Isatu as a nursing assistant and I

Isatu Tarawally TrailerMy grandfather was a fit man from what I remember. He used to take me everywhere. We use to have fun and play games. I am now 20 years of age and I remember very little about his condition. My grandfather was diagnosed with Parkinson’s disease. There was a period of time that I remember when he couldn’t take me outside or play with me. I was very upset because I thought that he didn’t want to play or take me anywhere anymore. I was very young so I didn’t understand what was going on and that he had a disease that made him unable to do a lot. I was told that he was slowly getting worse. My grandfather passed away with the incurable disease of Parkinson’s. I currently work as a nursing assistant and I take care of a person that has Parkinson’s disease. I would like to share and gain more knowledge and share my experience of this disease. Parkinson’s Disease (PD) Anatomy and Physiology Parkinson’s disease (PD) is a neurodegenerative disorder that affects predominantly dopamine-producing (“dopaminergic”) neurons in a specific area of the brain called substantia nigra. (Parkinson’s Foundation, 2017) Basically parkinson’s disease disrupts the way you move and when there is a problem with certain nerve cells.  Normally, these nerve cells make an important chemical called dopamine. Dopamine sends signals to the part of your brain that controls movement. It lets your muscles move smoothly and do what you want them to do. When you have Parkinson’s, these nerve cells break down. Then you no longer have enough dopamine, and you have trouble moving the way you want to. (Webmd, 2017) When a person has parkinson’s disease every  part of the system has a homeostatic imbalance. Particularly I will go into detail the digestive system/GI tract. In the digestive system it consists of  the Gastrointestinal(GI) tract and the accessory organs. The lower GI tract includes all elements below the stomach, including the small intestine, large intestine and anus. The large intestine is a wide tube that is a lot shorter than the small intestine. Most nutrients are absorbed in the small intestine. The large intestine absorbs water and electrolytes. Such as sodium and chloride. About 100 millimeters of water going in the colon is lost in feces daily. The watery chyme that enters the large intestine, including the undigested materials and waste products secreted by the liver turns into compact feces. There are many movements in the large intestine such as peristalsis, haustral churning and mass movements. (McKinley et al., 2016)In the small intestine the smooth muscle activity functions include mixing chyme with accessory secretions, moving the chyme against the brush border, and propeling contents through small intestine. All these functions include chemical digestion and absorption, including the process of segmentation and peristalsis. When chyme goes through the small intestine segmentation occurs. People who have parkinson’s there muscles start to get weaker. I will discuss further later on. (McKinley et al., 2016)Peristalsis moves material in the GI lumen by alternating contraction of circular and longitudinal muscle layers in small regions. In the duodenum muscular contractions is more frequent. Gastrointestinal reflex is started when food goes in the stomach. Ileum contracts, ileocecal sphincter relaxes and cecum relaxes because of the reflex that is going on. When material goes in the GI tract it moves from the ileum to the open ileocecal sphincter into the cecum. The ileocecal contracts to stop flow from the cecum into the ileum. (McKinley et al., 2016)The GI tract includes the mouth, salivary glands, pharynx, esophagus and stomach. Upper GI autonomic problems in Parkinson’s disease are delayed gastric emptying, esophageal motility and drooling. In Parkinson’s disease, the salivary production is not as much but drooling does occur because of swallowing. It affects the cranial autonomic ganglia. Majority of the saliva comes from submandibular glands and the superior cervical ganglia. Esophageal dysmotility is due to vagal having problems, making it delayed. Gastric emptying and gastric retention causes vomiting and abdominal distention, because of the vagus excitatory pathway. (Jain, 2017)Symptoms and DiagnosesParkinson’s disease is hard to diagnose because it could be any medical condition.  The signs and symptoms for parkinson’s are: Tremors Small handwritingloss of smelltrouble sleepingconstipationa soft low voiceshuffling stooping droolingLow Blood pressureTremorsDementaDepressionStiff muscles Most of the signs are all signs that my family saw in my grandfather, they saw one or more signs and were advised to see a medical professional. One symptom that may be part of the digestive system/GI tract is  Constipation is one of the common symptoms found in people with parkinson’s disease and a common GI problem to.Constipation in parkinson’s disease is very common because of the improper functioning of the autonomic nervous system. This system is responsible for the controlling smooth muscle. When the system is not functioning properly it affects the GI tract causing slow process causing the constipation.(Webmd, 2017).Tremor. At first the tremor may appear in one arm or leg only one side of the body. It affects the chin,lips and tongue. Not everyone with parkinson’s has tremors. The disease causes motor symptoms and non-motor symptoms. Motor symptoms are those that have to do with how you move. Weakness of face and throat muscles. It may get harder to talk and swallow. You may choke, cough, or drool. Speech becomes softer and monotonous. Loss of movement in the muscles in the face can cause a fixed, vacant facial expression, often called the “Parkinson’s mask.”Difficulty with walking and balance. A person with this disease is likely to take small steps and shuffle with his or her feet close together, bend forward slightly at the waist, and have trouble turning around. Balance and posture problems may cause frequent falls. But these problems usually don’t happen until later on. (Webmd, 2017)A closely related diagnoses is Progressive supranuclear palsy which a brain disorder that disrupts the ability to walk, balance and eye movements. This disorder has no cure just like parkinson’s disease. Some of the symptoms related to Parkinson’s disease are stiffness, difficulty sleeping, trouble talking. A lot of the times parkinsons is misdiagnosed and its really not known that you have parkinson’s until you get a autopsy. PSP can lead to serious complications. (Mayo Clinic, 2017)Treatment Parkinson’s is progressive and there are good treatments that can help people live a full life. Treatment options include speech therapy, exercise and support groups and medication. Levodopa is highly effective for parkinson’s disease. (Parkinson’s Foundation, 2017)   Personal impact As I mentioned before I  now take care of A 85 year old man with parkinson’s disease and dementia. I am well informed about the type of issues that he has to go through. Taking care of a person with parkinson’s can be difficult because they slowly get worse overtime. I make sure to watch his diet in order to avoid constipation and other issues he has. I take him to a parkinson’s support group. Which I think that my grandfather didn’t get a chance to go, I wish he had. It feels good that I am helping someone out with the same disease because if  my grandfather was still alive I would want a someone to take great care of my grandfather. I do my best to put in all my effort to take care of the 85 year old man. I was too young to remember my grandfather’s condition and how hard it can be on the family and friends. I think about my grandfather all the time. He’s the reason why I want to get into healthcare field because of medical issues like this that are not curable.