Therapy Achievements is dedicated to helping people with physical, cognitive and visual limits re-gain function and reach their potential. By providing out-patient physical, occupational and speech therapy services, we help people maximize their independence and reach their potential. Our multi-disciplinary team approach to rehabilitation enables us to tailor your plan of care to your specific and unique needs.
Click for more posts on:
Parkinson’s Disease Facts: The Numbers
- 10 million people worldwide are living with Parkinson’s disease.
- 60,000 Americans are diagnosed with Parkinson’s disease each year
- 4% of people with PD are diagnosed before the age of 50.
- Men are 1 ½ times more likely to have Parkinson’s than women
- $2,500 a year is the average annual medication costs for an individual person with PD
- Therapeutic surgery can cost up to $100,000 dollars per patient
Parkinson’s Disease Facts: Well known people with Parkinson’s Disease
- Michael J. Fox (b. 1961), Canadian actor
- Billy Graham (b. 1918), American evangelist
- Janet Reno (b. 1938), Former Attorney General of the United States
- Muhammad Ali (b. 1942), boxer (pugilistic Parkinson’s syndrome)
- Eugene McCarthy (1916-2005) American politician
- Francisco Franco Spanish dictator (1892-1975)
- George Wallace, former governor of Alabama (1919-1998)
- John Lindsay, New York City mayor (1921-2000)
- Mao Zedong, Chinese Dictator (1893-1976)
- Pope John Paul II (1920-2005), Polish cleric
- Salvador Dalí, Spanish artist (1904-1989)
- Sir Michael Redgrave (1908-1985), British actor
Parkinson’s Disease treatment with Deep Brain Stimulation (DBS) has been used for over a decade to help stop uncontrollable shaking. It is typically offered when medications no longer help. Similar to all of the presently available Parkinson’s drugs, surgical options offer symptomatic benefit. It can ease symptoms but has not been proven to change the underlying course of disease. It is usually done in people who have had Parkinson’s for at least four years and still get a benefit from medication but have motor complications, such as significant “off” time (periods when medication isn’t working well and symptoms return) and/or dyskinesia (uncontrolled, involuntary movements).
DBS typically works best to lessen motor symptoms like stiffness, slowness and tremor. It doesn’t work as well for imbalance, freezing when walking or non-motor symptoms. DBS may even exacerbate thinking or memory problems so it’s not recommended for people with dementia.
Deep Brain Stimulation: How It Works
A surgeon implants a small battery operated device similar to a pacemaker under the skin near the collar bone. The doctor then positions wires from the device with electrodes on their ends in areas of the brain that control motor function. Usually a person remains awake during surgery so that he or she can answer questions and perform certain tasks to make sure that the electrodes are positioned correctly. The device works by electrically stimulating these areas and blocking the abnormal nerve signals that cause the tremor in Parkinson’s disease patients.
Most people with Parkinson’s disease will require the surgery be done on both sides of the brain.The procedure is performed with the patient awake to ensure optimal placement of the electrodes and maximize the potential for benefit. A few weeks after surgery, a movement disorder specialist uses a handheld programmer to set parameters, tailored to each individual’s unique symptoms, into the neurostimulator. The DBS settings are gradually tweaked over time and medications are simultaneously adjusted. Most people are able to decrease (but not completely discontinue) Parkinson’s drugs after DBS. Determining the optimal combination of drugs and DBS settings — that which gives the most benefit and the least side effects — can take several months and even up to a year.
Parkinson’s Disease Rehab: Dr. David Greer
Parkinson’s Disease rehab is something Dr. David Greer is very familiar with. He has been treating patients with Parkinson’s Disease for over 10 years. And he knows first hand treating people who have Parkinson’s Disease can be very challenging.
At present, there is no cure for Parkinson’s disease, but there are a number of medications that can provide dramatic relief of the symptoms. The challenge comes in finding the most effective medication treatment for each patient. Factors to consider include:
- the correct drug or drug combinations
- the dosage
- the method of taking medication
Parkinson’s Disease Rehab: Dr. David Greer’s Challenge
The risk of side effects of drugs vary from person to person and finding the right treatment is like solving a puzzle. A “one size fits all” treatment approach will not work. And the puzzle often turns into a moving target. Because the effectiveness of treatment changes over time, what used to work well will gradually fade in effectiveness. Medications will need to be adjusted and new combinations may be necessary to optimize function. And that’s what Dr. David Greer likes the most about his work. In his words, “No two days are the same. Every day I have the opportunity to help people.”
Parkinson’s Disease Rehab in Huntsville, AL
Dr. Greer grew up in Durum, North Carolina. He went to the University of North Carolina at Greensboro and medical school at Irvine Medical School. He completed a residency at Vanderbilt. He specialized in neurology because “Neurology is who we are – the way we act, the way we think, the way we move. Conditions that affect the brain and nervous system are so meaningful and a neurologist has such an opportunity to make an impact. Even minor adjustments to treatment can have a significant impact on the quality of a patient’s life.”
