Parkinson’s disease is difficult to diagnose in the early stages. Doctors remind that in addition to the well-known “trembling hands”, unsteady gait is also one of the important precursors. If you are prone to falling while walking, don’t think it is simply aging or orthopedic problems. It is recommended to go to the hospital as soon as possible for further examination.
(Taipei News) As the elderly population increases, unstable gait has become an elderly problem that cannot be ignored. Neurologist Dr. Lin Dianyou pointed out that unstable gait in the elderly may be caused by many factors, one of which is neurodegenerative diseases of the brain. Parkinson’s disease is one of them, and it is the second most prevalent neurodegenerative disease of the brain. disease, second only to dementia.
Lin Dianyou said that the reasons why the elderly are prone to falls are quite complex and can be simply divided into “nervous system diseases”, “cardiovascular diseases”, “eye diseases”, “musculoskeletal diseases”, “psychological diseases” and “physical exhaustion”, etc. 6 Among them, there are many factors that can cause unstable gait, including neurological diseases, and Parkinson’s disease is one of them.
“Many people think that Parkinson’s disease will definitely have ‘trembling hands and feet’ symptoms. In fact, this is a wrong idea.”
Lin Dianyou shared a case in the clinic. There was a 56-year-old female patient who had undergone multiple spinal surgeries due to unstable gait. As a result, she was unable to walk and had to rely on a wheelchair. Therefore, her family brought her to the hospital for examination and wanted to apply for a physical and mental disability identification and certification. Disability diagnosis certificate.
Lin Dianyou opened the X-ray and found that the patient’s spine was covered with steel nails. He wondered why such a relatively young, middle-aged woman could still not walk after undergoing so many surgeries. After questioning her condition in detail, she found that in addition to being unable to walk, she also had symptoms such as stiffness and soreness all over her body, inability to lie down or stand up, and her right foot was shaking due to weakness.
Based on the symptoms and medical history of the case, Lin Dianyou suspected that in addition to spinal problems, the female patient might also have Parkinson’s disease, further arranging dopamine neurons in the brain.Nuclear medical imaging examination confirmed that she had Parkinson’s disease.
The most common age is 50 to 60 years old
Parkinson’s disease is a degenerative disease of the brain. Due to insufficient secretion of the neurotransmitter “dopamine”, nerve conduction is affected, resulting in various movement disorders such as stiffness of the body, trembling hands, leaning forward with small steps, and easy falls; some people If you have symptoms such as depression, “poker face”, slurred speech, or even smaller and smaller handwriting, you may be suffering from Parkinson’s disease.
Although a small number of people will develop the disease before the age of 40, Parkinson’s disease most commonly occurs between the ages of 50 and 60.
4 core symptoms of Parkinson’s disease:
Trembling of limbs
Stiffness of limbs
Unsteady gait (easy to fall)
He said that many elders were alerted to the possibility of Parkinson’s disease due to tremors in their limbs and sought medical treatment. However, they ignored the other three symptoms such as slow movement, stiffness of limbs and unsteady gait, and only thought that it might be something that would occur in old age. Symptoms of aging.
“In particular, gait instability is most often ignored, because most people with abnormalities will intuitively seek treatment from orthopedics, but ignore the possible gait instability caused by Parkinson’s disease. In fact, there are only 2 of the 4 core symptoms. Above, clinical suspicion of Parkinson’s disease will be high.”
Finger manipulation + walking test monthly self-test
Lin Dianyou said that Parkinson’s disease usually occurs in middle-aged and elderly people after the age of 50. The Taiwan Movement Disorder Society provides a simple technique for detecting slow movements and stiffness of limbs:
Use the “finger exercise” movement to make an OK gesture with one hand, then open the index finger and thumb, and then quickly tap the tips of the index finger and thumb 25 times in a row. During the process, the movement pauses, the fingers cannot open, and the movement If it slows down, changes in speed, or changes in opening and closing size, you may have symptoms of slow movement or stiffness of the limbs.
