“Parkinson’s disease is an age-related degenerative brain condition, meaning it causes parts of your brain to deteriorate. It’s best known for causing slowed movements, tremors, balance problems and more. It is ranking second among age-related degenerative brain diseases. It’s also the most common motor (movement-related) brain disease. The best-known symptoms of Parkinson’s disease involve loss of muscle control. However, experts now know that muscle control-related issues aren’t the only possible symptoms of Parkinson’s disease.  Parkinson’s disease is not curable, but there are multiple ways to manage its symptoms. The treatments can also vary from person to person, depending on their specific symptoms and how well certain treatments work. Medications are the primary way to treat this condition.”

Cleveland Clinic (https://my.clevelandclinic.org/health/diseases/8525-parkinsons-disease-an-overview)

“Parkinson’s disease affects 10 million people worldwide, along with its symptoms, causes and treatments. Symptoms generally develop slowly over years. The progression of symptoms is often a bit different from one person to another due to the diversity of the disease. The cause remains largely unknown. Scientists believe a combination of genetic and environmental factors are the cause.  The first step to living well with Parkinson’s disease is to understand the disease and the progression.”

Parkinson’s Foundation (https://www.parkinson.org/understanding-parkinsons/what-is-parkinsons)

What are the signs and symptoms (s/s) of this disease?

The early signs and symptoms of Parkinson’s disease that are often overlooked by both patients and doctors because the symptoms are subtle and the progression of the disease is typically slow. S/S of parkinson’s disease are:

Parkinson’s disease does not affect everyone the same way. In some people the disease progresses quickly, in others it does not. Although some people become severely disabled, others experience only minor motor disruptions. Tremor is the major symptom for some patients, while for others tremor is only a minor complaint and different symptoms are more troublesome.

The Motor function symptoms associated with Parkinson’s Disease:

• The tremors associated with Parkinson’s disease has a characteristic appearance. Typically, the tremor takes the form of a rhythmic back-and-forth motion of the thumb and forefinger at three beats per second. This is sometimes called “pill rolling.” Tremor usually begins in a hand, although sometimes a foot or the jaw is affected first. It is most obvious when the hand is at rest or when a person is under stress. In three out of four patients, the tremor may affect only one part or side of the body, especially during the early stages of the disease. Later it may become more general. Tremor is rarely disabling and it usually disappears during sleep or improves with intentional movement.
• Rigidity, or a resistance to movement, affects most parkinsonian patients. A major principle of body movement is that all muscles have an opposing muscle. Movement is possible not just because one muscle becomes more active, but because the opposing muscle relaxes. In Parkinson’s disease, rigidity comes about when, in response to signals from the brain, the delicate balance of opposing muscles is disturbed. The muscles remain constantly tensed and contracted so that the person aches or feels stiff or weak. The rigidity becomes obvious when another person tries to move the patient’s arm, which will move only in ratchet-like or short, jerky movements known as “cogwheel” rigidity.
• Bradykinesia, or the slowing down and loss of spontaneous and automatic movement, is particularly frustrating because it is unpredictable. One moment the patient can move easily. The next moment he or she may need help. This may well be the most disabling and distressing symptom of the disease because the patient cannot rapidly perform routine movements. Activities once performed quickly and easily — such as washing or dressing — may take several hours.
• Postural instability, or impaired balance and coordination, causes patients to develop a forward or backward lean and to fall easily. When bumped from the front or when starting to walk, patients with a backward lean have a tendency to step backwards, which is known as retropulsion. Postural instability can cause patients to have a stooped posture in which the head is bowed and the shoulders are drooped.

The Non-Motor function symptoms that are often associated with Parkinson’s Disease include:

-Cognitive impairment –Dementia –Psychosis –Depression –Fatigue -Sleep disturbances -Constipation -Sexual dysfunction -Vision disturbances.

