a guide for patients and families · what causes parkinson’s disease? doctors and researchers...
Post on 06-Jul-2020
5 Views
Preview:
TRANSCRIPT
DVDInside
Featuring Michael J. Fox
A guide For pAtients And FAMilies
A guide For pAtients And FAMilies
Copyright 2013
American Academy of Neurology
All Rights Reserved
No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying or recording, or by any information storage and retrieval system, without the written permission of the publisher, except when permitted by law.
Manufactured in the United States of America
Contents
Introduction................................................................................... 4
WhatCausesParkinson’sDisease?............................................. 6
HowDoIKnowIfIHaveParkinson’s?......................................... 8
MedicinesforParkinson’sDisease............................................. 12
DeepBrainstimulation............................................................... 15
stepsYouCantake.................................................................... 16
CaringforaPersonwithPD....................................................... 18
Conclusion.................................................................................. 20
Resources................................................................................... 21
DISCLAIMER: This guidebook and DVD program are intended for informational purposes only. The program was produced by Conrad Productions and Alan Weiss Productions, with editorial oversight from the American Academy of Neurology. Financial support was provided by AbbVie.
The guidebook author is Stephen Braun and the DVD scriptwriter is Deborah Gobble. Complete disclosure information on the physician experts who participated in this program (Dr. Stanley Fahn and Dr. Kathleen Shannon) is available at AAN.com.
The writers, producers, program presenter, and program funder make no representations or warranties, express or implied, regarding the accuracy or completeness of the information provided within.
No one should rely upon this information as the basis for treatment decisions. Anyone requiring medical or other health care should consult a medical or health care professional. Any actions based on the information provided are entirely the responsibility of the user, and of any medical or other health care professionals who are involved in such actions.
Photos in this booklet are used for illustrative purposes only. Any person depicted in the licensed material is a model, not an actual patient or health care professional.
4 5
IntRoDuCtIon
Parkinson’sdisease(PD)affectsthewayyourbraincontrols
yourmuscles.thiscanmakeithardtowalkanddomanyother
kindsofmovement.Morethan1millionpeopleintheusalone
havePD.Andeveryyear,about40,000peoplelearntheytoo
havethedisease.Ifyouoralovedonehavebeendiagnosed
withPD,youarenotalone!
PDmostoftenaffectsolderadults,butabout1outofevery
10peoplewiththediseaseisyoungerthan45.usually,PD
symptomsstartslowlyandgraduallygetworse.Buthowa
personfeels,andhowquicklythediseasegetsworse,canvary
alotfrompersontoperson.that’swhyit’simportanttoseea
neurologistifPDissuspected.
AlthoughPDcannotyetbecured,beingtreatedwithmedicine
canhelpreducesomeofthesymptoms.today,peoplewithPD
maylivemanyyearswiththecondition.
thereareanumberofthingsyoucandotohelpmanagePD
andcontinueyourdailyactivities.thisbookletandDVDcan
help.You’lllearnmoreaboutPDandhowitistreated.Working
closelywithyourhealthcareprofessionals,andmakinghealthy
choicesinyourdailylife,areimportantstepstocopingwell
withthechallengesofParkinson’sdisease.
DIDYouKnoW?
Neurologists aredoctorswhospecializeindisordersofthebrainandnerves.
Movement disorder specialistsareneurologistswhohavestudiedanadditionalonetothreeyearsinamovementdisorderprogram,orspecializeintreatingpeoplewithParkinson’sdiseaseandothermovementdisorders.
6
WHAtCAusesPARKInson’sDIseAse?
Doctorsandresearchersstillhavemuchtolearnabout
Parkinson’sdisease.For9outofevery10peoplewithPD,
noclearcausecanbedetermined.
eventhoughtherootcauseofPDisusuallynotknown,doctors
doknowalotabouthowthediseaseaffectsthebrain.PD
causesaslowlossofacertaintypeofbraincell.thesecells
produceachemicalcalleddopamine,whichhelpscontrol
movement.Whenabout60%to80%ofthesecellsarelost,
dopaminelevelsdropsolowthatmovement-relatedsymptoms
appear.shaking,stiffness,andslownessofmovementaresome
commonsymptoms.Forreasonsthatarestillnotclear,men
aresomewhatmorelikelytogetPDthanwomen.
