DEAR DR. DONOHUE: I ask you for an honest opinion on a potential medical-legal matter. My 82-year-old father has been treated for Parkinson’s disease for almost two years. The medicine prescribed didn’t improve him one bit. I took him to a neurologist for a second opinion about a week ago. It turns out my father doesn’t have Parkinson’s disease; he has progressive supranuclear palsy. Could those two years of treatment for an erroneous diagnosis have made him worse off? I think they could have. — S.S.

ANSWER: As honest and impartial as I can be in this situation, which is so charged with emotion, I believe you’re wasting time and money seeking legal redress.

Progressive supranuclear palsy, or PSP, is a relatively newly described illness whose early signs and symptoms mimic those of Parkinson’s disease. It often takes a couple of years before a doctor arrives at the correct diagnosis. Furthermore, drugs used for Parkinson’s disease are often used for PSP, although they are not as effective in PSP. Your father’s prognosis would not have been materially altered if he had had the correct diagnosis from day one.

Difficulty in walking and a tendency to fall are early signs of PSP, and they are signs of Parkinson’s disease, too. Rigid muscles and slow movement are two other PSP signs, and they are Parkinson’s signs also. In time, however, a sign develops that’s unique to PSP. It is the inability of the patient to move his eyes downward and then upward. That inability increases the risk of falling and makes reading impossible. The patient cannot aim the eyes correctly to follow the next line of print.

I can tell you something that would benefit your dad much more than the time spent in seeking legal advice. Contact the Foundation for Progressive Supranuclear Palsy. The foundation will supply you with the latest information on it and will give you a better understanding of what’s going on and what to expect. The foundation’s phone number is 800-457-4777 and its Web site is www.psp.org.

Incidentally, the famous musician, writer and actor Dudley Moore, who starred in many films, including “10” and “Arthur,” was a victim of PSP.

DEAR DR. DONOHUE: My doctor is an older man and a good friend. I respect him greatly. He has been an excellent doctor for me and my wife.

The doctor harps on us to get a tetanus shot. We are both 67. It seems like something that should be done for younger people. Do you think this is necessary? — R.M.

ANSWER: It is necessary if you want to be protected against tetanus — lockjaw. It’s an illness that is pure torture.

In both Canada and the United States, older people are the ones most likely to be infected with the tetanus bacterium. That’s because protection from the vaccine lasts only 10 years. For that reason, recommendations are for 10-year booster shots of the vaccines until death.

I’m with your doctor.

DEAR DR. DONOHUE: My wife had great trouble in controlling her bladder. She would leak urine from time to time and found this most troubling. She read about Kegel exercises in your column and asked her doctor if she could try them. He encouraged her to do so. They have worked quite well. I have the same trouble, and wonder if they will work for a man. Will they? — J.S.

ANSWER: They work for men if the men have lost bladder control because of weak bladder support and weakness of the muscles that hold the bladder closed. The exercises require you to learn how to contract those muscles. You do so by stopping urination in midstream. Tighten those muscles 10 consecutive times when you are sitting, lying in bed or standing. Do so three times a day. Hold each contraction for 10 seconds. It takes at least a month before you notice a difference.

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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