Dr. Greer chose to practice in Huntsville, AL because “It’s the right sized city. It has a mix of interesting people and it is in close proximity to Vanderbilt and UAB” – two medical centers where much of the research in treatment of Parkinson’s disease is happening. Dr. Greer remembers being impressed with Dr. Ray Watts, Dr. Harrison Walker and Dr. Erwin Montgomery at the UAB Neurology Clinic during his residency tours and was delighted when he was invited to tour the deep brain stimulation program and observe a deep brain stimulation placement surgery. He now works in close collaboration with UAB and patients who undergo the surgery, monitoring their progress and making adjustment to the units as necessary. “There are so many research things just around the corner for Parkinson’s Disease – extended release medications, duodenal infusions, drug drips – that’s what makes this work so much fun. We have such an opportunity to help people. It makes working not so much work.”
Parkinson’s Disease Awareness Month:
Each year, April is designated as Parkinson’s Disease Awareness Month.
What Is Parkinson’s Disease?
Parkinson’s Disease is a progressive disorder that results in the loss of nerve cells in the brain that produce dopamine. Dopamine is a chemical messenger that transmits signals between two regions of the brain to coordinate activity. If there is deficiency of dopamine, nerve cells “fire” out of control. This leaves the individual unable to direct or control movements. Although descriptions of people with Parkinsonism date back to ancient Egypt, it wasn’t until 1817 that paralysis agitans (shaking palsy)was first described in an essay by English surgeon James Parkinson. The condition was renamed Parkinson’s disease sixty years later.
Who Gets Parkinson’s Disease?
Parkinson’s disease usually affects people over the age of 50 although the illness does occur in people between the ages of 30 and 50, or in rare cases at a younger age.
What Are The Symptoms of Parkinson’s Disease?
Diagnosis of Parkinson’s disease is important so that appropriate treatment can begin. There are four primary symptoms of Parkinson ’s disease: tremor, or trembling in hands, arms, legs, jaw, and face; rigidity, or stiffness of the limbs and trunk; bradykinesia, or slowness of movement; and postural instability, or impaired balance and coordination. As these symptoms become more pronounced, patients may have difficulty walking, talking, or completing other simple tasks.
How Is Parkinson’s Disease Diagnosed?
At present, there are no laboratory tests that can confirm the diagnosis of Parkinson’s disease and a physician determines a diagnosis by taking a family and health history, performing a physical and neurological exam, observing the person’s movements and muscle function, and ruling out other disorders that can cause similar symptoms.
What Are The Causes of Parkinson’s Disease?
Although the exact cause for the loss of cells is unknown, most cases of Parkinson disease probably result from a complex interaction of environmental and genetic factors:
- Most cases of Parkinson’s disease occur in people with no apparent family history of the disorder.
- Approximately 15 percent of people with Parkinson’s disease have a family history of this disorder.
- Researchers have identified specific genetic mutations that can cause Parkinson’s disease, but these are uncommon. They have also identified alterations in certain genes that do not cause Parkinson disease but appear to modify the risk of developing the condition in some families.
- Some gene mutations appear to disturb the cell machinery that degrades or breaks down unwanted proteins in dopamine-producing neurons. In patients with Parkinson’s disease, the protein alpha-synuclein fails to break down and forms into clumps called Lewy bodies. Lewy bodies accumulate in dopamine-producing neurons and lead to the impairment or death of these cells.
- Other mutations may affect the function of mitochondria, the energy-producing structures within cells. As a byproduct of energy production, mitochondria make unstable molecules called free radicals that can damage cells. Cells normally counteract the effects of free radicals before they cause damage, but mutations can disrupt this process. As a result, free radicals may accumulate and impair or kill dopamine-producing neurons.
- Exposure to certain toxins or environmental factors may increase the risk of later Parkinson’s disease, but the risk is relatively small.
Treatment of Parkinson’s Disease:
In addition to the many new advances in medication therapy, treatment for Parkinson’s Disease may include:
- Rehabilitative therapy—Physical, occupational and speech therapists can assess the person’s abilities and needs, and provide exercises to help maintain the highest possible range of motion, muscle tone, balance and flexibility, and communication ability.
- Lifestyle alterations—Exercise helps maintain muscle tone and strength. Diet is important for nutrition, for maintaining an appropriate weight, and because protein level may be a factor in the person’s condition. Rest and stress reduction are also important.
- Support groups – Huntsville enjoys a very active Parkinson’s support group that offers aid, support, education, discussion and raises research funds for treatment of Parkinson’s disease. Information about Huntsville’s support group can be found at http://parkinsons-huntsville.webs.com or calling 256-859-6523.
April is Parkinson’s Disease Awareness Month!
Join the Parkinson’s disease community this April in raising Parkinson’s Disease awareness all over the US and around the world. Here are a few strategies to help you get started:
- Read All About It: Put PD in the Local Papers
- Paint the Town … with Tulips!
- Involve Public Officials
- Dare to Go Digital by Sharing Awareness Online
For now, there is no cure for Parkinson’s disease but with early diagnosis and an effective plan of treatment, the symptoms of the disease can often be controlled or lessened. For those with Parkinson’s disease, Huntsville offers many services and supports which enable people to remain active and have the quality of life that is important to them.