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Thursday, January 23, 2014

All You Want to Know about PD but are Afraid to Ask

Next month will be one year after my wife of 57 years( Macrine) was diagnosed with Parkinson disease, commonly called PD. She has been experiencing typical symptoms of the malady with involuntary hand tremors, slow body movement ( walking), unbalanced gait, softer voice, difficulty swallowing and had a couple of falls during the previous months. We have to purchase a cane, and I have to watch her almost all the time when she is awake to prevent another fall. Today however, she has not fallen and only occasional freezing in the muscles on her legs had occurred. Thanks to the two medications she is currently taking, Sinemet and Azilect.

Our doctor prescribed her Sinemet ( 25/100 carbidopa/levodopa) to be taken twice a day. During her first two weeks after taking the drug, she suffered nausea, vomiting, hallucinations and disturbed sleep, but her hand tremors stopped. As of today the nausea had stopped and the hand tremors controlled. She still walks very slow and her voice is very low and have a hard time swallowing. She needs my assistance in changing clothes, bathing and slicing her food into small pieces. She easily gets tired and from what I read in the Internet, there will be a time when the drug will no longer be effective. In the future as the disease progressed she will need palliative care and home nursing assistance. My wife's PD has a genetic component. Her father had PD and one of her aunts on her maternal side had also PD during their senior years.

Along with the Sinemet, her neurologist had also prescribed her a newer drug called Azilect Azilect is very expensive even if you have a medical insurance. I found out the other day that my Federal Employee Program with Blue Cross Blue Shield Pharmacy Mail Service Option will save me a lot of money. So starting yesterday I ordered my wife's PD drugs via mail order instead of buying direct from our local CVS pharmacy. Two whole sale pharmacy suppliers near us quoted me a price of $3,580 for 90 day supply of Azilect. Two other pharmacy outlets quoted me only 1,540 including our current pharmacy supplier CVS. My copay for the 90 day supply is $357. However, if I ordered it by mail my copay will be only $80, saving me $277 for 3 months and more than $1000 per year. It does pay to shop for your prescription here in the US.

Sinemet has several side effects as I mentioned above. However, one side effect that my wife suffers is constipation. Our neurologist gave us a recipe consisting of equal amounts( one cup each) of apple sauce, bran and prune juice. The mixture can be kept refrigerated for a week. Only 1 to 2 tablespoon should be taken daily. Of course several laxatives over the counter are also available in our local drug stores.

The following information from the National Parkinson's Foundation, I found very informative. This is the information that you want to know all about PD but are afraid to ask.

In the United States, 50,000-60,000 new cases of PD are diagnosed each year, adding to the one million people who currently have PD. The Center for Disease control rated complications from Parkinson’s disease as the 14th leading cause of death in the United States. Worldwide, it is estimated that four to six million people suffer from the condition. There is hope, however, as scientists work towards a cure and make progress in identifying the best treatment options for patients.

Parkinson’s disease (PD) is a neurodegenerative brain disorder that progresses slowly in most people. The dopamine levels in the brain neurons are almost non-existent in persons with PD compared to normal persons. The PD drugs alleviate the symptoms by increasing dopamine levels. What this means is that individuals with PD will be living with PD for twenty years or more from the time of diagnosis with medications. Parkinson’s disease itself is not fatal, but complications could occur and can cause death. There is currently no cure for Parkinson’s; however, investigations on animal models, gene therapy and stem cells research are undergoing so those with PD can have a good quality of life.

Treatment approaches include medication and surgical therapy. Other treatment approaches include general lifestyle modifications (rest and exercise, stop smoking), physical therapy, support groups, occupational therapy and speech therapy. Recent studies have indicated that a treatment is better than no treatment. In other words, medications and therapies can modify the progression of Parkinson’s disease. Michael Fox and Muhamed Ali are the two world famous personalities known to be suffering with PD.

Reference: ( National Parkinson Foundation)

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