As the disease progresses, walking may be affected. Patients may halt in mid-stride and “freeze” in place, possibly even toppling over.  Patients may walk with a series of quick, small steps as if hurrying forward to keep balance. This is known as festination.

A detailed overview of the Unified Parkinson’s Disease Rating Scale that is used by doctors to follow the course of disease progression and evaluate the extent of impairment and disability.

Abstract

The Movement Disorder Society Task Force for Rating Scales for Parkinson’s Disease prepared a critique of the Unified Parkinson’s Disease Rating Scale (UPDRS). Strengths of the UPDRS include its wide utilization, its application across the clinical spectrum of PD, its nearly comprehensive coverage of motor symptoms, and its clinimetric properties, including reliability and validity. Weaknesses include several ambiguities in the written text, inadequate instructions for raters, some metric flaws, and the absence of screening questions on several important non-motor aspects of PD. The Task Force recommends that the MDS sponsor the development of a new version of the UPDRS and encourage efforts to establish its clinimetric properties, especially addressing the need to define a Minimal Clinically Relevant Difference and a Minimal Clinically Relevant Incremental Difference, as well as testing its correlation with the current UPDRS. If developed, the new scale should be culturally unbiased and be tested in different racial, gender, and age-groups. Future goals should include the definition of UPDRS scores with confidence intervals that correlate with clinically pertinent designations, “minimal,” “mild,” “moderate,” and “severe” PD. Whereas the presence of non-motor components of PD can be identified with screening questions, a new version of the UPDRS should include an official appendix that includes other, more detailed, and optionally used scales to determine severity of these impairments.

How Parkinson’s disease is diagnosed:

There isn’t a specific test to diagnose Parkinson’s disease;  it is based on factors such as signs/symptoms, patient history, physical examination, and a thorough neurological evaluation.

A doctor trained in nervous system conditions (neurologist) will diagnose Parkinson’s disease based on your medical history, a review of your signs and symptoms, and a neurological and physical examination.

Your doctor may suggest a specific single-photon emission computerized tomography (SPECT) scan called a dopamine transporter (DAT) scan. Although this can help support the suspicion that you have Parkinson’s disease, it is your symptoms and neurological examination that ultimately determine the correct diagnosis. Most people do not require a DAT scan.

Furthermore, making the diagnosis is even more difficult since there are currently no blood or lab tests available to diagnose the disease. Your health care provider may order lab tests, such as blood tests, to rule out other conditions that may be causing your symptoms.  Some tests, such as a CT Scan (computed tomography) or MRI (magnetic resonance imaging) and PET Scans may be used to rule out other disorders that cause similar symptoms. Imaging tests aren’t particularly helpful for diagnosing Parkinson’s disease.  Given these circumstances, a doctor may need to observe the patient over time to recognize signs of tremor and rigidity, and pair them with other characteristic symptoms.

The doctor will also compile a comprehensive history of the patient’s symptoms, activity, medications, other medical problems, and exposures to toxic chemicals. This will likely be followed up with a rigorous physical exam with concentration on the functions of the brain and nervous system. Tests are conducted on the patient’s reflexes, coordination, muscle strength, and mental function. Making a precise diagnosis is essential for prescribing the correct treatment regimen. The treatment decisions made early in the illness can have profound implications on the long-term success of treatment.

Recommended Related to Parkinson’s

Questions to Ask Your Doctor About Parkinson’s Disease:

Since you’ve recently been diagnosed with Parkinson’s disease, ask your doctor these questions at your next visit.   1.What stage is my illness in now?

2. How quickly do you think my disease will progress?

3. How will Parkinson’s disease affect my work?

4. What physical changes can I expect?

5. Will I be able to keep up the activities, hobbies, and sports I do now?

6. What treatments do you suggest now?

7.Will that change as the disease progresses?

8. What are the side effects of medication?…

Because the diagnosis is based on the doctor’s exam of the patient, it is very important that the doctor be experienced in evaluating and diagnosing patients with Parkinson’s disease. If Parkinson’s disease is suspected, you should see a specialist, preferably a movement disorders trained neurologist.

