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The Dilemmas of Having Parkinson’s Disease: It Could Happen to You

going to the bathroom

Sherri Journeying Through

Warning: The names of those involved have been excluded to protect the embarrassed.

The air could sure use some cleaning out. I try to eat more fiber, but when I eat more fiber, my husband finds the air needs a good cleaning. So, I asked my doctor what I should do. He said I should be thankful I have Parkinson’s and am unable to smell the odors I make, and also that I should be grateful I can go to the bathroom. Having PD exacerbates the constipation problem.

I’m thankful I can go to the bathroom.

Isn’t everybody? I just wish it didn’t take so awfully long. I tried hissing one time while I was on the toilet, as someone in my support group suggested. They said it would relax my muscles. But it just distracted me, and I concentrated too much on whether anyone could hear me hissing and I forgot to relax. Or, I guess I did relax but not in the way I wanted, and I forgot what I was trying to do.

So, after that, I tackled putting the new satin sheets on my bed, determined that tonight would be the night I would get a good night’s sleep — for the first time in six years. Due to past experience, I didn’t have my heart set on that good night’s sleep. I’m not that foolish. But I was hopeful. At least I might be able to move easily while in bed for a change. 

I even bought satin pajamas to add to the ease of movement.

Bad idea. When my bottom side made contact with the side of the bed, try as I might to hold onto the nightstand for support, my body slid down to the floor with a thud. After struggling to get back up, I tried it again with the same result. 

With the next attempt, I had put my grandson’s side rails — which he uses when he spends the night — on my bed and crawled onto the bed in my regular fashion, like a dog trying to settle into his bed for the night. Around I circled on top of the bed, trying to find that comfy, sweet spot. Upon finally finding it, I gently laid down, pulled up the covers and laid very still — until I convinced myself, just short of a panic attack, that I had to pee one more time. 

I knew I wasn’t going to make it.

I slid to the end of the bed and landed with a thud onto the floor once again. By the time I stood up, I knew I wasn’t going to make it to the bathroom in time and wet my pants. 

After showering again for the night, I put on my flannel PJs, grabbed my favorite quilt and the pillow with the satin pillowcase, and went to the couch. After my pillow won the war of sliding out from under my head, I finally took off the pillowcase and went to sleep.

For sale: One set of satin sheets. Cheap.

***

Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to Parkinson’s disease.

The post The Dilemmas of Having Parkinson’s Disease: It Could Happen to You appeared first on Parkinson’s News Today.

Gut Bacteria Composition Linked to Parkinson’s Disease Severity, Study Shows

gut bacteria composition

The composition of intestinal bacteria in patients with Parkinson’s disease is correlated with disease severity and a worse prognosis, a study has found.

The study, “Gut microbiota are related to Parkinson’s disease and clinical phenotype,” was published in Movement Disorders.

Parkinson’s disease is a chronic and progressive neurodegenerative disorder, caused by the gradual loss of dopamine-producing neurons in the substantia nigra, a region of the brain responsible for movement control. Although the condition is mostly associated with motor symptoms, such as tremors, body rigidity, and balance instability, patients may also experience a series of non-motor symptoms.

Gastrointestinal problems, in particular constipation, are some of the most common non-motor symptoms of Parkinson’s. They are estimated to affect up to 80 percent of all patients and can occur years before the onset of the first motor symptoms.

Previous studies have shown that gut bacteria involved in the regulation of intestinal transit interact with the nervous system, “influencing brain activity, behavior, as well as levels of neurotransmitter receptors and neurotrophic factors,” according to the study. However, the impact of intestinal bacteria in neurological disorders, such as Parkinson’s disease, had never been investigated.

“Based on the early gastrointestinal involvement in PD [Parkinson’s disease] and the vast potential of microbiome-host interactions, we … hypothesized that the fecal microbiome of PD patients differs from that of matched control subjects in terms of bacterial diversity,” the researchers wrote.

To test this hypothesis, the University of Helsinki researchers compared the composition of intestinal bacteria found in stool samples from 72 patients with Parkinson’s disease and 72 healthy controls by genetic sequencing.

Data from the observational study (NCT01536769) revealed that patients with Parkinson’s had a 77.6% reduction in the amount of bacteria belonging to the Prevotellaceae family compared with controls. This family of bacteria, which includes the Prevotella genus, is a group of nonharmful bacteria that live in the colon and help break down complex foods.

“Our findings indicate that the Prevotella associated gut microbiome enterotype [bacteria that live in the intestine] could be underrepresented among PD patients. Investigating whether high abundance of Prevotellaceae has protective effects against PD or whether low abundance is rather an indicator of disturbed mucosal barrier function will be important,” the investigators wrote.