DIDYouKnoW?
Dopamine isachemical
messengerinthebrain.
Ithelpsyoucontrolyour
abilitytomove.
7
8 9
HoWDoIKnoWIFIHAVePARKInson’s?
thereisnofoolprooftestforParkinson’sdisease.nobloodtest,
brainscan,orx-raycanproveforsurethatapersonhasPD.
Instead,thediseaseisdiagnosedbycertainsignsandsymptoms.
therearefourclassicsymptomsofPD:
• tremor(shaking)whenalimbisatrest,mostcommonlyin onehand
• slowmovementinthearmsorlegs
• stiffnessofthearmsorlegs
• Lossofbalance
otherpossiblesignsofearlyPDinclude:
• smallhandwriting
• Difficultywithtasksthatrequirefinecontrol,suchas buttoningashirt
• slowwalking,draggingofafoot,ordecreasedarmswing whenwalking
Whenthediseaseworsens,apersonmayhaveahardtime
balancing.Heorshemayalsotriporfallfrequently.
noteveryonewithPDhasallthesesymptoms.somepeople
havesymptomsforyearsbeforetheyareproperlydiagnosed.
10 11
PatientswithPDmayalsohavesymptomsthatdonotinvolve
movementortheirmuscles.thesesymptomsmayinclude:
• Difficultywiththinkingandmemory
• Depressedmood
• Lossofthesenseofsmell
• Difficultywithsleeping
• Constipation
• sexualdysfunction
• Painordiscomfortinarmsorlegs
Asyoucansee,PDisacomplexcondition.Itcanalsobe
challengingtotreat.thatiswhyitisbesttobediagnosed
andtreatedbyaneurologistormovementdisorderspecialist.
Youcanfindaneurologistormovementdisorderspecialistin
yourareathroughsomeofthegroupslistedintheResources
sectionatthebackofthisbooklet.
12 13
MeDICInesFoRPARKInson’sDIseAse
thereareseveraltypesofmedicinesthatcanhelprelievesome
ofthesymptomsofPD.overall,thetreatmentsforPDtrytobring
dopaminelevelsinthebrainbacktonormal.Doingsomayrelieve
thesymptomsofPD.thekindsofmedicineused,andthedose
youtake,maychangewithtime.Asthediseaseprogresses,it
mayalsobecomemoredifficulttocontrolsymptoms.Buttoday
manydifferenttypesofmedicinesareavailable,whichmay
extendthelengthoftimesymptomscanbecontrolled.
HerearethetypesofmedicinesusedtotreatPD.someofthese
medicinesmaybetakenalone,orincombinationwitheachother:
Levodopa/carbidopaworksbytemporarilyincreasingthe
amountofdopamineinthebrain.
Dopamine agonistsmimictheeffectsofdopamineinthebrain.
COMT inhibitorsareusedtoextendtheactionoflevodopa.
However,theyworkonlyiflevodopaistaken.theyarenotuseful
bythemselves.
MAO-B inhibitorsslowthebreakdownofdopamineinthebrain.
thismakesmoredopamineavailable.
Anticholinergic medicines and amantadinemaybeusedto
helpcontrolthetremorthatmanyPDpatientsexperience.
Allofthesemedicinesmaycausesideeffects.talktoyour
neurologistaboutwhatsideeffectstoexpect,andwhattodo
ifyouexperiencethem.
14 15
DeePBRAInstIMuLAtIon
ApossibleoptionforpeoplewithadvancedPDisdeep brain
stimulation(DBs).WithDBs,tinyelectrodes(wires)aresurgically
implantedinthebrain.theelectrodesareconnectedtoasmall
batteryanddelivermildelectricalpulsesthatstimulatethebrain.
AlthoughDBscanhelptreatsomeofthesymptomsofPD,itis
notrightforallpeoplewithadvancedPD.Yourneurologistor
movementdisorderspecialistcantellyouifthistreatmentmight
behelpfulforyou.
