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PD is very frustrating......and I appear to be the one frustrated.  I have
learned a lot from you but I need some more help. I understand better now
about PD + and the "look alike" diseases.  Thanks.

My brother is in the 8th year (or more) of PD.  He is 68 years old.  He has
all the classic symptoms of PD (see below).  His symptoms have progressed to
a state where he needs total care.  PD Dr. just increased his 100/25 Senemet
to two pills every 4 hours beginning 7:00 am ending 7:00 PM.  He also takes
Parolodol 3 times a day.

My question is this:  With the symptoms below that my brother is exhibiting
is it practical to think that his quality of life can be improved?  Can his
speech be improved with medication?  Can his swallowing be improved with
medication?  Can his walking?  Is it practical to believe that medication
can make a difference in his quality of life?  Does anyone out there know of
any experience similar to my brother's and was there any improvement in the
quality of life?

Thank you for your candid remarks.  My brother and I have had some very
amusing times...we have had quiet a few laughs...sometimes I cried I laughed
so hard.  I did not "baby" him when I was there...but I was careful to
understand his limitations.  We often walked together and I wheeled him
outside to enjoy the open air.  I took him to church in the nursing home and
he followed the words in the hymn book (from what I surmised).  We had some
great times.

Larry

Symptoms are characterized below:

Brother is in Texas with PD in nursing home.
I am in Georgia.  I have been to Dallas twice within the last 2-3 months for
about 7 or 9 days each time.

A.  He is aware of what we are saying and understands.  He cried when my
sister and I went out to see him recently...when we walked up to him.  He
understands enough to shake his head "no" or "yes" (yes is hard for him to
do).  He responded to the PD DR and gave the right responses to his
questions...or did the correct things.

B.  He uses his arms and hands and easily catches a ball and throws it back.
Two years ago you could assist him outside, give him a ball and glove, hold
him until he began pitching with someone, let him go and he would stand by
himself, throw and catch the ball and throw the ball back harder than you
could.  Quick pitching and he would fall down.

1.  Brother began PD symptoms some 8 years ago.  When he came to Georgia on
business I noticed he walked funny.  I tried to get him to take long
strides....but he told me he had "gout".  He was shuffling (now that I can
look back).

2.  His voice gradually began to get quieter....until almost a whisper.  5
years ago he was officially diagnosed with PD.  He had fallen for the final
time before he agreed to go to the DR.  Three years ago he had a stroke but
did not do anything to his legs nor his arms nor his face permanently.  I
question whether he had a stroke but his wife says he had a MRI to confirm
that.  Gradually within the 3 years he quietly lost his voice.  When I
called over the telephone from GA I could hear a whisper at times until
recently (last 6 months) I could hear nothing.  Six-8 months ago he said
very loudly "Twister, my dog!"  (meaning to leave his dog alone when his son
was teasing the dog).  When the PD doctor saw him recently he ask him to
speak his name.  John could only "lip" the words, but you could tell what
was being attempted.

3.  Four years ago he began having bowel/bladder accidents.  Putting him on
the "stool" helped if the right time was selected.  Now he is totally
"incontinent".

4.  Four years ago when he came to GA he could not hold a glass in his right
hand without spilling the drink from shaking.  We would put it in his left
hand and it would be better.  (The shaking was not as severe).  When he was
put on PD medication his shaking reduced considerable until he could eat ok
and drink ok.

5.  We tried to get him to use the typewriter to "speak" but he could not
hit the keys properly.  We tried to get him to write but he would start
normally but trail off into very tiny script that one could not read.

6.  I cannot get him to use his wheel chair properly because he "forgets"
how to wheel it.  He cannot use a walker...he falls over it.

7.  He walks only with assistance now....this has been going on since about
3-4 years ago.  He freezes when he walks with assistance.  I noticed when he
goes through the door or gets in close places he stops....freezes and cannot
go without prompting and assisting him.

8.  He drools now...has been doing this for a year or two.

9.  His mouth forms an "O" when he is having bad days.  On good days...or
good hours he holds his mouth normally- I thought he had good times when he
was "ON" with his medication and bad times when he was "OFF".

10.  When he is eating he would stuff his mouth and would not (could not)
swallow.  Finally he got aspirated and got pneumonia and had to go to the
emergency room.....they did a barium swallow on him and found he was
swallowing into his lungs - this was 3 months ago.

11.  They put a feeding tube into his stomach....they use a syringe type
feeding method.

12.  When he feels bad or is hurting or is emotional he make a loud yell or
noise.

13.  He appears to have some type of dementia.  However, when he went to the
PD DR he understood all his commands and almost stood up by himself.  He is
quiet playful....don't know if this is dementia or just himself.

14.  He does not dress himself.  He did feed himself before the feeding
tube.

15.  He has lost considerable weight  - did weigh 175 lbs but lost over 3
year period down to 117.  He is 6 feet 3 inches. (This is probably because
he did not swallow enough nourishment.)

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