Parkinson’s Disease

Parkinson’s disease (PD) is a type of movement disorder. It happens when nerve cells in the brain don’t produce enough of a brain chemical called dopamine. Sometimes it is genetic, but most cases do not seem to run in families. Exposure to chemicals in the environment might play a role.

Symptoms begin gradually, often on one side of the body. Later they affect both sides. They include

  • Trembling of hands, arms, legs, jaw and face
  • Stiffness of the arms, legs and trunk
  • Slowness of movement
  • Poor balance and coordination

As symptoms get worse, people with the disease may have trouble walking, talking, or doing simple tasks. They may also have problems such as depression, sleep problems, or trouble chewing, swallowing, or speaking.

There is no specific test for PD, so it can be difficult to diagnose. Doctors use a medical history and a neurological examination to diagnose it.

PD usually begins around age 60, but it can start earlier. It is more common in men than in women. There is no cure for PD. A variety of medicines sometimes help symptoms dramatically. Surgery and deep brain stimulation (DBS) can help severe cases. With DBS, electrodes are surgically implanted in the brain. They send electrical pulses to stimulate the parts of the brain that control movement.

NIH: National Institute of Neurological Disorders and Stroke

Sleep Disorders

What is sleep?

Sleep is a complex biological process. While you are sleeping, you are unconscious, but your brain and body functions are still active. They are doing a number of important jobs that help you stay healthy and function at your best. So when you don’t get enough quality sleep, it does more than just make you feel tired. It can affect your physical and mental health, thinking, and daily functioning.What are sleep disorders?

Sleep disorders are conditions that disturb your normal sleep patterns. There are more than 80 different sleep disorders. Some major types include

  • Insomnia – being unable to fall asleep and stay asleep. This is the most common sleep disorder.
  • Sleep apnea – a breathing disorder in which you stop breathing for 10 seconds or more during sleep
  • Restless leg syndrome (RLS) – a tingling or prickly sensation in your legs, along with a powerful urge to move them
  • Hypersomnia – being unable to stay awake during the day. This includes narcolepsy, which causes extreme daytime sleepiness.
  • Circadian rhythm disorders – problems with the sleep-wake cycle. They make you unable to sleep and wake at the right times.
  • Parasomnia – acting in unusual ways while falling asleep, sleeping, or waking from sleep, such as walking, talking, or eating

Some people who feel tired during the day have a true sleep disorder. But for others, the real problem is not allowing enough time for sleep. It’s important to get enough sleep every night. The amount of sleep you need depends on several factors, including your age, lifestyle, health, and whether you have been getting enough sleep recently. Most adults need about 7-8 hours each night.What causes sleep disorders?

There are different causes for different sleep disorders, including

  • Other conditions, such as heart disease, lung disease, nerve disorders, and pain
  • Mental illnesses, including depression and anxiety
  • Medicines
  • Genetics

Sometimes the cause is unknown.

There are also some factors that can contribute to sleep problems, including

  • Caffeine and alcohol
  • An irregular schedule, such as working the night shift
  • Aging. As people age, they often get less sleep or spend less time in the deep, restful stage of sleep. They are also more easily awakened.

What are the symptoms of sleep disorders?

The symptoms of sleep disorders depend on the specific disorder. Some signs that you may have a sleep disorder include that

  • You regularly take more than 30 minutes each night to fall asleep
  • You regularly wake up several times each night and then have trouble falling back to sleep, or you wake up too early in the morning
  • You often feel sleepy during the day, take frequent naps, or fall asleep at the wrong times during the day
  • Your bed partner says that when you sleep, you snore loudly, snort, gasp, make choking sounds, or stop breathing for short periods
  • You have creeping, tingling, or crawling feelings in your legs or arms that are relieved by moving or massaging them, especially in the evening and when trying to fall asleep
  • Your bed partner notices that your legs or arms jerk often during sleep
  • You have vivid, dreamlike experiences while falling asleep or dozing
  • You have episodes of sudden muscle weakness when you are angry or fearful, or when you laugh
  • You feel as though you cannot move when you first wake up

How are sleep disorders diagnosed?

To make a diagnosis, your health care provider will use your medical history, your sleep history, and a physical exam. You may also have a sleep study (polysomnogram). The most common types of sleep studies monitor and record data about your body during a full night of sleep. The data includes

  • Brain wave changes
  • Eye movements
  • Breathing rate
  • Blood pressure
  • Heart rate and electrical activity of the heart and other muscles

Other types of sleep studies may check how quickly you fall asleep during daytime naps or whether you are able to stay awake and alert during the day.What are the treatments for sleep disorders?

