Parkinson's Disease and Small Farming Community Essay

At today’s visit she is accompanied by her husband and private aide. Her husband reports that she is doing much better. He states that her pain has improved and she has not taken her pain medication since last visit. He states that her anxiety had improved extremely with the recent change in her Xanax. He states that he has hired 24 help for the patient and since she has not fallen. She reports that she is feeling well. The caregiver reports that the patient continue to suffers from hypotension and hypertension with variation in blood pressure. The patient also continues to suffer from chronic tremors as a result of her Parkinson.

The article “Living with Parkinson’s and Looking for Relief”, written by Carla Gantz, was found in RDH magazine as a feature in the February 2013 volume on pages 34,36,38, and 95. It is about a dental hygienist, Carla Gantz, who develops Parkinson’s disease while still in practice, and the various ways she copes with the disease. Gantz had Parkinson’s disease that was only on her right side, hand, arm, and shoulder, classifying her as stage 1 Parkinson’s disease. She started off taking low doses of levodopa to help with her tremors, but as the disease progressed, the medications changed, and the doses increased. Her role as a dental hygienist was also affected as her disease progressed. She couldn’t administer local anesthesia, her manual dexterity with instruments became more difficult, and when polishing or scaling, her hand would come to a halt, a secondary motor symptom of Parkinson’s disease. She should break this “freeze” by allowing her left arm to lift up her right arm, but that only worked for so long. Five years after being diagnosed, Gantz had to give up her career because her tremors got worse and her medication increased; she was taking up to thirteen pills per day.

There are many treatments out there now like medication, therapy, surgery, and clinical trials. All these treatments are aimed to increase the level of dopamine in the system. There are many different medications out there that are used for PD patients. These are Carbidopa-levodopa, Carbidopa-levodopa Infusions, Dopamine agonists, MAO-B Inhibitors, Catechol-O-methyltransferase (COMT) Inhibitors, Anticholinergics, and Amantadine. There are many pros and cons to these medications the side effects that come with each of these medication makes it worth taking but having to find other medications to go along with the side effects of the original meds you are taking. Carbidopa-levodopa is the most effective medication out there for PD patients. A

The group leader facilitated the discussion that way, which seemed to flow appropriately. Steps 6-7, application and summary, also seemed to be completed simultaneously as well. The wrap-up included a recap of the session and helpful strategies shared. For the Parkinson’s group, there was no specific activity done during the session. The format of the group was an open group discussion where members were encouraged to participate. If anything, members needed the cognitive ability and working memory to engage in conversation. Also, adequate communication and social skills were required. There were many main ideas presented during the Parkinson’s discussion, but the two that were significant to the group were medications, and losing the ability to drive. The most common coping strategy amongst the group was exercise. Many of the members also expressed their medication concerns and side effects specifically. The most common coping strategy was exercise and being outdoors. Many of the members also expressed how they have become more grateful for the support of their spouses and or

J.N., a 65-year-old Caucasian female with a history of anxiety and depression, presents for diagnostic testing at Saint Mary Medical Center in Hobart, Indiana to confirm or deny a diagnosis of Parkinson’s Disease, after presenting with recent onset of upper extremity tremor affecting both sides and facial masking. Patient history also includes bradykinesia, restlessness, fatigue, muscle weakness, and poor balance and coordination, all of which are common in a diagnosis of Parkinson’s Disease. J.N. was referred to the Neurology Department of Saint Mary Medical Center after a routine appointment with her Cardiologist, who noted the recent onset of additional signs and symptoms. J.N. is my mother and my inspiration for this assignment.

The elevated striatal dopamine levels induced by rasagiline-dependent MAO-B inhibition has been correlated to improvements in PD motor symptoms in both monotherapy and adjunctive therapy studies. The TEMPO (TVP-2012 in Early Monotherapy for Parkinson’s Disease Outpatients) study, a 26-week, randomized, double-blind and placebo-controlled clinical trial observed the efficacy of rasagiline as a monotherapy for 404 early PD patients. Efficacy of rasagiline was quantified using the Unified Parkinson’s Disease Rating Scale (UPDRS), a rating scale used to measure the progression of PD by scoring four primary categories of symptoms: mentation, behavior and mood; activities of daily living; motor examination; and complications of therapy. Higher UPDRS scores correspond to greater severity of disease with the maximum possible score of 199 points representing total disability. The patients in the TEMPO trial had a mean baseline UPDRS score of 25 points and were subsequently divided into three groups: 1 mg rasagiline qd, 2 mg rasagiline qd or placebo. At the end of the trial period, compared with the placebo group, the average change in total UPDRS score was -3.56 for the 2 mg rasagiline group and -4.20 for the 1 mg rasagiline group. Of the four UPDRS categories, the greatest change was observed in the motor examination sub-scale with a mean change of -2.71 for the 1 mg rasagiline group and -1.68 for the 2 mg rasagiline group. This reduction in UPDRS score, especially with regards to

