00:00
Okay, we've talked
about the motor symptoms.
00:02
Now we're gonna look
at the non-motor symptoms.
00:06
Now it's got a big name there.
00:07
Autonomic disturbances.
00:10
Yeah, we're talking about
the autonomic nervous system.
00:13
Dry eyes.
00:15
They don't have the same sense
of taste or smell.
00:18
So food is definitely not as fun
as it once was for them.
00:23
They may have difficulty with swallowing
and also drooling.
00:26
Now we always worry about that
when you see somebody drooling
that that might mean
they're having difficulty swallowing,
and that's why they're drooling.
00:34
And sometimes Parkinson's patients
will drool
even if they're swallowing
is kind of okay.
00:41
So that's a fine balance.
00:43
First of all, it's difficult
for an adult to drool.
00:47
That's not--that doesn't make you
feel very independent.
00:49
That's something we associate
with people who are really, really sick,
or not all there,
or a baby.
00:56
So this can be a really touchy subject
with your patient.
00:59
But body fluids are not working
the way we want them to, right?
Their eyes are dry.
They can't taste or smell.
01:05
They might be drooling.
01:07
They might have excessive sweating,
difficulties with orthostatic hypotension.
01:11
Well, you know orthostatic hypotension
is when I go from lying to sitting
or sitting to standing
and they get real dizzy, right?
That happens to lots of people
if they're on blood pressure medications
or they have lower volume.
01:24
That can happen.
01:26
But you take orthostatic hypotension
with a Parkinson's patient,
well, they're already rigid, stiff,
slow-moving, risk for falls.
01:36
You had orthostatic hypotension to that,
now we've really got a recipe for disaster.
01:42
So they have to take extra care
when they go from lying to sitting,
waiting till they're kinda recalibrate,
and then sitting to standing very slowly.
01:53
Now, they're extra sensitive
to heat and cold.
01:56
So temperature changes
are problematic for them.
01:58
They might have bladder problems,
sexual dysfunction,
constipation, and weight loss.
02:04
So it's not just the motor symptoms.
02:08
These symptoms significantly
impact your daily life,
so they can struggle with depression.
02:14
Now that may be because
of what they're facing
or it might also be because
of the imbalance in their brain.
02:19
This is one of the tragic ones.
02:22
This is psychosis and dementia.
02:25
So very bright, sharp,
fun engaging people
can end up with symptoms
of psychosis and dementia,
and this is, I think,
even more difficult to deal with
than the motor symptoms
for some families.
02:37
It might lose what appears
to be their personality
and just have a very...
02:44
...flat affect.
02:46
They don't have
the same expressions.
02:48
They don't have the same
what appears to be enjoyment.
02:51
It's just a very flat expressionless face.
02:55
So if this is someone that's been
your partner for a very long time,
and they went from a very fun
and gregarious person
to just either this flat effect
or the psychosis symptoms
or dementia,
you can imagine how difficult
this is for the caregivers,
for the family members.
03:12
And then if the patient
has periods of being alert
and they understand
what's going on to them,
you can imagine how terrifying
that would be.