Interestingly, the amount of bacteria from the Enterobacteriaceae family was much higher in patients with postural instability and gait difficulty than in those with tremor-dominant (TD) symptoms. This family of bacteria includes several pathogens, such as Escherichia coli, and other species of harmless bacteria.

“In comparison with TD patients, patients with a non-TD phenotype progress faster [and] have a worse prognosis. Our results suggest that this may be associated with higher abundance of Enterobacteriaceae in the fecal microbiome of non-TD patients,” the researchers wrote.

“Further studies are warranted to elucidate the temporal and causal relationships between gut microbiota and PD and the suitability of the microbiome as a biomarker,” they added.

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Restless Legs Syndrome Could Be Risk Factor for Parkinson’s, Study Suggests

Restless legs syndrome (RLS) — recurrent discomfort and the urge to move the legs at rest — may be associated with an increased frequency of constipation and rapid eye movement sleep behavior disorder (RBD), two premotor symptoms of Parkinson’s disease, a study suggests.
The study, “The association between restless legs syndrome and premotor symptoms of Parkinson’s disease,” was published in the Journal of the Neurological Sciences.
RLS is more common in Parkinson’s patients than the general population. Studies have shown contradictory results, with some reporting that, similar to Parkinson’s, dopamine-mediated cell communication is impaired in people with RLS, while other researchers have found no hallmark Parkinson’s alterations in RLS patients.
To address this discrepancy, Harvard Medical School researchers conducted an analysis to identify associations between RLS symptom questionnaire responses and the development of well-known prodromal (early) Parkinson’s symptoms, including constipation; possible RBD, characterized by abnormal movements and dream-enacting behaviors during sleep; and hyposmia, or the reduced ability to smell.
This approach allowed scientists to analyze whether previous conflicting results could be due to the fact that RLS occurs during early neurodegeneration before Parkinson’s diagnosis.
Eligible participants were identified from a group of 51,529 men in health professions, ages 40-75, who took part in the prospective Health Professional Follow-up Study (NCT00005182) beginning in 1986. Questionnaires were sent biannually asking about lifestyles and medical histories. Researchers included individuals who had answered questions on RLS in both 2002 and 2008 and who had not been diagnosed with Parkinson’s disease for a total of 16,636 men.
RLS was diagnosed according to the International RLS Study Group criteria, which defines RLS as unpleasant leg sensations with motor restlessness and an urge to move the legs at rest, which worsened in the evening/night and occurred more than five times per month.
Constipation and possible RBD were determined in the 2012 questionnaire. Constipation was defined as a bowel movement every other day or less and/or laxative use at least twice weekly. Participants were considered to have possible RBD when they had been told by their sleep partners that they acted out their dreams while sleeping at least three times in the past. Hyposmia — determined in 2014 — was assessed with the 12-item Brief Smell Identification Test in 5,249 men with constipation or possible RBD and in age-matched controls.
Results revealed that the prevalence of RLS was 4.1% in 2002 (673 men) and 5% in 2008 (833). While only 232 men, with a mean age of 66.91 years, had RLS in both 2002 and 2008, 601 participants (3.8%), with a mean age of 66.38 years, became RLS-positive in 2008.
Race, body mass index, smoking history, physical activity, and alcohol, caffeine and lactose intake did not vary across the groups.
Having RLS in 2002 and/or 2008 was associated with a higher risk of constipation in 2012, compared with controls. Only individuals who had RLS in both 2002 and 2008 (continuous) showed higher odds of having possible RBD alone, and both constipation and possible RBD in 2012, “indicating a potential association between continuous/recurrent RLS and [Parkinson’s],” according to the researchers.
They cautioned that constipation

Source: Parkinson's News Today

Non-Motor Symptoms Different Among Men and Women, Study Shows

non-motor symptoms

Non-motor symptoms (NMS) in Parkinson’s disease are significantly more frequent and differ between men and women, a new study shows.

The study, “Frequency of non-motor symptoms in Parkinson’s disease presenting to tertiary care centre in Pakistan: an observational, cross-sectional study,” was published in the journal BMJ Open.

Parkinson’s NMS include anxiety, depression, dementia, psychosis, sleep impairment, pain, fatigue, constipation, and sexual dysfunction.

Although NMS are common and most of them treatable, some, such as bowel incontinence or sexual dysfunction, may be under-reported due to embarrassment or lack of awareness that they may be associated with Parkinson’s. Prior research in the U.S. has indicated that phsysicians failed to recognize anxiety, depression and fatigue in more than half of encounters with patients.

To determine the frequency of non-motor symptoms in Parkinson’s patients, researchers used the 30-item NMS questionnaire, which is intended to empower patients and caregivers to report relevant NMS not otherwise discussed in routine clinical visits.

This questionnaire has been independently validated and is recommended by the U.K.’s Department of Health for use in clinical practice.