The last type of medication is Carbidopa/Levodopa. These are the most common medications used to treat Parkinson’s disease and are combined to get the effects from both pills. “Sinemet is the brand name (Carbidopa/Levodopa is the generic). Levodopa is absorbed and goes to the brain where it is converted to dopamine. Carbidopa is combined with the Levodopa to lessen the side effects of Levodopa and increases how long the Levodopa keeps on working within the brain” (Luitjens). Sinemet comes in several different dosages and can also be used as a regular tablet or an extended release tablet. These extended release tablets usually have less side effects and the severity of them has dissipated. Because the medicine is not all released at the same time, the body has more time to absorb the medicine, instead of all at once with the regular tablets. Most patients will take both types throughout the course of their diagnoses. The regular release tablet will help when the patient's blood levels drop, due to the extended release tablets. On average the regular tablets are taken by patients every three to six hours, but some may take up to eight a day depending on their conditions. Most doctors will not prescribe this medication until

Levodopa is administered rather than dopamine, because dopamine cannot cross the blood-brain barrier. Because Levodopa is broken down in the intestines by an enzyme known as COMT, COMPT inhibitors combined with Levodopa help the effectiveness of the medication. These are tolcapone and entacapone.

The World Health Organization projects that, by 2040, neurodegenerative diseases will become more common than cancer (Cashell, 2014). Parkinson’s Disease (PD) is widely listed as the second most common neurodegenerative disease (Wuong, 2012; Gillies et al., 2014; Cashell, 2014; Walker, Davidson, & Gray, 2012). This disease, usually characterized by a tremor, but featuring systemic effects, has been diagnosed in one to two percent of people over age 65 (Casey, 2013). Parkinson’s disease is incurable; the goal of the healthcare team is to help the patient to maintain function, independence and quality of life (Miertová et al., 2014; Magennis, Lynch, & Corry, 2014). In the discussion that follows, current understanding of the causes and treatment of PD will be summarized, along with examples of nursing interventions.

Antiparkinsonian drugs are medications designed primarily for Parkinson’s patients. This type of medication helps controls the symptoms of Parkinson’s disease but not cure it. It helps patients with symptoms like gait disturbances but is not an infinite alternative. In addition to this medication physical therapy programs is prescribed to help stop symptoms. The fact is physical therapy improves gait while in the same instant help manage the symptoms when the time comes, medication cannot do this for patients. The brain dopamine measures is what causes motor impairment and with this disease muscle strength is important to be able to stand when dopamine is not fully reaching the brain to prevent falls. Physical therapy helps the patient strengthen other areas of the body like sensory cues overtime and can be very effective. Physical can be beneficial helping the patient with gait disturbances.

Parkinson disease (PD), also referred to as Parkinson’s disease and paralysis agitans, is a progressive neurodegenerative disease that is the third most common neurologic disorder of older adults. It is a debilitating disease affecting motor ability and is characterized by four cardinal symptoms: tremor rigidity, bradykinesia or kinesis (slow movement/no movement), and postural instability. Most people have primary, or idiopathic, disease. A few patients have secondary parkinsonian symptoms from conditions such as brain tumors and certain anti-psychotic drugs.

Parkinson disease (PD) is a progressive neurodegenerative disorder characterized mainly by physical and psychological disabilities. This disorder was named after James Parkinson, an English physician who first described it as shaking palsy in 1817 (Goetz, Factr, and Weiner, 2002). Jean- Martin Charcot, who was a French neurologist, then progressed and further refined the description of the disease and identified other clinical features of PD (Goetz, Factr, and Weiner, 2002). PD involves the loss of cells that produce the neurotransmitter dopamine in a part of the brain stem called the substansia nigra, which results in several signs and symptoms (Byrd, Marks, and Starr, 2000). It is manifested clinically by tremor,

Affecting an estimated 4 million people worldwide (NIH), Parkinson’s is one of the less common nervous system disorders. Despite its rarity, Parkinson’s is largely researched because there is no cure and few effective treatments. It also has a big impact on quality of life for those afflicted. This disease usually shows up after age 40 and occurs when the brain cells that are responsible for motor skills die. Symptoms include tremors, inability to move, and impaired cognitive function, all of which worsen over time. Because this is a condition that affects the brain, if an effective treatment can be established, treatments for other more common conditions such as Alzheimer’s may soon follow. This makes it a critical topic for today’s doctors and scientists.

Parkinson’s disease has four main symptoms it is associated with: slowness of movement, tremors, stiffness, and trouble with balance. In order to be diagnosed, a patient must have “two of the four main symptoms present over a period of time” (“Understanding”). Along with

In addition to your examination, your doctor may give you carbidopa-levodopa, a Parkinson's disease medication. You must be given a sufficient dose to show the benefit, as low doses for a day or two aren't reliable. Significant improvement with this medication will often confirm your diagnosis of Parkinson's