“Parkinson’s disease is a brain disorder that causes unintended or uncontrollable movements, such as shaking, stiffness, and difficulty with balance and coordination. Symptoms usually begin gradually and worsen over time. As the disease progresses, people may have difficulty walking and talking.  While virtually anyone could be at risk for developing Parkinson’s, some research studies suggest this disease affects more men than women. It’s unclear why, but studies are underway to understand factors that may increase a person’s risk. One clear risk is age since most are over 60 y/o.”

NIH National Institute on Aging (https://www.nia.nih.gov/health/parkinsons-disease)

“When you’re over age 65, your immune system isn’t as strong as it used to be. Seniors make up the bulk of the people who die or are hospitalized for flu-related problems like one being pneumonia to sepsis.  Getting older can be a triple whammy. You lose muscle as you age. That makes it harder to keep the pounds from creeping up. You also become less active. At the same time, your body burns fewer calories for the same physical activities as when you were younger.  Our nutritional needs change as we age. Many of us don’t eat as well. Plus, older bodies can more easily lack certain vitamins and nutrients.  Also, bones become less dense and more prone to breaks and fractures.  Did you know that age is the single biggest predictor of your chances of getting cancer? It jumps up after you hit age 50. Half of all cancers happen in people over age 65. For lung cancer, the median age is 70.  Still getting older doesn’t mean you’re destined to get cancer. You can adopt healthy habits proven to help you lower the odds.”.

WebMD (https://www.webmd.com/healthy-aging/challenges-of-aging)

 

 

Older adults are disproportionately affected by chronic conditions, such as diabetes, arthritis, and heart disease. Nearly 95% percent have at least one chronic condition, and nearly 80% of have two or more.

More than one out of four older adults falls each year.  3 million adults 65+ are treated in emergency departments for unintentional fall injuries each year.

People worldwide are living longer. Today most people can expect to live into their sixties and beyond. Every country in the world is experiencing growth in both the size and the proportion of older persons in the population.

By 2030, 1 in 6 people in the world will be aged 60 years or over the World Health Organization states.

What can you do about this?

1-Stay Active:

Exercise lowers your risk of heart disease, type 2 diabetes, high blood pressure, and some cancers, and that powerful effect leads to something experts call “compression of morbidity.” It essentially means you stay healthy longer in your late years, as compared with someone who spends the final five or 10 years of life battling chronic illness.

Exercise is also one of the best things you can do to help prevent dementia and other cognitive changes. You don’t have to kill yourselt in a workout environment for a long time or in anything.  Once you’re cleared by your doctor, aim for at least 30 minutes of physical activity most days of the week.

2-Diet:

We can always improve our diet.  There are all sorts of plans out there to help you lose weight, but it’s not only about dropping pounds. There is the Mediterranean-style diet for anyone hoping to avoid dementia as well as minimize other health risks. It’s high in fruits, vegetables, whole grains, olive oil, and fish, and low in meat, sugar and processed foods—all to help your cells function better.

Spring is the season of new life, and this includes many fruits and vegetables that come back into season in springtime. Produce like asparagus, cucumbers, radishes, peppers, sweet potatoes, and strawberries, just to name a few, all are in season in the spring. As so many varieties of fruits and greens are available again, this makes spring the perfect time to easily find fresh and organic foods to incorporate into your diet. Making changes to your diet can have long term positive effects on your overall health. Consider swapping out processed foods for fresh ingredients, limiting red meat, and incorporating sources of healthy fats like avocado or fish. Making these changes and eating seven to 10 servings of fruits and vegetables each day can help reduce your risk of chronic illnesses like heart disease, diabetes, cancer and dementia.

Always check with your doctor about changing your diet and activity changes you want to make!

