To Your Good Health: There is help for those with Parkinson’s

Dear Dr. Roach: A friend of mine has Parkinsons disease. She is 90 years old and has been very active for her age, but recently she has not enjoyed life as much as she had. What do you know about Parkinsons? Are there any cures or relief? W.W.

A: Parkinsons disease is caused by loss of dopamine in cells in a deep area of the brain. The cells are responsible for smooth, coordinated movement. As a consequence, people with Parkinsons usually have a tremor, a rhythmic shaking of the hands while at rest, often worse on one side. Pillrolling is a characteristic movement of the forefinger and thumb. Muscles become rigid, and as the disease progresses, the muscle rigidity causes people with Parkinsons to get frozen, unable to move at all for a few seconds or longer.

Slow movement is common. The gait can become shuffling, which can predispose the patient to falls.

Parkinsons disease affects more than a million North Americans and usually is diagnosed in people over 60. Those diagnosed younger than age 60 frequently have a more rapidly progressive form, but the disease is variable.

Often, the face shows less emotion than before the diagnosis, but its predominately an effect of Parkinsons on the muscles of the face, not a lack of emotion. I have had patients become very frustrated with the inability to show their feelings or perhaps I should say with others inabilities to read their emotions.

There are many treatments for Parkinsons disease, and they can bring dramatic relief even if there isnt a cure. Sinemet is one medicine that helps by restoring dopamine to the brain, but there are now many others. In my opinion, Parkinsons disease should always be evaluated and treated by an expert, usually a neurologist with special expertise in movement disorders.

Von Willebrand's a rare blood condition

Dear Dr. Roach: My granddaughter was recently diagnosed with Von Willebrands disease. Do you have any information on this disease or its treatment? R.G.

A: Von Willebrand disease (vWD) is bleeding disorder. About 1 percent of the population has the condition, but only about 1 percent of those who have it get appreciable symptoms. Von Willebrand disease is caused by the lack of a blood clotting protein (von Willebrand factor), and shows up as easily bruised skin or mucosa bleeding (bleeding in areas such as the gums, stomach or uterus).

There are several subtypes of vWD, and because the range of severity is so large, its impossible to say just how much any one person will be affected. Most often, people with vWD dont need treatment unless they have significant bleeding or are planning surgery. Treatment is usually with dDAVP, which can be given as a nasal spray or by injection.

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To Your Good Health: There is help for those with Parkinson’s