Talking to Your Doctor About Parkinson's Disease

" hi and welcome to our webcast on doctor David marks. Parkinson's disease poses tremendous challenges little patience and their caregiver. Fortunately doctors have a number of effective treatments available that. Now these treatments can help alleviate symptoms and approve -- quality of life. One way to improve that -- and that communication between patients caregivers and their doctors here to talk about the latest treatment options and the importance of dialogue between doctor patient. Our -- expert. First is doctor may help Talley -- and neurologist from Beth Israel Medical Center in New York City welcome thank. And next to him is doctor wrong Alterman he's -- neural surgeon -- all sort of Israel thank you for being. I haven't -- a fortunate enough to have a parkinson's patient. Carol -- welcome. And -- heat is caregiver of parkinson's patient named Richard who can't be here but I noticed is going to give us his expertise on the subject line and thank you doctor telling -- What is parkinson's."

" Well parking and disease is caused by the premature death of a small area in the brain which produce safe and we called -- called -- The grainy don't mean to coordinate. Their movements up about. And went opening his decree because -- To premature death of the small area. The -- apart and the Kirk but how can you tell someone actually has the disease or you're not a silly looking numbering only. There are three fundamental -- that the -- and and one trend are the second one piece. Unusual law on the floor lack of that editing their movement and luck Courtney. And the third -- Stiffness so much that we -- rigidity -- done that usually occur later on that he take. -- ability a lot of balance well walk. And they have to have all the until we -- parkinson's not dig down deep depth thing you know of the -- in the press has at least two of the sport they are intent and there is that are allowed real. Malt. Other symptoms like lack of rest of your case. It difficulty in writing letters come out there is small and -- our fault. And problems that ring sleeping her or I'd be doctor Alterman as a neurosurgeon. And be very writing you because. -- a time when we have an increasing number of treatments for -- tell."

" About them yet and isn't very exciting time I'll be Kossuth it -- isn't in various technologies and in our understanding in the physiology we unit eight. A renewal of the interest and surgery for parkinson's disease. Nevertheless the front line treatment of parkinson's continues to be medications. The most successful of those medications or something called -- Which is taken up by the brain and literally replaced as the delta meaning that has -- law and it will go PL to open. Over time however we note that the leader -- will lose its effective. And maybe his short -- here for some people but it can be as long fifteen or twenty years or other. In addition to losing it's effectiveness. Many occasions the gulf side effects from the Medicaid political leader -- but induced to Chinese. We abnormal almost legally snake like movement of the patients experience when they have doesn't -- In addition to pay full periods may experienced -- called on off a situation where they quickly switch from the on state when the medications are effective. To -- off state and not as quality of life here it's because of these on all fluctuations in the complications medical therapy. Those patients may benefit from surgery. And surgery is currently reserved only for those instances where the medications are no longer effectively. Giving people good quality of life when you say surgery what exactly do you mean. Predominantly today -- that we performed is deep brain stimulated and where we implant very small electrodes. In two a no -- structure in the Frankel an awful lot of nuclear. I'm alternatively one can implanting electrodes into a structure Golden Globes -- In both case has to treat advanced parkinson's disease -- just part of -- part to bring. Those electrodes have been connected to a pacemaker. Literally just like the heart pacemakers -- people with heart disease have only the current goes up into the brain and down to the heart. And -- makers can be programmed as needed to release many of the symptoms of parkinson's disease. "

" Doctor -- adding what are the barriers parkinson's patients receiving the latest treatment. Well there -- Really no Bay Area to -- Annan medication. Or parkinson's that are widely available usually provided on this income become -- Affecting your quality of life. As -- surgeries on -- and the brain surgery you still seem. Something very dangerous. And that something. That shouldn't be done unless you -- strayed to her again but don't want. And -- do that perception that a missing our experience. Should be and didn't. I'm writing -- excited because. When park and a band that point -- we had medication they're no longer effective. Surgery is not only paid in court and off and study something that the -- should be our. But without. You know -- dictated. Bite -- knowledge. Let's ask of patient. When you hear that term brain surgery. Does that scare you."

" Now my students and praised Clinton's very wonderful. The only pain that was where none from nicotine and seeing. Can dull the pain you have to quickly and let alone. Strategy for invade. --"

" Did it scare you both forehand when you or -- your doctor about sparing surgery. He is -- concept to many people."

" Well let down his throat and -- better have -- that. With and know until -- And number and told me explain to me. It was -- clone. -- is that kind of the gotten."

" Otis nodding his head right at my partner Richard wasn't the -- of it one bit either. He was looking forward to it and I guess the scariest part about it was. How he looked when he had -- Attached to his head going into surgery -- Us. It is not -- blurted things like that but it just looks scared. But he had no problem with -- or no pain except vote as was mentioned the little. Pin pricks in them -- his skin to dozens of pain felt in June."

" Great people only -- but wouldn't you suggest to patients who may not be a fight with their treatment. Within medical and our medical -- obvious I think they need to speak with her position and explore various options there are what are called unconventional options terms of vitamin therapy and such and and there are expert in those area that people can Equant. If there is that the patient is being treated by general morale someone who does not a particular expertise in movement disorders. They may ask for referral to a movement disorder and around. On people such as my colleague doctor telling us they are. Expert at manipulating medications and in many patients that are referred to a from surgery often can get another couple of years. I'm just with management of their medications tiny troop movements order extra Carol we have. Now vitamins they're. -- adult there's little brain surgery how to go about deciding. Which treatment or -- yet."

" Well runs Thursday because I didn't know what's critical in an excited to mountains police -- And I am really trying to vitamin therapy. That they can has lead to blood he was lacking was not acting and I didn't let -- be -- I didn't. Right and had to be trust us. I don't need. -- basically does love me and don't need. Yeah. And alone. And let it run that was what I was until -- he -- Artwork and you know which car -- Alston on. And unknowns and then ever lived with him and I thought then rounds and even. He told me that century and he never."

" Thing don't vote is there's a lot of information out there honey you find out. The latest information it'll lead to very latest in treatment we found we went to really support group of parkinson's support group. And -- quite a -- Support groups they're not as if you -- in Manhattan here and also around the country I would recommend that people. Find out about support groups in their neighborhoods -- in -- in their communities thank you for being here and I want to thank the doctors are being here. Thank you for joining our webcast on doctor David mark and by."