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 dcv¢iopracnls 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
