thumbnail of Your doctor speaks II; Parkinson's Disease
Transcript
Hide -
If this transcript has significant errors that should be corrected, let us know, so we can add it to FIX IT+
At the University of Illinois Medical Center campus in Chicago percents. Your doctor speaks during the series doctors in the colleges of medicine dentistry pharmacy nursing and graduate college at the University of Illinois. Well discuss the latest advances in cancer and heart research. Painless dentistry psychiatry nursing care and modern drugs. All of these and more will be presented on here doctor speaks. Your host for this series is Jack Gray camera coordinator of public service radio and TV programming for the University of Illinois Medical Center campus and champagne Urbana. This is jabbering and we're bringing another program that we do with our doctors from the University of Illinois Medical Center campus in Chicago. Our guest today is Dr. Louis Basham director of the consultation clinic for epilepsy University dawn I associate professor of neurology College of Medicine University when I and me
attending neurologist and psychiatry in chief of the neurology clinics. Michael Reese Hospital and Medical Center and member of the Medical Advisory Board United Parkinson's Foundation and he is also now president of the Chicago neurological society. And our topic today is going to be Parkinson's disease. Doctor botches Could you give us the actual scientific medical definition of what is Parkinson's disease. Yes Mr. Rigg Harmer Parkinson's Disease is a slowly progressive neurological illness which carries three major symptoms usually rigidity distressing and often uncontrollable tremor and an associated loss of automatic and unconscious posture movements which are essential to normal movements. It is a slowly progressive illness which affects only a small area in the brain we call the basal ganglia. In other words it does not affect the brain itself.
It was an illness that was described by James Parkinson in 1817 and he described it vividly in the following fashion quotes involuntary tremulous motion with lessened muscular power with a propensity to bend the trunk forward and to pass from a walking to a running pace. The senses and the intellect. Unimpaired In other words Mr. Rigg time or as I have already described these individuals bend forward. There's a certain amount of drooping of the head and there are small steps which we call shuffling are fascinating. Or in French the Petit pop. Well Doctor Who. Well who can be affected by Parkinson's. Actually anyone may be affected. A child may not be immune to this illness. Certainly there are some who have had measles with high fever who later develop Parkinson's symptoms. But you have this illness change so
affect individuals between the ages of 13 and 80 and men are slightly more affected than women. The most common age of onset may be between 45 to 55 during the most productive and useful years of a man's life. Perhaps sometimes he even dropped this from 30 to 50 years of life. So this is this is the age between 30 and 50 as you indicated the most productive years of a man's life and affects men more than it does women. That's correct. Are there many cases of programmed disease in this country right now. Yes Mr. economy or medical authorities estimate that perhaps there are bottom men you know half of Americans who are presently suffering from this illness only cancer and cerebral vascular. In other words diseases of the blood vessels of the brain exceed Parkinson's disease and the number of crippled and disabling cases right here in our own state. We have a hundred thousand cases 100000. That's right. There are
practically 25000 to 43000 cases of this noted every year. In other words these are new cases. Goodness than not. I would indicate from what you said that Parkinson's disease is becoming a national problem isn't it. That's right. The reason Mr. Rick hammers this we are living longer the lengthening span of life has brought a sharp increase in the over 65 year population. And I'm sure I don't have to remind you of this. With Medicare so strong in the wind it 900 There are only three million who are over 65. Now we have almost 17 million who are over 65 since at least one of. 20 perhaps 30 over 65 may develop Parkinson's symptoms a sharp rise in patients is inevitable until we find some means of prevention and some
means of cure. So it's because of the fact that we are living so long and because medical science has cured her or has gotten rid of some of the childhood diseases for instance polio and things of this nature that now we're seeing would you say more Parkins because now they're manifesting themselves later. That's right and not only that we're looking more and we have better means of finding these symptoms that suggest Parkinson's disease. What types of. Parking fees are there other types for that matter. Yes there is mystery commer we have different types of Parkinson's disease and if I were to classify him I would do it as follows. There is a so-called post encephalitis Parkinson's disease. These were casualties of the severe epidemic of Spanish influenza and the subsequent encephalitis of 1917 to nineteen twenty seven. However few of these cases have developed in the last three decades. I should remind you that in 1934 in St. Louis and in certain parts
