As part of the pre-operative routine, it’s customary to take video before and after surgery, in both the “on” and “off” states. I’m in the process of tapering off right now, and I don’t really like where I’m going. I can still type, somewhat slowly, after my last dose (11 am). But boy, am I stiff. And that cervical dystonia is really aching. The tremor is getting worse, so I’ll be back later to write more.
For older people, and especially those with Parkinson’s, a fall-related injury is the first event in a chain that leads to ever-worsening problems. I’d say it’s probably the best indicator of how advanced a person’s progression is: the cane, the walker, the wheelchair, and the ability to negotiate even a door jamb or threshold.
in the Journal of Neuroscience Nursing (reprinted at Medscape) describes interviews with 28 people with Parkinson’s. Nearly all of them knew that they were at higher risk for falling. However, many did not understand the factors that might lead to falling, especially the risk posed by medication:
Although our cohort recognized that their probability of falling was substantial, they lacked awareness of specific risk
factors for falling, particularly those associated with medication use. This was a surprising finding, considering that the participants enrolled in this study were taking numerous medications, and many of those medications are known to increase risk for falling. The fact that these individuals attended a movement disorder clinic led us to hypothesize that
their awareness of all risk factors would have been much higher.
Maybe it’s simple denial, a willful whistle past the graveyard, or maybe there’s some pathological blind spot that leaves those of us with PD in ignorance of even the obvious. Hopefully our friends and partners are more aware of these problems, and are willing to look out for us.