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Parkinson's stages


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#1 spouseandmore

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Posted 18 March 2011 - 12:37 PM

I am wondering what the various stages are to Parkinson's and do they overlap at all. My husband had an allergic reaction to Phenergan and then was given Thorazine when he was vomiting with Pneumonia in 2000. Within a couple of weeks, he could no longer walk, and had what the neuropsycologist referred to as a 10% working memory (short term memory was bad) however, he could remember everything he did before he got sick. Now he has reached the point where he has fallen 4 times in the last two months once splitting open the skin on his head and requiring staples. (He refuses to use his wheelchair) Is in constant pain and his long term memory is starting to fade. The other day he was telling me things about his ex wife that she did that bothered him, but the things he was talking about are things I did and we have been married for 13 years. When we were at the neurologist the other day, he is answering the questions, but showed no expression and kept his eyes closed during most of the visit. Now he has started to cry a lot in the last week for no reason. He is currently taking Carbo/L-Dopa (just increased to BID), Loritab-PRN, Morphin-DID, clonazepam (taken for years now) 2 mg. 7 times a day (that doesn't stop all the tremors though), Atenolol, Captipril, and Omega 3. He has been sleeping a whole lot more in the last couple of weeks and gets frustrated, yells, and angry more often than yrs earlier. He has said he is ready for God to take him home.
Just wondering if he could be crossing from a stage and into another and the stages are overlapping. I am trying to figure out what stage he is in exactly while the doctors are still debating about what exactly is causing his other symptoms....they know he has Neuropathy and the nerves in his right leg are dead, while the ones in his left leg and arms are dying. Can you give me any ideas?
Thanks million.

Everything happens in life for a reason.....


#2 Dr. Okun

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Posted 19 March 2011 - 09:13 AM

Reading your post I would strongly encourage you to get re-evaluated immediately at an advanced center for Movement Disorders or Parkinson's disease.

There are many issues that must be addressed.

Many times severe depression can appear to be dementia and this needs to be addressed.

Additionally all the pain meds and the clonazepam may be falsely making him look "demented."

His medications should be reviewed.

Medicines like phenergan and metoclopramide can unmask pre-existing PD or alternatively make patients look like they have PD. We recommend meds like zofran for nausea (Zofran does not block dopamine). If the symptoms don't improve after a few months you may be dealing with regular PD that was unmasked.

In cases of cognitive and behavioral issues we manage medications (taking away or limiting pain meds and benzos), treat depression aggressively, and we often get a brain MRI as well as check some labs (B12, thyroid, syphilis, etc.).

Finally, if he has PD then the sinemet is likely underdosed and the docs may need to work up to much larger doses given more frequently along with an antidepressant drug(s). If he hallucinates or has behavioral issues while the motor features improve the doc may need to add clozaril and seroquel.

Finally, daily exercise and lots of stimulation along with physical and occupational therapy can help turn things around.

I would suggest you print this advice and go through it with your doc(s) and seek a center with a lot of experience to help guide your local center.

Good luck and keep writing.
Michael S. Okun, M.D.
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips

#3 spouseandmore

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Posted 25 March 2011 - 10:59 AM

My husband doctor called last night to tell me that his MRI indicated a very small area in the left side of his brain indicating that he had a stroke sometime between last June and last month. He is also ordering a holter monitor, MRA, echogram of his arteries, and sending him to an Endocrinologist (? spelling) for the diabetes, and Ortho doctor for the pain in his hip. He also said that the MRI showed arthritis in C3 and C4 of his neck that is pressing on the spinal cord.
Just wanted to update you as to the latest.

Everything happens in life for a reason.....


#4 Dr. Okun

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Posted 25 March 2011 - 12:38 PM

Thanks for the update. Hopefully it will all workout. You may want to print the recommendations above and bring to your doc for discussion.
Michael S. Okun, M.D.
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips

#5 spouseandmore

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Posted 04 September 2011 - 02:32 PM

Thanks for the update. Hopefully it will all workout. You may want to print the recommendations above and bring to your doc for discussion.


A lot has changed since I last wrote. The tremors never stop, he now talks to his mother and his aunt who have both been dead for over 20 years. He says he dreams of going places with them while he is asleep. He is constantly yelling at me and blaming me for things, even if he is the one that did it. He can't remember things from even 10 minutes ago now. His doc increased his carbo/ levo to 4 times a day and that still hasn't helped. He is on anti-depressants, but those aren't helping. He keeps trying to self medicate with the pain meds, taking lortabs, morphine, and muscle relaxers when I am not looking, so I locked them up. Now that he isn't popping them like candy, he started in with his other meds, so I had to lock them up also.
He is combative, (dementia) i assume, and keeps saying, "Either give me a pain pill or synide". I don't give him the pain med, but I tell him I did, and he is at the point memory wise where he believes me. He says he is ready to "just get it over with" and just wants to die, but I keep reminding him that he will be here for a long time and that I love him. He has finally given up sleeping in the same bed with me and got a hospital bed.

Everything happens in life for a reason.....


#6 Dr. Okun

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Posted 04 September 2011 - 05:54 PM

I am so sorry to hear about this evolution.

I recommend taking him back to the doctor and also considering a second opinion for diagnosis and treatment options.

Pain meds and also muscle relaxers can make things worse, and in some cases more carbidopa/levodopa is not the answer.

This is a very complex situation and I hope you find some relief soon.
Michael S. Okun, M.D.
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips

#7 spouseandmore

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Posted 22 November 2011 - 06:35 PM

UPDATE:
My how things can change and sometimes so quickly. My husband is now at the point that he sleeps about 23 hours a day, does not want to eat (sometimes I can get him to eat cereal or tapioca, but that is it), drinks a lot of nutrition drinks because I make him, has "ACCIDENTS" with his bowels on a daily basis, and says he is ready to home to his momma. He also tells me daily that he will be watching over me and our 4 yr. old from Heaven. He sees and talks to his mother and aunt who have been dead since the 80's. He says, " I am not afraid to die, I just don't want to leave you here alone", but I know you have lots of friends who will help you out.
I am suppose to take a trip out of state the first week in Jan. and he keeps telling me he will die while I am gone, but he wants me and our daughter to go anyway as this is her big chance to do something very special that she otherwise would not get to do.
His tremors have died down some and they are not constant like they were, but I figure it is because he sleeps so much....sometimes when he is asleep, his oxygen concentrator just quits pumping air (I am told that it pumps the air as he is breathing). I know he quits breathing some even though he is on O2 and CPAP. He actually looked up the stages of Parkinsons one day and when I got home proceeded to tell me, "I am in the 5th stage now".."so I will be dying soon".
Just thought perhaps an update was in order. Thanks for your help in the past...if you have any comments, please let me know.

Everything happens in life for a reason.....


#8 Dr. Okun

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Posted 23 November 2011 - 08:31 AM

My prayers are with you, but be sure you have a psychiatrist look at him as he sounds articulate and depressed from the description. Depression is very treatable, and in some severe cases even electroconvulsive therapy is very effective in PD. Medications, and behavioral interventions can also be helpful.
Michael S. Okun, M.D.
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips




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