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Parkinsons

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Parkinson's Disease
Michelle Briscoe
Drexel University
Introduction to Online Learning and Scholarly Writing
N324
Professor Hawes
January 26, 2012

Parkinson's Disease
To understand why I chose Parkinson’s disease, one must understand what Parkinson’s disease can do to a person. Parkinson’s ravaged my mother for 9 years, the deterioration left her unable to swallow, communicate, and eventually led to dementia which took her life in April, 2010. Not only did it wreak its revenge on her, but it took its toll on the family watching her decline rapidly over the years but knowing the medications had no effect on her after time. As a nurse it took everything I had to ensure her safety, her being comfortable, and helping with her care. A once vibrant, pleasant, happy woman who laughed and smiled, was independent she now was somnolent with no expression, no laughter, and not able to complete a sentence or her thoughts. She became incontinent, unable to perform ADL’s, unable to roll over in bed, and unable to speak or communicate. Nine years had passed since her diagnosis, she suffered from depression, anxiety, cognitive impairment and she withered away to a mere 100 pounds. January 2010 it all began, the end of the end, she lost the ability to swallow solid foods and liquids and began pureed foods and thickened liquids. By March 2010, she no longer could communicate verbally her wants and needs; she followed you with her eyes. April 2010, her eyes open all the time, she no longer visually followed you anymore, tears rolled down her face all the time. The tremors were constant day and night, she curled up, stretched out, twisting, the medications no longer effective, and moans, cries when you touched her or repositioned her, her skin fragile and thin. In pain, standing orders for sublingual morphine and PRN morphine, none of it mattered, it didn’t help, and she twisted and shook. By now, hospice had been doing everything they could, they added Ativan to ease the anxiety, they tried a mixture of Haldol, Ativan and morphine, and finally relief had been gotten. She fought for another week, April 29, 2010 she died peacefully in her sleep. No more pain and suffering, but a loss that is hard to take, now both parents had succumbed to terminal illness. What I remember the most is her will to move on, the constant tremors, the drooling, the dyskinesias, her will to keep moving.
Parkinson’s disease is a progressive disorder of the central nervous system (Sikio MSc et al., 2011, p. 1217).It is one of the most common neurodegenerative disorders affecting about 1% of the population over the age of 60(Padovani, Costanzi, Gilberti, & Borroni, 2006)). Initial symptoms start insidiously and emerge slowly over weeks to months, tremor being the most common symptom. There are four cardinal symptoms of Parkinson’s disease: resting tremor, rigidity, bradykinesia, and postural instability. As the disease progresses, Parkinson’s patients will also experience impairment of the autonomic nervous system, have difficulty with sleep and speech, and have injuries related to falls. Psychiatric issues will develop as well, in particular depression, anxiety, and cognitive impairment. “The average age of onset is 60 years and the mean duration of the disease from diagnosis to death is 15 years (Lees, Hardy, & Revesz, 2009, p. 2055).”

References
Lees, A. J., Hardy, J., & Revesz, T. (2009, June 13, 2009). Parkinson’s disease [journal]. Lancet, 373, 2055-66. Retrieved from www.thelancet.com
Padovani, A., Costanzi, C., Gilberti, N., & Borroni, B. (2006). Parkinson’s Disease and dementia [journal]. Neurological Science, 27, S40-S43. doi:10.1007/s10072-006-0546-6
Sikio MSc, M., Holli MSc, K. K., Harrison MSc, D, L. C., Ruottinen MD, PhD, H., Rossi MSc, M., Helminen MSc, M. T., Dastidar MD, PhD, P. (2011). Parkinson’s Disease: Interhemispheric Textural Differences in MR Images [journal]. Acad Radiol, 18, 1217-1224. doi:10.1016/j.acra.2011.06.007
Willis MD, A. W., Schootman PhD, M., Kung MD, N., Evanoff MD MPH, B. A., Perlmutter MD, J. S., & Racette MD, B. A. (2012, January 2.2012). Predictors of Survival in Patients with Parkinson’s Disease [journal]. Archives of Neurology. doi:10.1001/archneurol.2011.2370

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