For eighteen years she’s had PD, and she’s been seeing the doctor since she was first diagnosed. She had been married then, living in the Keys with her spouse where they owned a restaurant. That was some time ago and now she lives on the east coast of the state and makes the three hour journey with a friend who drives. They have a birthday party to attend later in the day. She uses a rolling three- wheeled walker when she walks. It has a large pocket where she stashes all the things she might need.
She mentions when she was a child she used to be claustrophobic. She had to sit in the passenger seat in the front of the car, because sitting in the middle, or in the very back of the car made her feel as though she can’t breathe. She was the youngest and smallest child in the family and yet she was relegated to the seat in front. She still gets the sensation these days, and feels it may be worsening. The doctor states Parkinson’s disease probably has little to do with the feeling. She stands and paces in the small room, then sits back down. Her blood pressure is quite high today. The systolic a bit over 170. The doctor checks her past pressures and notes they have become progressively higher over time. He urges her to take her pressure regularly, and to make sure her general physician is aware of her numbers.
Without dyskinesia, she has occasional tremor in both hands. It doesn’t stop her from activities. She played bingo the previous evening. Her symptoms are well controlled with morning Parcopa, the dissolvable form of Sinemet, and the Neupro patch. She gets the original formulation, flown in from England monthly and kept on ice until it gets to her door. She keeps the medication in the refrigerator. Every month she pays five hundred dollars. She concedes it took two months to get her medications under control when she began using the patch. She was not able to immediately cut the intake of Sinemet, but she’s become accustomed to it.
The autonomic signs of the illness appear in flashes of sweating, somewhat akin to what menopausal women experience. She knows to eat fiber rich food, for her bowels. Her frequent urination was diagnosed previously. She claims the issue doesn’t bother her. Her voice lacks the breathy quality many patients with the disease acquire.
The doctor would like to add a mild antidepressant to her regimen of medications. It will also improve her sleep quality, as she is unable to take Seroquel without feeling as though she has been completely anesthetized. She claims to be able to feel her medication begin taking affect in her body. The sensation begins in the toes and works upwards, as though a current, covering her entire body. Other times she will feel her muscles suddenly slacken from the constant tension that keeps them rigid.