After one visit to a Neurologist it seems we came away with what seems like almost a diagnosis of Early Parkinsons for my husband. We're really kind of shocked to have the Dr. say it's Parkinsons so quickly, especially since my husbands symptoms are so mild. I probably shouldn't be so shocked because it was what I have been guessing he had for about 6 months now, but hearing a doctor say it now has me having second thoughts. I though it would take quite a while for a diagnosis. By husband very subtly and gradually has been having changes in his gait -- shuffling his feet, reduced arm swing, holding his upper body stiffly when he walks. It also seems to me he has some bradykinesia. He seems to be moving more slowly and deliberately --sometimes seems like mechanically and stiffly -- just seemed like his movements were often less fluid than normal. He would complain of muscle aches and pains but he works a physical job outside in the cold, so that didn't seem that unusual. He doesn't have a resting tremor -- but has a mild tremors when using his hands -- runs in his family -- his sister is especially shaky-- that part seems much more like a benign essential tremor.
We first went to our primary with his symptoms and he did a bunch of bloodwork and an MRI and referred us to a Neurologist. The MRI reported some scattered subcortical hypointense foci which our primary didn't know if was relevent to his symptoms so he wanted us to go to a neuro. The neurologist pretty much said the "spots" on the MRI were nothing.
After the exam he said he felt my husband had very early Parkinson's but was doing a bunch of more tests. I gave him what the Primary had already done so as not to repear them. The Neuro is repeating the Lymes test primary did and added: ANA,Hepatitis, HIV(If I had known I would have told him was quite impossible, my husband and I were childhood sweethearts and both virgins when we married), Rheumatioid Factor, Angiotensin-Converting Enzyme, Cryoglobulin, Q1, B6, Copper, Zinc Ceruloplasmin, Transglutaminase (we have a son with celiac disease) and a 24 hour urine heavy metal screen. Then he ordered and MRA and a DAT scan. We do appreciate him being thorough but it seems like an awful lot of testing.
Even though he's doing a lot of other tests he sat down and explained Parkinson's to us as if he felt he had it. He gave us a book on it and told us to Neurology News website for info. Even though he felt my husband's symtpoms were not severe enought to be treated yet, he prescribed Azilect because he feels it might slow disease progression. My husband feels like he pretty much has a sure diagnosis of PD, because of the way the neuro presented it. Since I have my own journey of diagnsis of chronic disease, I don't feel it's quite a done deal yet. We were both too shocked to ask how sure he was if this was parkinson's.
I started thinking maybe I exaggerated my husband's symtpoms too much (I think I'm in a denial stage). So I did ask him what he saw on the exam to make him think it is Parkinson's. He said he felt some rachety rigidity and saw some bradykinesia but admitted it was still very mild. It just surprised me that he could see that so quickly in an exam. Although I have had people close to us ask if my husband is OK because he walks kind of stiffly, the bradykinesia is only really noticed by me and my kids. But I guess that is what neuros are trained to do. He is not an MDS but has been a neurologist for 30 years and has a lot of PD patients.
My husband does not want to take the Azilect because after researching it doesn't seem like there is a great deal of proof of it slowing progression. He also doesn't want the DAT scan -- he figures if he is not ready to take meds yet why expose himself to the radiation. He kind of wants to watch and wait. He agreed to all the other tests. I'm not sure what to do-- to call the neuro and say he doesnt' want the DAT scan yet? Any thoughts and advic would be appreciated.