of Illinois we had as and satellite yes after a mix. There's also the Japanese type there are the Russian types there are the horse types the east and the West types. But there are different kinds hind types of encephalitis. And then we have a large group mystery commer we call the idiopathic type. This is probably currently the most prevalent form of the illness usually develops between the ages of 40 and 55. However most cases of this type seem to begin between 30 and 35. The cause of this type. I'm going to ask you. Yes but authorities believe that certain stresses of life. Perhaps a blood vessel or circulatory disturbances and even abnormalities of metabolism can play a determining role. Finally Mr. requirement we have the arteriosclerotic type this rarely if ever develops prior to 55 years of age and surely is more commonly seen between
60 and 65. This generally sets in with a shuffling gait slowness and stiffness in both legs and trunk. This is a little different from the idiopathic type which often sets it with the tremor of an arm or of a leg. Also whereas in the latter that is the NEA pathic type of illness the Parkinson's symptoms appear suddenly in the background of an individual who ordinarily had good health in the outyears Carette a sclerotic type. The symptoms appear in what we call evanescent forms and there is often the antecedent history. What does it mean prior history of heart disease high blood pressure trouble with hearing headaches dizziness ringing in the years memory defects confusion or even we have in these individuals histories of what we call little strokes. And as I have already told you because people live longer we're seeing more and more cases of the arteriosclerotic type.
Boy Well since you said in the one of the areas we do not know the cause of this particular problem and unifies into three areas Parkinson's disease. What about the what about the treatment for Parkinson's disease can treatment help at all. Yes indeed. This mystery commers like any other reality is the sooner we see the person the better. If we give prompt and proper treatment we can help a patient to continually use fully functioning well as a member of society for many years. We can help functions which are lost for a while. We can even help control the progress of the disease. But as the challenges become greater we have to involve certain treatment facilities which are now available to help these people but unfortunately these are small. We don't have enough personnel who are trained. We don't have sufficient
numbers of rehabilitation centers physical therapy units psychotherapy services. We don't have enough in the way of occupational retraining. Even when such services are available unfortunately the costs are way beyond the means of certain people and certain families. And unfortunately too well as a result of all this mystery crime or neglect and insufficient treatment may lead to serious complications within a very short period of time an individual may become disabled may become a burden to himself his family and to society. His muscle rigidity can bring on a severe contractures and Sutton's certainly deformities his gait is such that he may fall and hurt himself cause fractures. He may be confined to a chair or to a bat and eventually become a total invalid. The tremor which may be severe causes sweating loss of weight loss of appetite inability to
sleep weakness depression and suicidal attempts. I could perhaps best capitalized capsulize this by saying that the treatment of Parkinsonism involves three major areas one medicine to physical therapy and three exercise. Could you expand on these areas what do you mean by medicine. What treatment would medicine play in is what you want a physical therapy and exercise. We fortunately have at our command the many medications medications which are meant for tremor. Some which are particularly good for rigidity and other medicines that help the loss of movement. The physical therapy is used to keep an individual's limbs moving flexible. If I were to equate this say to a bucket of water out in the cold the bucket of water would eventually become a bucket of ice. By the same token an individual who lives in Bath and who is
not moving his limbs becomes stiff because after all muscles are made up of water to almost 80 percent. Finally the patient himself must do exercises. Just keep moving. Other words like a waterfall in the woods a constant motion on a part of the creation as much as is possible without tiring the individual. What can the patient to do for well for himself or what should a patient know about Parkinson's disease. I'm glad you asked it that way mystery Kyra because a patient should be educated right from the start. In other words the first visit of the patient to the doctor's office is the most important thing. If the illness is treated early and intensively the prospects of a Parkinson's sufferer is better than the victim of other ailments that afflict mankind. Remember there is no inheritance the disease is not contagious. It's progressive slowly and some individuals may have a stationary period for up to