Treatments for sleep disorders depend on which disorder you have. They may include

  • Good sleep habits and other lifestyle changes, such as a healthy diet and exercise
  • Cognitive behavioral therapy or relaxation techniques to reduce anxiety about getting enough sleep
  • CPAP (continuous positive airway pressure) machine for sleep apnea
  • Bright light therapy (in the morning)
  • Medicines, including sleeping pills. Usually, providers recommend that you use sleeping pills for a short period of time.
  • Natural products, such as melatonin. These products may help some people but are generally for short-term use. Make sure to check with your health care provider before you take any of them.

Statins

Statins are drugs used to lower cholesterol. Your body needs some cholesterol to work properly. But if you have too much in your blood, it can stick to the walls of your arteries and narrow or even block them.

If diet and exercise don’t reduce your cholesterol levels, you may need to take cholesterol medicine. Often, this medicine is a statin. Statins interfere with the production of cholesterol in your liver. They lower LDL (bad) cholesterol levels and raise HDL (good) cholesterol levels. This can slow the formation of plaques in your arteries.

Statins are relatively safe for most people. But they are not recommended for pregnant patients or those with active or chronic liver disease. They can also cause serious muscle problems. Some statins also interact adversely with other drugs. You may have fewer side effects with one statin drug than another.

Researchers are also studying the use of statins for other conditions.

Food and Drug Administration

Stem Cells

Stem cells are cells with the potential to develop into many different types of cells in the body. They serve as a repair system for the body. There are two main types of stem cells: embryonic stem cells and adult stem cells.

Stem cells are different from other cells in the body in three ways:

  • They can divide and renew themselves over a long time
  • They are unspecialized, so they cannot do specific functions in the body
  • They have the potential to become specialized cells, such as muscle cells, blood cells, and brain cells

Doctors and scientists are excited about stem cells because they could help in many different areas of health and medical research. Studying stem cells may help explain how serious conditions such as birth defects and cancer come about. Stem cells may one day be used to make cells and tissues for therapy of many diseases. Examples include Parkinson’s disease, Alzheimer’s disease, spinal cord injury, heart disease, diabetes, and arthritis.

NIH: National Institutes of Health

Telehealth

What is telehealth?

Telehealth is the use of communications technologies to provide health care from a distance. These technologies may include computers, cameras, videoconferencing, the Internet, and satellite and wireless communications. Some examples of telehealth include

  • A “virtual visit” with a health care provider, through a phone call or video chat
  • Remote patient monitoring, which lets your provider check on you while you are at home. For example, you might wear a device that measures your heart rate and sends that information to your provider.
  • A surgeon using robotic technology to do surgery from a different location
  • Sensors that can alert caregivers if a person with dementia leaves the house
  • Sending your provider a message through your electronic health record (EHR)
  • Watching an online video that your provider sent you about how to use an inhaler
  • Getting an email, phone, or text reminder that it’s time for a cancer screening

What is the difference between telemedicine and telehealth?

Sometimes people use the term telemedicine to mean the same thing as telehealth. Telehealth is a broader term. It includes telemedicine. But it also includes things like training for health care providers, health care administrative meetings, and services provided by pharmacists and social workers.What are the benefits of telehealth?

Some of the benefits of telehealth include

  • Getting care at home, especially for people who can’t easily get to their providers’ offices
  • Getting care from a specialist who is not close by
  • Getting care after office hours
  • More communication with your providers
  • Better communication and coordination between health care providers
  • More support for people who are managing their health conditions, especially chronic conditions such as diabetes
  • Lower cost, since virtual visits may be cheaper than in-person visits

What are the problems with telehealth?

Some of the problems with telehealth include

  • If your virtual visit is with someone who is not your regular provider, he or she may not have all of your medical history
  • After a virtual visit, it may be up to you to coordinate your care with your regular provider
  • In some cases, the provider may not be able to make the right diagnosis without examining you in person. Or your provider may need you to come in for a lab test.
  • There may be problems with the technology, for example, if you lose the connection, there is a problem with the software, etc.
  • Some insurance companies may not cover telehealth visits

What types of care can I get using telehealth?

The types of care that you can get using telehealth may include

  • General health care, like wellness visits
  • Prescriptions for medicine
  • Dermatology (skin care)
  • Eye exams
  • Nutrition counseling
  • Mental health counseling
  • Urgent care conditions, such as sinusitis, urinary tract infections, common rashes, etc.

For telehealth visits, just like with an in-person visit, it is important to be prepared and have good communication with the provider.

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