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January 10, 1997     Cape Gazette
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January 10, 1997

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32 - CAPE GAZETTE, Friday, Parkinson's 0cus on Health Continued from page 26 tion of the disease may include a slowed rate of speech and an altered tone of voice. The voice may become softer and monotone. "They're harder to understand, but that's just in severely advanced cases," said Mangum. "Otherwise it is rare." Also a problem in severe cases is difficulty swallowing. Patients are at risk of aspirating and develop- ing pneumonia, but because of modern med- icines available to treat those secondary symp- toms, that complication is less commonly seen than it was years ago. Ordinarily, the onset of Parkinson's disease strikes those between the ages of 58 and 60 years, and more men than women are afflicted with the illness. A small proportion of the popu- lation under age 58 is likely to be diagnosed with the disease, and occasionally children and teens will develop the symptoms. "In most cases, it's sporadic" - it crops up on its own. There are some family groups that have Parkinson's disease, but there is no proven genetic link at this time," said Mangum. "There may be genetic and environmental influences, but MANGUM January 10 - January 16, 1997 nobody really knows." The progression of the disease varies considerably from patient to pationt, Mangum said that some people rapidly deteriorate with a two- to four-year period, but others might go for 15 to 20 years without serious difficulties and problems. "Most commonly, it's some- where in between that time frame," said Mangum. Parkinson's disease is not usu- ally painful, and it does not suddenly develop full force in a patient. The disease generally begins at a relatively slow pace. "Most commonly, people start noticing an intermittent hand tremor on one side," said Mangum. Some tasks may take longer to accomplish, and fine motor tasks become quite chal- lenging. "Initially, it doesn't get in the way," she said. That stage of the disease often lasts from six months to two years. "Friends and family members will start commenting on it more, and then the people will ask a doc- tor about it," said Mangum. "Some people will wait until the point where it becomes socially inhibiting before they'll seek medical care for it, which is a shame because it is so treatable - especially in the early stages." Parkinson's disease itself is not fatal. Years ago, said Mangum, people would die from seddBdary complications such as pneumonia. Modem dcviopracnls in twat- ment for the disease now allows many patients to not only avoid or easily treat secondary complica- tions. Drug treatment allows many patients to reduce the impact of the primary symptoms and condi- tions associated with disease. Sinemet is a drug containing the chemical L-dopa, which the brain changes to dopamine. Mangum said the drug works similarly to the way in which insulin works for a diabetic: the pancreas fails to produce adequate insulin, so injected insulin pro- vides the body with that chemical which it needs for balance. Similarly, when the brain begins to fail producing dopamine, taking a Sinemet pill with L-dopa in it provides the body with more balance of that chemical. Many patients have responded very well to the drug therapy, regaining some of the motor skills lost as a result of the disease. "It's usually very effective in treating tremors and slowness in movement," said Mangum. "It's less effective in treating stiff- ness." Along with Sinemet, a new drug called Selegiline is being used to treat the disease, she said. It, too, is dispensed in pill form, and it is designed to slow down the rate of the loss ofdopamine. Generally, it is used in tl earl stages of the disease, said Mangum, and it can be used in conjunction with Sinemet. Mangum said no research to date indicates that any particular diet will directly affect the dis- case's progression. However, a high protein diet has been shown to interfere with the effectiveness of the L-dopa medication. Other treatments for Parkin- son's disease include surgery and a controversial option involving neuro-transplantation. Mangum said that there appears to be a resurgence of treating patients by cutting some of the connections in the brain area where dopamine is produced. The theory behind the surgery, she said, is that it helps reduce some of the tremors and rigidity; however, it is generally performed only for cases where medication has failed to work effectively. Mangum said there is also some research into implanting fetal cells into the brain, but it remains a controversial concept. Mangum said exercise can help Parkinson's disease patients feel more comfortable. Occasionally, she said, patients will get physical therapy. "Usually, routine exercises are recommended to maintain good joint mobility," she explained, which helps patients keep more limber and less restrained by the stiffness causedby the disease. Joint surgery seminar set for Jan. 30 A free Focus on Health Seminar "Joint Replacement" will be held at the Lewes Library from 7 to 8 p.m., featuring Beebe Medical Center orthopedic surgeon Wil- son Choy. Please call 645-3332 to regis- ter. r i Bag Some Shoe BARGAINS Men's Women's Kid's Shoes & Boots 20-40% OFF Styles at our Semi ,Annual SAJ,E Now In ProgressH momsStl00S 998 Kings Hwy., Lewes 645-9431 Southern Delaware Health Partnership to meet at Milford Memorial January 29 Milford Memorial Hospital will host the inaugural meeting of the Southern Delaware Health Part- nership on Wednesday, Jan. 29 at 6:30 p.m. in the Milford Public Library, located at 11 S.E. Front Street. A community based coalition of the Greater Milford and Sussex County regions, the Partnership Will focus on the improvement of community health status. Over the past several month. approximately 50 focus groups were conducted with the participa- tion of more than 250 community members. The objective was to identify community trends, themes and opportunities for collaboration with health status improvement. The results of the preliminary analysis and the formation of three Task Groups will be announced at the upcoming meeting. Members of the community are encouraged to attend this informative meeting. Call (302) 424 -5615 for more information. Briefly LPN refresher course to be offered at Del Tech The Nursing Department at Delaware Technical & Communi- ty College, Owens Campus, is currently registering students for the LPN Refresher Course which begins Feb. 25. This course is designed for the licensed practical nurse who has not been in active practice recent- ly and who wishes to update theo- retical knowledge and clinical skills so that he/she may return to clinical practice. Priority will be given to those practical nurses who are required by Delaware law tc attend an approved refresher program for relicensure. According to the Delaware Board of Nursing Rules and Reg- ulations, the individual must be a graduate of a state-approved pro- gram. Interested persons should con- tact Judith S. Caldwell, Nursing Technology chairman, at 856- 1614. Tn= O.UT.ONA00 I n NOTE: ..... :QETA:i00: CER:::iSCEENIr'IG, Coastal Psychiatric Group__ w Providing comprehensive mental health services to communities throughout Southern Delaware Outpatient Treatment- Mood and Anxiety Disorders MaritalCouples Therapy- Woman's Issues Group Therapy for Anxiety Disorders, Incest Survivors, and Borderline Personality Individual Adult and Adolescent Psychotherapy Robert T. Allen, M.D. - Toni Ballas-Rowe, LCSW - Melody Benson, M.D. Jose R. Capiro, M.D. - Carol Culp, Ph.D. - Terri Pierce, LCSW 1532 Savannah Road, Suite B, Lewes, DE 19958 (302) 644-2770 for Appointments