20 years with nothing happening. Remember there is no paralysis there's no numbness there's no loss of vision there's no loss of hearing or speech. I've already stated that mental facilities and faculties are unaffected. Since there is no paralysis as we have say multiple sclerosis or atrophy or wasting and muscles like we have in the old days of polio there should be little of any fear or prospect on the part of the patient becoming crippled except if this treatment is neglected or is inadequate. And yes and this is this is where the important point is that he must. Well he must work with the physician in treating himself this is very very important is not what is the inference is like you might maybe ask you his next area going into the next area what is the management for instance from your standpoint of Parkinson's disease. Well I've already told you Mr. Rick Heimer that fortunately we have in our armamentarium in our bag of medications for these
people certain drugs that can handle certain symptoms. In addition besides medicine we are now making some great strides in the management of the relief of symptoms with surgery. There are certain surgical procedures that have been developed in the past several years which have been developed through research have promoted and supported by Parkinson foundations. In other words there have been surgical procedures developed which can cut down on tremor which can cut down on rigidity and which can even help the matter. The so-called loss of automatic movements. Could you give us go into this a little more could you tell us more about some of the what you consider the recent developments to give hope to this whole problem of Parkinson's disease. Yes the medications are becoming better. Some of the finest laboratories in the country are sending us medicines all the time which we certainly give to our patients. For example I have in my laboratory
now three new medications which are not even named as yet which show considerable promise and in certain areas of this country there is considerable being done and research on surgery. Which surgery is being used all over the world. I might tell you that a long time ago there was some surgery called ligation of the anterior Karate the larger E which was an artery that supplies the area which is involved in Parkinson's disease. Subsequently a better operation was devised called chemo pal object to me in which the area which is involved was made inactive by chemicals such as alcohol or even hot water. Presently we are using what is called cryo genic surgery or the so-called freezing technique in which the individual's basal ganglia are destroyed by this structure by this structural change through freezing. Now we are coordinating research programs everywhere over this country to
help check the disease to discover its causes cure and its prevention. We're also doing much in the way of public education for the patient to understand. We're also working with families and also within the community to understand and recognise that a Parkinson individual is a fine person who just simply needs help but who can't act and can't even function the same as any of our ordinary normal individuals these are our objectives to recover. I think we want to make one point again. The fact is that Parkinson's disease is not to be. How confuse with mental retardation or is nothing there. This is the not connected is this true servants might disappoint again this this is entirely true Mr Reg timer and some of the mental retardation there are some children who have some involvement of the basal ganglia as a Parkinson's disease but these are rarities. No the Parkinson's Disease which I have
described particularly is that which is seen in the adult. Good this is a point we want I want to get this this across because I mean it might have been confusion in this particular area. How do you feel Doctor as a person who is involved in this area and Parkinson's disease and worked with. How do you feel the treatment can be as well as beat up as it were how can it be more progress be made in this area. We here at a university setting as others and other university settings can help by providing trained personnel rehabilitation facilities and equipment which is presently on available to many for the great majority of Parkinson's sufferers. And as I have stated large scale coordinated research programs must develop better drugs and better surgical techniques to treat to check the disease. And as I have stated to find its specific cause its cure and surely the prevention
cure it. He mentioned surgery many times in this particular discussion. What is the precious present status of surgical treatment at this time. The status is good festering Heimer. We have found that surgical measures for the management have been tractable. I use the word intractable because I mean these are those patients who have been on able to receive any kind of relief with good judicious medical care. These are the patients who are operated upon or operated upon properly and with the correct techniques and who can be bettered. In other words after a patient has had every good honest and sincere attempt to be managed on a medical basis if this does not succeed then he may be considered as a candidate for surgery at this particular time. Yes indeed Mr read Homer.
