The C word

Among the few benefits there was to having Parkinson's Disease had been the theory that along with the diagnosis comes a reduction in the likelihood of getting most cancers. Recently, however, various studies have been poking holes in that belief. While the debate still goes on as to whether Parkinson's helps or hurt certain cancer formations all conclude that Parkinson's Disease patients have a MUCH higher rate of skin cancer than the 'normal' population. From double to nearly four times more likely depending on who you listen to.  So after conversing with my neurologist, her recommendation was to get an examination by a dermatologist and repeat them yearly.

With that knowledge, I immediately called the dermatologist office to set up the appointment - Ugh, six-week wait.  If you've read some of my earlier posts you would know that I don't wait very well.  If there is something that needs to be checked I want to do it now.
The wait went quicker than expected with Christmas and New Years acting as a nice diversion and now it was appointment day.  The exam was pretty quick also. Under a magnifying glass, the dermatologist examined anything that looked other than what could be called normal skin.  She called out what she saw to a waiting nurse that diligently clicked away on the computer capturing all my abnormalities. The dermatologist did reassure me that even though some of the words she used sounded a bit frightening what she is seeing are just normal things one finds on the skin of a 50+ year-old person.  That is until....she gets to the back of my neck.  "Hmmm", she says, "tell me about his mole on the back of your neck."  Not exactly the words you want to hear when they are examining you for skin cancer. So a quick poke for a sample (actually a biopsy but the word sounds much more ominous than sample) and off to the lab it goes.  7-10 days until diagnosis. Great, more waiting.  As I said, I don't do that very well.

The information is somewhat muddled out there on whether having Parkinson's Disease helps or hurts you with the rate of getting cancer.  Some studies show a reduction of some types of cancer while others show an increase in others.  Overall though, the message is pretty clear: Skin Cancers, especially melanomas are increased with having Parkinson's.  So to my Parkie friends out there, please go and get yourself examined.  It's quick and painless and if they find something early on it is 100% treatable.


Good Article here- describing the connection between Parkinson's and skin cancer

An article describing reduced risk of some cancers (non-skin type) - here

Recent study claiming higher incidence of 16 types of Cancer in Parkinson's patients here

Excellent guide here for dealing with melanoma's  - 

The weirdness that is Parkinson's Disease

     While researching the symptoms of Parkinson's Disease for the last two blogs, I started to think about all the weird maladies I was experiencing in the years leading up to my diagnosis. Some were more strange than others and none, even now, seem related to Parkinson's.  However, I wonder how many could have been caused by my brain trying to cope with the slow closure of the dopamine tap. 

     All of these symptoms would come and go.  Some lasting for weeks or months while others lasted for years before going away.  That's one reason I am having a problem figuring out if any of this is related.  I would think once you have a certain symptom you would continue to have it.  Maybe not all the time, but it should pop back in now and again wouldn't you think?  
     I'll start with the weirdest first and I guess it could be classified under vivid dreams.  About 10 years before I was diagnosed, I was terrorized by dreams about spiders.  Not a dream where something was happening and spiders were in there too.  No, these were dreams of me lying in bed and seeing spiders dropping down from the ceiling onto the covers.  I would jump out of bed throw the covers back and flick the light on.  My heart would feel like it was coming out of my chest as I agonized over where they went.  Surprisingly, this would wake my wife up every time. She would calmly tell me it was just a dream and go back to sleep, but it was so real I'd be up for a while.  This would repeat a couple times a month for about a year and then they thankfully stopped.  I remember telling my Mom about this and she said dreams about spiders aren't a good sign.  They usually mean something bad is about to happen.  Once again, Mom you were right!
If that wasn't strange enough, keep reading, I only get weirder from here.
    A lot of research is coming out about how Parkinson's affects the eyes.  This one I haven't shared with anyone before now because it is so strange.  Picture yourself driving down a country road and everything seems fine as you stare straight ahead.  Then suddenly, everything in your field of view rotates to the right about 30 degrees. You were looking straight down the road before but now you are looking at the left shoulder of the road.  Keep in mind you never moved your eyes or your head.  Its just that the spot you were focused on has been picked up and moved. It would be like you are staring at this blog then suddenly the scene rotates and you're staring at your left arm yet you never moved anything.  It's only happened twice, thankfully, and I have no idea if it's related to Parkinson's, but it would be interesting to find out. 
     There were more strange things happening to me prior to diagnosis that to this day remain unexplainable. I'll share just a couple more at the risk that by confessing any additional publically the men with the white suits may come and toss me into the back of a rubber truck. (Yes, that was a MASH reference),   I don't know if these symptoms will ever be linked to Parkinsons or anything else for that matter, but they happened.  Things like sweating profusely but just under one arm.  Luckily for me (and anyone that stood near me) this only lasted a short time. Also, allergies that have seemed to have come and gone are another one.
     I should retitle the main blog "The weirdness that is Parkinson's". Or, maybe this isn't related at all and I'm just a little batty, but seems odd that all these symptoms would attack an otherwise healthy person.
  
