Should my father be treated for "parkinson-like" symptoms if he is otherwise in good health?
My 88-year-old father has what his doctor refers to as "Parkinson's-like symptoms" but refuses to prescribe medication that may help some of the symptoms (shuffling feet, stooped gait, vacant stare, weakness and palsy in one arm). He was temporarily prescribed Sinemet at one point by another MD while his GP was away and his symptoms seemed to improve. His GP says that the side effects of the meds are too great to chance taking the Sinemet. My father is in great health -- strong heart, blood pressure stable, and so on, otherwise. Should I push to have him prescribed this medication? I would be most grateful for your input.
Take your father to a movement disorder specialist, a specialization within neurology. These specialists can be found at centers listed on the web site of the National Parkinson Foundation http://www.parkinson.org. "Parkinson's like symptoms" could come from several causes and not just from PD. It is important to get a proper diagnosis for a neurological impairment.
There is no question that your father would be helped by being treated for parkinsonian or old age symptoms. The question is what that treatment should be. You already were advised that a proper diagnosis should be made by a neurologist specializing in movement disorders and that is standard practice. What is also important is that any medication being prescribed should be discussed with the patient and also family if they are involved. It is important to know what side effects can occur as well as what the medication will do and what it could do with ongoing use. Temporary Sinemet is odd because levodopa/carbidopa must be titrated both up and down. I think that if I were an alternate doctor I would have provided a list of supplements appropriate for older age and your father's condition. In this case I would have proposed some simpler ones such as vitamin B complex and certainly antioxidants such as CoQ10 because your father would have been refered to a neurologist for diagnosis. There may be other medications which would be more suitable depending upon the diagnosis. What you should push for is a diagnosis and not symptom treatment.
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