What is the what is the national Parkinson's foundation and what is it. What are the trying to do. The National Parkinson Foundation is a non profit voluntary organization. It's an aim is to organize public support for a coordinated attack on this disease we're discussing this morning. In this way it will accomplish for its sufferers what other national health agencies have done for victims of cancer tuberculosis polio heart disease etc.. The research the treatment facilities and the public education needed to meet these problems seem to be beyond the scope of individual communities. Hospitals physicians and patients. Because there are so many patients and I told you there is such a lack in this country. What these patients need and otherwise Mr. Rigg Heimer only a concerted effort can meet the challenge of America's third most
crippling yellowness Parkinson's disease. Dr. Abbas's let's get into a I think a very important area and this is the emotional aspects of Parkinson's disease. I imagine you play and pay a lot attention to how the patient himself feels and how he's reacted to by other people. What is my what is the physician's role in this area of emotional aspects of Parkinson's disease how do you help the patient in this area. This is a very important question and I'm glad you asked it of me. Because we must think of the patient and how he feels from within. Just remember here is a person who was a very active productive individual and as time goes on he becomes just the opposite. For example a man who is a writer who cannot use his hand any longer in writing or an individual who is an artist not how can he feel. Certainly
something has been taken away from him and this emotional impact with all the accompanying stresses and strains must have a very detrimental effect upon him. How can he respond. Many respond with depression. And so that is where the physician comes in to explain to the individual that he has an illness. Unfortunately it is an illness but it is a kind of an illness which has the characteristics that I've already described. And he must make the best of it. I should also tell you that the Parkinson individual is one of the most appreciative people we know. Anything you do for him is appreciated. As a matter of fact when you put him on medication he responds almost immediately. Often these medications have to be changed but still he responds very well and he's very happy with whatever you do. Now back to the depression aspects we tried to make this individual understand that he has to face the future
constructively and he can even be productive. We have to assure his place within the family because he may withdraw he may become seclusive he may become very antisocial. And we must not permit this to happen he must still retain a place within the family. He must play a role amongst his friends. In other words the friend must understand that his friend the patient has an involvement. It is only a group of symptoms which make up an illness. In other words he can still play golf as he did before. He can still play ball if he wants to. He complained checkers. He can go to the movies he can go to the theater he can go to the opera along with the friends he may go to a party. The only thing is this that friends should not look upon this patients and show severe pity or compassion. Actually most preach hate. Most people see a Parkinson once and then after that he is just the same as anyone
else within the community. In other words what I'm trying to tell you Mr. Rick Heimer is that if we can prepare the participation properly to accept his illness and to still go ahead in spite of the symptoms that we have a find individual who can function as well as an individual without Parkinson's disease beautifully productive. Thank you very much for being our guest today we've been talking about a most interesting and important topic and that is Parkinson's disease. Our guest has been Dr. Louis Boxer's WHO director of the consultation clinic for epilepsy University of Illinois and also associate professor of neurology College of Medicine University of Illinois and attending neurologist and psychiatrist in chief of the neurology clinics. Michael Reese Hospital and Medical Center and a member of the Medical Advisory Board United Parkinson's foundation and Dr. Bhatia is also president of the Chicago neurological society. And as I said our topic today was Parkinson's disease.
Series
Your doctor speaks II
Episode
Parkinson's Disease
Producing Organization
U. of Illinois Medical
Contributing Organization
University of Maryland (College Park, Maryland)
AAPB ID
cpb-aacip/500-pk07248x
If you have more information about this item than what is given here, or if you have concerns about this record, we want to know! Contact us, indicating the AAPB ID (cpb-aacip/500-pk07248x).
Description
For series info, see Item 3434. This prog.: Parkinson's Disease. Dr. Louis Boshes.
Date
1968-07-01
Media type
Sound
Duration
00:25:03
Embed Code
Copy and paste this HTML to include AAPB content on your blog or webpage.
Credits
Producing Organization: U. of Illinois Medical
AAPB Contributor Holdings
University of Maryland
Identifier: 68-24-6 (National Association of Educational Broadcasters)
Format: 1/4 inch audio tape
Duration: 00:24:48
If you have a copy of this asset and would like us to add it to our catalog, please contact us.
Citations
Chicago: “Your doctor speaks II; Parkinson's Disease,” 1968-07-01, University of Maryland, American Archive of Public Broadcasting (GBH and the Library of Congress), Boston, MA and Washington, DC, accessed September 20, 2021, http://americanarchive.org/catalog/cpb-aacip-500-pk07248x.
MLA: “Your doctor speaks II; Parkinson's Disease.” 1968-07-01. University of Maryland, American Archive of Public Broadcasting (GBH and the Library of Congress), Boston, MA and Washington, DC. Web. September 20, 2021. <http://americanarchive.org/catalog/cpb-aacip-500-pk07248x>.
APA: Your doctor speaks II; Parkinson's Disease. Boston, MA: University of Maryland, American Archive of Public Broadcasting (GBH and the Library of Congress), Boston, MA and Washington, DC. Retrieved from http://americanarchive.org/catalog/cpb-aacip-500-pk07248x