P.S. Four shopping days left till Christmas.  Remember when Sundays weren't counted in the shopping days calculation?

Parkinson's symptoms - 70 and counting Part 2

Part 2 of my look into the symptoms of Parkinson's Disease.  If you know of any I missed please forward information and I will look into adding it.  This list contains items I've found to be caused by Parkinson's, or at least according to the attached link for each one.  By no means is it meant to be exhaustive or a diagnosis.  
I was really amazed by the number of vision problems that Parkinson's can cause.  I had no idea of the association but will definitely bring the list with me next time I visit the ophthalmologist.



MOTOR

We begin with the four tenets of Parkinson's Disease:

• Tremor
• Bradykinesia - slowness -
• Rigidity
• Postural Instability

Musculoskeletal

• Micrographia - my writing is nearly illegible now.  Makes writing out cards nearly impossible
• Dystonia - a disease in itself however Parkinson's and especially Parkinson's meds exacerbate the condition
• Myoclonus-a quick, involuntary muscle jerk. I get these occasionally and they can happen anywhere in my body.  I've had them most while drifting off to sleep. 

Postural deformities

•    Stooped posture -Camptocormia - typically seen in later stages
•    Kyphosis - exaggerated rounding of the back
•    Scoliosis - twisting of the spine

• Difficulty turning in bed
•      difficulty standing from chair/car
• Dysphagia - difficulty swallowing
• 
  
• Sialorrhea -increased saliva production leading to drooling - I've seen this placed in the non-motor group but it seemed a better fit for my list here.
• Hypomimia (masked facial)

Gait

• Shuffling, short-stepped, drag
• Freezing - one of the many symptoms that I am least looking forward to and probably most worried about
• Festination of gait
• Decreased arm swing
• Turning en bloc rather than the usual twisting of the neck and trunk and pivoting on the toes, PD patients keep their neck and trunk rigid, requiring multiple small steps to accomplish a turn.

Vision

• Impaired contrast sensitivity - ability of the visual system to distinguish bright and dim components of a static image
• Colors appear duller loss of retinal cells that rely on dopamine to process color
• Hypometric saccades - mis-targeted eye movements
• Impaired vestibuloocular reflex - visual acuity lost when moving such as walking
• Lid apraxia - inability to open the eyes voluntarily.
• Glabellar reflex - tap on forehead causes continued blinking
• Decreased blink rate - which causes dry eye
• Irritation of the eye surface - from reduced blink rate
• Alteration in the tear film - reduction of tears
• Visual hallucinations
• Decreased eye convergence - eyes moving together like while reading
• Blepharospasm - excessive blinking
• Abnormalities in ocular pursuit, ocular fixation and saccadic movements Limitations in the upward gaze
• Blurred vision
• Diplopia (double vision), produced by a reduced eye convergence

Speech
Speech disturbances (hypokinetic dysarthria)
Hypophonia: soft speech.
Monotonic speech: Speech quality tends to be soft, hoarse, and monotonous
Festinating speech: excessively rapid, soft, poorly-intelligible speech.

Urinary
difficulty holding - I hate that sudden 'attack' of I have to go NOW!
difficulty emptying


Other Akathisia: an unpleasant desire to move. restless leg?