The study included 85 adult Parkinson’s patients who came to a movement disorder clinic at a tertiary care center in Lahore, Pakistan. The team evaluated NMS’ pattern and analyzed potential differences between men and women.

Results revealed a mean of nearly seven different NMS per patient. Constipation (56%) and nocturia (frequent urination at night, 49%) were the most common NMS, while 35% of patients reported urinary urgency.

As for neuropsychiatric complications, 47% of patients reported low mood and sadness, while 36% reported anxiety/panic, and 45% short-term memory impairment.

Light-headedness and dizziness were reported by 40%, sexual dysfuntion by 30%, difficulty falling asleep by 29%, pain unrelated to the musculoskeletal system by 30%, and loss or change in the ability to taste or smell by 29%. All other NMS, including daytime sleepiness, were under 25% in frequency.

Regarding sex differences, feeling sad or blue, light-headededness and dizziness, unexplained pain, unpleasant sensations in the legs while at rest, difficulty in swallowing, and faecal incontinence were the most frequently reported NMS in women; men reported constipation, nocturia, and problems with memory more often.

Male patients reported sexual dysfunction more frequently than women, which the authors attribute to women in Pakistan being uncomfortable with discussing intimate issues.

Among the study’s limitations, the scientists mentioned the low number of women (15), which they hypothesize may be due to men seeking medical care more often.

“In this study we have shown the high frequency of NMS in patients with [Parkinson’s] in Pakistan … Certain NMS are more common in women as compared with men,” researchers wrote, adding that the findings warrant large-scale study to assess the sex-specific incidence of NMS in Parkinson’s patients.

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Source: Parkinson's News Today

Parkinson’s Disease and the ‘C’ Word

constipation

Sherri Journeying Through

You’ve seen the commercials about diarrhea. It’s not something to be embarrassed about, but we try to make light of it by calling it by some other name like the runs, the squirts, the trots, Montezuma’s revenge, or the really polite word: dysentery. When it comes down to it, they all mean the same thing: RUN!

The blessing of Parkinson’s disease is we don’t have to deal with the trots or the squirts as others do. We get to deal with that other word we don’t want to talk about: constipation. You know, that plugged up feeling you get in which you have to poop but you can’t. And for people with PD, this can be a real stopper. When you’re at that place of blockage, you want to get some of that miracle stuff they advertise and be one of the “thousands who poop with ease.”

What to do?

There is no miracle pill, and you don’t want yet another medication. And as user-friendly as marketers want you to believe Metamucil (psyllium) is, if you’ve got PD, get rid of it. For whatever reason, it hardens once digested in a person with PD and will only make things worse. MiraLax (polyethylene glycol 3350) is a good substitute. It is a clear, fairly inexpensive liquid, and is recommended by doctors to ready patients for colonoscopies. And it is safe for adults.

Your diet plays a crucial part in this war against being plugged up. If possible, stay away from white bread, pasta, and rice, and replace them with whole grains and brown rice. Don’t forget what your mother told you: Eat your fruits (figs and dates are great) and veggies. Lots of them. And just as important is drinking WATER — dehydration can cause constipation.

Constipation also affects medications. It causes the stomach to empty more slowly, disallowing the pills to enter the intestine where they are absorbed more efficiently. Constipation has also been linked to bowel cancer and, really, who wants that? PD is enough.

Another thing you can do is to walk each day, as that has “un-constipational” effects (did you like that big, made-up word?). Also, try rocking when seated on the commode, and I don’t mean like in a rocking chair. Lean to the right and then the left slowly as that helps to move the muscles associated with making a good poop. I also saw a video of a woman demonstrating how to poop easier (she was just demonstrating, not actually pooping), and she suggested rubbing your lower back and lower abdomen to try to help things along.

Whatever you do, don’t take constipation lightly. Tell your doctors. Recently, I spoke with a woman who along with having PD was diagnosed with colon cancer. It went undetected for some time, as she and her neurologist thought she was just having constipation issues. Perhaps. But at some point, that changed.

So, keep on top of your bowel movement situation. If it changes, tell your doctor. If you’re struggling, tell your doctor. If you’re in pain, tell your doctor. If you can’t poop, tell your doctor. Don’t be embarrassed. If you can’t seem to broach the topic, just print out this article and hand it to them and say with pleading eyes, “Help.”

Doctors are there to help things run smoothly for you, so stop straining and start smiling.

***

Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to Parkinson’s disease.

The post Parkinson’s Disease and the ‘C’ Word appeared first on Parkinson’s News Today.

Source: Parkinson's News Today

10 Early Signs of Parkinson’s Disease

Because Parkinson’s disease is a progressive condition, it can be difficult to spot the early warning signs. However, we’ve put together a list of 10 of the most common early signs and symptoms of the disease, according to the National Parkinson Foundation.

