>>>Kerry Baus wrote:
>>> Jay M. Baus <[log in to unmask]> 06/17/97
04:05pm >>>
>>>My dad is 52 years old and  was diagnosed with PD in
>>>January of 1995....he has tremor in his left arm and
>>>hand, shuffles a little when he walks, is slower overall.....
>>>He has a very high energy, stressful job as an attorney.
>>> What I am concerned about, is that lately, he has been
>>>telling me that he thinks he is losing his memory.  I have
>>>to wonder if his memory really is becoming damaged due
>>>to PD.  Does anyone know what PD does, if anything, to
>>>the memory of a person? To their mind? Is there
>>>anything I can tell my father to ease his worry?
>>>Thank you, Kerry<<<

Hi Kerry:

     I too was a litigation attorney when, at the age of 46, I
was diagnosed with Parkinson's.  The stress of litigation
required that I transfer to a more sedentary work group in the
firm.  My medication is Sinemet CR 50/200 three times a
day and Eldepryl 5 mg twice a day.  My tremor still appears
when the medication wears-off or when I am stressed (at
home or work).
     Over the past six years I have noticed a decline in my
ability to mentally process information on more than one
level.  The high-speed practice of law requires the "juggling"
of many tasks during a day and requires an abrupt "shift of
gears" when a client telephones with a crisis or the court
calls for your appearance.  I do not juggle or shift gears so
fast anymore.  However, when I am performing one task, I
can fully concentrate and reach my goal.
     Parkinson's disease may effect cognitive functioning.
Some reports have listed decline in cognitive function after
about 10 years of PD in at least 30% of patients.   Cognitive
changes (reduced ability to juggle or shift gears) leading to
memory loss or confusion can occur with or without
medications.
     Researchers sometimes refer to this symptom as a
patient's inability to concentrate and can be caused by a
combination of lack of adequate sleep, depression and
medication.  The medications for PD that are most likely to
worsen cognitive functions are anticholinergics such as
Cogentin (benztropine) and Artane (trihexyphenidyl).  These
drugs are usually prescribed to treat tremor.  Tricyclic
antidepressants (such as Buspar) may also effect memory,
and so can amantadine.
     Reduction of cognitive ability caused by medication
should be managed by a gradual decrease in dosage and
perhaps discontinuance of a particular med. Drs. usually
start with the anticholinergics, then Eldepryl, tricyclic
antidepressants, amantadine, then dopamine agonists
(Parlodel or Permax). . . . until the patient reports
improvement.
     First, Dad must consult with his neurologist (who should
be a Parkinson's specialist in Movement Disorders) to review
his medication.
     Second, Dad must slow down.  Less anxiety, less stress
equals less confusion and more cognitive function.
     Third, Dad should speak with other patients and learn
how they deal with this symptom.  It is not life or death, its
just a 'thing' which must be dealt with . . . like deteriorating
eyesight.
     Fourth, and most important, he should get a rubber
chicken and swing it over his head whenever he suffers a
memory lapse . . . laughter is VERY important!

Good luck!  and duck! here comes the chicken!

Stephan 52/6