An upbeat look at parkinson’s disease

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DEAR DR. DONOHUE: Will you please write about Parkinson’s disease? And will you make this upbeat in some manner? — R.M.

ANSWER: It’s not hard to be upbeat about Parkinson’s disease. Yes, it’s a major problem, but there are many medicines that can control it. Lots of people lead active lives in spite of their Parkinson’s diagnosis.

The major signs of Parkinson’s disease are muscle rigidity, slow movements, a resting tremor and difficulty with balance, which accounts for the frequent falls Parkinson’s patients take. Muscle rigidity indicates that fluid movement is problematic. Muscles work like they are ratchets, moving stiffly from one position to the next. A resting tremor is one that comes on when the hands are not active. The tremor is pronounced when the hands are resting on a table or in the lap.

What lies at the bottom of Parkinson’s disease is a depletion of dopamine, a brain chemical involved in the transfer of information in the parts of the brain that control movement.

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Seldom thought of but deserving to be included in Parkinson’s treatment are physical therapists, who can teach a patient how to stay active, and occupational therapists, who can devise ways for patients to assist themselves in performing activities made difficult by this illness.

Another upbeat aspect of Parkinson’s disease is its usually slow progression.

Medicines often can restore dopamine to the brain. Levodopa is one such medicine, and it has been used for this condition for many decades. There are many more medicines that are prescribed as conditions call for them. If medicines fail to control symptoms, then deep-brain stimulation is a possibility for some. Wires are implanted in the movement centers of the brain, and electrical signals are transmitted through the wires from a gadget that looks much like a heart pacemaker.

DEAR DR. DONOHUE: My son had severe chickenpox when he was 7. He is now 52. I hear a lot about shingles, which is very painful. I have heard that there is a shot to prevent shingles. I would like to know its side effects. I do not know anyone who has taken the shot. — E.W.

ANSWER: The association you made between chickenpox and shingles is valid. Once infected with the chickenpox virus, a person always stays infected with it. Later in life, usually at older ages, the virus comes out of its cell home and travels down nerves to reach the skin, causing a shingles outbreak. The severity of chickenpox has little to no bearing on later shingles. Upward of 95 percent of adults are infected with the virus, and many of them don’t remember ever having had chickenpox, so mild was the illness for them.

The shot for shingles prevention is a vaccine called Zostavax. It boosts a person’s immunity against the virus. A boosted immunity against the chickenpox virus keeps it within cells and prevents shingles from occurring. All who are 60 or older are encouraged to get the vaccine. The most common side effects are pain and redness where the shot was given and a headache. Neither is long-lasting.

DEAR DR. DONOHUE: My question is in the realm of sexuality. I readily understand married people continuing their sexual activity and desires even in their senior years, but the surfacing of sexual feelings after many years of singleness and no companion eludes me. That is, it eluded me until I met someone who came into my life. After getting to know him, I had to acknowledge to myself the sexual attraction.

This causes me much distress, as I am a female over 70 who can pass for 60. I lead a busy life and have many friends, both male and female. I am completely taken by surprise by my feelings. The surfacing of those dormant sexual desires has left me questioning whether this is normal. Should my feelings cause me to feel guilty and ashamed? — B.

ANSWER: In no way should they cause guilt or shame. Those are normal human feelings that can persist until a person draws his or her last breath. They indicate a healthy body and mind.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www .rbmamall.com.

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