More education on using resources helps Parkisonian patients cope better | Canada News Media
Connect with us

Health

More education on using resources helps Parkisonian patients cope better

Published

 on

Parkinson’s Disease (PD) Awareness week is currently being observed by health officials across the world. The disease which continues to be steeped in superstitions and stigma leading to delays by patients to seek early treatment. Using available resources is the key to help them enjoy a better quality of life, says a neurologist who believes that awareness raising and education of patients is the first step towards halting this world’s fastest neurological condition in its tracks.

The Sunday Observer spoke to Senior Consultant and Neurologist , Sri Jayewardenepura Teaching Hospital Dr Harsha Gunasekera to get a more in depth knowledge about this subject and why he thinks it is so vital to rase more awareness among the Lankan Parkisonian community .

Excerpts.

Q. Starting from April 11- Parkinsonian (Parkinson’s disease) Awareness Raising Month – health officials across the world have begun pooling their ideas and resources on improving the quality of life of patients with Parkinson’s Disease (PD). For the benefit of our readers, could you explain what exactly this disease is?


Dr Harsha Gunasekera

A. Parkinson’s disease is caused by a loss of nerve cells in the part of the brain called the “substantia nigra”. Nerve cells in this part of the brain are responsible for producing a chemical called dopamine. Dopamine acts as a messenger (neurotransmitter) between the parts of the brain and nervous system that help control and coordinate body movements (basal ganglia). If these nerve cells die or become damaged, the amount of dopamine in the brain is reduced. This means the part of the brain controlling movement cannot work as well as normal, causing movements to become slow and abnormal.

Q. Why is it necessary to devote an entire month to raise awareness on this specific health topic when there are so many other health problems that require urgent attention right now?

A. Because recent studies have shown that Parkinson’s Disease (PD) is the fastest growing neurological disease globally, with doubling of the number of PD patients over the 25-year period from 1990 – 2015. It’s predicted to double again by 2040. Yet in spite of this, PD is still a misunderstood disease and lack of awareness makes people with PD vulnerable and discriminated against in society.

Q. How common is it in Sri Lanka and how does our prevalence rate compare with other countries according to your latest data?

A. We don’t have national level data to compare with international data. Some clinic studies have shown that classical PD is the commonest type of Parkinsonism in Sri Lanka.

Q. What are the common symptoms associated with it?

A. “Parkinsonism” is the umbrella term used to describe the common symptom triad of tremor, muscle stiffness or rigidity and slowness of movement. PD is the commonest type of Parkinsonism worldwide. The other movement related (motor) symptoms are poor balance when changing posture, stooping forwards and shuffling when walking, falls, reduced facial expressions (mask like appearance), monotonous speech and small-sized letters with hand writing (micrographia). Its important to understand that PD affects much more than movement. There are over 40 possible “non-movement” symptoms affecting sleep, memory, mood, bowel and bladder control, sexual functions and pain. These distressing symptoms are often invisible and further isolate patients with PD.

Q. Is it curable ?

A. Unfortunately despite ongoing research on this subject no cure for PD has still been found although advancements of treatment can improve quality of life.

Q. What is the special focus of this year’s awareness month for Parkinson’s disease and how relevant is it to Lankans afflicted with this condition?

A. The theme for 2023 Parkinson’s Awareness Month is #Take6forPD, in light of our new incidence study which indicates that a person receives a Parkinson’s disease (PD) diagnosis every six minutes.

Q. Tremors due to advancing age- How does one distinguish symptoms of Parkinson’s Disease from those due to old age tremors?

A. The tremors we see with advancing age are called the senile tremor. This is quite different to the tremors in PD which occur predominantly when the hands are rested (rest tremor) and usually affects one side. Senile tremor affects both hands and occurs when hands are outstretched (postural tremor) or being used for a particular task like holding a cup. Besides this, tremor is a very common symptom which can be seen in a variety of medical conditions which can be differentiated from PD by clinical examination.

Q: Do all those who have Parkinson disease develop the same symptoms?

A. The classic triad of symptoms described above are seen in all patients but may vary in severity and extent. For example, one patient might have a very dominant tremor but less stiffness and slowness or vice versa. The non-movement symptoms also can vary from patient to patient.

Q. Who are those most vulnerable to developing it age wise and gender wise?

A. PD is indiscriminate against gender, ethnicity, age and geography. Although it’s a neurodegenerative disease most commonly affecting people over 65 years of age, up to 10% of people affected are younger than 40 years.

Q. While it is still unclear what causes Parkinson’s, it has been reported that some cases can be traced to a genetic mutation as well as environmental factors, which coupled with genetics, could play a role in the development of Parkinson’s disease. Do you agree?

