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Dear Ray

There is something interesting that I would like to share with everyone. 

I have been treating Parkinson's patients over the past ten years. Three years ago, I moved to my present hospital, and made two interesting discoveries about Parkinson's. 

Firstly, I began to notice the non-motor side of Parkinson's - depression, anxiety, hallucination, sleep disorders, etc. I supposed that since I work in a private hospital nowadays (and no longer teach medical students), I have more time to spend with my patients, and thus discover all the non-motor symptoms that my patients have. Previously, I had always focused only on the movement disorder (i.e. the motor symptoms of Parkinson's).  

Secondly, there is a dramatic increase in the percentage of young-onset Parkinson's in my clinic. I really can't explain this phenomenon. I have patients whose symptoms started as early as 26. I also realize that the young-onset Parkinson's patients are a special subset of Parkinson's patients which needs a rather different management approach - they are really special. 

The take home message is that we are always at a learning curve, especially when dealing with Parkinson's. 

Dr Chew, Kuala Lumpur.

> Date: Tue, 7 Jul 2009 19:08:42 -0700
> From: [log in to unmask]
> Subject: Young-Onset PD more common now
> To: [log in to unmask]
> 
> Doctors Diagnosing 'Young Onset' Parkinson's More Often
> Token Creek Man Managing Symptoms
> UPDATED: 10:13 am CDT July 7, 2009
> 
> MADISON, Wis. -- Since the high-profile diagnosis of actor Michael J. Fox in 
> 1991 at age 30, Parkinson's disease has become well-known as a growing and 
> even somewhat common disease.
> 
> The disease, though, is not one confined to just the aging anymore. When 
> someone younger than 40 is diagnosed, it's considered "young onset" 
> Parkinson's disease. The brain degeneration that causes rigidity and tremors 
> can be even more challenging mentally for a younger patient.
> 
> However, as the disease becomes more common, some are taking it in stride.
> Bob Nasett was diagnosed 10 years ago at the age of 37, after watching his 
> father die of Parkinson's.
> 
> "When he got the disease, he was stiff and had slowness of movement," said 
> Nasett. "Turning a screwdriver, I could tell that movement was difficult for 
> me, and I was stiff getting out of chairs, and that's when I started to 
> realize that it was probably what I had."
> Nasett's brother was diagnosed just a year later, at the age of 31. They're 
> both one of a growing number being diagnosed at what seems like younger and 
> younger ages.
> 
> "I think we are seeing more and more because we're more aware of the 
> disorder," said Dr. Efrain Perez, director of the American Parkinson's 
> Disease Association. "In the old days, we started attributing that we were 
> getting older, so it's OK to have a little problem with balance, it's OK to 
> be slow, OK to be hunched. But nowadays, we realize that this is different 
> manifestations."
> 
> Get embed codeSave & ShareDr. Perez said stiffness or weakness in limbs can 
> be the first signs of the brain function failing. The major effort, 
> especially in younger patients, is to manage the symptoms, because they can 
> only be controlled for 25 to 30 years, said Perez.
> "The whole idea is maintaining the patient's ability to function," said 
> Perez. "There's no cure for Parkinson's disease, so you basically treat the 
> symptoms."
> Nasett has been dealing with symptoms now for 10 years. Despite the disease, 
> has managed to landscape the outside of his Token Creek home.
> 
> "The medications I'm on now today, I feel like I have better control," said 
> Nasett. "With my exercise program, and my desire to fight as long as I can, 
> I think I have better control today than I had before."
> 
> The treatment of Parkinson's now can include a number of different 
> medications that can control the symptoms. Some come with side-effects and 
> can affect each patient differently. Dr. Perez said that exercise is also 
> proving to help drastically with movement. Nasett is currently in a study at 
> the University of Wisconsin dealing with how exercise can help control 
> motion.
> 
> There is no cure, and there isn't a known cause for Parkinson's. Doctors 
> will diagnose 60,000 new cases this year alone -- most will be in people 
> over age 60.
> 
> According to the American Parkinson Disease Association, roughly 20 percent 
> of those diagnosed are under age 50, and half of those patients got that 
> diagnosis before age 40.
> 
> Rayilyn Brown
> Director AZNPF
> Arizona Chapter National Parkinson Foundation
> [log in to unmask] 
> 
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