“According to research, 40% to 60% of patients with Parkinson’s disease (Parkinson’s disease) may have problems such as depression and anxiety.”
Ao Yu, Ph.D., Department of Parkinson’s and Movement Disorders, Department of Neurology, China Medical University Affiliated Hospital, pointed out, “There was a female patient whose motor symptoms improved significantly after taking the medicine, but every time she went back to the clinic, she would start to cry after speaking a few words. After learning more about the pressure she felt, we adjusted the medicine and invited family members to learn about Parkinson’s disease and resolve misunderstandings.”
In terms of drugs, in addition to the traditional use of left dopamine, dopamine receptor agonists or drugs with other mechanisms can also be considered. Dr. Ao Yu said that dopamine receptor agonists can improve motor symptoms, but also help non-motor symptoms. In the follow-up, the above-mentioned patients responded well, their mood improved, and there were no obvious side effects.
Dr. Ao Yu said, “In the face of Parkinson’s disease, complete communication, family support, and appropriate medication are all very important!”
There are three core symptoms of Parkinson’s patients, tremor, slowness, and stiffness. Dr. Ao Yu pointed out that these motor symptoms will cause a lot of inconvenience to daily life, and will also affect work and social interaction. It was observed in the clinic that most of the patients came to see a doctor because they felt inconvenient, slow movements, and stiff postures.
In Parkinson’s disease, in addition to the above-mentioned motor symptoms, there will also be non-motor symptoms, and these symptoms will appear gradually even ten to twenty years before the motor symptoms appear. Dr. Ao Yu said that patients often actively complain about constipation, sleep disturbance, pain, etc., but there are also some non-motor symptoms that patients may not notice, such as depression, mood swings, anxiety, changes in smell, etc.
Patients may become reluctant to go out, lose interest in their original hobbies, and change their eating tastes. These conditions depend on daily observations by family members and careful evaluation by doctors during consultations.
Among the patients who came to see a doctor for the first time, in terms of the stage of Parkinson’s disease, it is about between the first and second stages, that is, most of them have unilateral symptoms. Dr. Ao Yu said that now that medical information is developed, many patients or their family members will check the information on the Internet, so most of the symptoms can be detected when they are not too serious.
However, sometimes it can be seen that patients have symptoms of Parkinson’s disease due to concurrent spine, bone and joint problems, or complex medical diseases, but often attribute the symptoms to these problems, so that they do not go to the neurology clinic until the later stage of the disease.
Dr. Ao Yu said, for example, the patient has always had 50 shoulders and felt that the shoulders were always stiff and could not be lifted. After treatment for a long time, there was no significant improvement, and it was later discovered that the stiffness and inability to move partly came from Parkinson’s disease.
Because non-motor symptoms may appear earlier than motor symptoms, and sometimes family members can observe them more than patients themselves, Dr. Ao Yu explained that special attention should be paid to unexplained hyposmia, nightmares, yelling, dancing, and long-term constipation. These may be non-motor symptoms of Parkinson’s disease.
In addition, patients in the early stage may not notice that their movements are slow, but because their movements become unsmooth, it takes half an hour to prepare for going out, but now it takes an hour, or their limbs tremble when they are still, and they are prone to falls when walking. These clues can indicate that the patient has abnormal neurological function. If the above situation is observed, it is recommended to go to the neurology clinic for treatment.
People over the age of 50 can use the finger exercise self-test every month. The first step is to spread the five fingers of the right hand, the second step is to press the thumb and index finger 25 times, and the third step is to switch to the left thumb and index finger 25 times. Dr. Ao Yu said that if you find that the opening and closing speed and finger opening and closing range of both sides are obviously different, you can go to the neurology department for a detailed evaluation.
Treat Parkinson’s disease early to help maintain quality of life
Parkinson’s disease will have many impacts on patients and their families. Whether it is motor symptoms or non-motor symptoms, it will lead to a significant decline in the quality of life. Dr. Ao Yu said that early intervention can allow patients to maintain a certain quality of life and reduce complications caused by these motor symptoms or non-motor symptoms, such as fractures caused by falls and cerebral hemorrhage. The motor symptoms and non-motor symptoms of Parkinson’s disease can be improved by drugs. Common drugs include levodopamine and dopamine receptor agonists.
Dr. Ao Yu said that clinically, he will discuss carefully with the patient and family members to understand the degree of distress caused by various motor symptoms, and then decide the dosage of the drug. Everyone has their own suitable dose. Usually, when using drugs, it can achieve the smoothness that patients can accept and live without too obvious side effects, which is the most ideal situation. In addition to improving non-motor symptoms through drugs, sometimes non-drug treatments can also be used to help improve, such as exercise, rehabilitation, healthy diet, water supplements, etc.
“A common clinical situation is that patients sometimes adjust their medications by themselves,” said Dr. Ao Yu. “It may be because of the inconvenience of taking medications outside the home, or because of some misunderstandings and fear of continuing to take medications. There are also some patients who feel that the medications are not effective enough, so they increase the dosage by themselves, which is actually dangerous.”
Self-adjustment of drugs may lead to insufficient drug efficacy, making patients less active, prone to falls, and may not be able to participate in sports or family activities, and the quality of life will also be significantly reduced. Dr. Ao Yu said that if you have any doubts about the use of the drug, it is recommended to discuss it with the doctor, and try not to adjust the dose by yourself.
The use of levodopamine can effectively improve motor symptoms, but attention should also be paid to motor complications, such as uncontrollable twisting when the patient is at rest, or sudden inability to move halfway through walking. Dr. Ao Yu said that the doctor will carefully evaluate the patient’s response to the drug and the degree of improvement that the patient feels at each return visit, and try to avoid using too high a dose of levodopamine with sufficient drug effect, and use other drugs in combination, such as dopamine receptor agonists, monoamine oxidase b inhibitors, etc.
Parkinson’s patients move slowly, and it is inconvenient to go out to see a doctor. Dr. Ao Yu said that if they can be treated nearby, it will be beneficial to both the patient and their family members.
How to help Parkinson’s disease patients with poor appetite?
Gastrointestinal symptoms are common problems for patients with Parkinson’s disease, and a vicious circle may occur. Dr. Ao Yu said that patients often dare not go for activities because they are afraid of falling, and the reduced amount of exercise will lead to poor gastrointestinal motility. Poor gastrointestinal motility will lead to poor appetite, eating less, and drinking insufficient water, which will aggravate the constipation caused by Parkinson’s disease and worsen appetite.
In the face of such a vicious cycle, it is recommended to adjust the drug to an appropriate dose and improve by increasing the amount of exercise, such as arranging appropriate outdoor activities, receiving rehabilitation, increasing walking time, and so on. Dr. Ao Yu said that the diet can be as healthy and light as possible, drink plenty of water, and increase fiber intake. If the appetite is poor, small meals and frequent meals can be used to help patients achieve sufficient food intake.
It is also worth mentioning that since levodopamine drugs are easy to compete with protein foods (eggs, beans, fish, meat) for absorption, they are better absorbed when taken before meals.
Parkinson’s disease is a progressive neurodegenerative disease, which has a great impact on the patient’s physical and psychological state, and even the life of the entire family. Early diagnosis, careful observation of one’s own symptoms, cooperation with doctors, and the use of medication can all bring about changes in patients’ discomfort. Dr. Ao Yu expressed that he hoped that patients would not shy away from medical treatment, and that they could actively discuss the condition and drug effects with doctors when seeking medical treatment. The current medical development is changing with each passing day, and doctors will use the best weapons to accompany you to face the disease.
2023-07-20 01:20:53
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