"JIM"? - You wrote - >>> REINDELJIM <[log in to unmask]> 03/30/98 >>>I am 58 years old and was diagnosed with early Parkinsons in December 95. I turned down an offer to try drugs . . . <<< My symptoms include: . . . >>>Shaky right hand with some loss of motor control Arm and Leg shakiness when having sex Small, illegible handwriting Slowness on my feet, getting of car etc. Some difficulty with slurred speech Stiff gait and lack of natural arm swing when walking Treatments that I have tried or am trying are: I was able to retire and thus reduce stress and get more sleep A type of acupuncture which deals with teaching my body to more productively respond to allergens and toxins. A herb or vitamin called NADH [trade name ENADA] [Seemed to help but am presently not taking to see if it was upsetting my stomach] Nutrients prescribed by my acupuncturist. Chiropractic Treatments; specifically Towers and Atlas Wedge adjustments by a chiropractor trained by Dr,Versandalls [retired] Exercise regimen from Parkinsons Internet forum Saunas with Niacin for detoxification Vitamin E - 800 to 1600 I. U. /day It is hard to measure but I believe that I am slowly getting worse. Are any of the above treatments helping slow the rate of degeneration, how can I tell?<<< "JIM"? - Parkinson's disease is a progressive disorder which results in the gradual loss of dopamine nerve cells in the brain, leading to a parallel decline in dopamine levels. As of today, there is no medication manufactured for the treatment of the disease which claims to absolutely slow the progression of PD. Researchers have theorized that one or another of the available therapies has a "neuroprotective" quality. Selegiline and dopamine agonists have been used in laboratory studies to demonstrate neuroprotective effects, mainly because they are said to reduce the amount of levodopa required by a patient to manage PD symptoms. Dopamine metabolism results in the release of oxyradicals into the blood which interferes with body cell functions. Too many oxyradicals could lead to oxidant stress which in turn could injure or kill dopamine nerve cells. Therefore, the less levodopa the patient needs the less likelihood of stressing dopamine nerve cells with excessive oxyradicals, thereby prolonging their life. Researchers have been trying to pin down just what clinical, measurable physical signs exhibited by PWP could establish that there has been or continues to be a loss of dopamine nerve cells. The major symptoms are: tremor, rigidity and slowness. Doctors have created different types of objective tests to measure each condition and how it gets externally worse over time. These scales do not measure changes in nerve cells, no biological measuring device exists. In an effort to find a physical sign which predicted nerve cell loss, researchers using PET brain scanning techniques measured the existing loss of brain cells (using an injection of flurodopa - which metabolizes to dopamine) in PD patients. First, the researchers gave each PD patient a test to measure finger and hand dexterity. When the tests were compared with the PET scans it was shown that slowness of movement (bradykinesia) was the best clinical sign of PD that more directly reflects the rate of loss of brain cells. As a patient's bradykinesia worsens it is a marker for the rate of progression of the disease. When you say you are getting worse, which symptom(s) are most troublesome? If slowness of movement (more than tremor or rigidity) is most bothersome, then your rate of progression may be increasing. Whether any of your therapies (acupuncture, diet supplements or exercise) has a neuroprotective effect can only be guessed at based upon your subjective measurement of your symptoms. You may wish to try using the "Daily Symptom Evaluator" printed below, to help quantify any progression in your symptoms. Good luck. "Remember, whatever you do in life, 90% is half mental." - Yogi Berra Stephan 53/7 Daily Symptom Status Evaluator (DSSE) Introduction There has been, and still is, a need to maintain a personal journal that allows for a continual monitoring of Parkinson's Disease (PD) symptoms over time. There has been, and still is, a need for good communication among, between, and with Doctors, Patients, Caregivers, and other family members. There has been, and still is, an awareness of the uniqueness of each individual experiencing PD. The DSSE allows one to track the effects of medication administration, exercise, diet, etc by selecting two times of day for recording. It is suggested that the initial selected times be done with your Neurologist. Although this DSSE was developed for a senior age population, it certainly may be used for any age population. The layout of the form and it's specific symptoms maybe altered to fit any set of individual conditions that would benefit from status evaluation monitoring You will note that each weekly three hole sheet checklist form is designed for ease of recording, convenience, durability, and symptom variation. Listed on each sheet are general or most common symptoms. There are additional available spaces for individual characteristics that one may elect to use. There is another monthly recording form which allows for notation of medications: names, dosage, dates and prescribing Doctor. Additional spaces for exercise programs, diet or anything else you feel you would like to record . Coding There are four possible daily recording codes: + Symptom Improvement 0 No Change - Symptoms Getting Worse NA Not Applicable (at this time) Suggestions Here are some suggestions for ease of record keeping: 1. Use a standard three ring loose leaf binder 2. Use easily obtained page protectors for maintaining past weekly evaluations 3. Keep a glossary of personal symptoms and note change of meanings, if such occurs. Remember you are recording your own reactions, they are and will be your subjective reality. But they must be definable 4. If you are interested in further personal research, you might ask your long term caregiver to keep their own DSSE based on their defined perceptions Acknowledgements Many people participated in this project, People with Parkinson's Disease, Caregivers, Neurologists, Psychologists, Family members of PDers, Nurses and Folks Who Care. All were there to provide suggestions and evaluation for the design and consideration of each aspect of The Daily Symptom Status Evaluator. In the process we all learned from one another, we acquired new friends and we gave ourselves an extra bit of loving. We encourage you to consider this offering as a method that asks for your involvement and revision. BB2-97 + Symptom Improvement 0 No Change - Symptoms Getting Worse NA Not Applicable (at this time) Daily Symptom Status Evaluator (DSSE) Weekly Record Start Day 1 2 3 4 5 6 7 am pm am pm am pm am pm am pm am pm am pm Balance Bed or Chair Rising Constipation Depression Dressing Drooling Falling Facial Expression Freezing Hygiene Muscle Cramps Posture Rigidity Speech Swallowing Tremors Urination Walking Writing + Symptom Improvement 0 No Change - Symptoms Getting Worse NA Not Applicable (at this time) Daily Symptom Status Evaluator (DSSE) Weekly Record Start Day 1 2 3 4 5 6 7 am pm am pm am pm am pm am pm am pm am pm Daily Symptom Status Evaluator (DSSE) Medication, Exercise, Diet and ---- Month of Year Medicine Dosage Doctor Date Medicine Dosage Doctor Date Medicine Dosage Doctor Date Medicine Dosage Doctor Date Medicine Dosage Doctor Date Medicine Dosage Doctor Date Medicine Dosage Doctor Date Medicine Dosage Doctor Date Exercise Diet Other