Parkinson’s Disease: Case Study

Parkinson’s Disease

The paper focuses on the case study of Walter, who has been diagnosed with Parkinson’s disease. The illness remains one of the most common neurological conditions that affect people globally. In essence, it is a neurodegenerative disease. In most individuals, it progresses slowly. The brain of a patient usually stops producing a neurotransmitter. Primarily, Parkinson’s disease involves the malfunction and destruction of neurons that surround the brain. The condition impacts the neurons at the substantia nigra (“Parkinson’s Disease,” 2016). These dying neurons usually produce dopamine. It is a chemical that sends signals to other parts of the brain; hence, the process affects one’s movement and coordination. The progression of Parkinson’s disease causes a decline in the production of dopamine in the brain. As a result, an individual fails to control own movement. It is estimated that 1 out of every 500 people in the United States have the disease. The condition is more common in aging people (“Parkinson’s Disease,” 2016). In fact, statistics indicate that 1% of individuals above the age of 60 have Parkinson’s disease. In such a manner, the average age of diagnosis is 59. Men have a higher likelihood of developing Parkinson’s disease than women. The case study considers Walter, who is an older white American, who is diagnosed with Parkinson’s disease (PD). He is 67 years of age. Consequently, he has been started on Sinemet.

Clinical Manifestation from the Pathophysiological Perspective

Walter has signs and symptoms that prove the presence of PD. In essence, these clinical manifestations have pathophysiological explanations. First and foremost, Walter goes to the hospital with a complaint of the physical sign and symptoms of motor dysfunction. Nevertheless, before considering these manifestations, it is crucial to comprehend the role of dopamine in the coordination of human moments. Dopamine is a neurotransmitter. In essence, it transmits chemicals from one cell to another across the synapse. A neurotransmitter is usually secreted from the storage vesicles to an external membrane. Subsequently, it crosses synapses and gets attached to the postsynaptic layer. It activates the dopamine receptor (McCance, Huether, Brashers, & Rote, 2010). However, the unused dopamine undergoes repackaging and gets back to vesicles. Research indicates that dopamine cells usually die at a slow rate progressively. Nevertheless, in a person with Parkinson’s disease, such as Walter, this rate is high. In fact, by the time the first motor symptoms appear, there is usually a significant decline in the dopamine level in the patient’s body. Evidently, PD is a condition of increased cell death that occurs in the process of normal aging (McCance et al., 2010).

Walter demonstrates the symptom of tremors. It is the most evident and gnawing sign of the disease. Tremor begins in limbs. It is usually a continuous shaking. One can easily notice a back-and-forth movement of fingers. When a person is in a relaxed state, there is a tremor in their hands. The condition is caused by the declined number of neurotransmitters. The second symptom that Walter has is the difficulty in walking while playing golf. It is called bradykinesia. In essence, Parkinson’s disease limits one’s ability to move by slowing the patient’s movement over time. Consequently, it becomes time-consuming for one to move from one place to another. Steps usually become shorter. In some instances, one finds it difficult even to get off the chair. There are other symptoms that Walter does not demonstrate at the moment. They include impaired posture and balance, speech changes, writing difficulties, and urinary incontinence, among others. These problems are the main symptoms of PD. In fact, doctors call them all as Parkinsonism. However, there are some other symptoms, as well. Walter also complains of difficulty with sleeping and constipation. It is critical to note that an individual can also demonstrate mental symptoms. For example, the lack of sleep, which is also known as insomnia, can occur to a person with the condition. It is because of the excessive sleepiness that one experiences in the daytime.

Risk Factors

Risk factors are the agents that increase the chances of developing or acquiring a condition. There are certain risk factors that predispose an individual to the development of Parkinson’s disease. Nevertheless, from the onset, it is fundamental to highlight that the primary cause of the condition is yet to be established. Consequently, the list of risks only points out the possible causative factors. The first one is age. Statistics indicate that it occurs in older people, who have higher chances of developing Parkinson’s disease. However, there is evidence that it can also affect young individuals (“Parkinson’s Disease: Risk Factors,” 2016). The explanation behind the risk factor is that patients with PD have neural damage that is caused by their genetic or environmental makeup. However, it tends to get worse with age. According to the case study, Walter’s condition seems to have worsened at the age of 67 years. The second factor is sex. Research asserts that males have a higher likelihood of developing PD than their female counterparts. There are reasons for these findings. Males have greater exposure to toxins and head trauma. There are also theoretical perspectives that observe that estrogen has a neuroprotective influence. Moreover, the genetic predisposition states that the gene that is predisposing an individual to Parkinson’s disease is linked with X-chromosome. According to the study, Walter is male. Therefore, his case reaffirms the assumption that men are predisposed to the condition.

