Over a million people in the U.S. are now living with Parkinson’s disease and every year another 60,000 new cases are diagnosed.
According to the Centers for Disease Control and Prevention, complications from Parkinson’s are a leading cause of death in this country and the Parkinson’s Disease Foundation puts an annual price tag for the ailment at more than $25 billion a year.
For Dr. Xabier Beristain, a newly arrived neurologist at the Indian River Medical Center, the best way to deal with this distressing disease is through a collaborative effort.
“When I treat patients,” says Beristain, “I like to be their co-pilot rather than the driver of the bus. I tell them what their options are. Then that person can consider those different options. I want them to be involved with their own care and tell me what they would like to do. Some people like to be told what to do, but I like to share that responsibility with the patient.”
And when it comes to Parkinson’s, there’s a great deal to share.
The National Institute of Neurological Disorders and Strokes cites tremors or trembling of the hands, arms, legs, jaw and face along with stiffness of limbs, slowness of movement, and impaired balance and coordination as the most common symptoms of Parkinson’s, and it’s those symptoms rather than the disease itself that do the most damage.
As Parkinson’s progresses, those symptoms become life-threatening. Falls, difficulty in swallowing and pneumonia are all closely linked to the disease.
Parkinson’s patients are four times more likely to contract and die from pneumonia than the population at large; fully 70 percent of all Parkinson’s-related deaths are attributed to aspiration pneumonia.
Pneumonia develops so frequently in Parkinson’s patients because when the muscles in the throat and esophagus fail to operate properly, they can direct food or liquid into the patient’s lungs rather than the stomach. The lungs and airways then get infected causing the frequently fatal lung disease.
Parkinson’s patients are also at risk for asphyxiation or choking to death from food blocking their airways. Fatal falls from balance problems leading to cerebral hemorrhages are also far more common in people with Parkinson’s than the public at large.
Beristain adds that severe malnutrition can also affect Parkinson’s patients “because people may not be willing – or able – to eat much.”
If all that is not enough, an often-overlooked part of the Parkinson’s puzzle is depression.
“Actually,” says Beristain, “as many as 40 percent of Parkinson’s patients do experience acute depression as a part of the disease. But sometimes the depression can even happen before they have obvious symptoms of the disease. So, in a sense, it’s a change in the chemistry of the brain that makes them depressed before they really have enough to be depressed about.”
The root cause of Parkinson’s is not known and there is currently no cure.
The Mayo Clinic says Parkinson’s develops when nerve cells or neurons in the brain break down and are no longer able to produce the chemical neurotransmitter called dopamine.
When dopamine levels decrease – and right now no one knows why they do – the brain is no longer able to control a wide variety of functions including controlling the muscles in the body which results in those tremors as well as those balance and swallowing problems.
While a cure still seems far in the future, Beristain says there are medications that can treat and ease Parkinson’s symptoms. He first points to medications originally created to prevent seizures saying those can be diminish the involuntary movements or tremors of the disease.
Beristain is just starting to build his neurology practice here in Vero Beach and he seems genuinely proud to say, “Every patient is different and I learn different things from my patients every day,” which does, indeed, sound more like a doctor looking to be his patients’ co-pilot.
Dr. Xabier Beristain is with the Indian River Medical Center. His office is in the new Health and Wellness building at 3450 11th Court. The phone number is 772-770-6848.