Movie Time!

Scenes adapted from movie- Love And Other Drugs

(*Warning: Content includes inappropriate language)

Love and other drugs parkinson scene 1

link found here: http://www.youtube.com/watch?v=YmyWRi7J4ck

Movie Time!

Love and other drugs parkinson scene 2

link found here: http://www.youtube.com/watch?v=pIe7auDw230

Movie time! - follow up

Deeper than the typical romantic comedy of 2 main characters, these scenes from the movie Love and Other Drugs tell us the real struggles of living with Parkinson disease.

In the first scene, the symptoms are showing in the main lead actress Maggie Murdock, who at the age of 26, is suffering from stage 1 Parkinson disease. Notice her hands trembling when she pours a cup of alcohol. Not only that, the scene shows how the disease has deterred her from having a normal relationship with the male lead, Jamie Randall. She feels she would be a burden to him in the future if he continues dating her and marries her, and that he is being with her because he pities her state. This is one of the real impact of Parkinson disease, especially for those sufferers at a young age, as Parkinson disease is a long term degenerative disease. It only gets worse, or at the most delayed but it would not get better. This scene mimics how Parkinson's sufferers are unable to cope both emotionally and physically, putting their dreamed, shared future with their spouses in jeopardy.

Scene 1 continues to show us how Jamie Randall came back for Maggie when she broke down, and they went to Chicago afterwards. Maggie attended a Parkinson convention. Although the Parkinson patients took turns to perform a stand-up comedy with their jokes, nevertheless it actually tells us the blunt honesty of Parkinson disease itself. The daily little things that they can't do anymore, and the way the society judges them, and how the disease has led them to have a constant battle to retain some dignity and grace in society,  and how they have to move on and accept themselves with the disease no matter how hard life journey is going to be.

In scene 2, at the refreshment table, Jamie meets a middle-aged man whose wife is in the final stage of Parkinson disease. The conversation that follows after is so real and so saddening and it breaks my heart. T.T

Here goes:

Jamie: You've got any advice?

Man: You don't need my advice.

Jamie: Come on, I am very trainable.

Man: 

Well, my advice is that you go upstairs, pack your bags and leave a nice note...

find yourself a  healthy woman...........

I love my wife... i do. But i wouldn't do it over again.... 

Nobody tells you this disease will steal everything you love at her.. Her body, smile, mind.... 

Sooner or later, she will lose motor control, eventually she wouldn't be able to dress herself.........   then the fun really begins... clean up her shit, frozen face, dementia...

This is the part where it shakes me. We really do not know the real struggles of how a Parkinson patient, the impact on his/her life and on the people that are close to them, their family, spouses and friends. This scene is very impactful as it is so blunt and so true. It is really not easy for them to be able to lead a carefree life. So be thankful for every little thing in your life and be compassionate and patient with the people around you that is suffering from Parkinson disease! 

So.. are you dying to find out whether Jamie and Maggie got together at the end? 

This is for us to know and for you to find out ^^ Not going to be a spoiler!!

Embarrassing Bodies - Young lady suffers from Parkinson's

LIFE STORY OF A YOUNG WOMAN WITH PARKINSON"S DISEASE

"Shaking Palsy"

handwriting of a parkinson patient

PARKINSON'S DISEASE

Parkinson's disease is a degenerative neurological disease. Basically, it is a disease of the nervous system that gets worse over time. Characteristic signs of a Parkinson's sufferer experience would be the tremor (involuntary trembling of limbs), rigidity (Stiffness of muscles), lack of movement/slowness and also postural instability (difficult to maintain balance and bending of body), as you can see from the life story of the young lady who has suffered from Parkinson disease when she was just 27 or 28 years.

The disease seems to eat up her lifestyle, she experiences involuntary shaking or jerking which is known as tremor, unable to lift things easily, or act or sleep normally. She becomes slow and rigid, unable to coordinate her movements such as walking and balancing. Sooner or later, communication might become a difficulty, as she wouldn't be able to stabilize her hand while writing, and facial expression is affected as the patient face may seem masked and staring, and the tone of voice may become monotonous, and frequent drooling may occur. As the disease progresses, she might require assistance even in the mundane things in life, such as applying make up, buttoning a shirt, rising from a chair, getting in and out of a car, using a keyboard etc..

   
      


As for the psychological impact on the Parkinson patient, it is rather obvious that they would be embarrassed by their state and feel frustrated with themselves. People around them would start to judge them, not being understanding as seen in the life of the young lady in the video earlier. The public may start to isolate these sufferers or view them as people with mental disability. Depression and anxiety are also very common among the Parkinson sufferers, and drug-induced hallucinations and delusions may occur as well. However, the lady in the video learns how to cope with her changed lifestyle and being positive is really the key to living on even with this disease.

So many may wonder what actually happens in Parkinson's disease. Let us fill this thirsting question.

Firstly let us look at the brain. (sideview)

Notice the very small area located deep in the brain called the Substantia nigra. That's the part where the neurons located there starts to degenerate, disrupting the brain's ability to generate body movements, and then you will get those symptoms characteristic of Parkinson's disease!

                                                                            

Here is another picture of the brain and the Substantia nigra. 

