The nurse pushes his wheelchair into the small room. He’s smiling. The doctor comments he doesn’t have the face of a person with Parkinson’s disease. He has expression and movement in his features.
He reviews his past notes with the patient, explaining what he believes he suffers from; lower body parkinsonism brought on by chronic hypertension, diabetes and microvascular disease. With decreased sensation in his feet, a consequence of neuropathies in his legs, his balance and gait are affected. His wife reports he has fallen twice in the past six months and both times they had to call medics to help him from the floor.
Though he had been taking levodopa he has weaned from it, when he concluded it had no affect on the gait and balance problem he contends with. Behind the desk, the physician tells him there is no medication he can recommend for his problems with walking. The medications given to those with idiopathic PD are of little help to him, an anticholinergic medicine would increase the fogginess in his mind and increase urinary flow. With prostatic hypertrophy he has to be cautious about urinary function. Essentially, there is little he can advise. The wife nods and comments they have kept their appointment to check whether something new has presented, that would be useful to him.
The doctor nods and comments physical therapy is important. Continuing the exercises independently will help him retain strength in his lower body. His wife comments it’s very hard to motivate him and he gets angry at her for badgering him about exercise. The doctor nods. Five minutes every day for a week would be a conceivable start. Increasing the time weekly as he gets used to the idea, he will begin to see changes in his body.
So what if the patient begins exercising and gets seriously involved, dedicating time daily. Will this begin to repair the neuropathy he has in both legs? Damaged nerves can repair. The man has diabetes. Will a new diet and exercise regimen change what ails this guy? He is only sixty-seven. He is perhaps twenty pounds overweight. His wife too, is heavy. Microvascular disease has a hereditary component, but what if he changes his habits?
The doctor notes if he can regain strength in his legs he’ll be able to get back to golfing. The patient mentions the pool in their community, and the doctor comments he would recommend wearing some sort of flotation device, in case he gets a cramp. Anyway to increase blood flow to the brain, would be beneficial. The wife pushes her spouse from the examination room, her hand full of a new prescription for Zoloft and physical therapy. The husband comments one of his old golf buddies won the Master’s competition.