WHenAMeDICIne“WeARsoFF”
overtime,thewayyourbodyrespondstoaPDmedicine
maychange.oftenyourmedicinesworknormally
torelieveyoursymptoms(“on”time).Youmayalso,
however,havetimeswhenthemedicinedoesnotwork
well(“off”time).
somepeoplewhotakePDmedicinesoveralong
timecandevelopmore“off”time.Inaddition,some
peoplemayexperiencespasmsoruncontrolledmuscle
movementsduetothemedicinestheyaretaking.
somesideeffectsmaybereducedwithothertypesof
medications.tellyourhealthcareprofessionalifyouor
alovedoneareexperiencingincreasing“off”timeor
havinganysideeffects.
16 17
stePsYouCAntAKe
therearemanythingsyoucandotohelpmanageyourlife
withPD.Howyouexercise,whatyoueat,andhowyouuse
yourmindcanmakeadifference!Herearesomethingsthat
havebeenfoundtohelpthosewithPD:
• Exercise–especiallyswimming,stretching,walking,and
exercisestoimproveyourbalance.Youmightalsotryphysical
therapy,whichismorefocusedonsuchthingsasbalance,
walking,andstrengtheningspecificmuscles.
• Healthy eating–anormaldietwithplentyoffruitsand
vegetableswillpromoteoverallwell-beingforPDpatients,just
asitwouldforanyoneelse.Itisnotnecessarytotakevitamin
supplements,unlesssuggestedbyyourdoctor.
• Voice therapy–peoplewithPDsometimeshavespeech
problems.therapyfocusedonimprovingvocalcontrolandvoice
volumemayhelpyoucommunicatebetterwithothers.
• Alternative approachessuchasacupunctureandmassage
arewidelyusedbypeoplewithPD.somesmallstudiesof
acupunctureandmassagetherapysuggestthatsuchtherapies
mayhelprelievesymptoms.otherstudieshavefoundnobenefit.
Alwaysbesuretotellyourneurologistaboutanyalternative
treatmentsorherbalsupplementsyoumaybeusing.
18 19
CARIngFoRAPeRsonWItHPD
PeoplewithPDoftenneedsomehelpwitheverydaytasks.they
mayneedmorehelpasthediseasegetsworse.spousesand
otherfamilymembersorfriendsoftenprovidethishelp.But
caringforapersonwithParkinson’sdiseasecanbetiringor
stressful.Caregiversshouldtalktoothersaboutanyfrustrations
theyareexperiencing.talktofriendsorfamilymembers,orjoina
supportgroupforcaregivers.(theResourcessectionattheback
ofthisbookletcanhelpyoufindasupportgroupinyourarea.)
Caregiversneedtotakecareofthemselvesandmakesure
theirownneedsarebeingmet.Youdon’twantto“burnout”
ordevelopyourownphysicaloremotionalproblems!You
needtostayhealthy,soyoucanbestcareforalovedonewith
Parkinson’sdisease.
Watchforsignsofdepression,confusion,memoryproblems,
orothermentalproblemsinthepersonwithPD.Reportany
concernspromptlytoyourlovedone’sneurologistordoctor.
20 21
ConCLusIon
PDisaseriousillness,buttherearereasonsforhope!
Peoplediagnosedtodaycanbenefitfrommedicinesthat
helpmanagesymptomsofPD.newtreatmentsare
beingdiscoveredasscientistslearnmoreaboutthis
complicateddisease.
LivingwithPDisajourneythatchangesgraduallyovertime.
Withthehelpofyourneurologistandsupportfromfamily
membersandfriends,youcanlivewellandthrivewith
Parkinson’sdisease.