A. Yes, the exact cause of PD is still unknown as in most other neurodegenerative diseases such as Alzheimer’s disease and motor neuron disease. A mixture of genetic and environmental factors are thought to play a role in its development. PD can run in families with a faulty genetic mutation but this type of familial PD is very rare.

Q. Brain damage and head traumas -– can they also lead to PD?

A. Head injuries can increase a person’s risk of developing PD. However, even with this increased risk, it’s a very rare complication of head injury.

Q. So if you were to summarise the main underlying causes, what would they be ?

A. Genetic and environmental factors play a role. Environmental factors such as exposure to toxic substances such as pesticides and herbicides, industrial and air pollution may contribute to its development but evidence linking PD to environmental factors has been inconclusive.

There are several causes for secondary Parkinsonism which includes long term use of certain medications, following stroke and some brain infections.

Q. Is PD a slow process or does it happen overnight?

A. The loss of nerve cells in the brain is a slow process and it predates the onset of symptoms by a number of years. The symptoms appear only after 50% of the nerve cell activity in the area of the brain called “substantia nigra” is lost.

Q. How can it be diagnosed ? What are the tools you use ?

A. Diagnosis of PD is essentially clinical based on the patient’s symptoms and signs. In rare instances, doctors may use brain scans to rule out other secondary causes and other disease states.

Q. Who is able to diagnose it ?

A. For the initial diagnosis, it’s better to refer the patient to a neurologist or a specialist physician as important decisions need to be made on initiation of treatment. Movement disorder clinics are established in some major hospitals for these patients to be followed up.

Q. Once a patient has been diagnosed with Parkinson’s disease what is the next step? Take us through the procedure followed.

A. Specific treatment measures are directed at increasing the dopamine levels in the areas of the brain affected by the disease. Initially, patients may have only mild symptoms, which may not affect their functional status. However, these patients need treatment using the appropriate first line treatments (usually oral medications). Later on, as the disease progresses treatment may need changes. In addition, physiotherapy for improving mobility and balance and speech therapy in patients with swallowing difficulties will be recommended as appropriate. All patients should be assessed and provided general and supportive care for non-movement symptoms which are distressing but invisible.

Q. Does a patient have to be warded once diagnosed? Or can he/she be treated at home?

A. No. Most patients are assessed and initiated on treatment as outpatients. The initial first line treatments are decided depending on the severity of symptoms and the age of the patients.

Q. How effective and safe are these treatments?

A. The current treatments available are effective in controlling symptoms and improving the quality of life of patients. They are relatively safe. However, as the disease progresses usually beyond 3 to 5 years, patients may notice a reduced response and fluctuations in their response to the treatments. When this occurs, appropriate advice should be taken from the neurologist to minimise these changes. Under any circumstances, the treatment should NOT be stopped abruptly as this can lead to a serious complication called the “acute dopamine withdrawal syndrome”.

Q. Any new breakthroughs in diagnosis, and treatment interventions?

A. New treatment formulations to deliver the medications to the intestine or to the circulation using an infusion pump are available in some developed countries. In addition, in selected patients who are not controlled on optimum medications are recommended surgical treatment or deep brain stimulation.

Q. Are they available in Sri Lanka as well?.

A. Unfortunately not.

Q. I understand there is an Association of Sri Lankan Neurologists (ASN) which is in overall charge of such patients. What has this Association done so far to raise awareness on PD and ensure a better quality of life for both the patients and their carers?

A. ASN together with the Movement Disorder Society of Sri Lanka (MDSSL) conducts educational programs to update health professionals on advances in the management of patients. Awareness programs are conducted, especially connected to World Brain Health Day activities to promote brain health among the public.

Q. Your message to patients?

A. A diagnosis of PD is life changing. Long term treatment will be needed to control the symptoms and with time you may need to adapt changes to your lifestyle even to the extent of changing the way you do simple activities of daily living. The medications prescribed should be taken carefully and at no time should be stopped abruptly. Regular exercise helps PD patients to reduce muscle stiffness, improve mood and relieve stress.

Q. Is there a hashtag or website that can be reached by persons wanting more information on this subject?

A. The International Parkinson and Movement Disorder Society has resources available for patients which can be downloaded at; 5https://www.movementdisorders.org/MDS/Resources/Patient-Education.htm

 

Source link

Continue Reading

Health

Health Canada approves updated Moderna COVID-19 vaccine

Published

 on

 

TORONTO – Health Canada has authorized Moderna’s updated COVID-19 vaccine that protects against currently circulating variants of the virus.

The mRNA vaccine, called Spikevax, has been reformulated to target the KP.2 subvariant of Omicron.

