Fanny's Parkinson

Fanny's Parkinson

Story time

ONCE UPON A TIME...

About Fanny : - 65yo - a hairdresser retiree - 2 healthy children - her father died at 80yo : lung cancer (he was an active smoker)

before retirement

Evolution of her symptoms

Step 1

asthenia

Step 2

difficulties focusing

Step 3

night sweat.

Step 4

constipation

One day...

She noticed she has TREMOR on the right hand only.

(doctor) Simon says...

She does have the triad : - tremor - low akinesia : she walks slowly - Froment's sign : + (= rigidity) FIRST STAGE OF PARKINSON DISEASE --> LEVODOPA one time a day before breakfast

The doctors recommendations : - exercices - regular follow-up - keep socializing, communicate with other people : try to talk about the disease with other one, don't keep it for oneself

--> Adapt the treatment

During 5 years, her symptoms were well controled and her lifestyle was quite normal compare to another retired woman. = Honey moon stage However now she's experiencing fluctuations... (third stage)

Fanny's now 70yo

ON

Normal

OFF

rigidity

loss of intellectual functioning

Fanny's now 75yo and a lot of new symptoms appeared...

dementia

Apathy

loss of motivation

DEPression

hallucination delusions

Loss of balance

swallowing deficiency & salivation

finally...

Fanny's disease got worse with a lot of new deficiency due to the loss of some reflex like swallowing saliva. She's unable to take care of herself because of loss of autonomy, dementia, muscles rigidity... Few years later, she's even unable to stand, so she's bedridden all day long... Parkinson disease is a very lonely degenerative disease, without support, a lot of patients develop depression and anxiety and because of the loss of dignity in the final stage, some patients would choose assisted suicide, but it poses ethical problems.

For the family members, it is also a very hard situation, they have to be always present

≠ Alzheimer (amyloid plaque)

- raisoning ability dysfunction- hallucination A disease in itself and not a symptom in Parkinson disease

VS

Delusions

a false BELIEF or JUDGEMENT about external reality, held despite incontrovertible evidence to the contrary

Hallucination

an experience involving the apparent PERCEPTION of something not present