Detecting Parkinson’s disease (PD) early is very important to slow down the destruction of brain cells. However, because there’s no standard early detection test, it can be very difficult for a general practitioner (GP) to conclusively diagnose Parkinson’s in the early stages, or in people with young-onset PD.

Doctors may dismiss symptoms or movement difficulties as the effects of normal ageing or fail to recognise the many other invisible non-motor signs of PD unrelated to movement. These include loss of smell (hyposmia), barely audible speech, fatigue, light headedness, sleep disorders, bladder problems and cognitive symptoms.

Sometimes you may not be aware of the early signs yourself, and it may be another health professional or family member that alerts you to see your doctor.

In Karen Smith’s* case, her father first noticed she was walking strangely and not swinging her right arm. Diagnosed with early-onset Parkinson’s at age 34, Karen recalls that, at the time, she noticed she was typing the wrong keys when using the computer at work.

Once your doctor rules out other conditions that can masquerade as PD and suspects you have Parkinson’s, be sure to ask him/her to refer you only to a movement-disorder specialist or neurologist with experience and knowledge of how to assess and treat PD. It’s vital to find the right doctor.

Consider this advice when choosing a PD specialist:

• Look for a doctor that can answer your questions and puts you at ease so you feel comfortable talking to him/her.
• As the treatment and management of your illness will be over a long period of time, you need to have a positive relationship with your doctor and be confident he/she is prepared to work with you and your family.
• Make sure the specialist treats you with respect and takes your concerns and opinions seriously.
• Your symptoms and medications may change frequently, so you’ll need to see your neurologist and other members of the health team on a regular basis (probably every three to six months).

Empower yourself with knowledge – find out as much as you can about PD. This will also help you to ask relevant questions when you visit a neurologist for the first time.

During a consultation with a neurologist, he/she will take a thorough medical history, enquire about your symptoms and also find out more about your family’s medical history. The specialist will also conduct several physical and neurological examinations. You’ll most likely be asked to sit, stand and walk to assess your coordination and balance.

Some questions you might want to ask the doctor about Parkinson’s include:
• Treatment options and the various pros and cons of each.
• Possible side effects of PD medication and how to minimise them.
• Non-drug options.
• Lifestyle modifications.
• Other therapies you need to include in your treatment plan (physiotherapy, occupational therapy, speech therapy etc).

REMEMBER: People with PD have hugely varying symptoms and levels of severity, so no one standard treatment works for everyone.

* Not her real name.

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