As for unstable gait, you can do a 3-meter stand-up and walk test: the subject sits on a chair, stands up and walks forward 3 meters, walks around the placed objects or cones, comes back, and then sits down. If the time for a circle is greater than 10 seconds, it means that the walking speed begins to slow down; if it is greater than 20 seconds, it means that the mobility is significantly reduced, and there is the possibility of unstable gait and falling.
Lin Dianyou said that Parkinson’s disease is a disease that can be controlled with drugs. As long as it can be diagnosed early, drugs can be used to slow down the disability and improve the quality of life. In addition, maintaining a healthy lifestyle and cultivating regular exercise habits are also good ways to avoid neurodegenerative diseases.
He also called on patients with Parkinson’s disease not to lose heart, but to discuss their condition with doctors and take active treatment. He believes that they will be able to live a wonderful life of their own.
Text ◆Chen Jialiang (teaching students, treating patients, doing research, the dean of the School of Medicine of the Chinese University personally shares the big and small things in Xinglin)
It’s easy to treat a disease but difficult to practice
A mother-in-law brought her wheelchair-bound husband to seek medical treatment. The uncle suffered from Parkinson’s disease but had not received treatment for more than a year.
His movements became slower and slower, his appetite continued to decrease, and even bowel movements became difficult. In recent months, my uncle’s loss of appetite and constipation have been getting worse, so my mother-in-law has been looking for doctors for her husband.
When we met for the first time that day, my uncle looked sluggish, saliva was drooling from the corners of his mouth, and his thumbs were constantly trembling. He was a typical example of Parkinson’s disease.
I couldn’t help but think: “Why didn’t we receive treatment earlier? In fact, medicine can effectively alleviate these problems.” After repeated questioning, it turned out that the previous treatment experience was quite unpleasant. My mother-in-law felt that the specialist outpatient doctors were always very busy and did not explain properly at all. Treatment options.
The mother-in-law said: “I don’t think it makes much difference if he takes medicine. The doctor just keeps asking me to give him medicine.” Instead of spending a lot of effort to take her wife back for follow-up consultations every time, she simply gave up those ineffective measures. treatment.
Worry about further delaying the condition
Without the right medicine, the uncle’s condition became worse and worse, and his eating, digestion and defecation were also affected. My mother-in-law once sought help from a gastroenterologist. After the doctor performed gastroscopy and colonoscopy on my uncle, he just told her that “everything was normal” and then referred his uncle to a specialist clinic of the Hospital Authority for follow-up.
After listening to my mother-in-law’s narration, I couldn’t help but feel sad. So, I explained to my mother-in-law again about the treatment of Parkinson’s disease and how to improve my husband’s mobility and intestinal problems through medication. However, adjusting the medication requires time and patience. Because the waiting time for re-referral to the neurology department was very long, and I was worried that it would further delay the condition, I called my colleague in the computer department to ask for his opinion, and then prescribed some drugs to treat Parkinson’s disease, hoping to initially improve his condition. Referral will be made after the patient’s condition is diagnosed.
In addition, I also arranged for my uncle to receive a speech therapist to assess the risk of swallowing food.
Frequent exposure to similar events
This story seems familiar because I have been exposed to similar incidents frequently. In addition to the shortage of doctors in Hong Kong, there are deeper problems. Doctors are busy prescribing bags after bags of priceless drugs every day, but they have no time to explain and listen, and miss many opportunities to cure patients.
The streamlined medical treatment can only shorten the waiting time on the surface, but how easy is it to “cure the disease with the right medicine”? Avoiding unnecessary referrals is expected to reduce the waiting pressure for new specialist diseases and allow patients who really need them to receive specialist care. Being a specialist does not mean that he lacks the ability to deal with general diseases. If a patient suffers from diseases of three different organs, does he need care from three different specialists? Let doctors return to treating patients!
Medical practitioners should also stick to their original aspirations and not use busyness as an excuse to get tired of listening to those who are not as lucky as us; nor should they overdo medical treatment in search of economic opportunities or fear of making mistakes. Practicing medicine is difficult, but it is even harder to stick to your original intention and not follow the crowd. Love comes from the heart, I hope we will not be eroded by the ruthless years until our faces are blurred.