Dear Drs. Donohue and Roach My dad, age 77, has just been told he has Parkinson's disease. We, his children, aren't sure of the implications of this for him, our mother or us. Currently, he isn't greatly impaired. He moves more slowly, but his thinking is clear. His hands don't shake.

What can we expect? B.B.

Answer Parkinson's disease, PD, is estimated to affect a million North Americans. It's a difficult illness difficult to have, difficult to treat and difficult to understand. Most of the time, the illness strikes people over the age of 60, and most cases of Parkinson's disease are not inherited.

The underlying problem is a depletion of dopamine, a brain chemical that is vital to smooth, coordinated muscle movement and to thinking. Four prominent signs distinguish this illness. One is tremor, a shaking of the hands when they're at rest, as they are when they're lying in the lap. The index finger and thumb constantly roll over each other. Muscle rigidity is obvious when a doctor tries to move the arms or legs of the patient. They tend to be tightly frozen. Parkinson's patients find it hard to button a shirt or tie shoes. Bradykinesia, slowness of movement, is another sign of PD. Typically, patients walk with slow, shuffling steps. They're quite prone to falls. As times passes, many patients develop trouble with clear thinking.

The treatments for Parkinson's disease are many. Often the first choice is Sinemet, a combination of levodopa and carbidopa. It restores brain dopamine levels. I'll mention some other drugs to give you an idea of available medicines, but I can't elaborate on the way they work space isn't available for that. Amantadine, Artane, Requip and Comtan are but a few of the Parkinson's medicines that can be turned to if Sinemet fails to bring a satisfactory response.

From the time of diagnosis, Parkinson's patients average 10 more years of life.

Dear Drs. Donohue and Roach Doctors, three, told me they thought I had ovarian cancer and that I needed urgent surgery. I was taken to surgery but I didn't have ovarian cancer. I had a dermoid cyst.

How come three doctors, all of whom had me get ultrasounds, couldn't diagnose this without sending me to surgery? N.C.

Answer Dermoid cysts contain cells that belong to skin, hair, oil glands, teeth, muscle, lungs and the digestive tract. Although ultrasound pictures of the ovary are able to furnish an answer on the nature of such a mass, the pictures don't always provide a definitive answer.

Write Drs. Paul Donohue and Keith Roach at P.O. Box 536475, Orlando, Fla. 32853-6475.

Go here to see the original:
A primer on Parkinson's disease