>>> Posting number 056006
Date: Wed, 3 Feb 1999 09:45:17 -0500
From: janet paterson <[log in to unmask]>
Subject: Re: new member / reply to david thurston
hi david
you wrote:
>Hello list members,
>I was diagnosed with PD less than a month ago. I have a shuffle in my
>gait on the left side and some loss of dexterity in left hand with a
>very very slight tremor. I can live with these symptoms with minor
>adjustment to the way I live. The main symptomatic problem, for which I
>had sought medical attention in the first place, is a painful "frozen
>shoulder" with severly restricted range of movement of my left arm. I am
>told that this is a separate issue from PD, but that the latter's
>tendency to tighten muscles of neck and shoulder could be causing lack
>of response to physical therapy for the shoulder joint. Therefore
>starting PD medication, why not yet strictly necessary, could benefit
>this condition.
what kind of medico made your diagnosis - a movement disorder specialist?
i disagree with the idea that 'frozen shoulder' is separate from pd
i believe that it is a symptom of the muscle rigidity of pd
[i relate it to a permanent cramp]
and also believe that levodopa would ease it
been there done that
>I have not started medication yet because of another worry: In order to
>get a balanced understanding on what was happening, I sought a second
>opinion from another neurologist. Result: complete confusion. One
>recommends that I commence with dopamine agonist Pergolide, the other
>(who knows about the other's recommendation) favours levodopa in the
>form of Madopar. Both tell me it is my decision. These are two reputable
>medical men, when the time comes that I feel I am ready for the
>commitment, which course do I choose? Not so much that, how, as a
>layman, do I choose?
>Dave Thurston
go back to both, tell them of both opinions
and ask them to explain their reasoning to you
ask them how much experience [how many patients/at what stages]
they've had with pd
you can be a layman no longer
you have to become your own best advocate
this kind of disagreement and ignorance about pd will not stop here
pd ignorance among medicos can be fatal as we have seen on this list
the best kind of pd info in the world is here in our archives at:
<http://james.parkinsons.org.uk/>
as maintained by simon coles
janet
>>> Posting number 056013
Date: Wed, 3 Feb 1999 10:48:16 -0500
From: janet paterson <[log in to unmask]>
Subject: Re: new member / frozen shoulder
hi all
jeannette wrote, in part:
>...I, too, had a frozen and painful left shoulder and after
>unsuccessful cortizone shots by MD was referred to a neuro who
>after a process of elimination diagnosed possible PD and SINEMETCR
>therapy began and I returned to exercising and my shldr improved.
>Was the improvement from exercise or SINEMETCR or both? I don't
>know. Probably some of both....
i would venture a guess that it was the dopamine in the sinemet
if i am dopamine dis-advantaged
a repetitive movement like typing will become slower and slower
as the muscles involved get tighter and tighter
[which is what i relate to a muscle cramp]
i can't imagine trying to exercise an already cramped muscle
but i could be wrong here
in my case this tightness can only be relieved by meds:
when dopamine-enhanced,
i find that my tight muscles 'melt' and 'loosen' back to normal
janet
>>> Posting number 092447
Date: Fri, 16 Feb 2001 12:23:31 -0500
From: janet paterson <[log in to unmask]>
Subject: Re shoulder pain / Doctor David Grimes times two
hi all
At 13:23 2001/02/16 -0330, Anne Rutherford wrote:
>Many years ago when I was seeing one of the doctors at the
>movement disorder clinic in Toronto he mentioned a small
>study they had just finished They had asked clinic patients
>about shoulder problems such as pain and stiffness in the
>years before PD was diagnosed. They were very surprised at
>the number of PWP who had such problems.
>Since then I have asked many PWP if they had needed treatment
>for shoulder pain and a surprising number said yes.
>>I don't know if any such research has been written up in a
>medical journal. Perhaps one of the great hunters could do a
>search. Anne Rutherford
this is one of the best descriptions i have found:
-------------------------------------------------
Shoulder joint pain is a frequent problem in Parkinson's.
Commonly called "frozen shoulder", it includes pain, a limited range of
motion, and stiffness.
It occurs becasue of decreased arm swing and shoulder movement.
Frozen shoulder has been noted before the appearance of the main symptoms
of Parkinson's and it affects the body side first affected.
It is seen more in patients with slowness and stiffness rather than tremor,
and has been noted to clear after thalamotomy.
Initiation of anti-parkinsonian therapies (meds) will often improve this
problem.
Also, range of motion exercises, and moving the shoulder with heat (warm
shower), will help significantly.
Anti-inflammatory drugs such as aspirin or ibuprofen will help.
If shoulder pain becomes severe and persisitent, a referral to
physiotherapy or a rheumatologist is recommended.
Biceps dendonitis may also cause shoulder pain and may result from the
forward shoulder posture that some parkinsonians develop. The patient has
tenderness of the biceps tendon over the front of the shoulder.
The clavicle and shoulder are often injured in falls and very unpleasant
chronic shoulder region pain results. This is another good reason to avoid
falls.
-------------------------------------------------
excerpted from page 161 of:
"Parkinson's - One Step at a Time"
by
J.David Grimes MD FRCPC
and
David A.Grimes MD FRCPC
[IBSN 0-9694243-1-0]
First Edition Published 1966
Third Edition Published 1999
by
The Parkinson's Society of Ottawa-Carleton
1053 Carling Avenue
Ottawa, Ontario K1Y 4E9
Canada
-------------------------------------------------
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