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Early Onset Parkinson's
The confirmation diagnosis came in January after noticing the resting tremor in my husbands right hand. He was 46 then. When we got in with a neurologist several tests were done to rule out stroke and peripheral neuropathy, but Parkinson's was #1 suspect. However, 1st doctor backed off Parkinson's dx and went for peripheral neuropathy prescribing Cymbalta for depression and pain. At one of those appointments, I discovered that my husband of 26 years was hiding things from me. He leaves for work before I get up for work so it was easily hid. Not using right pants pocket, brushing teeth with left hand, using mouse with left hand. It was affecting his entire right side and he was compensating. We have since changed doctors. He still takes cymbalta, Salengaline (?SP)and Mirapex. Tried the ropinarole but was not well tolerated and Mirapex is much better. He watches his diet, takes stool softeners, Milk of Magnesia, and still often relies on ememas for the severe constipation. Our youngest son is a senior in high school this year and our futures financially and as empty nesters scare me. How can I judge how fast this is progressing? He has 25 years in at his work. When should he take disability and retire? I really suspect he is not being honest with me regarding the degree to which Parkinson's is affecting him.
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Dr. Sanchez-Ramos said...
Wednesday, July 21, 2010 9:27 PM
Most likely symptoms had been brewing for many years before his diagnosis at 46. Patients with young-onset PD in general respond very well to dopamine replacement. They also tend to develop dyskinesias (involuntary jerking, twitsting, turning of the limbs, trunk and head) when started immediately on levodopa. Hence it was wise to start with a dopamine agonist (requip or mirapex) and only add levodopa/carbidopa when symptoms cannot be controlled by the agonist alone. If he still has symptoms localized to only one side, then he is not progressing that fast. The next stage of PD (Stage II on the Hoehn and Yahr scale) is characterized by bilateral signs and symptoms. Stage III is heralded by beginning to lose balance. Stages IV and V are characterized by more disability and difficulty ambulating. I have patients with young onset who have had the illness 40 years and though they have many difficulties are still able to enjoy many things in life.
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