Now spring has arrived!  It is especially important to stay hydrated. With aging, the ability to notice thirst may begin to decline. This means that it can be difficult for seniors to drink enough water and prone to dehydration. Drinking water throughout the day is the best way to stay hydrated, but this can be difficult to remember to do or for those who prefer flavored beverages. A couple of tricks to make it easier for you to increase your water intake are to carry a water bottle with you and try adding fresh or frozen fruit to add a boost of flavor. Dehydration can make you more vulnerable to fatigue as well as memory loss or poor concentration. You can further boost your daily water intake by eating foods that are rich in moisture, like watermelon or cucumber.

A simple way to calculate how much water you need to drink each day is to take half your body weight and drink that amount in ounces of water.

Ex. Let’s say the weight is 185lbs and that divided by 2 is 92.5 lbs and now x 16 oz=1480ml of water a day. 1.5 ml/day and you always check with you primary doctor!

3 Good Sleep:

Lack of sleep impacts your memory, emotions, weight and even your appearance. The older you get, the harder it can be to fall and stay asleep, but you still need the same amount of hours.

Older adults need about the same amount of sleep as all adults—7 to 9 hours each night. But, older people tend to go to sleep earlier and get up earlier than they did when they were younger.

According to the National Sleep Foundation, most sleep problems are a result of snoring, medication side effects and underlying medical conditions, such as acid reflux, depression and prostate problems. Addressing those issues with your doctor is a good start. You can also enjoy more satisfying sleep by creating a calming space, dedicating enough time for sleep and practicing relaxation techniques.

Breaking the old habits can be hard, what can you do?

Breaking old habits and creating new ones can be hard, but health changes are key to continue healthy and independent living. Consider quitting smoking, drinking alcohol less and eating more nutrient-dense foods to improve physical health.  You need to prioritize what your goals are.  To either loose more weight, get more active, or whatever the key is disciplining yourself with rewarding yourself in return at first which is reaching closer to your goal=SUCCESS.  If you need to loose weight change your diet for the better.  Increase your activity with exercise and daily activities of living increase. Exercise can be 30 minutes a day.  It probably won’t happen over night but don’t expect results over night, like most things it takes some time. Stress and mental health also largely impact health and quality of life. Try picking up a new hobby, being more social and keeping an organized and tidy living space to boost your moods and encourage calmness. In order to help you stay consistent and create new habits, set clear goals for yourself and practice consistency. Try sharing your goals with a caregiver, friend or family member to cheer you on and hold you accountable and help push you.  In time these changes will be something you want to do.  When you loose the weight treat yourself now and than as a reward!

You may just love the results in what you find in time; your goal achieved and your in better health lessening your chance of disease!!

Remember to always check with your MD when you make changes in diet or activity that the MD approves who knows your health status better than anyone else!

“The American Cancer Society’s most recent estimates for oral cavity and oropharyngeal cancers in the United States are for 2023:

• About 54,540 new cases of oral cavity or oropharyngeal cancer
• About 11,580 deaths from oral cavity or oropharyngeal cancer

The average age of people diagnosed with these cancers is 64, but they can occur in young people. Just over 20% (1 in 5) of cases occur in people younger than 55.”.

American Cancer Society (https://www.cancer.org/cancer/oral-cavity-and-oropharyngeal-cancer/about/key-statistics.html)

“Overall, about 1 in 2,000 people in the United States may have narcolepsy. The actual number of people who it affects may be higher. This is because the symptoms can be similar to other sleep disorders, such as obstructive sleep apnea.

Narcolepsy develops as a result of changes in the hypothalamus region of your brain, basically. This small gland is located above your brain stem.

The hypothalamus helps regulate the release of hormones that affect numerous parts of your body. For example, it’s responsible for releasing hypocretins, which help regulate sleep.

Hypocretin neurons help regulate your sleep-wake cycles. These chemicals in your brain are at their highest levels when you’re awake. They naturally decrease during your normal bedtime.

