Managing Parkinson’s Comorbidities: Routine Doctor Visits

On August 26th, I celebrated my 49th journey around the sun. The next day, I went for a maintenance / road-worthiness physical, which was my first in a couple of years.

I routinely “donate blood” to monitor my non-Parkinson's meds and see my neurologist for the major stuff. It’s not as if I’m not routinely checking the oil, but getting a physical gets lost in the shuffle.

However, Parkinson’s disease (PD) changes are the new normal, so it’s best to know what’s what. Lately, my body has been feeling more fatigued and rigid. Something is definitely changing, and not for the better. Thus, with the added effects of quarantine, it has become essential to know what’s what.

Dealing with doctors & specialists

Ever since the revelation of my diagnosis on September 27, 2016, my life has been a parade of doctors and specialists. When the topic of Parkinson’s presents itself, I swiftly move into clinical instruction. Be it explaining never heard of medications, discussing symptoms, or telling my history, I’m an open book.

Within weeks of getting my PD diagnosis, I got the call about an additional hit to the system - Lyme Disease. Those in the know call this the Great Imitator since it mimics many neurological conditions.

I took a deep breath, a spinal tap, and a hefty dose of doxycycline. I’d like to think it’s behind me now, but I still have the physical side effects of having that experience.

All of these medical professionals manage to find a way to give me additional free toasters to go with my Parkinson’s disease. Who would have thought Parkinson’s would be the gift that keeps on giving? Such is the glory of comorbid conditions.

Addressing the comorbidities

But wait, there's more! Comorbid conditions are bonus "prizes" that go hand in hand with the bigger diagnosis. Generally, we associate Parkinson’s with specially-named terms like dyskinesia, dystonia, or hyperhidrosis. You get these things when you play for the team nobody wants to join.

We diagnose other new and unique problems when we look “under the hood.” Maintenance checks often end up like this. Think about it; when you do a home renovation, you will always find something behind the wall that you rip out or repurpose.

The simple fix never is so simple. Unfortunately, with PD, we can’t just keep things as is. We need to diagnose and treat the new stuff. Hence, we get fixed, and then we get the doctor bills.

Managing the symptoms: Old & new

I am now adding new symptoms to my old ones, and with my maintenance efforts, I will address these problems directly. Some things, like the “Frankenstein Walk,” are what they are. My right leg feels longer and doesn’t bend when I walk anymore. At least it matches my arms. The joy of Parkinson’s gait!

Whether I name them or someone else does, the symptoms of PD are many and varied. From head to toe, we get a motley collection of shakes, jerks, aches, pains, and diminishing returns.

My future appointments run the spectrum of addressing simple fatigue to ruling out potential narcolepsy. This means the old sleep study is back, but this one comes with a nap study, too.

I also recently found out my left eye strength and field of vision are down dramatically. Since this is midlife maintenance time, there has to be another future hit on the soundtrack. This comes as a glaucoma test, which is in the works! Our fluctuating dopamine levels mess with our sense of smell and taste. It’s only logical that they would mess with the visual cortex, too!

Dental & oral health

Bring on the doctors... I'm ready. And let’s not leave the dentists out of this maintenance effort! I’ll be getting periodontal work done since Parkinson’s dry mouth issues affect this, too. We are definitely prone to mouth infections, which aren’t fun. They’re so not fun that they can necessitate root canals. Nobody’s favorite.

Looking in the rearview mirror, I had a thyroid ultrasound due to difficulty swallowing. This condition, which is called dysphagia, is a problem with dry mouth as well. To describe it simply, it’s as if the throat doesn’t want to swallow. Knowing the evils of aspiration pneumonia, I want to be careful and avoid anything that I possibly can.

Medication changes & other concerns

Pharmaceutical changes, thyroid medication increases, and my changing body are just another moment in the life of a marvel of medical science!

A surgeon will be removing my hernia. Could it have been due to Parkinson’s related constipation or limited mobility with Parkinson’s rigidness? Who knows, but whoop, there it is, making my ‘innie' into an ‘outie’!

This hernia, PD related fullness, belly aches, and lack of proper food movement have left the dormant muscle less than ideal. That, too, has a special name, which is gastroparesis. I don’t think it’s a stretch to say that I’m tired of these well-intentioned, though necessary, “spirit guides.”

It would be nice to come home and say, “I’m ok” and not follow it up with “...but.” So what's next? With the annual physical and routine checkups, as the old song goes, "anything goes!"