Is PD a gradual deterioration or do you go downhill in steps? I seem to deteriorate in steps followed by a long period of level performance.
I can trace back to several significant worsening of symptoms, and have just had another seemingly permanent drop. Maybe they were triggered by infections etc, but I don't go back to what I was. These are permanent moves in the downward spiral.
I recently had a gum infection, following a broken tooth. My symptoms nosedived but I have now cured the infection, but have not recovered to my previous form. I can only just get out of bed in the mornings now, and many other changes.
The medical literature describes PD as a gradual loss of functions, but is it? Is this another one of the myths? What is your experience?
Ron

It is common for PD symptoms to first "bloom" after an unusually large stress, both physical and psychic. In my own case it was a bout with the flu. I had had a tremor for eight years with little worsening until then. Currently I am dealing with huge mental stresses as a result of the real estate crash and I can feel a need to be very wary-a sense of fragility. I think the answer is clearly yes, we are subject to periodic drops and I do think that stressors are the trigger.
As to what actually happened in Ron's situation, I can only speculate. The infected tooth resulted in at least three changes in the chemical soup beyond the leaking BBB. 1)Exotoxins from the living bacteria, 2)Endotoxins from dying bacteria - was there an antibiotic? and 3)Increased pro-inflammatory cytokines from the immune system's microglia. The first two have presumably been taken care of with the infection but number 3 can be a bear. Liu, Hong, and other researchers at the NIH found that in a rat a single exposure could trigger a response like number 3 that lasted for months.
What to do? I can only tell you what I would do for legal reasons. First, I would look for things that attenuate the microglial response. Medline suggests that likely ones include resveratrol or red wine which should be easy to obtain; others
include blueberry extracts, minocycline, silymarin, etc. Also, our old friends curcumin and dextromethorphan.

I would also keep up my own ginseng and gingko for general toning of my systems.
-Rick

It is an NIH piece that hints at the question of progression, equilibrium, etc. From http://science-education.nih.gov/nih...l/biomed1.html

<BEGIN QUOTE>
She and others have shown that the immune system and the brain and the rest of the nervous system "talk" to each other through a number of chemical "mediators" -- cytokines from the immune system and neurotransmitters (like serotonin) and hormones from the nervous system.

The chatter among the mediators is elaborate and complicated, but the goal of all their signalling is a common one -- to keep the body's brain and immune systems in balance (6). When balance is lost and the host encounters an inflammatory trigger or psychological stress, diseases as different as EMS, arthritis, seasonal affective disorder, multiple sclerosis, and chronic fatigue syndrome can develop. It is often difficult to identify which mediator has signalled too much or too little in a sick patient, notes Sternberg, because, by the time the patient seeks medical help, the whole signalling system may already have been thrown out of whack.

<AND>

Sternberg says that every person is born with a unique set of genetic predispositions that affect disease susceptibility. Some of these predispositions may be so strong that, even with the tiniest exposure to a disease-causing or inflammation-causing agent, the person will get sick. Others may be much weaker, and, in those cases, whether the individual will get sick or not will depend on other factors. One such factor is the stress response. <END>

cannot comment on the role of infection however I always think of PD progression as a number of small steps which manifest themselves in time as a large noticeable increment.

So I guess my answer to your question is a bit of both as "perception is reality".

Neil.

I was diagnosed with PD in 1981 and for about 15 years about the only symptom I had was a slight tremor in my right hand. Then out of nowhere it seemed, I took a major nosedive. Extreme tremor, stiffness, balance problems....Since then I have noticed it takes longer to recover from illness, etc., and I too never seem to "get back to where I was".

I've noticed a decline as well, and usually after getting over a bad cold or respiratory infection like I had in late January. It took me forever to come back up to close to where I was. Since then I've had to increase my Sinemet to make me feel normal. I agree it's like steps going down with long periods of smooth passage in between as though I coast along with what seems to be a good routine and balance.

For me my piano plaing isn't anywhere near what it was 4 years ago, yet I seem to be playing better now than I did a year ago due to my Sinemet dose timing and adjustment. Now if I could have what I had 4 years ago, and combine it with what I have now musically, I'd be totally on cloud nine.

Now I don't make my living at it, but I can't give up my music either. This is my entity, and should I lose this, it would defintely lead to my demise.


John