Positive approach key in Parkinson’s fight, says specialist

September 21, 2016

© Krysta Carroll /Special to TC Media

Dr. Mohamed Boodhan is a neurologist in Grand Falls-Windsor, the only neurologist in central Newfoundland, meaning he treats all Parkinson’s patients in the region. He always paints a beautiful picture for his patients, and stays positive.

“Don’t go too near the tree as to miss the forest.”

“Don’t focus too much on a single issue, look at the big picture, and I think it will be OK.”

This is advice from Dr. Mohamed Boodhan, neurologist in Grand Falls-Windsor.

Positive thinking, and positive people around you is a big part of the battle when dealing with any disease.

“You are very much influenced by your company,” he said. “That’s why it’s always a good habit to keep the company of good people because they have a good influence on you.”

Boodhan has the responsibility to treat all Parkinson’s patients in the central region, and he always gives words of hope and encouragement.

“I think in our positions, what we say matters,” Boodhan said. “If you paint a bad picture you depress people.”

He paints a much brighter picture for his patients.

“You have Parkinson’s but don’t let the disease eat you, you eat the disease,” Boodhan said. “Walk daily, take your medication and make the best of what is left. Be happy and everything will fall into place. At the end of the day I think people of faith do better than people of no faith. They have tomorrow, heaven, as a good incentive that this is not going to be forever.”

Boodhan said he can only speak for himself, and not what the book says about Parkinson’s disease.

“If it affects them, and it will, then they need to talk to the right person who will give words of encouragement,” he said.

Parkinson’s disease, he said, is a neurodegenerative condition. There is lack of a dopamine in the brain that leads to the symptoms and signs of Parkinson’s disease.

“Like other diseases, anybody who is alive can have Parkinson’s,” he said. “The more elderly we are, the more at risk we become.”

It can be genetic or environmental, but the percentage is very low, he explained.

“In fact, they are not 100 per cent sure why there is a lack of dopamine in the part of the brain that secrets that substance,” he said. “However, the final common pathway is a lack of dopamine.”

Symptoms

There are four cardinal symptoms - tremor, rigidity, akinesia (slowness of movement) and postural instability.

“Technically if two of these four cardinal symptoms are present, then one can confidently make a diagnosis of Parkinson’s disease,” Boodhan said.

The tremor of Parkinson is unique, are usually at rest, and disappear with movement or thinking, he explained. That specific tremor alone allows for a Parkinson diagnosis even without the other features, but then it would be minimum Parkinson’s.

“This becomes a social problem for many,” the doctor said. “I tell them to put their hands in their pocket,” Boodhan said.

Rigidity is the main problem in Parkinson because the muscle becomes tight, and can cause diminished facial expression.

“When the muscles of the face are involved, they lose that spontaneity,” Boodhan said.

After 30 years, Boodhan said, it only takes him five seconds to diagnose Parkinson’s disease.

“The moment they enter the room, before they sit down, I know they are dealing with Parkinson’s,” he said.

“Whenever I diagnose a patient with Parkinson’s, I tell them, ‘The first thing I want to tell you is there is nothing serious, and nothing dangerous in what I have diagnosed,’” Boodhan said.

He then informs them that their problem is a lack of dopamine.

“I wish I didn’t have to use the word Parkinson’s because I don’t like it,” Boodhan said. “I find it more like a label. But because the word is so deeply entrenched in the medical field, unless you say Parkinson’s, it won’t sink in.”

He also tells them they will live their life.

“I do not believe that people die from Parkinson’s,” he said. “They should live OK depending on the extent of the disease. I am a little doctor philosopher, not just doctor.”

It impairs their quality of life, however, people can live with it, he said.

“They have to, and because they have to, better live it well. I think many to most of them live their lives OK. A few cases, like any other case, they are bad cases.”

There is a spectrum of conditions for Parkinson’s.

“Some can continue to worsen, some can stay at minimal Parkinson’s,” Boodhan said.

Once the Parkinson’s becomes established you may see other conditions.

People with the condition could complain of tiredness, they could complain that their writing has become smaller, or they don’t write as clearly as before, some people lose their sense of smell, and some people drool from their mouth.

There are other symptoms of more advanced Parkinson’s, called Parkinson’s plus, that affect people’s lives, such as hallucinations. Sometimes it’s the Parkinson’s itself. Sometimes it is the medications side effect. Some have dementia when the Parkinson advances.

“What I have observed over time when we read about Parkinson’s on the Internet, we usually get the signs and symptoms of Parkinson’s, but we get it at its worst type,” the doctor said. “But people can be like you or me and that’s all that you see.”

Treatment

There is no specific test to tell if you will have Parkinson’s disease, and to catch a disease early, Boodhan said, depends on how comfortable somebody is with the condition.

“The eyes cannot see what the mind doesn’t know. For a mind that is trained, the eyes will see it early,” he said. “I think like every condition, most of the time it is better to attend to them at the earlier stage.”

As for a cure, Boodhan said, there is no cure for any disease in life.

“I am not being sarcastic here,” he said. “To me, cure means to put the organ back in its healthy state,” he said. “What cure is there for cataracts? Nothing, but you can put a different lens there. We can call this a cure, but we didn’t cure what was sick. We throw it away and replace it with something else.”

There is treatment for Parkinson’s disease, mostly for rigidity, as treating the tremor is not worth it most of the time because it never goes away, Boodhan said.

“One thing I always tell the patients is don’t gauge your improvement by your tremor, you will be deceived,” he said.

Some people do well with treatment, the doctor said, adding it is amazing when people are first put on medication, most of them say it has made such a big difference. However, he said, they will always find the symptoms of Parkinson’s, even with medication. It never goes away completely. But their ability to move around improves.

“I tell them I will give you medication but the most important medication in addition to what I am going to give you is I want you to walk every day,” he said.

“You are who you are. If you are happy, you smile a lot, whatever you have in your life you will live it well.”

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