Happy Birthday, James! : World Parkinson’s Day, April 11th

James Parkinson, the neurologist who declared ‘paralysis agitans’ as a serious neurodivergent disease and described it as ‘shaking palsy’. Each year, on April 11th, the world comes together to celebrate and create awareness about Parkinson’s Disease. The month of April is observed as Awareness month for Parkinson’s Disease. 

Silver ribbons and red tulips got adopted as the symbols of the Parkison community. A red tulip with a white rim, developed by a Dutch horticulturist suffering from Parkinson’s Disease, named the tulip after James Parkinson. 

Parkinson’s is a neurodivergent and progressive disorder, which occurs due to the loss of dopamine in the brain. Starting with a tremor in one hand movement, it progresses to affect the quality of life by affecting one’s day to day progressive symptoms such as:

• Posture
• Balance
• Speech
• Walking
• Cognitive functions
• Stiff joints
• Depression
• Constipation
• Insomnia
• Slow Mobility 

 In recent times, there has been an increase in the cases of young individuals getting diagnosed with Parkinson’s. It can affect anyone, at any age given there is an underlying history of genetic predisposition, lifestyle practices, and environmental vulnerabilities. However, delay in the diagnosis results in rapid progression as well as risks of disability. While the hard pill to swallow about Parkinson’s Disease is that there is no cure for it. Thus, medicines aren’t the only aid, one must indulge in healthy lifestyle practices and keep exercising a regular activity in their routine. 

A conversation with Dr. Manali Shah, a neuro-physiotherapist, gives us some meaningful insight into the understanding of Parkinson’s Disease (PD) and creates an awareness perspective on early diagnosis and care. “ It is important to make people aware of the disorder as major factors associated with the disorder happen due to late diagnoses and negligence. We encourage individuals with Parkinson’s Disorder to join free services of neuro physiotherapy and aid them with information on the most advanced protocols for managing a lifestyle with the disorder.”(A) What are the early signs and symptoms of Parkinson’s disease?
A: Early signs and symptoms which should not be neglected include tremors, slowness of movement, postural instabilities, balance issues, sleep disturbance, freezing of gait (FOG) wherein you might face issues in making feet movements. Parkinson’s disease can get broadly classified into two categories:

                        (i) Late-Onset Parkinson’s Disease (LOPD)

                       (ii) Early Onset Parkinson’s Disease (EOPD) 

(B) Who is affected by the condition?
A: Anyone can get affected by PD, usually it was believed that people above the age of 50 were more prone to the disorder but in recent times, more young people between the age of 30 to 50 are getting diagnosed with YOPD (Young Onset Parkinson’s Disease).

(C)  What are the specialists that can help manage the care of a diagnosed individual?
A: Neuro physicians and Parkinson’s super-specialist doctors, especially movement specialists, should seek consultancy to get help in specific diagnoses. Usually, early set symptoms are enough for the diagnosis but in rare cases, they use a Trodat scan( tracing and imaging the dopaminergic system) for confirmation and further treatment.

(D) What are the treatment options available?
A: Prescribable medication called syndopa, dopamine-containing drugs, and dopaminergic stimulators are given on a long-term and permanent basis to manage the symptoms and slow the progression. 

However, physical exercises, physiotherapy, speech therapy, art and dance therapy, aerobics, yoga, tai chi, flexibility training, cycling, and a regular active lifestyle shall help to manage the disorder effectively. 

(E) Given that Parkinson’s is a neurodivergent condition, are memory and thinking processes getting affected? What are the lifestyle changes that come along post diagnoses?
A: Parkinson’s affects the thinking process, judgement, concentration, and memory as well as one’s psychological symptoms also occur like depression, hallucinations, and delusional experiences. 

As mentioned, PD is a progressional disorder, it affects balance and posture which increases the frequency of disbalance. Major areas of effect which can impact one’s day-to-day activity are communication, socialization, and job efficiency. Patients become dependent and may make them bedridden in the later stages. 

(F) In recent cases, we can see young individuals being diagnosed with the disease. Why so? What precautions are to be taken?
A: YOPD, Young Onset Parkinson’s Disease, can be the effects of one’s lifestyle habits, stress, and environmental simulations. Major causes of early-onset PD can also be traced down to genetic dispositions. Regular exercises, a balanced diet, and a stress-free and active lifestyle are crucial choices for individuals to lead healthy lives. Cycling is said to be the best exercise to keep neurodegenerative disorders’ at bay!

• Understanding Parkinson’s Disease from a caregivers point of view: 

Being diagnosed with a neurodivergent disorder such as Parkinson’s Disease does not only affect an individual but also the caregivers. Caregivers are on their toes at every minute and it is learning at every step. We spoke to one of the family members, whose mother got diagnosed with PD. 

• When did they get diagnosed with the condition? What progression do you see in their treatment?
  A: My mother, Mrs. Shah was diagnosed with Parkinson’s 7 years ago. In this span she has developed some walking issues, freezing of steps, involuntary movements in the body, termed dyskinesia, backaches, and some stiffness in joints.

• How are you responding as a family member to help them cope with their diagnosis?
  A: Medicinal treatment eventually increases. However, we focus more on exercising regularly to control the progression for which we make sure to attend support groups regularly. As a family member, it becomes extremely vital to make sure you support them and note their progress, keep them motivated, and charge up for exercise sessions, check-ups, and their medications.
• What can be some steps to support and care for individuals and families, who have recently got diagnosed?
  A: For patients who recently got diagnosed with PD should keep up with the support groups, as support groups are a form of blessing. One will better understand the condition, both now and in the future which at times gets missed out by neurologists during counselling.

If the patient is exercising and following a multidisciplinary strategy promptly, as well as being aware of symptoms, their concern over the sickness will get balanced.

“Coping with relentless assault and accumulating damage is not easy. Nobody would ever choose to have this visited upon them. Still, this unexpected crisis forced a fundamental life decision: adopt a siege mentality or embark upon a journey.”
― Michael J. Fox