As you can observe, the autopsy of the brain of a Parkinson patient shows that the Substantia nigra has lost its usual black pigment. To add on, there are fewer cells in the Substantia nigra in Parkinson disease, in which that the remaining cells often are abnormal, and the presence of Lewy bodies (small substance) can be seen in the cells.









So.. what is so important about this small Substantia nigra we keep repeating?
Here is the juice of it:

It is the part that is important for control and regulation of motor activity (movement)!

Every movement in us is dependent on the complicated series of electrical and chemical events that occurs when a neuron (nerve cell) transmits information to the next neuron in the brain! These connections are vital and the chemicals involved are called neurotransmitters! They are like signals the brain cells use to communicate with one another. Yes, the Substantia nigra produces and use a specific neurotransmitter called DOPAMINE. And in this blog, you would come across this term later on! 

In Parkinson's disease, the cells of Substantia nigra degenerate and die, and there goes the Dopamine and the various dopamine-relayed messages to the other motor centers. When Dopamine concentration declines, the concentrations of other neurotransmitters such as Serotonin and Norepinephrine decline as well as other parts of the brain are affected.  The central nervous system (brain) can no longer control the muscles as well as it should be, the muscles start to act strangely.... giving rise to those symptoms of Parkinson's sufferers.

Biochemistry behind Parkinson’s disease

We all know that Parkinson’s disease is a neurodegenerative disease, so let’s take a look at the main components that are involved.

Firstly we have acetylcholine and its cholinergic receptors, which is responsible for stimulation muscle contraction. Next, we have Dopamine and its dopamine receptors, which have an opposite effect – to inhibit muscle contraction.

Now, most of you would be thinking that Parkinson’s disease is caused by the excess of acetylcholine therefore the effect of dopamine is less than that of acetylcholine. But that is not true; in fact, it’s the deficiency of dopamine that causes this neurodegenerative disease.

Dopamine is produced in the dopaminergic neurons, and they are cells that do not reproduce. However study has shown that it is not the physical lack of dopaminergic neurons that causes Parkinson’s, but the reduction of dopamine activity in the brain.

Knowing what a crucial component Dopamine is in this neurodegenerative disease, let’s take a look at how it is formed (in 2 steps):

L-tyrosine → L-dopa → dopamine

Step 1: Biosynthesis of L-dopa by the enzyme tyrosine hydroxylase. The following is the complete reaction:

L-tyrosine + THFA + O2 + Fe2+ → L-dopa + DHFA + H2O + Fe2+

*THFA is a coenzyme derived from folic acid (vitamin)

The activity of this enzyme is often as low as 25% in Parkinson's disease and in severe cases can be as low as 10%. This indicates that one or more of the elements required for the formation of L-dopa are in insufficient quantities.

Step 2: Biosynthesis of dopamine is by the enzyme aromatic L-amino acid decarboxylase. The following is the complete reaction:

L-dopa + pyridoxal phosphate → dopamine + pyridoxal phosphate + CO2

* pyridoxal phosphate is a coenzyme derived from pyridoxine (vitamin)

So for dopamine biosynthesis from L-dopa, pyridoxal phosphate is essential. The activity of the enzyme rises and falls according to how much pyridoxal phosphate there is. The level of this enzyme in Parkinson's disease can also be around 25% or less.

*NADH which is also a coenzyme for the formation of both THFA and pyridoxal phosphate. All these coenzymes are essential too.

G protein is also an important component involved to relieve or aggravate Parkinson's disease. They must be stimulated by the following pathway.

L-tyrosine → L-dopa → dopamine → dopamine receptors (D2, D3, D4) > G proteins

What matters to Parkinson's disease are the alpha subunits of G protein, because it is actually these that ultimately relieve (or aggravate) Parkinson's disease. There are five types:

• G proteins that aggravate Parkinson's disease : Gs 1 alpha
• G proteins that relieve Parkinson's disease : Gi 1 alpha, Gi 2 alpha, Gi 3 alpha
• G proteins that have little effect on Parkinson's disease : Go alpha

The sole purpose of dopamine (or dopamine agonists) stimulating dopamine receptors is to cause the alpha subunits (the active part of G proteins) to break away from the rest of the G protein. Without this occurring almost everybody would have Parkinson's disease.

Once the alpha part of G proteins is released, via cyclic AMP, it takes the final action in the series of event that leads to the ridding of Parkinson's disease, which is to inhibit the cells it has effect on.

AM I AT RISK OF PARKINSON?

A new file : Who gets Parkinson?

The most honest answer to this question is that we don't know. For now, many researchers and scientists are still figuring out to why one gets Parkinson and the other does not. It is like there are no risk factors. True enough, aging might have something to do with getting Parkinson, 60 years old is the average onset of Parkinson's disease but it does not mean that only the elderly gets Parkinson's disease. There are people getting the disease as young as when they are in their twenties or thirties. Parkinson is also too common for one to state that it is a hereditary disease. It can be coincidence that 2 people in the same family has the disease. Multiple environmental factors such as potential toxins, and drugs may damage the neurons of the Substantia Nigra and cause Parkinson symptoms subsequently but no single, specific toxin is responsible for the disease itself. Hence, the file on this does not close, as there isn't a satisfactory to this 'WHY ME?' question yet.