Parkinson’s disease

Parkinson’s disease is a chronic neurological disease. The first symptoms usually come after age 55. The symptoms may come earlier, but it is less common. You may not recover from the disease, but there are various treatments and medications that can reduce the hassle.

Dopamine is a signal substance that the brain uses to send signals between the brain cells. In Parkinson’s disease, the cells that make dopamine are destroyed. The brain then becomes more difficult to control the nerve signals that control the body’s movements.

About one in a hundred people over the age of 60 gets Parkinson’s disease and it is more common in men. The cause of the disease is not entirely clear.

symptoms

The first complaints are often vague discomfort in an arm or leg. You may become fuzzier and the writing may also be worse. Because the symptoms are quite common, it can be difficult to link them precisely to Parkinson’s disease.

The trouble usually starts in one half of the body, but eventually arises on the other side as well. Gradually, the symptoms become clearer, but it often takes several years.

These are the first major symptoms:

  • The body shakes at rest.  It usually starts with one hand. For example, there may be shakes where the thumb moves toward the index finger. Later the tremors spread to the leg on the same side and to the other side of the body. The head can also shake. The shaking often stops briefly as you move actively. For example, the hand can shake as it rests on the table, but if you reach for a glass, the shakes will disappear. Then they return as the glass is brought closer to the mouth and the movement stops.
  • The muscles become stiff.  Another symptom is that the muscles become stiff and feel sluggish as you move. It helps you feel restrained and tired. You may also experience pain in different parts of the body, often in the back and shoulders. The muscles of the face can also be affected so that the mimic will solidify.
  • Impaired mobility. Another symptom is that the movements become slower and more difficult to start. This means that it takes longer with everyday activities such as dressing, brushing your teeth and eating. Writing is slow and the writing is smaller. Anything that requires smooth movements is often difficult, such as unbuttoning buttons, tying the laces or using a screwdriver. It can also take longer to make decisions in different situations, not least in traffic. Sometimes it feels like the world is going too fast.

    Simultaneous capacity can be impaired, which means that you find it difficult to take the initiative and do several things at the same time. It can be difficult to complete a movement if you are interrupted, for example, by a question. If you stop, it may be difficult to start the movement again. Over time, the impaired ability to move can prevent almost all spontaneous movements, as concentration is then required to move.

Other symptoms

You may get low blood pressure. Then it can be labeled as dizziness when standing or traveling quickly. It can also make you faint.

You may become hard in the stomach or get constipated. This is because the movements of the gastrointestinal tract become slower. You may also have trouble with the bladder in the form of so-called urge. This may mean that you have to go to the toilet more often, especially at night. Other symptoms that may be considered troublesome are urinary incontinence .

Sexual desire can decrease, and you may have difficulty getting an erection or orgasm. Sometimes you may have problems with the regulation of body temperature, which can cause you to sweat more than usual. You can get dandruff, especially on the face and scalp.

Your speech can become unclear and your voice weakened, which can make it difficult for you to understand. You may find it harder to feel the flavors and smells.

You may feel depressed due to lack of energy belonging to the disease. It is also common for you to sleep poorly and have difficulty falling asleep.

No one who gets Parkinson’s disease gets all the symptoms and complications that exist. You can live about as long as if you had been healthy, but the quality of life may have changed.

It is possible to live as usual for many years

During the first few years, the disease usually does not cause any major worries, which means that you can live about as usual. Gradually, the symptoms tend to increase and then the problems become more noticeable, but with the help of drugs the body can function well. There is a slow and gradual deterioration for 15-20 years.

Treatment

There are several  drugs  that you can use when you have Parkinson’s disease. They are often combined for the best possible effect and relief of the symptoms. The drugs work by affecting dopamine in various ways. Dopamine is a so-called neurotransmitter in the brain and in Parkinson’s disease the cells that make it are destroyed.

The drugs can be combined in different ways to get the best possible relief from the symptoms. The treatment with drugs is to replace the lack of dopamine, improve the action of dopamine or slow down the breakdown of dopamine.

One help might be to keep a diary of how the symptoms vary during the day. If you include it at your doctor’s visit, your doctor can understand and monitor how your drug works, and thus prescribe the treatments that are most appropriate and effective for you.

If the disease is severe and regular drug treatment does not provide sufficient symptom relief, so-called advanced Parkinson’s treatment may be necessary. You can then receive medication continuously via a pump either in the subcutaneous vein or via a tube in the intestine, and dose adjustments can be made if needed.

