‘I am a neurologist, and I have Parkinson disease’

Movement disorders

By Michael Woodhead

18 Feb 2021

Australian neurologist Professor David Blacker is sharing his personal experience with Parkinson Disease in a bid to stimulate professional interest in the condition and highlight some of the nuances of its diagnosis and treatment.

Professor Blacker, who is medical director of the Perron Institute for Neurological and Translational Science in Perth, WA, first went public as a person with PD to coincide with the World Federation of Neurology World Brain Day in July 2020.

He has now penned an article in Internal Medicine Journal to provide an individual insight to professional colleagues as a physician-patient into the numerous issues he has experienced surrounding early diagnosis and management of PD.

Prof Blacker notes that the words used by clinicians when giving a diagnosis of PD are very powerful, and despite his own clinical knowledge of the condition he found he underestimated the impact of learning the diagnosis, which brought on a period of grief and transient mild depression.

But he says there are many positive steps that clinicians can take to improve understanding and perceptions of PD, starting with a move away from the stereotype of the patient being a  “stooped elderly male”.

He also describes his own personal ‘wins’ in PD through physical exercise, and in particular with a program of non-contact boxing, yoga and walking that has helped him tackle issues such as muscle rigidity, balance and also general health to improve sleep.

“Physicians who treat PD might be able to learn a great deal from physiotherapists, exercise physiologists, exercise scientists and sports coaches,” he writes.

Professor Blacker says he has also learned from personal experience about the benefits of early versus delayed commencement of medications, and some of the nuances of levodopa dosing such as how to manage nausea and lightheadedness.

In his article he also highlights the fact that non-motor symptoms can be just as problematic as motor symptoms in PD, especially for younger patients.

Sleep disturbance, nocturia and also pain can be common and difficult to handle for PD patients, he notes, and the threat of cognitive decline is also something that weighs on the mind of patients.

Professor Blacker says patients can benefit from access to good information such as via the Michael J. Fox website and also from support groups and sharing information with other patients with PD.

And although no medication has yet to be proven disease modifying in PD, he says medication may have a an indirect beneficial effect on disease progression if it enables a patient to participate more actively in physical exercise; an approach which itself offers hope for slowing PD.

“As a clinical researcher, I know the value of clinical trials, and I hope to be a participant in one of the early rounds of trials the Australian Parkinson’s Mission is conducting exploring several candidate repurposed drugs as potential disease-modifying agents,” he writes.

“This strategy of trialling drugs for PD already approved for other conditions seems like a promising way of rapidly testing a variety of possible disease-modifying candidates, and in conjunction with collaborations linking together researchers around the world should produce some results reasonably quickly.”

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