01/10/20 (4) Parkinson?

 I dropped a hint a day or two ago, and now here it is in full, as far as things have gone.

Back before the March lockdown, Sue and I were in Springfield for either a blood test or a Zometa drip, and while she was preparing my left arm one of the nurses (always a very observant one) spotted the slight tremor I've had in my left hand for years and asked "Have you got Parkinson's?"

The idea had never entered either of our heads so we just said "No" and she replied "Are you sure?" and we left it at that. Since then the tremor has definitely got worse, and a similar shakiness has increased from barely noticeable to quite obvious in the right hand as well. It used to be that it would stop if I was doing anything involving fine motor control, but that's not true any more, or at least not completely true.

That was the seed planted. A few days ago Sue was watching me moving around doing things in the house and she said "I think you might have Parkinson's." Since then I've been googling symptoms and there are quite a few that match and others that don't  - but a Parkinson's diagnosis doesn't require all of them. The big problem of course is to work out what relates to the myeloma, what relates to the myeloma treatment, what relates to just getting older, and what might be an indicator of Parkinson's.

The big ones are:

From the NHS website:

1. Tremor – shaking, which usually begins in the hand or arm and is more likely to occur when the limb is relaxed and resting.

2. Slowness of movement (bradykinesia) – physical movements are much slower than normal, which can make everyday tasks difficult and result in a distinctive slow, shuffling walk with very small steps.  (I get the slow movement esp. doing things around the house, and the shuffling walk is there to a small extent but erratic.)

3. Muscle stiffness (rigidity) – stiffness and tension in the muscles, which can make it difficult to move around and make facial expressions, and can result in painful muscle cramps (dystonia). (No problem with facial expressions as far as I know, but a possible alternative explanation of things like the right shoulder / neck problem recently.)

4. Balance problems – these can make someone with the condition more likely to have a fall and injure themselves (two or three times recently I've suddenly lost balance and felt for a moment that I had no idea which way was down. It has only been momentary and hasn't (yet) led to a fall. Every time has been indoors and not far away from a wall for support.)

5. Nerve pain (the right thigh "trapped nerve" goes back at least 30 years so is hardly likely to be involved but possibly it's been worsened...)

6. Constipation (well, I certainly have that now and never did before I started myeloma treatment, so probably innocent but might be contributory.)

7. Excessive production of saliva (drooling) (yes, esp. when asleep.)

From the American Parkinson Disease Association website:

1. Urinary frequency (the need to urinate often) and urinary urgency (the feeling that one must urinate right away, even if the bladder is not full) (yes.)

2. Fatigue is a complex symptom of Parkinson’s disease that is not fully understood. (contributory?)

 3. A common, early symptom of Parkinson’s disease is a decrease in the natural swing of one or both arms when walking. (Yes but been like that for years.)

For all this to make sense I have to assume that I've had very mild Parkinson's for a good few years and that for some reason it's started to develop more recently. Could there be a connection with the myeloma or the treatment? As someone wrote on the Facebook Myeloma Support UK group when I raised the question there, "totally different system involvements" but that doesn't necessarily mean that treatment for one can't have an effect on the other...

Having worked through all that I decided that I wanted a face-to-face appointment with my GP to see if he felt it deserved further investigation and possibly a referral to a neurologist.  After the usual long wait on the 'phone (nearly broke into the sacred 17:00 backgammon hour) I was told that Dr.Ku would 'phone me and then decide whether an appointment is needed. As I already have a 'phone call booked for the 12th (about my diuretic pills) and there was nothing available earlier, we agreed to add the Parkinson's issue to that call. OK because I don't think there's any rush  but still far too long!

And there you have it. Possibly all in my fevered imagination, possibly not. We shall see, but not for some time after the 12th.