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Barbara Smith wrote: >Ken and I attend a weekly support group for PWPs and their caregivers. >This week, the subject came up of what people do if there is an emergency >at home such as a fire or an earthquake, and you have to evacuate quickly. > We used to worry about how we could manage to get my husband to safety if there should be a fire or major earthquake. In the daytime, when he spends much of his time in his wheel chair, it would be hard enough for fast movement, but at night, when he must either have my help to get out of bed to get to the bathroom or else crawl on hands and knees, it seemed it would be nigh impossible. However, after a couple of recent incidents, that fear is much less worrisome. At 3:00 AM a couple of nights ago, at what is usually the nadir of Neal's ability to move, I was astonished to hear him leap out of bed and literally race to the bathroom. Turned out he had sneezed and precipitated a sudden copious nosebleed. (A year ago he had experienced a sudden nosebleed that refused to stop for hours and required a trip to the ER.) This event reminded me that we have two sources of dopamine in our bodies. In PD we focus on the brain and its dopamine as a neurotransmitter. But dopamine is also the source of epinephrine (adrenalin) and its source is the adrenal gland. This dopamine (which in turn is manufactured from the amino acid tyrosine) is used to fuel the fight or flight protective mechanism. In the morning we had a good laugh about his sudden athletic prowess, and about his spending the rest of the night with one of my hair clips pinched on his nose. Last winter we had another demonstration of adrenal dopamine at work when a water pipe burst at 2:00 AM and he was the only one who knew how to shut it off. It is truly amazing how fast he can movein an emergency, even out of a sound sleep. It may be somewhat comforting to realize that now, while he is not yet bedfast, he can move in an emergency. But we don't rely on that alone. One of the first things we did when we moved into our present home was to have a door to the outside cut into our bedroom. The other doors were too far away and we realized that in the event of a fire it would be very hard for two arthritic elderly people, one with advanced PD, to crawl out of a window on the double. Even if it is on the ground floor and only a couple of feet to drop. It boggles the mind to contemplate having to climb down one of those emergency rope ladders that one can toss out of an upstairs window in case of fire! If at all possible, the person with advanced PD should have a bedroom on the ground floor where they would not have the everpresent danger of stairs to cope with. Stairs can be a real hazard if the PWP is subject to episodes of nocturnal hallucinations and wandering. Medications can precipitate emergencies like that unexpectedly. I have a neighbor whose husband is bedfast with his PD. She has moved his hospital bed into their living room. There it is close to the door and the household activity, and he can watch the community life passing by on the street. He had felt isolated and depressed when his bed was at the back of their house. Martha Rohrer CG for Neal, 78/13 [log in to unmask] Barbara, you asked for permission to use responses for your support group. You are welcome use any any of this you find helpful.