Another alternative is so-called DBS, Deep Brain Stimulation where you can alleviate the symptoms via deep electrode stimulation in the brain. This means that thin electrodes are inserted into the brain and stimulated via a box placed on the chest, much like a pacemaker. The stimulation can be changed if necessary via external programming.

What is the cause of the disease?

The brain cells are constantly in contact with each other. Nerve signals are sent from one cell to another with the help of chemical substances, so-called signal substances. How much neurotransmitter to send, and when to send it, is closely regulated by  systems in the brain . These can both slow down and activate the nerve cells. A neurotransmitter is dopamine that the brain uses to control the nerve signals that control the body’s movements.

If you have Parkinson’s disease, cells that make dopamine are destroyed. Lack of dopamine causes nerve impulses to change and you cannot control your movements as well as usual.

The reasons are not clear

The causes of Parkinson’s disease have not yet been fully established. There are probably several interacting causes. The disease can be hereditary in some rare forms and research is ongoing.

Investigations and investigations

Before seeking treatment, you may have for a long time suspected that something is not right. Being told that it may be a life-long illness can be difficult, but it can also be a relief to finally get an explanation. At the doctor’s visit, it is good to have someone close to you as a support. Relatives may also need knowledge and information about the disease.

It is not possible to diagnose Parkinson’s disease through a blood test. Because the symptoms are not noticed much, it can be difficult to get a diagnosis in the first years of the disease. The doctor makes the diagnosis based on your symptoms and how they have changed. You can sometimes get to try tablets in tablet form to see if your problems go away.

Examination of the brain

You may undergo an X-ray examination if your doctor needs to rule out other causes of the symptoms. But images with a computed tomography  or magnetic camera  cannot confirm the diagnosis of Parkinson’s disease. The doctor can see changes in the dopamine system and estimate the amount of dopamine receptors in the brain by injecting radioactive tracers that search for the central parts of the brain. The study is called Dat-Scan but is not a routine examination that is found in all hospitals. Nor is it specific to Parkinson’s disease.

Hospital care is rarely needed

Almost all investigation and treatment for Parkinson’s disease can be done at a reception, but sometimes you need to be hospitalized. This is, among other things, when testing and testing of drugs should be done, when new and unexpected symptoms need to be investigated and when major changes may need to be made in drug treatment.

Right to information

In order for you to be active in your care and to make decisions, it is important that you understand the  information you receive  from the healthcare personnel. Ask questions if you don’t understand. You can also ask to have the information written down so you can read it peacefully.

When and where should I seek care?

Contact a health care center if you suspect you have Parkinson’s disease. You can seek  care at any healthcare center you want  throughout the country. There you also often have the opportunity to get a regular doctor’s contact.

Living with Parkinson’s Disease – What can I do for myself?

For example, if possible, try to avoid stress that can aggravate the problems. It is good if you can find a method that will help you relax.

To feel as good as possible, it is helpful if you have established routines to cope with daily life and medication. Maintain body mobility and agility by exercising regularly. It can be good to contact a physiotherapist for advice and exercise programs. For example, you can try Nordic walking, which helps to straighten the body, and exercises arm movements which helps you to walk better. By using other senses such as hearing and vision, you can influence and improve your ability to move. Beat-fast music and visual impressions with markings on the floor can make you go better. If you have lived with the disease for a long time, you may need different technical aids.

If you acquire knowledge about the disease and how it works, you will have a much greater chance of living a good life. Therefore, it is also good if close relatives get involved and get to know everything about the disease.

To eat the right food

Since the protein in the food can compete with your medication, you should contact a dietician if you feel worse after a meal.

Difficulty swallowing

Over time, Parkinson’s disease can make you more difficult to swallow. Then there is the risk of putting a bite to the throat, which causes cough attacks and also increases the risk of pneumonia. The best thing is to eat foods that are easy to chew. Various types of thickening agents that can be added to both cold and hot liquid to make the liquid more viscous are available at pharmacies. If you find it difficult to swallow tablets with water, you can take them with some viscous drink, such as file or rosehip soup.

Constipation

Both the disease itself and the drugs can cause  constipation . This is mainly because the bowel is slower in its movements than before. A sedentary life also makes you more easily constipated. You can prevent being constipated by drinking enough fluid, preferably water. Exercising regularly and eating high fiber foods are also good.

dentistry

When you find it difficult to make nice hand movements, you need different  tools . An electric toothbrush is good for cleaning your teeth. You should also visit a dental hygienist twice a year as it can be difficult to clean between the teeth.

