The World Health Organization estimates that about 6.1 million people worldwide suffer from Parkinson’s. By 2040, that number could rise to about 13 million due to increasing life expectancy and improved therapeutic methods. Today, we will chat with one of our patients, Alexandra, and her therapist, Eva Krecisz, PT about her life with the disease.
Alexandra has been your patient for two years. When did you notice the first symptoms that could indicate Parkinson’s disease?
Eva: She came to us with severe back pain. During the first visit, I noticed she was walking hunched over and shuffling her feet. The symptoms could have indicated developing Parkinson’s, but given Alexandra’s back problems and age, they didn’t have to at all. What’s more, she didn’t exhibit the distinctive hand tremor that comes first in the vast majority of cases.
Is it easy to miss the first symptoms of the disease?
Eva: Yes, very easily, especially when a patient does not have the most common symptoms. Parkinson’s takes a long time to develop, with either no signs at first or with symptoms that are so mild, we can miss them. Only a significant decrease of dopamine production in the brain after multiple years causes the typical hand tremor. Other symptoms include the lack of facial expressions, problems with balancing one of the hands while walking, or the characteristic “shuffling” when the patient hardly lifts his feet off the ground. When Alexandra returned for treatment with a different problem in October of that year, in addition to worsening postural issues, I noticed mild bradykinesia, which is a slowing of movements that often occurs in the early stage of Parkinson’s disease. I suggested that she should bring this to the attention of her PCP at her next visit.
Alexandra, have you noticed any symptoms back then?
Alexandra: I noticed that I had more trouble moving around. I also got tired faster, and my joints hurt, but I thought it was because of my age. I fell backward once and I got a decent bump on my head, but I was sure that the reason was my issues with my knees. Since I didn’t develop typical symptoms, it didn’t cross my mind that it could be Parkinson’s. During one of my physical therapy sessions at P D Rehab my therapist Kris asked me to write something on a piece of paper. I started writing as I always do, in big letters, but they got smaller and smaller. Kris told me that this is a textbook symptom of Parkinson’s disease and it absolutely cannot be ignored.
Eva, what is the problem with writing?
Eva: One of the characteristic symptoms of Parkinson’s is the so-called micrographia – patients write in a very small font. They start writing a line normally, and further on letters get so small that they become unreadable, the direction of letter positioning changes frequently, and they have trouble writing letters or whole words correctly. When we saw how Alexandra writes, we did not doubt that she should see a specialist.
Alexandra, what happened next?
Alexandra: I made an appointment with a neurologist at Northwestern Hospital. I was sitting in the waiting room with another patient when the doctor got out of his office. He had watched me closely when I rose from the chair and walked to his office. I was shocked when he told me that watching my movements and the lack of facial expressions was enough for him to diagnose Parkinson’s. He ordered me to perform some tests, which only confirmed his words. I have prescribed medications, and soon after that, I flew to Poland for two months to visit my family. It was there that I felt the illness manifested. I was feeling dizzy, and weak, and fell twice.
How are you feeling now?
Alexandra: Quite well because I exercise a lot. I have long noticed that the more physically active I am, the better I feel. It’s easier for me to get up from a chair or walk up the stairs. I come to P D Rehab three times a week for rehabilitation, exercise at home, and try to walk as much as possible. I am bothered by occasional dizziness at night and whole-body tremors. I have balance problems and I occasionally forget things.
Eva, are memory problems also one of the symptoms of Parkinson’s?
Eva: Yes, and they can occur with varying degrees of severity, but not everyone diagnosed with Parkinson’s will also have dementia. I’ve had a patient running his own business many years after diagnosis, managing logistics and finances.
What would you advise people who are suffering from Parkinson’s?
Eva: Just as Alexandra said – movement is the most important thing! Therefore, at every stage of the disease, we should be active as much as possible. Specialized physical therapy is crucial because we teach proper and safe exercises for coping with everyday life. Plus walking, dancing, yoga – anything that makes us happy and keeps us in shape.