What is Parkinson’s Disease (Paralysis agitans)
In this disease there is gradual degeneration of the neurons that produce dopamine, one of the chemical neurotransmitters. There is lack of control and co-ordination of muscle movements resulting in :
a) Fixed muscle tone, expressionless features, stiff shuffling gait and stooping posture.
b) Muscle tremor
There is progressive physical disability but the intellect is not impaired. People with Parkinson Disease often experience one or more of the following :-
1) Nausea
2) Constipation
3) Loss of taste, sense of smell and / or appetite
4) Unplanned weight loss
5) Depression
6) Difficulty in swallowing
7) Choking
Symptoms of Parkinson’s Disease
Primary Symptoms :-
1) Rigidity – It is an increased tone or stiffness in the muscles.
Unless it is temporarily eased by anti – Parkinson medications, rigidity is always present and it increases during movements.
2) Tremors – These are most often identified with Parkinson’s disease. When it is present, the termor may be worse on one side of the body. Besides limbs it sometimes affects head, neck, face and jaw.
3) Brady Kinesia – It means slowness of movements. This symptom is characterized by a delay in initiating movements caused by the brain’s slowness in transmitting the necessary instructions to the appropriate parts of the body.
4) Poor Balance – This is particularly true when they move abrupty, causing a sudden change in the position of their bodies. Some patients experience repeated falls due to poor balance.
5) Walking problems commonly include a decreased or non-existing arm swing, short, shuffling steps, difficulty in negotiating turns and sudden freezing spells (inability to take next step).
Secondary Symptoms :-
These include depression, sleep disturbances, dizziness, stooped posture, constipation, dementia and problems with speech, breathing, swallowing and sexual function.
It is important to note that different patients experience different symptoms.
People with Parkinson’s Disease are at risk for hospitalization for a number of reason :-
1) RISK OF BONE FRACTURE – Malnutrition, weight loss and a higher incidence of falling greatly increase the risk of bone fracture and other disabilities.
How to avoid :-
Change any unhealthy habits that cause porosity of bones like smoking, excessive alcohol use and inactivity, add enough calcium, magnesium, Vitamin D and Vitamin K. It may also be helpful to use a calcium supplement. Chewable Calcium tablets are better absorbed, because they are already broken down when they reach the stomach. Ask your doctor before taking any. Without adequate amounts of Vitamin D, Calcium cannot be absorbed by the body. Vitamin D is easy to get through about one hour per week outdoor in the sunshine. Magnesium is as important as calcium. It helps rebuild and strengthen bone. Dark green vegetables dried beans and peas and whole grains are all rich in bone building magnesium.
2) RISK FOR DEHYDRATION – Some people report that they often feel thirsty and sometimes of dry mouth, thick or sticky saliva and dry eyes. This may be due to or may be aggravated by anti-parkinson medications, used to treat tremors are particularly known to cause such symptoms.
How to manage :-
If you are drinking six to eight glasses of water daily plus juices and other beverages yet still feel that your mouth is dry, try sipping water frequently and swishing it around your mouth to keep it moist.
3) RISK FOR BOWL IMPACTION – Constipation is common in Parkinson’s disease and if not dealt properly can lead to a mass of dry, hard feaces, impossible to pass normally, which is called bowl impaction. Two main reasons for constipation in Parkinson’s Disease :-
a) Medications used to treat Parkinson’s Disease often slowing peristalsis (movements of Gastro Intestinal tract).
b) Parkinson’s disease cause some degeneration of the nerves of the Gastro intestinal tract.
Management :-
Use of laxatives can release constipation. Increase fiber in the diet. Take more of fruits and vegetables. It’s best to increase fiber content gradually otherwise bloating and gas can occur. Fluids are as important as fiber. Four to eight glasses of water per day, plus juices, milk and other beverages are necessary.
4) RISK FOR WEIGHT LOSS – Unplanned weight loss may be due to the risk factors such as nausea, loss of appetite etc. Unplanned weight loss combined with malnutrition can lead to a weakened immune system, muscle wasting, loss of important nutrients and greatly increase risk for disease.
Solution :-
Instead planning 3 large meals, plan 3 small meals and 3 nutritious snacks each day. It may help to choose softer foods like soups, stews, avoid raw vegetables, salads if they take too long to eat, cooked vegetables, vegetable juices, soups may be better choices.
TIPS FOR IMPROVING A POOR APPETITE :-
1) Avoid non-nutritious beverages such as black coffee and tea.
2) Eat small frequent meals and snacks.
3) Walk or participate in other light activity to stimulate your appetite.
4) Drink beverages after a meal instead of before or drinking in between a meal.
5) Plan meals to include your favourite foods.
6) Increase variety of food you are eating.
7) Avoid eating foods that provide little or no nutritional value example – potato chips, candy bars, colas etc.
8) Make foods preparatian an easy task – choose foods that are easy to prepare and eat.
9) Make eating a pleasurable experience, try not to eat alone.
10) Use colourful garnishes.
11) Try some of high calories recipes.
GUIDELINES FOR HEALTHY LIVING :-
1) Try to limit food containing sugar
2) Moderate use of salt – Use herbs or no salt spices to flavour your food.
3) Drink at least 8 glasses of water per day.
4) Ask your doctor about drinking alcoholic beverages because alcohol may interfere with some of your medications.
* The Parkinson’s medication works best when taken on an empty stomach about ½ hour before meal or at least 1 hour after meals.