It will replace the previous version of the vaccine that was released a year ago, which targeted the XBB.1.5 subvariant of Omicron.

Health Canada recently asked provinces and territories to get rid of their older COVID-19 vaccines to ensure the most current vaccine will be used during this fall’s respiratory virus season.

Health Canada is also reviewing two other updated COVID-19 vaccines but has not yet authorized them.

They are Pfizer’s Comirnaty, which is also an mRNA vaccine, as well as Novavax’s protein-based vaccine.

This report by The Canadian Press was first published Sept. 17, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

Source link

Continue Reading

Health

These people say they got listeria after drinking recalled plant-based milks

Published

 on

 

TORONTO – Sanniah Jabeen holds a sonogram of the unborn baby she lost after contracting listeria last December. Beneath, it says “love at first sight.”

Jabeen says she believes she and her baby were poisoned by a listeria outbreak linked to some plant-based milks and wants answers. An investigation continues into the recall declared July 8 of several Silk and Great Value plant-based beverages.

“I don’t even have the words. I’m still processing that,” Jabeen says of her loss. She was 18 weeks pregnant when she went into preterm labour.

The first infection linked to the recall was traced back to August 2023. One year later on Aug. 12, 2024, the Public Health Agency of Canada said three people had died and 20 were infected.

The number of cases is likely much higher, says Lawrence Goodridge, Canada Research Chair in foodborne pathogen dynamics at the University of Guelph: “For every person known, generally speaking, there’s typically 20 to 25 or maybe 30 people that are unknown.”

The case count has remained unchanged over the last month, but the Public Health Agency of Canada says it won’t declare the outbreak over until early October because of listeria’s 70-day incubation period and the reporting delays that accompany it.

Danone Canada’s head of communications said in an email Wednesday that the company is still investigating the “root cause” of the outbreak, which has been linked to a production line at a Pickering, Ont., packaging facility.

Pregnant people, adults over 60, and those with weakened immune systems are most at risk of becoming sick with severe listeriosis. If the infection spreads to an unborn baby, Health Canada says it can cause miscarriage, stillbirth, premature birth or life-threatening illness in a newborn.

The Canadian Press spoke to 10 people, from the parents of a toddler to an 89-year-old senior, who say they became sick with listeria after drinking from cartons of plant-based milk stamped with the recalled product code. Here’s a look at some of their experiences.

Sanniah Jabeen, 32, Toronto

Jabeen says she regularly drank Silk oat and almond milk in smoothies while pregnant, and began vomiting seven times a day and shivering at night in December 2023. She had “the worst headache of (her) life” when she went to the emergency room on Dec. 15.

“I just wasn’t functioning like a normal human being,” Jabeen says.

Told she was dehydrated, Jabeen was given fluids and a blood test and sent home. Four days later, she returned to hospital.

“They told me that since you’re 18 weeks, there’s nothing you can do to save your baby,” says Jabeen, who moved to Toronto from Pakistan five years ago.

Jabeen later learned she had listeriosis and an autopsy revealed her baby was infected, too.

“It broke my heart to read that report because I was just imagining my baby drinking poisoned amniotic fluid inside of me. The womb is a place where your baby is supposed to be the safest,” Jabeen said.

Jabeen’s case is likely not included in PHAC’s count. Jabeen says she was called by Health Canada and asked what dairy and fresh produce she ate – foods more commonly associated with listeria – but not asked about plant-based beverages.

She’s pregnant again, and is due in several months. At first, she was scared to eat, not knowing what caused the infection during her last pregnancy.

“Ever since I learned about the almond, oat milk situation, I’ve been feeling a bit better knowing that it wasn’t something that I did. It was something else that caused it. It wasn’t my fault,” Jabeen said.

She’s since joined a proposed class action lawsuit launched by LPC Avocates against the manufacturers and sellers of Silk and Great Value plant-based beverages. The lawsuit has not yet been certified by a judge.

Natalie Grant and her seven year-old daughter, Bowmanville, Ont.

Natalie Grant says she was in a hospital waiting room when she saw a television news report about the recall. She wondered if the dark chocolate almond milk her daughter drank daily was contaminated.

She had brought the girl to hospital because she was vomiting every half hour, constantly on the toilet with diarrhea, and had severe pain in her abdomen.

“I’m definitely thinking that this is a pretty solid chance that she’s got listeria at this point because I knew she had all the symptoms,” Grant says of seeing the news report.

Once her daughter could hold fluids, they went home and Grant cross-checked the recalled product code – 7825 – with the one on her carton. They matched.

“I called the emerg and I said I’m pretty confident she’s been exposed,” Grant said. She was told to return to the hospital if her daughter’s symptoms worsened. An hour and a half later, her fever spiked, the vomiting returned, her face flushed and her energy plummeted.

