpha synuclein que parece estar mal formada y doblada en la enfermedad del Parkinson …..pero aun no se sabe todavia cual exactamente es su papel en el desarrollo de la enfermedad precisamente.
Toda regllas tienen una excepción y la excepción son las personas que contraen la enfermedad en temprana edad antes de los 50 años (<10%). En estos casos la genética tiene más influencia.
Los investigadores han descubierto varias mutaciones genéticas que pueden causar directamente la enfermedad, pero estas solo afectan a un pequeño número de familias. Algunas de estas mutaciones involucran a genes que tienen un papel en las funciones de las células dopaminérgicas. La enfermedad del Parkinson que se desarrolla a temprana edad tienden a tener mutaciones en los genes parkin, PINK1, LRRK2, DJ-1, y glucocerebrosidasa, entre otros. ( Todavia no se sabe si estos forman parte de la enfermedad clasica del Parkinson que afecta principalmente a personas mayores de 55 años y tienden al sexo masculino…..pero mi observacion hasta el dia de hoy me ha indicado que especialmente aqullos que son diagnosticados antes de los 40 tienden hacer del sexo femenino….no hay estudios tyodavia ….esto es solo mi observacion).

Puesto que las formas genéticas de una enfermedad pueden ser estudiadas con gran detalle en el laboratorio, y porque el comprender las raras formas genéticas del Parkinson podría ayudar a entender formas más comunes de la enfermedad, la genética es actualmente sujeto de intensa investigación.

¿ Por qué es que el Parkinson es tan mal interpretado?

Hay ciertos medicamentos que pueden imitar o causar el Parkinson. Este tipo de medicinas son algunas que causan o bloquean los receptores de la dopamina en el cerebro. Por lo general cuando estos factores son removidos los síntomas desaparecen igualmente. Algunas medicinas que causan síntomas similares están en la página 13. Nunca paren de tomar sus medicinas repentinamente sin consultar con su médico. Si usted ha estado tomando alguna de estas medicinas y cree experimentar algunos de los síntomas relacionados con el Parkinson …llame a su médico de inmediato.
Cada persona progresa de manera diferente. Por lo general esta enfermedad no acorta la extensión de vida -pero tiene varias etapas (leve a severo)…la etapa severa se entra después de los 15 a 20 años por lo general. Pero todos toleran las medicinas diferentemente, y son diagnosticados a varias etapas y presentan con síntomas diferentes. Por ejemplo, en general los que tienen temblor dominante (avanzan más lento) y otros que son categorizados como akinetic o predominantemente rigidos( poco temblor- estos tienden a progresar de manera más rápida).
En la última etapa o etapa avanzada de la enfermedad las personas tienen más problemas para caminar porque son más lentos, y se les pegan los pies al suelo, se caen con mas frecuencia y tambien tienen mas dificultar para hablar y trajar al igual que requieren de mayor asistencia para hacer sus quiaceres cotidiadonos porque tienen más dificultad para usar sus manos. Estos tienden a tener más riesgo a contraer pulmonías por causa de aspiración. El 40% al 50% también empieza a tener dificultad con la memoria y pueden desarrollar demencia.
A pesar de que hasta el día de hoy no existe un tratamiento definitivo que pueda curar todos los síntomas, hay varios medicamentos que ayudan a mantener la función y calidad de vida. Entre más activo sea el individuo y participe activamente en su salud mejor éxito tendrá de combatir la enfermedad. Pero principalmente lo que ayuda a un paciente que padece del Parkinson aparte de tener una red social y familiar bien fundada es tener un especialista del Parkinson. Los estudios han demostrado que aquellos que son atentidos por un especialista tienen major calidad de vida y tambien es ecencial empezar tratamiento cuanto antes y no esperarse a progresar porque puede ser muy tarde.

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Dr. M. De Leon is a retired movement disorder specialist, PPAC member and research advocate for PDF; Texas state assistant director for PAN (Parkinson’s Action Network). You can learn more about her work at http://www.facebook.com/defeatparkinsons101 you can also learn more about Parkinson’s disease at www.pdf.org or at www.wemove.org