A deficit in a person’s executive function can be of the first signs of the onset of Parkinson’s disease (PDD).
So, how is executive dysfunction manifested in PDD?
And what have I been noticing? Let’s talk about this morning’s shower.
I got the water going, made sure my shower seat was where it was supposed to be, put my washcloth over the faucet, placed the towel on the toilet seat (after first closing the toilet seat), pulled down the shower nozzle and sat down to scrub myself.
So far, so good. I leaned over, switched off the shower, then realized there was one part of my body that I hadn’t washed yet, and I would have to wash that standing up. So I turned the water back on, got it to the correct temperature, put the shower nozzle back on its hook and finished washing myself.
OK, so the shower was done. I dried myself. I have to do this systematically now to make sure I don’t forget to dry any part of myself. I start with the face, the head, and work my way down. I have gotten out of the shower before after drying one arm and not the other, one leg and not the other, leaving my back wet. Now, I have to give conscious effort to section off my body in my mind and dry each portion in a set order.
Over to the sink. I look at all the stuff there and for a moment have to think about what to do next.
Ah! The pre-shave lotion. I grab the bottle, poot a generous portion of the lotion onto my hand, rub it into my face and scalp.
OK, that’s done. Now, while allowing the pre-shave to work, I brush my teeth. I can do this pretty much automatically as the toothbrush and toothpaste are close together on the sink. Where I tend to screw up is in the area of mouthwash. More than once, I’ve caught myself reaching for the after shave, unscrewing the top and ALMOST pouring it into a glass before I realize I’m about to gargle with cologne. I put the top back on the bottle, grab the Listerine, and do the job properly.
Shaving goes pretty well, although it’s a slow process to buzz my head and face and do a good job of it.
The point is… things that used to be automatic now require thought. When I’m at the computer and I need to shift from one task to another, I find myself looking at the icons on my screen wondering just what the hell was I supposed to do. Even working on the blog, if I see a correction that needs to be made, I will go to the edit screen and completely forget where the mistake was, what kind of mistake it was, was it a typo or a format error…
I find my focus wandering. I find my ability to pay attention wavering. And I’m seeing what my doc calls “illusions.” Yesterday, sitting here at my desk, there were two different instances of something dashing under the table from my left… about the size of a mouse. Didn’t get a good look. And one of the dogs was under the table at the time and would have CERTAINLY been alerted by the presence of a mouse. If there was one. Which there wasn’t.
And all of these are symptomatic of the onset of Parkinson’s disease dementia.
My doctor and I talked about this at my last visit, and he felt I was still relatively early in that process and that the side effects of the drugs he could offer would probably not be worth the relief I’d get.
The appearance of PDD, even at a low level at this point, does not bode well . Here’s an abstract from a scholarly article on the subject.
From the article itself…(subscription required)
I have the PIGD type of Parkinson’s. I have never had any real tremor to speak of. Now that my DBS is working right, rigidity is under control, but not postural instability or my gait. I’m having problems with speech and some with swallowing.
According to Wikipedia, “cholinergic” refers to the neurotransmitter “acetylcholine” which is a chemical you need in the thinking parts of your brain to work properly. PD patients, as well as Alzheimer patients suffer from a lack of this chemical.
Oh well. According to the literature , folks who are diagnosed at 45 have an average life expectancy of 21 years. Dementia cuts into that somewhat. Everything from here on in is gravy, I s’pose.
So, in other words, I have nothing to worry about. As long as I don’t step in front of a bus. Or think I’m chasing a rabbit and fall and break my hip. Or swallow incorrectly and drown or get pneumonia.