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Thank you for your note. It would be unusual for a DatSCAN to be abnormal, and I would encourage you to talk to your neurologist, and actually look at the scan. Here is a link to a presentation to the FDA, but the first slide shows the difference between a normal and abnormal:
http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/PeripheralandCentralNervousSystemDrugsAdvisoryCommittee/UCM186404.pdf
If your scan looks abnormal, and your neurologist does not think this is parkinsonism, consider asking for a scan to be repeated - perhaps you are the "one in a million" that had a false positive result and the next will be ok.
If your neurologist does not think you have PD, ask him about other conditions that can produce this result, and if one of these could be the diagnosis. Please know, I am not sure I would have the answers to these questions in an office visit, and would likely suggest watching to see how this evolves. Do not give up on your doctor, if this is the response.View Thread



Thank you for your note. The type of jerking movements you describe sound like "myoclonus." Myoclonus means "jerking" in doctor speak!
This type of movement is most often associated with decreasing blood levels of levodopa dosing, so I think it may be likely more often at the end of the day. Because you do not want to risk dyskinesia, your doctors decision to start a dopamine agonist - particularly the once a day patch, Neupro, makes good sense. I do suspect you have a mild case of PD, but it is important to take care of it - remember, it is the only PD you have, and everybody "lurking" on the site wants what is best for you.View Thread

Thank you for your note. We have many people here to support you, and share there strategies for dealing with the worries that have been handed to you about a diagnosis of Parkinson's Disease. I am sorry that the doctor did not spend enough time with you.
Here are some basics. Parkinson's disease is an illness that causes motor and non-motor symptoms, but everybody has a unique combination of these signs. When making the diagnosis, I look for a resting tremor and slowness of movement when performing finger tapping or foot tapping. It usually affects one side of the body first - and so one side is often worse than the other. Other early symptoms may be vivid dreaming or depression.
Please know that this is not a 5 year or even a 20 year road. We have many good medicines for PD, and I think you would feel better with medicines like levodopa, pramipexole, rasagiline, ropinirole, rotigotine, or selegiline. Please consider looking at these websites for more information:
American Parkinson's Disease Association (APDA)
National Parkinson Foundation (NPF)
Parkinson's Disease Foundation (PDF)View Thread

Patient confidentiality and data protection is a big business, and I think it is quickly coming up to a point where your fears can decrease. As we learn the culture of the electronic record, we are all going to be more comfortable with providing our health record data in private and protected fashion, and we will quickly develop methods to allow sharing of our limited health data sets. Nonetheless, a motivated hacker seems like a difficult thing to stop.View Thread

Thank you for your note, and simple question! I would agree that this is a time of great of unknown for the health care system in the United States and in many other countries. In the United States the health care system must undergo many changes to care for our people. I am not sure this can happen strategically unless we begin to speak the same language and be on the same page. I think many of the things you describe may represent the pain points of all the stakeholders to live on the same page. From a physician standpoint the profession has changed from an independent small business model, and I suspect your neurologist was at a point that he or she could retire rather than shift to a new standard. I think 5 years from now we will see a different system, that makes sense in a long term, resource-limited environment. I also think it will be better, and doctors and patients will not feel like we are the last stakeholders to be asked to the table.
I also do not plan to stop practicing medicine - and appreciate your tact!View Thread

It is hard to know how your physician came to a diagnosis from the examination you describe. I look for the presence of tremor and difficulty with performing rapid movements - like finger tapping or opening and closing the hand. If these are slow - or one side is worse than the other, I will look for "rigidity" or a stiffness of the limbs. I will then look at walking and balance, but this symptom usually comes later than the others.
I would suggest asking your doctor about these, and whether you should see a neurologist.View Thread

Thank you for your note. Given that the Heart and Lung tests are normal (that's good!), I think it is very likely that this is related to PD. Because it occurs in the morning, I think it may be from low levels of medication in your system, after a night's sleep. If the symptoms ease within 30 - 60 minutes after taking your first dose of carbidopa/levodopa (Sinemet), I am almost sure of this.
You may want to talk with your doctor about how to rearrange your levodopa dosing schedule or adding additional medications to avoid this symptom - called wearing off. Other symptoms of wearing off are listed in a questionnaire called the WOQ-19.View Thread

The symptoms you describe sound like wearing off - and occur at the end of your medication dosing. The anxiety you feel is a fairly uncommon wearing off symptom but it does occur. You may want to talk with your doctor about taking sinemet every 4 hours or add a longer acting medication like pramipexole, ropinirole or rotigotene.View Thread
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