Grant says they were sent to a hospital in Ajax, Ont. and stayed two weeks while her daughter received antibiotics four times a day until she was discharged July 23.

“Knowing that my little one was just so affected and how it affected us as a family alone, there’s a bitterness left behind,” Grant said. She’s also joined the proposed class action.

Thelma Feldman, 89, Toronto

Thelma Feldman says she regularly taught yoga to friends in her condo building before getting sickened by listeria on July 2. Now, she has a walker and her body aches. She has headaches and digestive problems.

“I’m kind of depressed,” she says.

“It’s caused me a lot of physical and emotional pain.”

Much of the early days of her illness are a blur. She knows she boarded an ambulance with profuse diarrhea on July 2 and spent five days at North York General Hospital. Afterwards, she remembers Health Canada officials entering her apartment and removing Silk almond milk from her fridge, and volunteers from a community organization giving her sponge baths.

“At my age, 89, I’m not a kid anymore and healing takes longer,” Feldman says.

“I don’t even feel like being with people. I just sit at home.”

Jasmine Jiles and three-year-old Max, Kahnawake Mohawk Territory, Que.

Jasmine Jiles says her three-year-old son Max came down with flu-like symptoms and cradled his ears in what she interpreted as a sign of pain, like the one pounding in her own head, around early July.

When Jiles heard about the recall soon after, she called Danone Canada, the plant-based milk manufacturer, to find out if their Silk coconut milk was in the contaminated batch. It was, she says.

“My son is very small, he’s very young, so I asked what we do in terms of overall monitoring and she said someone from the company would get in touch within 24 to 48 hours,” Jiles says from a First Nations reserve near Montreal.

“I never got a call back. I never got an email”

At home, her son’s fever broke after three days, but gas pains stuck with him, she says. It took a couple weeks for him to get back to normal.

“In hindsight, I should have taken him (to the hospital) but we just tried to see if we could nurse him at home because wait times are pretty extreme,” Jiles says, “and I don’t have child care at the moment.”

Joseph Desmond, 50, Sydney, N.S.

Joseph Desmond says he suffered a seizure and fell off his sofa on July 9. He went to the emergency room, where they ran an electroencephalogram (EEG) test, and then returned home. Within hours, he had a second seizure and went back to hospital.

His third seizure happened the next morning while walking to the nurse’s station.

In severe cases of listeriosis, bacteria can spread to the central nervous system and cause seizures, according to Health Canada.

“The last two months have really been a nightmare,” says Desmond, who has joined the proposed lawsuit.

When he returned home from the hospital, his daughter took a carton of Silk dark chocolate almond milk out of the fridge and asked if he had heard about the recall. By that point, Desmond says he was on his second two-litre carton after finishing the first in June.

“It was pretty scary. Terrifying. I honestly thought I was going to die.”

Cheryl McCombe, 63, Haliburton, Ont.

The morning after suffering a second episode of vomiting, feverish sweats and diarrhea in the middle of the night in early July, Cheryl McCombe scrolled through the news on her phone and came across the recall.

A few years earlier, McCombe says she started drinking plant-based milks because it seemed like a healthier choice to splash in her morning coffee. On June 30, she bought two cartons of Silk cashew almond milk.

“It was on the (recall) list. I thought, ‘Oh my God, I got listeria,’” McCombe says. She called her doctor’s office and visited an urgent care clinic hoping to get tested and confirm her suspicion, but she says, “I was basically shut down at the door.”

Public Health Ontario does not recommend listeria testing for infected individuals with mild symptoms unless they are at risk of developing severe illness, such as people who are immunocompromised, elderly, pregnant or newborn.

“No wonder they couldn’t connect the dots,” she adds, referencing that it took close to a year for public health officials to find the source of the outbreak.

“I am a woman in my 60s and sometimes these signs are of, you know, when you’re vomiting and things like that, it can be a sign in women of a bigger issue,” McCombe says. She was seeking confirmation that wasn’t the case.

Disappointed, with her stomach still feeling off, she says she decided to boost her gut health with probiotics. After a couple weeks she started to feel like herself.

But since then, McCombe says, “I’m back on Kawartha Dairy cream in my coffee.”

This report by The Canadian Press was first published Sept. 16, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

Source link

Continue Reading

Health

B.C. mayors seek ‘immediate action’ from federal government on mental health crisis

Published

 on

 

VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.

Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.

In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.

The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.

Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”

Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”

This report by The Canadian Press was first published Sept. 16, 2024

The Canadian Press. All rights reserved.

Source link

Continue Reading

Trending

Exit mobile version