The genetic factor is another important issue. Research, conducted by Mayo Clinic, has revealed that the gene known as alpha-synuclein plays a critical role in the risks of developing the disease (“Parkinson’s Disease: Risk Factors,” 2016). In fact, the studies assert that an individual with a more active gene has 1.5 times higher chances of acquiring the condition. These findings prove the necessity of developing alpha-synuclein suppressing therapies that report the ability to slow down or halting the process after an extended period. There are also environmental factors. For example, head trauma is a predisposing agent. Recent researches assert that there is a link between the damage that occurs to the head, neck, or cervical spine and the emergence of Parkinson’s disease. A study that was conducted in 2007 and used 60 patients showed that such kind of trauma was associated with the upper cervical damage (“Parkinson’s Disease: Risk Factors,” 2016). Some patients remembered these incidents. Moreover, it took them years to develop the disease. Agricultural work is another critical point. In such a manner, this activity exposes a person to environmental toxins such as pesticides and herbicides that enhance the production of dopamine and contribute to the free radical change. It is vital to point out that these toxins cause a greater prevalence of PD symptoms. Consequently, people involved in farming activities are at great risk. Having a close relative, who has suffered from Parkinson’s disease, increases one’s likelihood of developing the same condition. The risk tends to increase if one has a high number of relatives with the disease.

Rational for Common Treatment Modalities

The treatment of Parkinson’s disease remains one of the most interesting areas that science continues to advance. There are two basic approaches to the treatment of this condition. The first one seeks to increase the level of dopamine in the brain. In its turn, the second approach attempts to manage the symptoms by using other techniques. In this case, Walter has been put on Sinemet. Sinemet (also known as Levodopa) is the most common prescription for patients with PD. It is effective in managing symptoms of Parkinson’s disease. Particularly, it helps ease bradykinesia and rigidity (Fahn et al., 2004). It is crucial to consider the pharmacological process of drug intake. Levodopa is transported to nerve cells in the brain that are responsible for producing dopamine. Subsequently, it is turned into dopamine. Consequently, it is used by the body as a neurotransmitter. It is crucial to note that Sinemet is composed of levodopa and carbidopa. While levodopa gets into the brain and is changed into dopamine, carbidopa improves the effectiveness and inhibits side effects of the first (Fahn et al., 2004). Usually, levodopa causes nausea, vomiting, and irregular heartbeat. Therefore, Walter is suggested to take Sinemet before meals.

It is critical to note that while Sinemet is considered the most effective drug, it has long-term impacts. For example, it has been reported to cause the development of dyskinesia in patients. In fact, research indicates that levodopa can result in restlessness and confusion that are coupled with irregular movements. There are doctors who recommend that patients start with alternatives and only use the drug if little or no improvement is experienced. There are other drugs that are known as Dopamine agonists. They activate the dopamine receptors in the human body. In essence, they copy the functioning of dopamine in the brain. They include Requip, Mirapex, and Neupro, for example.

Lifestyle Implication for an Individual

There are lifestyle implications of the disease for Walter. First, the family is affected. It is a crucial pillar for the sustenance of the economy. Parents require physical strength in order to provide for the family. When an individual develops Parkinson’s disease, the slow progression prevents one from full participation in the family activity. It is vital to note that relationships and roles within the family are going to change, as well (Kenney, 2014). In fact, as the disease progresses, Walter is likely to be unable to take part in some activities. It is critical to note that children should take part in family discussions of such changes. This practice will help them cope with the ailing parent and come up with appropriate strategies for taking part in the healing process of Walter. While the diagnosis of Parkinson’s disease does not mean an end to the career of an individual, it may limit one’s effectiveness. In this regard, Walter is better placed because he has already retired from his career. However, playing golf and traveling are parts of his enjoyment plan. Nevertheless, because of tremor and bradykinesia, there is a likelihood that he will have to give up these activities. In fact, it would also be unsafe for the man to drive alone. It is because of the potential accidents that may arise. There are also some cultural implications (Kenney, 2014). It is vital to note that Walter may not accomplish the traditional role of a man in his family. It is evident that the society expects a male to cope with the most difficult and strenuous tasks. Nevertheless, Parkinson’s disease reduces the effectiveness of an individual. Therefore, it is imperative that one of the nursing interventions regards education concerning the life changes that Walter will experience. The knowledge will be fundamental in helping him cope with rigid cultural perspectives of society.

Conclusion

The discussion considers a case study of Walter, a 67-year old man, who was diagnosed with Parkinson’s disease. This condition is a neurologic disorder that affects dopamine which is a neurotransmitter. The signs symptoms include tremor, bradykinesia, speech and writing problem, insomnia, and constipation, among others. There are contributing risk factors. They include age, gender, genetics, environment, and head trauma. Sinemet remains one of the most effective drugs for the treatment of the condition. Parkinson’s disease has both family and cultural implications on the lifestyle of an individual.