Latest Treatments Help Control Symptoms of Parkinson's Disease
With support, a steely resolve to stay active and the latest treatment options available through the Parkinson’s and Movement Disorders Program of Froedtert & The Medical College of Wisconsin, patient Al Jones looks forward to the future.
Al Jones doesn’t mess around. Not when he’s refereeing youth soccer. He gears up as if he were getting ready for church: socks, shorts, and shirt are in impeccable order. And as a Parkinson’s patient, he times his medication so that it will reach its peak effectiveness when he hits the field. A retired software designer, Al has been refereeing for nearly 25 years. But once he was diagnosed with Parkinson’s disease, keeping active took on a whole new meaning.
“The more exercise you get,” Al noted, “the better you do.”
One of several motor system disorders, Parkinson’s disease is a slowly progressive degeneration of the nervous system stemming from the loss of dopamine-producing brain cells. According to the National Parkinson Foundation, more than one million people in the United States are affected, with 50,000 to 60,000 new cases diagnosed each year.
The primary symptoms are tremors, slowed movement, rigid muscles and impaired balance. People with the disease may find it difficult to initiate voluntary movements, their gait can be reduced to a shuffle or their feet may freeze to the floor, their posture may become stooped, and speech can become hesitant or slurred. Parkinson’s can also affect a person’s perception of their actions — they think they are walking normally when they are shuffling or do not realize they are speaking quietly. They may also experience non-motor symptoms including depression, anxiety, disturbance of sleep, cognitive changes, loss of sense of smell, and change in bowel and bladder function.
A Range of Treatment OptionsWhile there is no cure for the disease, the Parkinson’s and Movement Disorders Program of Froedtert & The Medical College of Wisconsin offers a comprehensive range of strategies to treat the symptoms. These include the latest and most effective medications, botulinum toxin injections to address painful muscle spasms, clinical trials of new treatments, and specialized physical, occupational and speech therapy, such as the Lee Silverman Voice Treatment®. This treatment is an intensive system of vocal exercises developed to help patients enhance the sound of their voices.
Because patients have emotional and psychological needs, team members include a neuropsychiatrist — a physician who assesses cognitive, emotional and behavioral problems — and neuropsychologists who assess cognitive problems, and with speech therapists, help patients relearn and/or compensate for impaired neurological functions.
In addition, Froedtert & The Medical College of Wisconsin have the only program in southeast Wisconsin to offer deep brain stimulation (DBS), a surgical procedure that, in selected patients, has shown dramatic results.
Al was 57 when he first noticed a tremor in his right arm. It was early 2005 and he’d lost his wife a few months before. He was understandably depressed, so he didn’t think much of it. But his doctor did, and sent him to a neurologist who diagnosed the disease and started Al on medication. Targeted at replenishing or mimicking dopamine — the neurotransmitter in the brain essential to a healthy nervous system — these medications reduce the rigid muscles and tremor associated with Parkinson’s, affording patients more fluid and coordinated movement. When scrupulously prescribed and attentively monitored, they can make a significant change in the Parkinson’s patient’s ability to pursue and enjoy daily activities.
Al is now under the expert care of Karen Blindauer, MD, Medical College of Wisconsin movement disorder neurologist and associate professor of neurology, and co-director of Froedtert & The Medical College’s Parkinson’s and Movement Disorders Program.
“Al is an amazingly upbeat and motivated patient who is a pleasure to work with,” Dr. Blindauer said. “I see him every four to six months to adjust his medications, and he keeps in touch with us if any questions or problems come up in the interim.”
The medications have improved his symptoms, with “less shaking, less of a problem with balance and freezing up,” Al said. Still, there are times when he struggles. When walking around the house, he regularly runs into furniture, he said, as the scars on his knees and shins attest.
Staying Active Helps SymptomsIn addition to following the medication regimen carefully, exercise is a key component to living well with Parkinson’s disease, Dr. Blindauer said, as well as eating a well-balanced diet, getting adequate sleep and keeping a positive attitude.
Luckily, running is easier than walking, so Al continues to referee. He also has made a determined effort to incorporate a slew of other activities into his life, all aimed at helping him manage his condition. He hits the treadmill at his local YMCA, as part of an exercise class. The classes, held twice weekly, are led by physical therapists experienced in working with individuals with Parkinson’s.
