Parkinson’s or parkinsonism: What’s the difference?
Dr. Keith Roach
Question: Could you please explain the difffffffffffference between Parkinson’s disease and parkinsonism? My neurologist told me that I have parkinsonism. I have been reading about Parkinson’s disease and read that with it, one does not produce dopamine, which regulates movement. My internist (a geriatrician) wonders why I am not on medication from my neurologist. I had a couple of strokes, many years ago, which affffffffffffected my motion and my speech (slightly). I always believed that my walking diffifficulty came from the strokes. Can parkinsonism turn into Parkinson’s disease? — B.B.
Answer: Motor parkinsonism is always seen in Parkinson’s disease, but it also may be found in numerous other conditions, which is why an expert is sometimes required to confifirm the diagnosis. The word “parkinsonism” refers to slowed movements (called bradykinesia) and either a tremor at rest or muscle rigidity. In Parkinson’s disease, the underlying problem is loss of dopamineproducing nerve cells in an area of the brain called the substantia nigra, which itself is part of the basal ganglia in the midbrain.
In addition to Parkinson’s disease, other causes of parkinsonism include essential tremor, several uncommon degenerative diseases of the nervous system, some medications. Some neurologists believe that multiple small strokes (in or near the basal ganglia) can cause parkinsonism. Not everybody with strokes in this area of the brain develops the motor problems that resemble Parkinson’s disease, but that might be the case in you.
Often, neurologists will give dopamine medica- tion (the combination of levodopa and carbidopa works best) as a diagnostic test: People with Parkinson’s disease markedly improve with this treatment, whereas people with parkinsonism from other causes may not.
Q: How can I control the urge to pass gas after I eat? I have no control over it, and it is quite embarrassing. I have avoided gasproducing vegetables and other foods. I have only 7 inches of my colon left due to diverticulitis surgery when I was 35 (I am now 74). I have tried GasX, Beano, drinking lots of water after my meal, eating more slowly, not talking, etc. Any advice? — L.M.
A: You have already done everything I would advise you to do. I might have you keep a diary of food versus how bad the gas is, to fifind if there are triggers you might not be aware of (it’s usually those with a lot of fifiber). Carolyn Hax
Question: My girlfriend and I have been seeing each other for almost eight months, and we still each live separately and have our own houses. We have two difffffffffffferent opinions on various household and yard tasks that take more than a couple hours. She is a do-it-yourselfer. She is very handy and prefers to accomplish many tasks on her own without paying for outside professional help. I, on the other hand, would much rather pay someone to do something that would otherwise take me a whole day or more to accomplish so that I can enjoy my time offff from work.
My belief is that neither one of us is right or wrong in these instances.
However, recently she is asking for my assistance for tree removal, which I have no interest in doing and would have paid someone to do if it were my property. If I don’t want to do this at my own house, then why would I want to do it at hers?
How should I approach this particular situation, and others like it that would no doubt come up in the future? — Yard Work Not for Me
Answer: Couples don’t have to agree on everything, they just need to agree on the way they handle disagreements.
So, if your girlfriend is puttering around in her yard as a form of recreation, then there’s no harm in your opting out on the grounds that it’s no fun for you.
If she’s laboring ver-