But when you have narcolepsy, hypocretin releases are low. This causes disruptions during the daytime, such as excessive sleepiness and fatigue. You may also tend to take more naps during the day.

Reduced hypocretins are strongly linked to narcolepsy type 1. This type of narcolepsy includes:

• disrupted sleep cycles
• daytime fatigue
• cataplexy (sudden loss of muscle control)

A rare form of narcolepsy can develop as a result of   damage to the hypothalamus from a brain injury. This is known as secondary narcolepsy.

Secondary narcolepsy is a severe neurological condition that can lead to irregular sleep cycles as well as memory loss and mood disorders.   If you have type 2 narcolepsy, you may experience issues with sleep cycle regulation but don’t   have issues with cataplexy.  The cause of type 2 narcolepsy is unclear.”

Healthline (https://www.healthline.com/health/narcolepsy/narcolepsy-and-your-brain#brain-chemicals)

“Narcolepsy is a neurological disorder that causes persistent sleepiness and additional symptoms such as brief episodes of muscle weakness known as cataplexy, vivid, dreamlike hallucinations, brief episodes of paralysis when falling asleep or upon awakening (sleep paralysis), and fragmented nighttime sleep. Symptoms typically develop over several months and last a lifetime.

Narcolepsy is a manageable condition, and people with narcolepsy can lead full and rewarding lives.  One cause is genetic factors clearly play a role. Most people with narcolepsy have inherited a gene that codes for the human leukocyte antigen (HLA) DQB1*06:02, which is important for immune function. This gene is found in 12–25% of the general population, and it increases the risk of developing narcolepsy 7- to 25-fold.³ Additional genes can increase or decrease the risk of developing narcolepsy, and, like HLA-DQB1*06:02, most of these affect the functions of the immune system. Normally, the immune system kills off bacteria and viruses. These discoveries suggest that narcolepsy is an autoimmune disease in which the immune system accidentally kills off the hypocretin-producing neurons. “.

Harvard University (https://healthysleep.med.harvard.edu/narcolepsy)

Those bugs that are common in fall, winter that are also seen in the spring time are       2 Viruses =The COLD and The FLU.

You may ask yourself why the flu when its also in the fall and winter but in the beginning of the spring we have up and down temperatures; days when freezing and days when warm.  Less than 2 weeks ago in certain areas of the NE it was 50 degrees or higher and after a few days back to freezing temperatures.  People dress in warm clothes and forget when freezing comes in to still dress for winter weather.  Than the flu starts hitting again with colds over those areas of the NE.

HOW ARE THESE BUGS DIFFERENT:

Both influenza and the common cold are viral respiratory infections (they affect the nose, throat, and lungs). Viruses are spread from person to person through airborne droplets (aerosols) that are sneezed out or coughed up by an infected person, direct contact is another form of spread with infected nasal secretions, or fomites (contaminated objects). Which of these routes is of primary importance has not been determined, however hand to hand and hand to surface to hand to contact seems of more importance than transmission. The viruses may survive for prolonged periods in the environment (over 18 hours for rhinoviruses in particular=a common virus for colds) and can be picked up by people’s hands and subsequently carried to their eyes or nose where infection occurs. In some cases, the viruses can be spread when a person touches an infected surface (e.g., doorknobs, countertops, telephones) and then touches his or her nose, mouth, or eyes. As such, these illnesses are most easily spread in crowded conditions such as schools.

The traditional folk theory that you can catch a cold in prolonged exposure to cold weather such as rain or winter settings is how the illness got its name. Some of the viruses that cause common colds are seasonal, occurring more frequently during cold or wet weather. The reason for the seasonality has not yet been fully determined. This may occur due to cold induced changes in the respiratory system, decreased immune response, and low humidity increasing viral transmission rates, perhaps due to dry air allowing small viral droplets to disperse farther, and stay in the air longer. It may be due to social factors, such as people spending more time indoors, as opposed to outdoors, exposing him or her “self” to an infected person, and specifically children at school. There is some controversy over the role of body cooling as a risk factor for the common cold; the majority of the evidence does suggest a result in greater susceptibility to infection.