Mouth dryness,  which is a common side effect of the drugs, puts you at risk of getting holes in your teeth. Although you have difficulty swallowing saliva, you can get dry mouth. You can therefore be dry in the mouth even if the disease causes you to drool.

Help from physiotherapist

It is important to contact a physiotherapist, also known as a physiotherapist, for advice on good activities and how you can best counteract that your posture and physical ability are impaired. The physiotherapist can also help you gain better body awareness. Such exercises also include training in being able to relax. You also need to train yourself at home, preferably every day, to reduce the risks of reduced mobility and maintain fitness and strength.

In order to be able to stay at home for as long as possible, you have regular contact with a doctor, nurse and physiotherapist. You may also need the help of a occupational therapist, speech therapist, curator and dietitian. Help from the home service also makes it easier to live at home, even if the illness is more difficult. In some parts of the country there are special Parkinson’s hospitals and Parkinson’s teams. There are also patient associations where you can get tips and advice.

Having Parkinson’s disease in working life

If the work is adapted to the disease, you can often continue working for a number of years. Therefore, it is important that you discuss with an administrator at the Social Insurance Office and the employer at an early stage to make the necessary changes to the work. You also need to have regular meetings to adjust the measures based on how the disease develops.

Sex and cohabitation

Parkinson’s disease reduces sexual desire, but at the beginning of the disease, the drugs can help to make the appetite as normal or even increase.

Different forms of disability and the rapid fluctuations in the effects of the drugs can create uncertainty in a couple relationship, and you can doubt whether you are capable as a partner. The same fear can make you dare not meet a new partner. Sex and social life change when you get Parkinson’s disease.

By changing their habits and patterns, cohabitation can work again. It can ease prestige and performance requirements and provide new ways to enjoy. Do not hesitate to seek help regarding sexual problems. Being able to talk about these issues with someone outside can often be of great help. You can address the problems with your doctor at the reception you are in contact with. If needed and depending on the problem, you can go to a urologist, a sexual reception or to a family counseling that in some places also has a sexologist.

To you who are related

The disease also affects you who are related because the person who is ill becomes more dependent on others. It may also happen that the workplace or home needs to be adapted to the new needs. It becomes more difficult in everyday life for the sick person as things take longer and the initiative ability and the desire decrease. If the person who is ill gets sleep problems, memory problems or depression, it also affects you as a relative. Medication is often perceived as complicated and careful planning is required for everyday life to work. It is good for you as a relative to obtain information about the medicines used by the person with Parkinson’s disease.

Getting the disease can change a lot in life. It is good if you as a close relative try to respect that the person who has become ill needs more time and help to stay active. In order to cope with the changes within the family, you as a relative may also need support and help.

Help to cope with daily life

Those with Parkinson’s disease often need a lot of help to cope with their daily lives. Therefore, the planning of care and care should begin as soon as the diagnosis is established. As a relative, you get to talk to doctors and other health care professionals, as well as assistance officers from the municipality.

It can be stressful to be close and you can feel sadness and anger. As a relative, you may need a lot of support in your task to help. In some municipalities, there are support teams for relatives of people with Parkinson’s disease. The team makes contact and informs about the municipal resources that exist and can act as call support.

Support for staying at home

If someone with Parkinson’s disease does not have the right to personal assistance, you can apply for other contributions from the municipality such as home care. It can give can provide practical help with many everyday tasks such as personal hygiene, laundry, cleaning, grocery shopping and more. In many municipalities, there are park nurses who can provide advice and support. The nurses also have close contact with the home care staff. The fee for the help you can get varies from municipality to municipality. More detailed information about what different efforts the home municipality can provide and what these costs can be obtained through the home municipality.

Anyone who has Parkinson’s disease or you as a relative apply for help from the social services in the municipality. The municipality’s aid officers make an inquiry about the needs that exist and make decisions based on them. The decision may be appealed.

When the disease becomes severe

Over time, the ability to move can become so impaired that the sick person needs mobility aids. It can be difficult to get the help that is needed in the home and then the sick person may need to move to another place to get enough help.

Permanent care contact

Anyone who has contact with many different people within the care can get a permanent care contact. It is a person who among other things helps to coordinate care. It is possible to choose a permanent health care provider throughout the country.

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