The combination of stretching for trunk mobility and walking on a treadmill for aerobic conditioning should improve or maintain the participants’ abilities to perform daily activities. He also rides a recumbent tricycle whenever he can, and once a week attends a dance class created especially for Parkinson’s patients with his dance partner and wife of five years, Thelma.
Created by Dee Schwaiger, owner of The Exercise Studio in Mequon, in collaboration with Movement Disorder Program physicians, the class, Parkinson Dance Project, has been instrumental in Al’s efforts to maintain mobility.
“His gait has changed since the program began in August 2009,” Schwaiger said. “He had a shuffling pattern and now he’s able to lift more through his hips and knees. The way he begins moving and the speed of his walk increased. Parkinson’s patients sometimes speak quietly and develop rigid muscles in the face, called facial masking, so we get them to sing and change their facial expressions.”
“Don’t get the impression the class is like an episode of ‘Dancing With the Stars,’ ” Thelma said. “It’s a bunch of us doing the best we can, trying not to trip over each other’s feet. And the facial exercises can look a little funny, but it’s been really beneficial for Al.”
Supporting Each OtherWhile remaining physically active is crucial to ensuring Al’s quality of life, so too is the camaraderie of the Young Onset Parkinson’s Support Group run by Froedtert & The Medical College. Founded and directed by Vicki Conte, coordinator of the Parkinson’s and Movement Disorders Program in the Department of Neurology, the group gathers once a month.
“I run several Parkinson’s support groups, but it seemed the needs of the young onset patients — those in their 30s, 40s and 50s — are different from other patients,” Conte said of the group’s inception. “Many of them still work and have difficulty functioning at their jobs, or are still raising children.”
Participants, including spouses, family members and friends, share their concerns with one another, and Conte brings in speakers to address such issues as memory, speech impairment and developing strategies for dealing with fatigue and pain. “The idea,” Conte said, “is that they can look around the room and see people in their age group that have the same diagnosis, but they’re all living their lives. I think that is very encouraging.”
Al is certainly living his life. He’s logged over 2,000 miles on his recumbent tricycle, and with Thelma, has become an unstoppable traveler. He went to Brewers baseball spring training in Arizona and refereed numerous games at a major international youth soccer tournament in Minnesota last year. The couple visited England, sailed from Spain to Florida, cruised the Panama Canal and traveled to the western United States.
With support, his resolve to stay active and healthy, and the latest treatment options available to him, Al looks toward the future with hope and the steady determination that has made him an excellent ref.
Patients may be referred to the Parkinson’s and Movement Disorders Program by their physician, or they may contact the program directly for evaluation and treatment at 414-805-3666 or 800-272-3666. To learn more, visit froedtert.com/movement, and check out the program team’s blog, “Moving Forward.”
Froedtert & The Medical College of Wisconsin Parkinson’s and Movement Disorders Program
|Physician specialists and team approach
Largest program in the state, with four movement disorder specialists, including board-certified and fellowship-trained neurologists
Because there is no definitive test (such as a blood test or imaging scan) to diagnose Parkinson’s disease and its symptoms are similar to other neurological conditions, evaluation and treatment by a physician with expertise in movement disorders is key.
Team includes physical, speech and occupational therapists, registered dietitian, neuropyschologists, clinical psychologist, psychiatrist, program manager and program coordinator
Program treats more than 2,000 patients per year|
|Local and national collaboration for individualized patient care
Weekly team meetings to review patient cases, including patients who may be candidates for the deep brain stimulation (DBS) procedure.
Physicians are members of national physician groups centered around the disease
Publish research and articles nationally|
|Research, clinical trials and breakthrough advancements
Only center to offer DBS in southeast Wisconsin
As the area’s only academic medical center, patients may have access to clinical trials.
Patients can consent to be part of the Movement Disorders Databank, which helps researchers measure the long-term effectiveness of different treatment options.
Latest research, such as an iPhone™ application that continuously records patients’ motion data to help physicians decide on treatment options|
|Comprehensive and appropriate treatment options and therapies
The latest treatment options including medication, botulinum toxin injections, collagen injections and DBS
Complementary therapies such as physical, occupational and speech therapy, wellness support, exercise, neuropsychiatry and neuropsychology and nutritional support
Annual symposium for patients and families, support groups and medically directed activities such as Parkinson’s exercise classes
Community education classes taught by physician specialists for patients and their families to learn more about the disease|
Source: Froedtert Today
Date: January 2011