The SIMPLE COMMON COLD:

The common cold (also known as nasopharyngitis, rhinopharyngitis, acute coryza, head cold) or simply a cold is a viral infection of the upper respiratory tract which primarily effects the nose. There are over 200 different known cold viruses, but most colds (30% up to 80%) are caused by rhinovirusesThis means you can pass the cold to others, so stay home and get some much-needed rest for yourself and not passing it on to others for the contagious period at least.

If cold symptoms do not seem to be improving after a week, you may have a bacterial infection, which means you may need antibiotics, which only kill bacterial infections not viral.

Sometimes you may mistake cold symptoms for allergic rhinitis (hay fever) or a sinus infection (bacterial). If cold symptoms begin quickly and are improving after a week, then it is usually a cold, not allergy. If your cold symptoms do not seem to be getting better after a week, check with your doctor to see if you have developed an allergy or inflammation or the sinuses (sinusitis).

Influenza is commonly referred to as “the flu”, this is an infectious disease of birds and mammals caused by RNA viruses of the family Orthomyxoviridae, the influenza viruses. The most common sign or symptom are chills, fever, runny nose, coughing, aches and weakness to headache and sore throat. Although it is often confused with other influenza-like illnesses, especially the COMMON COLD, influenza is a more severe illness or disease caused by a different virus. Influenza nausea and vomiting, particularly in children but these symptoms are more common in the unrelated gastroenteritis, which is sometimes inaccurately referred to as “stomach flu” or “25 hour flu”. The flu can occasionally lead to pneumonia, either direct viral pneumonia or secondary bacterial pneumonia, even for persons who are usually very healthy. In particular it is a warning sign if a child or presumably an adult seems to be getting better and then relapses with a high fever as this relapse may be bacterial pneumonia. Another warning sign is if the person starts to have trouble breathing.

Each year, 10% to 20% of Canadians are stricken with influenza. Although most people recover fully, depending on the severity of the flu season, it can result in an average of 20,000 hospitalizations and approximately 4000 to 8000 deaths annually in Canada. Deaths due to the flu are found mostly among high-risk populations, such as those with other medical conditions (such as diabetes or cancer) or weakened immune systems, seniors, or very young children. There are 3 types of influenza viruses: A, B, and C. Type A influenza causes the most serious problems in humans and can be carried by humans or animals (wild birds are commonly the host carriers). It is more common for humans seem to carry the most with ailments with type A influenza. Type B Influenza is found in humans also. Type B flu may cause less severe reaction than A type flu virus but for the few for the many can still be at times extremely harmed. Influenza B viruses are not classified by subtype and do not cause pandemics at this time. Influenza type C also found in people but milder than type A or B. People don’t become very ill from this Type C Influenza and do not cause pandemics.

The common cold eventually fizzles, but the flu may be deadly. Some 200,000 people in the U.S. are hospitalized and 36,000 die each year from flu complications — and that pales in comparison to the flu pandemic of 1918 that claimed between 20 and 100 million lives.

The best defense against it:   a vaccine once a year.  It works for me; and being a RN 28 years almost with getting it yearly with being average healthy I personally have not had the flu since childhood.  I am no spring chicken either.

References for Part 1, 2, and 3 on the two bugs The FLU and The COLD (Spring bugs):

1-Wikipedia “the free encyclopedia” 2013 website under the topic Influenza.

2-Kimberly Clark Professional website under the influenza.

3-Web MD under “COLD, FLU, COUGH CENTER” “Flu or cold symptoms?” Reviewed by Laura J. Martin MD November 01, 2011

4-2013 Novartis Consumer Health Inc. Triaminic “Fend off the Flu”

5-Scientific American “Why do we get the flu most often in the winter? Are viruses virulent in cold weather? December 15, 1997