 |
| http://www.pdf.org/parkinson_awareness |
About a dozen years ago, my uncle was diagnosed with Parkinson's Disease. He has the classic tremor along with forward-flexed posture (camptocormia) and shuffling gait, small handwriting (micrographia), and depression. A couple times when he's had medication issues, he has also suffered hallucinations, delusions, and anxiety. About 5 years ago, after a severe parasitic infection (babesiosis) and subsequent medication cross-reaction, he was diagnosed with dementia or Alzheimer's despite my mother's and my protests that there's no such thing as sudden onset Alzheimer's and that he had been perfectly fine mentally prior to the infection. Luckily, it was "temporary dementia," in other words, he was misdiagnosed. :) My uncle is now 87 years old, stable on his medications, and living comfortably in a nearby assisted living facility. His health is otherwise good and he'll probably outlive all of us.
About 4 years ago, my father was also diagnosed with Parkinson's Disease after a period of just not feeling "right." He does not have much of the classic Parkinson's tremor. What he does have, instead, is nearly every other symptom of Parkinson's Disease. These include slowness of movement (bradykinesia), postural instability, shuffling gait, decreased arm-swing while walking, dystonia, soft speech (hypophonia), swallowing problems (dysphagia), fatigue, a mask-line facial expression (hypomimia), difficulty rolling in bed or rising from a seated position, impaired fine motor dexterity and motor coordination, impaired gross motor coordination, an unpleasant desire to move (akathisia), memory problems, depression, anxiety, sleep disturbances including excessive daytime somnolence and nighttime insomnia, extreme constipation, and double vision. Additionally, he has developed Levodopa-induced dyskinesia (think Michael J. Fox wobbling around) after several years on that medication.
To make matters worse, my father broke his hip about 10 years ago. He had it repaired at the time and then replaced a couple years ago. He suffered hallucinations in the first few days after replacement surgery, probably due to an interaction between his Parkinson's medications and either anesthesia or pain meds. In the end, the hip replacement worked wonders and made him more comfortable than he had been in years. Then, this past fall, he hurt his back while raking leaves. Turns out he had age-related spinal deterioration and just moved the wrong way while raking leaves and tweaked it into a painful position. After trying therapy for a couple months, he had back surgery in February which again worked wonders and took him from extreme pain to virtually no pain overnight. Having learned from the hip replacement hospital experience, my mom was able to better prepare the nursing staff and monitor his medication timing during this hospitalization and thus avoided hallucinations and other crap that someone without Parkinson's wouldn't have to worry about.
The subacute (rehab) hospital has been another story. See, with Parkinson's, medication timing has to practically be down to the minute. Meds have to be taken 30 minutes before or one hour after eating so that they are properly absorbed in the body. Each dose lasts a few hours with improvement seen soon after taking the dose with a peak period a couple hours later, followed by the medication wearing off before the next dose is due. This means that not only does medication administration have to be coordinated with meal times, but also with physical therapy as it's useless to try to get a Parkinson's patient to do therapy in a "down time" in the medication cycle. He needs to do therapy at his peak times or forget it. Despite numerous reassurances by the rehab staff that they understand Parkinson's, they don't. Every couple days, my mom has a talk with the nurse on duty and my dad has everything timed properly for a couple days. Then it gets shot to hell until she has another talk with them. Thus, it's been a rollercoaster ride for my dad.
A few days before he was due to be sent home, having gotten to the point where he could walk up a double flight of stairs unassisted and walk down holding the handrail, he got up in the middle of the night (without calling for assistance like he was supposed to), fell, and "cracked" his hip. Sort of like tapping a hard-boiled egg but not breaking the shell... that's what he did to his bone. No surgery required but now he's back to only doing a toe touch with that leg and has added at least 2 weeks onto his rehab stay. Needless to say, he is miserable. My mom is also miserable because she's been driving 25 miles each way nearly every day to visit him (and keep the staff in line) since he went to the rehab about 5 weeks ago. I should mention that my mother is 78 years old and has a pacemaker and thyroid disease. My dad is "only" 70. He's due to be released in 10 days (assuming continued progress and no more mishaps) and my mom has no idea how she's going to handle him. That will be a story for another blog post.
Bottom line: While my dad probably still would've had the hip replacement and the back surgery, the recovery from both would have been markedly easier and simpler if he didn't have Parkinson's, which is essentially a movement disorder, to contend with. Parkinson's sucks and makes everything else that's sucky suck more. Unless you're Michael J. Fox. He says Parkinson's is the best thing that ever happened to him. God bless 'im.