1. Tremors and Shaking
This is one of the most recognized symptoms. Although there could be many other reasons for tremors, facial-twitching or limb-shaking is a common early warning sign of Parkinson’s disease.

2. Small Handwriting
Many Parkinson’s disease patients find that their handwriting suddenly becomes very small. The way you write may also have changed if you are in the early stages of the condition.

MORE: Gregory Chandler’s amazing Parkinson’s story

3. Loss of Smell
Many people temporarily lose their sense of smell due to colds or the flu, but if the loss is sustained over a length of time without any noticeable congestion, then it could be an early sign of Parkinson’s disease.

4. Sleeping Disorders
Trouble sleeping can be attributed to many illnesses and Parkinson’s disease is one of them. Waking due to sudden body movements, or thrashing your legs in your sleep could be a warning sign of the condition.

5. Stiffness in Walking and Moving
General stiffness that can’t be attributed to exercise aches and pains and doesn’t ease up when moving around could be an early warning sign of Parkinson’s disease. Many patients complain that it feels like their feet are literally stuck to the floor.

MORE: Did you know that Parkinson’s disease patients may benefit from dancing?

6. Constipation
Unable to move your bowels is also a common early sign of Parkinson’s disease. Although this is a common enough problem in healthy people, Parkinson’s patients are more susceptible to constipation. If you suddenly find you’re constipated and consider your diet normal then you should have a doctor check you out.

7. Low or Soft Voice
A sore throat or a cold can change the way you speak, but if you have been experiencing a sudden softness to the tone of your voice and are now speaking in a quieter or hoarser tone, this could be an early symptom of Parkinson’s disease.

8. Masked Face
A face set into what others may perceive as a bad mood or being angry or depressed is a common early sign of Parkinson’s disease. Also, an expressionless face with unblinking eyes could be a warning sign.

MORE: Check some seated exercises for patients with Parkinson’s disease

9. Dizziness or Fainting
Feeling faint or dizzy is an indication of low blood pressure, which is an early warning sign of Parkinson’s disease. If you are regularly feeling dizzy when you stand up then you should see your doctor.

10. Stooped
If you suddenly become stooped or your back hunches over then this could be an early warning sign of Parkinson’s disease. A slouch or hunch could be attributed to other conditions, such as arthritis or other bone diseases, but you would need to see your doctor to determine the cause.

MORE: Did you know that there’s an eye test that can help detect Parkinson’s before first symptoms show up?

Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

The post 10 Early Signs of Parkinson’s Disease appeared first on Parkinson’s News Today.

Source: Parkinson's News Today

10 Complications of Parkinson’s Disease

As well as the symptoms usually associated with Parkinson’s disease like rigidity and tremors, those living with the condition may also experience other complications. According to the Mayo Clinic, these complications may include:

Cognitive Problems
Cognitive problems tend to occur in the later stages of the disease, where thinking and reasoning may become impaired. Currently, there is no medication available to treat this complication.

Depression and Anxiety
It’s common for people living with Parkinson’s disease to suffer from emotional changes such as depression or anxiety. Speak to your doctor if you’re finding it hard to cope emotionally as medication or counseling may help.

Difficulty in Swallowing
As Parkinson’s disease progresses, some patients may find they experience swallowing difficulties. This may also lead to an excess of saliva in the mouth and drooling.

MORE: 11 Facts About Parkinson’s Disease You May Not Know

Sleep Disorders
Sleep disorders are extremely common in people with Parkinson’s disease. Common complaints include difficulty falling asleep, waking to go to the bathroom, restless leg syndrome, REM sleep behavior disorder and sleep apnea.

Bladder and Bowel Problems
Difficulty in controlling urination or starting urination is a common complication of Parkinson’s disease. In addition, many may find that they suffer from constipation.

Sudden Changes in Blood Pressure
Dizziness when standing up is due to a sudden drop in blood pressure.

MORE: Lifestyle Changes That Can Improve Quality of Life for Parkinson’s Patients

Loss of Sense of Smell
Many Parkinson’s disease patients report a decline in their sense of smell or being unable to distinguish between different smells.

Fatigue
Fatigue can affect many Parkinson’s disease patients, often without any known cause.

Pain
Pain experienced by Parkinson’s disease patients can be in specific areas or a general pain felt all over the body.

Lower Sex Drive
A lower sex drive or sexual dysfunction is a complication of Parkinson’s disease for many people and may be due to other symptoms such as fatigue, pain or depression.

MORE: 10 Complications of Parkinson’s Disease

Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

The post 10 Complications of Parkinson’s Disease appeared first on Parkinson’s News Today.

Source: Parkinson's News Today