RES
OURCES
ResouRCes
American Academy of NeurologyAAn.com
American Brain FoundationAmericanBrainFoundation.org
Neurology Now® Magazineneurologynow.com
Neurology Now® Books“Navigating Life with Parkinson Disease”AAn.com/view/PatientBookseries
American Parkinson Disease Associationapdaparkinson.org
Michael J. Fox Foundation for Parkinson’s Researchmichaeljfox.orgTo learn how you could help advance Parkinson’s research by participating in clinical trials, click on the Fox Trial Finder link
National Parkinson Foundationparkinson.org
Parkinson’s Disease Foundationpdf.org
Parkinson’s Action Networkparkinsonsaction.org
Parkinson Allianceparkinsonalliance.org
Fundingsupport
AbbVie AbbVieisaglobal,research-basedbiopharmaceuticalcompanyformedin2013followingseparationfromAbbott.thecompany’smissionistouseitsexpertise,dedicatedpeopleanduniqueapproachtoinnovationtodevelopandmarketadvancedtherapiesthataddresssomeoftheworld’smostcomplexandseriousdiseases.In2013,AbbVieemploysapproximately21,000peopleworldwideandmarketsmedicinesinmorethan170countries.Forfurtherinformationonthecompanyanditspeople,portfolioandcommitments,pleasevisitwww.abbvie.com.Follow@abbvieontwitterorviewcareersonourFacebookorLinkedInpage.
American Academy of Neurology theAmericanAcademyofneurology(AAn),establishedin1948,isaninternationalprofessionalassociationofmorethan26,000neurologistsandneuroscienceprofessionalsdedicatedtopromotingthehighestqualitypatient-centeredneurologiccare.Aneurologistisadoctorwithspecializedtrainingindiagnosing,treating,andmanagingdisordersofthebrainandnervoussystem,suchasParkinson’sdisease,Alzheimer’sdisease,multiplesclerosis,epilepsy,andstroke.
FormoreinformationvisitAAn.com.
American Brain FoundationtheAmericanBrainFoundation,thefoundationoftheAmericanAcademyofneurology,isanindependent501(c)(3)organizationthatfundsthemostcrucialresearchtocurebraindisease,suchasAlzheimer’sdisease,stroke,Parkinson’sdisease,neuropathy,multiplesclerosis,andepilepsy.Braindiseaseaffectsmorethan50millionintheunitedstatesalone.Inmovingtowarditsvision,theAmericanBrainFoundation’sgoalistoreducetheprevalenceofbraindisease50percentby2040.
FormoreinformationvisitAmericanBrainFoundation.org.
ProgramPresenters
22 23
CreditsParkinson’s Disease: A Guide for Patients and Families wasmadepossiblethroughtheexpertise,funding,time,andeffortsofmanyindividuals.specialgratitudeto:
Program Presenters
American Academy of Neurology American Brain Foundation
Funding Support AbbVie
Contributors to the Video
Stanley Fahn, MD, FAANH.HoustonMerrittProfessorofneurologyDirectoroftheCenterforParkinson’sDiseaseandotherMovementDisordersatColumbiauniversity
scientificDirector,theParkinson’sDiseaseFoundationnewYorkCity
Kathleen M. Shannon, MDProfessorofneurologyRushuniversityMedicalCenter
Director,Huntington’sDiseasesocietyofAmericaCenterofexcellenceatRushuniversityMedicalCenterChicago
specialthanksto:Michael J. Fox and the Michael J. Fox Foundation for Parkinson’s Research
Project ManagerCarol BrandenburgExecutive Producer Conrad & Associates
Guidebook AuthorStephen BraunMedical Writerbraunmedicalmedia.com
Guidebook DesignCinda DebbinkDesign Partnersdgdesignpartners.com
Program Research and DevelopmentElizabeth T. Conrad, MD, DABFM
Michael J. Fox photos by Mark Seliger
DVDInside
Parkinson’sdisease(PD)isaseriousillness,buttherearereasons
forhope.Peoplediagnosedtodaycanbenefitfrommedicines
thathelpmanagesymptomsofPD.newtreatmentsarebeing
discoveredasscientistslearnmoreaboutthiscomplicateddisease.
LivingwithPDisajourneythatchangesgraduallyovertime.
Withthehelpofhealthcareprofessionalsandsupportfrom
familymembersandfriends,youcanlivewellandthrive
withParkinson’sdisease.
In this booklet and DVD, you will learn about:
•signsandsymptomsofPD
• treatmentsthatmayreducesymptoms
• thingsyoucandotoimprove youroverallhealth
A guide For pAtients And FAMilies
Presented by Funding Support provided by
top related