Dopamine

I guess that anyone with any experience of Parkinsons is familiar with dopamine. It (or the lack of it) is the root of the condition. The NHS website describes it succinctly:

Parkinson's disease is caused by a loss of nerve cells in part of the brain called the substantia nigra. This leads to a reduction in a chemical called dopamine in the brain.

Dopamine is an important neurotransmitter, that is, a chemical that stimulates neighbouring cells to transmit messages around the nervous system. Just about everything our bodies do depends on communication from our brains so as these transmitters diminish, we can expect all manner of symptoms.

I delayed speaking to my GP for several years after noticing that I was finding it more difficult to move my right hand probably due to fear and denial. I think it was my wife who persuaded me that I really ought to have it looked at. I asked for an appointment to see a GP at my local surgery but, in their wisdom, they made an appointment with their nurse practitioner instead. He checked me over, tested my reflexes and, to my relief, told me that it was nothing neurological and diagnosed a frozen shoulder.

On his advice, I bought a massage ball to use on that shoulder and booked an appointment with the occupational health representative at work. She was very helpful and made a number of useful recommendations to relieve any stress that I was putting on that shoulder. She mentioned that they had an arrangement with a local physiotherapist and that I could have three one hour appointments with her if I wanted. I had heard great things about her from a number of colleagues so I thought 'why not?'

It was a gloomy day when I cycled over to her practice but I was in good spirits and went with high hopes. I was given a questionnaire to fill in before I saw her. I answered as honestly as I could but my answers seemed vague and unhelpful even to me. We started the appointment by going through the questionnaire. This was about five years ago now but I can remember a creeping dread coming over me as we both started to realise that the reason my answers were vague was because the questions were designed to diagnose something different from what I had been experiencing.

"Do you feel like you are sending the messages to move but that they are not getting through?" she asked.

I tried to protest, still in denial, but that was exactly how it felt. We take it for granted that when we think we are going to turn our toothbrush to clean the back of our teeth, our fingers will respond and just turn the toothbrush. I was finding that process was taking anything up to about 30 seconds. It became clear that physiotherapy was not going to solve my problem so she typed a letter to my GP to say that all the indications suggested to her that I either had Parkinson's Disease or that there was a brain tumour pressing against a nerve that was preventing signals from getting to my right hand. She handed it to me and told me earnestly that it was very important that my GP read the letter as soon as possible.

It was difficult to absorb the information and its consequences but I felt a strange sense of relief that I had a name for my symptoms. I have read a number of accounts of other Parkinson's patients saying much the same since.

The next morning I stopped at the health centre on my way to work. It was busy (its always busy) so I queued with my letter for twenty minutes. Finally, it was my turn. I handed the letter to the receptionist and repeated "it is very important that my GP reads this as soon as possible." The receptionist wearily looked me in the eye, took the letter, put it on a pile and called the next in line. After a week, it was obvious that it wasn't so important to my health centre. I tried to complain to try and move the process along but it sounded like that process would take even longer. About a month later, the letter had risen to the top of someone's in tray and I finally saw a GP who arranged an MRI scan and a Neurology appointment. Fortunately, I didn't have a brain tumour. Unfortunately that meant that I did have Parkinson's.